Scar Grafting with Dr Cole

[northeastguy]

I was saying IF you have bumps, you'd be able see them whether your hair was short or long... All you need to do is look. You don't need to get a buzz cut to evaluate that issue. The very fact you don't notice them now is a good sign you most likely don't have them. How would I know if you had bumps?
You need to relax a bit dude. Your making this far more serious than it really needs to be. Step 1, get a short cut and evaluate. Step 2, do step one first.

And post photos....

[Stevie R]

@Victum of DHT, I use to have bumps but after I laser-ed the hairs out they went away, some hairs remain, maybe 10 percent or less, but they are thin and like I said the area is flat now. It was pretty apparent to me that I had bumps (even though my wife didn't think so) so I was worried...now all I do is pluck like 10 hairs, maybe more, but I think I pluck original hairs. I agree with everything Northeastguy is saying here and I understand your pain, but this can be remedied. I will probably laser those remaining hairs off a couple more times just so it doesn't bother me and it is one less thing to do or worry about, but like Northeast says if you don't see em you probably don't have them.

I don't wanna rush you to do anything as you have to make an informed decision after some deep research and talking to a few guys, but the sooner you do some lasering out of hairs, fue into the scar or whatever step you need to take to fix your situation you will feel alot better and can take a breather knowing for a year that you have done all you can do.

[VictimOfDHT]

Hey Stevie. I don't understand, what "laser" are you talking about? Are these the ones (helmets, brushes....) some people use on their heads or are you talking about going to a skin clinic or a dermatological center where they do cosmetic surgeries and procedures....? Also, the "10% hair" that's still there, is that transplanted hair? So you're actually trying to get rid of those hairs?

Yes I have bumps. I can see them now that my hairline is thin again. But there are areas in between where there used to be hair along the hairline that are completely smooth as if they've never been transplanted. I don't know what the hell is going on.

If it ever gets to the point where all my transplanted hair is lost I think my only option would be a full head tattoo and I'm not talking the rip-off they call "SMP" but actual tattoo (designs..). If I'm going to look like a freak (due to scars and bumps) then I might as well be a total freak but do it my way- tattoo my head.

If any body knows the answer, does a biopsy show if someone has an autoimmune problem or not? When I had mine before my last HT it didn't show anything. How can I know if the transplanted hair I keep losing I actually lose because of an autoimmune problem???

[DAVE52]

Pics ?
It's probably not as bad as you think it is

[Stevie R]

Hey Stevie. I don't understand, what "laser" are you talking about? Are these the ones (helmets, brushes....) some people use on their heads or are you talking about going to a skin clinic or a dermatological center where they do cosmetic surgeries and procedures....? Also, the "10% hair" that's still there, is that transplanted hair? So you're actually trying to get rid of those hairs?

Yes I have bumps. I can see them now that my hairline is thin again. But there are areas in between where there used to be hair along the hairline that are completely smooth as if they've never been transplanted. I don't know what the hell is going on.

If it ever gets to the point where all my transplanted hair is lost I think my only option would be a full head tattoo and I'm not talking the rip-off they call "SMP" but actual tattoo (designs..). If I'm going to look like a freak (due to scars and bumps) then I might as well be a total freak but do it my way- tattoo my head.

If any body knows the answer, does a biopsy show if someone has an autoimmune problem or not? When I had mine before my last HT it didn't show anything. How can I know if the transplanted hair I keep losing I actually lose because of an autoimmune problem???

I was saying I lasered the hairs out three times (the transplanted hairs) and that about 10 percent still remain. I was trying to convey that lasering them out is fairly easy and straightforward...It is hard for me to help you because you don't want to FUE your scar and you have a problem with your transplanted hairs but you don't want to remove them. I think it may be best for someone else to help you as I only know about cortisone shots (flattening raised scars), the derma roller (improving the color and texture of the scar), creams and gels, and FUEing into the scar, at least I only know about those by experience.

I will say however that you seem to be getting into your own head, you need to relax. I would not tattoo your head, if I was you I would do exactly what Northeastguy is doing, besides perhaps putting more hairs on top, as you may want to rectify those bumps up top first, I think you can smooth it out though I just can't remember what it is called, perhaps someone here can help...

[VictimOfDHT]

Thanks for the reply, Stevie. But still would like to know what laser you're talking about? I'm assuming you mean skin care clinics where they do cosmetic stuff...

The reason why I won't consider an FUE into my scar because I simply cannot afford to lose any more money on this. I've already paid over $22,000 for my HTs and it may be for nothing (if I eventually lose all my transplanted hairs) and I cannot spend another $6000 or god knows how much on my scars when I'm barely surviving on my income. And, what if I lose those FUE hairs too? It IS a possibility.

The problem I'm having with my transplanted hairs is that I keep losing a good portion of them (probably 1/2). Why would I want to remove the rest? I'd still be happy if I could keep what I have left even though it's already thin. I -and my doctor too- don't think putting in more hairs especially in the hair line is an option any more. In a year they'd be gone too. I've already done more than 4500 grafts in the frontal 1/3 of my head over the years and especially the hair line ends up getting thin again and again and again. I'm not bald on the crown but it's thinning but I'd say I still have 60% of my pre-thinning hair.

What are cortisone shots used for?


To those who are bothered by hair loss, the experience is hellish as it is. To someone who has BDD (body dysmorphic disorder), the experience is only a trillion times more traumatic...and I think that's an understatement. You have no idea what this past month has been like.

Sorry guys. Taking a pic is one of the hardest things for me to do. I'm trying to avoid the reality of my situation.

[gillenator]

Victim,

I have been silently reading the dialogue in this thread and really feel that it is time to offer my thoughts. We have dialogued in times past regarding your lost of grafts from several procedures.

I remember when you had the biopsies and they turned up negative, meaning, there was no damage to the underlying follicles, etc. Please correct me if I am misunderstood as it can be a challenge to remember all of the details.

A couple of things. I do not believe to my knowledge that a biopsy would indicate any relevance to your autoimmune system. That is normally done via a blood test with conclusive lab analysis. As you know, I am not a doctor, yet that is what I have observed and also in my own personal experience.

Cortisone is a steroid and something that would take advice from an experienced HT repair doctor and/or dermatologist.

What you may be experiencing is necrosis in that area and the level of necrosis can vary throughout any zone. That could be the problem of why your grafts are not surviving. Again, just my observation and I may have stated that in our past dialogue.

For whatever my thoughts may be worth, I would not recommend that you have more surgery in that area. It could potentially compromise your frontal recipient zone further and no amount of cortisone injections will help IMHO. Even if it did, steroids do not have a long term or lasting effect and that in itself can potentially just add further dilemma to the issue.

It is complex, yet after listening to patients who had multiple procedures over the years pretty much experience a decrease in overall yield when a subsequent pass is made within the same surface area. Why? Because the same recipient zone continues to be compromised with added scar tissue and possibly some level of dead tissue, namely necrosis. As you know, we all heal differently.

And even though a biopsy may show life under the surface, the more impending issue is, to what degree? In other words, is there enough life sustaining blood flow to your grafts for them to survive the long term?

And in the more severe/chronic cases of necrosis, the dead tissue must be removed because it can potentially begin to be infected and also begin to impede the surrounding tissue.

So could further incisions to the same area do more damage that what it's worth? It's possible. Again, not a doctor but I have read some cases and the last thing you want to do is compromise the limited blood supply that you have at present.

I consider you a friend. If I was in your situation and I had to have a head of hair, then give some serious thought to a quality hair system. I know, it's not your hair growing out of your scalp yet hair systems have come a long way. I ran into a old friend not long ago who became a class 7 before he hit age 30. I knew he had some hair loss but did not know he was wearing a system until he asked me what I had been doing over the years. When I told him I had four HT procedures, he was shocked. He then confided in me and told me he was wearing a full hair system.

Honestly, his hairline looked sooo good and I know what to look for because I wore them for a decade when they were not natural.

Yes they cost money too but at least you can custom tailor the system for appropriate levels of density and a mature placed hairline. That's what he did.

And you already know the other option which is to wear your hair short.

Lastly, I have been wanting to mention these things to you and yet trying to be more of a listener and friend who will stand the ground with you my friend. Even if this is not what you wanted to hear, I don't want to see you end up in a worse situation.

My hair is not what it once was especially after chemo yet I am trying to look for the blessings in my life that does not involve having the head of hair that I always wanted. Aint gonna happen for me and I have come to terms with it. Life is much better and meaningful and I wish the same for you dear friend.

You can always call me if you want to talk more about some of the points mentioned or if you just need someone to listen.

Always sending you best wishes my friend.

[VictimOfDHT]

Thank you very much Gillenator for sparing the time to write your reply. I really appreciate that. I've been keeping this whole thing to myself since day one. No one even knows what I've gone through (HTs...) and I still can't talk to any one.
Since my last visit to my HT doctor over a month ago I've been living a nightmare. I don't think I've ever felt worse (about my hair loss problem) since in the past I would always tell myself I'd get more HTs. But now, that's not an option any more. So, I'm facing the biggest fear ever -going bald, and not only that, but having a scarred head, which to someone with BDD is unimaginable hell. I don't know what the hell I'm going to do. Thought about going homeless as I can't have any kind of social life or get a job (I only do little work now and then on my own but it's hard physical work and my body cant handle it any more with all the back pain and other pains...). But where I live it's always raining and a life on the streets won't be easy. I even thought about doing drugs or drinking to help me forget about my pains (mental) and anxiety. So now what?

I don't know about this necrosis thing. My hair seem to grow just fine for some time (1-4 years) and then suddenly it just starts falling off! The last 2 HTs only lasted 1 year each though. Previous ones lasted a few years. I don't understand this f*cking thing. WHY? Why my last HTs won't last as long?
I went to see a doctor and I have an appointment with a dermatologist but here in Canada you wait forever to see a specialist. My appointment is still more than 2 months away (been waiting a month already)!! and I'm losing more hairs every day. This is really f*cked up.

I'm just dying to know what is happening and why. But the anxiety is killing me because I don't know if this loss will stop or if it'll continue until all my transplanted hair is gone. I've lost a lot of wait and can't eat or sleep much at all. I'm also waiting for someone to call me for counseling, but again god knows how long it'll be. Meanwhile, I'm just living like a prisoner (in my basement). Life is beautiful !! Yeah. Sure.

One thing, I've been wearing a baseball cap literally every day for the past couple of decades even when I had a full head of hair. I just hate my hair. I sometimes wonder if it has something to do with the loss of the transplanted hairs. But then if it did, why they last 1-4 years?

I don't think a hair system is something that would work for me. My hair is thick and too wavy I'm not sure they have anything that would match. But the ridiculous cost and maintenance required makes me steer away. Not to mention knowing that I have FAKE hair..

I pray to god that I keep what I have now. If it goes, I think the only option left is like I said - a full head tattoo.

Thanks again, gillenator. Nice to know someone cares and I really appreciate it. I wish you the best too.

[northeastguy]

Gill that is some great advise and options. I think what DHT needs to do at this point is go talk to someone.
I'm not being insulting. I am truly offering my opinion. You really need someone to help break the unrealistic thought pattern your in. Go get some counseling. At this point your fortune telling. Nobody knows the future. Nobody. homeless, drugs.... are you really listening to yourself? Shit, life without hair is NOT a death sentence so you need to move on from that. You don't have cancer, ALS, MS .... or some other life debilitating disease. There are over 1 billion men in the world who are bald. over 40 million alone in the states. think about those numbers.
I would really like to see you actually take a step to do something that those on this forum have advised. You haven't even done the short hair cut yet! If that doesn't have the look you can live with, you most definitely can go with a quality hair system... that will DEFINATELY hide your issue. Yet you already write that off.... without even consulting with someone who deals with them. BTW, they do wavy hair.
Do us a favor and start doing something.... get your hair cut as short as you can this weekend and evaluate that ( save the clippings because you will need those so the people you chose to make your systems can match texture, color, and wave).
Do us another favor and post photo's. enough with the excuses about it being hard to look at. I've been posting photos for 2 years and have been able to do it without compromising my identity. I've also been about to do it without getting down every time I am reminded of the shit storm on the back of my head. You can make it happen.... you will also get some valuable advise from both experience patients and MD's. they all chime in. make them clear, detailed photo's.

I hope you don't feel I'm being cruel, I'm not. I'm trying to get you to get off the couch, make a move and stop wasting time. start living your life. Tomorrow, I'd like to see some photo's posted with your hair cut as short as you can and still cover the scars.

till then...

[northeastguy]

Dr. Cole, perhaps you have some insight of why transplanted hair is falling out 1-4 years post surgery?

[VictimOfDHT]

Northeastguy, first of all thanks for the reply. I don't think you're being cruel or anything. I know you're trying to help but what might work for some doesn't necessarily work for all. This is something I wish people would understand.

Anyway, about seeking counseling, that's exactly what I said I was going to do (in my last post). Like I said, I've already seen a doctor and I'm just waiting for them to call me for an appointment with a counselor.

As for cutting my hair short, I think I'm going to wait on that. I'm trying to convince myself to feel ok with what I have left (in the hair line/front), but if it gets thinner then I will most likely cut it short. I've never had my hair short and I'm not sure it'll suit me and it really terrifies me to even think about it. That's why I'm reluctant. I'm also hoping against all odds to get some of the lost hairs back. I know that's a long shot but I'm thinking maybe.

The hair system, at this moment I'm not even going to consider it. I'm not going to consider anything that requires an on-going financial commitment. I've seen people who were using hair systems at one time and who could afford them quit all of a sudden. I don't think they're practical or affordable (for me anyways).


Now, here's the argument that I really hate, " you don't have cancer or MS... it's just hair"! I'd expect this from people with full heads of hair but not from someone who's obviously been through a lot of sh*t to try and remedy his problem with hair loss. There are 7 billion people on this planet and the overwhelming majority of them do not have cancer, MS ...but just because they don't have cancer that doesn't mean they should all be dancing and singing. There are a billion other problems and then some that can make our lives miserable and unlivable hell. One million people around the world commit suicide each year and countless millions attempt to. Countless millions use drugs and alcohol as a way to ease their pains or as a way to try and escape the reality of their situation...and I guarantee you the vast majority of these people DON'T have cancer or any terminal illnesses.

The simple fact is that millions of men have had their lives completely ruined by this curse. We just don't hear about them because 1) men's suffering in general is always overlooked and marginalized and 2) they usually go live "under a rock" because they don't want to be ridiculed (by society) for being "whiney wimps" or "vain",.... If hair loss wasn't such a big deal to men -at least those who are emotionally affected by it- this site wouldn't exist, and neither would the other 100's of sites and the millions of members and men wouldn't be spending billions of dollars on snake oil products or legitimate ones to try and keep their hair. Just happened to finish reading an article that said British men see hair loss as worse than being financially broke or not having a partner in life. It also quoted some doctors saying some of their patients were suicidal (because of their hair loss). I'm pretty damn sure some of the men on this site know exactly what they mean.

So, no I don't have cancer and that's why I wouldn't know what it's like to have cancer...and that's exactly why to me my hair loss and the consequent problems is the worst thing that has happened to me. And this is coming from a guy who's seen all kinds of sh*t, tragedies and hardships ever since I was a child. Like I once told Spencer -through massaging on the Sunday show- " hair loss is our cancer", and he actually liked what I said. The other thing I want to mention is that about 4 years ago I was told by a specialist that I had MS. I was devastated but I can say not as much as I am now with this hair loss sh*t. (MRI showed negative results later).
The other thing, like I said before we're different and our reactions to the same problems are also different. There are men who don't give a crap about hair loss or even being disfigured. Others do. I don't know why but I happen to be in the latter. It's not that I choose to be miserable about it. If I could deal with hair loss I wouldn't have spent over $22,000 and 6 HTs and wouldn't have put my whole life on hold and lived like a hermit. And for the 3rd time, I happen to have BDD. Ask a psychologist what this can do to someone...

Anyway, I don't want to make this any longer and I don't want to turn this into a lecture but I really hope people would stop always quoting the " it's not cancer it's just hair loss...". For all I know hair loss can be more devastating (mentally) than anything and it can turn someone into a lifeless shell of a human.

[northeastguy]

I am going to wish you well with this journey. There are so many things we disagree on we would be just going in circles. However, I can't compare Cancer with Hairloss. I'm sorry, hairloss is NOT our cancer. There are so many people on this forum who have dealt with hairloss, got diagnosed with cancer and I assure you, none of them felt like they did when the Dr informed them of their potential death sentence.
How we accept baldness is all about our personal perception. How we accept it is going to pave the path how we live our lives. plain and simple. Rewire that thought process and your going to be a lot happier long term.

Be well...

[jetfan11]

I am going to wish you well with this journey. There are so many things we disagree on we would be just going in circles. However, I can't compare Cancer with Hairloss. I'm sorry, hairloss is NOT our cancer. There are so many people on this forum who have dealt with hairloss, got diagnosed with cancer and I assure you, none of them felt like they did when the Dr informed them of their potential death sentence.
How we accept baldness is all about our personal perception. How we accept it is going to pave the path how we live our lives. plain and simple. Rewire that thought process and your going to be a lot happier long term.

Be well...

NEguy,

Any update on those beard hairs? ANy growth? Also just to confirm you did 790 grafts of scalp then 891 of beard? Do I have that right?

[northeastguy]

Hey Jetfan.... We did 891 beard grafts. It's only been a month so too soon to see effects of this procedure. I will say I am getting the occational pimple in the recipient areas so that's a good sign. End of May and I'll be seeing some effects.

[35YrsAfter]

Hey Jetfan.... We did 891 beard grafts. It's only been a month so too soon to see effects of this procedure. I will say I am getting the occational pimple in the recipient areas so that's a good sign. End of May and I'll be seeing some effects.

Related to other beard hair cases, we recently had a patient return for additional beard grafts, 7 months after his previous necrotic scar repair surgery. Beard hair was used in both surgeries. The major focus was a slick bald area in his lower donor area about the size of an ear. Our patient had a strip surgery years ago and suffered necrosis, or death of tissue in that area. He speculates it may have been caused by lack of adequate blood supply after the strip incision was stretched shut.

Word gets back to me that some doctors tell our patients when they are in the consult phase, that scalp hair barely grows in scar tissue if it grows at all.

Scalp hair consistently/reliably grows with a decent yield in scar tissue when the surgery is properly performed.

Beard hair consistently/reliably grows with a decent yield in scar tissue when the surgery is properly performed. ACell and PRP contribute to an optimal outcome.

This particular patient is the first of our patients I'm aware of to have beard hair grafted into slick bald formerly necrotic skin. At seven months we are seeing excellent growth and our patient is thrilled with his repair work.

Just wanted that to be an encouragement to men with limited traditional scalp donor seeking repair.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck