Dr. John Cole - FUE 3605 Grafts on Class 5 Results

This patient was a Norwood Class 5 upon his first visit to our clinic. At this time, he has undergone two surgeries with Dr. Cole, the first on 3/13/2013 and the second almost a year later on 2/20/2014. During his first surgery, the patient received 3605 grafts in the frontal area. In addition, ACell and PRP were applied at the time of the procedure and following his surgery. While the patient was pleased with his outcome following the first surgery, he wished to return for a second procedure to add grafts to his crown, an area that had not been worked on during his previous surgery.
















Looks like he was a good candidate from what I see in his donor. Nice result and natural looking. Do you have any top down photos?

This is 3600 grafts?

Very impressive.
(Also - a NW#5? I think you are selling yourselves short. In the shaved pics he looks more like a NW#6.)

I wonder what a couple thousand more grafts would do for this guy.

On the other hand I can’t imagine is in the average range of results. This must be a pretty top-shelf case. His donor hair shafts do look pretty darn thick.

Looks good… but it’s difficult to see how much coverage there is without a top-down photo. The zone one might only be an inch deep.

the results to the hairline are very nice and symmetrical and impressive but you guys know better and clearly did not post a pure top-down photo.

i can take pictures all day long of the 4000 fue grafts i had done with pictures straight on my face and i look like i have hair from when i was 20. but i have a very easily seen bald crown spot. i have chosen not to treat that yet but taking a hairline only shot just is not fair to newbie’s or any others trying to educate themselves and take this leap. so please be fair and show a crown shot so someone who is thinking about a procedure understands what the deal is

We did not work on the crown, this will be accomplished in his 2nd procedure soon.
His crown is thin and need work, these are the photo we chose considering the patient

[quote][postedby]Originally Posted by dreamster[/postedby]
the results to the hairline are very nice and symmetrical and impressive but you guys know better and clearly did not post a pure top-down photo.

i can take pictures all day long of the 4000 fue grafts i had done with pictures straight on my face and i look like i have hair from when i was 20. but i have a very easily seen bald crown spot. i have chosen not to treat that yet but taking a hairline only shot just is not fair to newbie’s or any others trying to educate themselves and take this leap. so please be fair and show a crown shot so someone who is thinking about a procedure understands what the deal is[/quote]

Happy to clarify. This is an 11 month result and our patient is thrilled with his result so far. The day I took photos of his 11 month result, was also the day he had his second surgery where the crown was addressed with 1802 grafts. He is coming back in the middle of March 2014 for an additional 698 grafts. His final total will be 6105 grafts and his final result will be available in early 2015. Seeing our patient in person, I believe he will be able to achieve very nice complete coverage without a comb over look in another year, once his second result has grown in.

For all you guys in the Norwood 5-6 range… Hair transplants create an illusion of coverage. Even if you have great donor hair characteristics, you will need more than 3600 grafts to address both your front and back balding area.

According to surveys, the vast majority or men with hair loss in both the front and back believe that framing the face with hair in the frontal area provides the greatest cosmetic benefit. Some men don’t care much about thin or bald areas in the back, while others do. Regarding those who do, we had a patient in his late fifties come in to fix a silver dollar sized thinning spot on the back of his head. He had hair like the late ex-president Reagan in the front. Everyone is different.

Related to this result, we didn’t post photos of the top because we had not yet done any work there. As I mentioned, in early 2015, we will post more photos once the crown area has grown in. In 2015, our patient may want even more density because 6105 grafts is not a lot of grafts to cover this large of an area.

I think the it is important to see all angles including the top and the back. It matters to us to see what kind of coverage was achieved because guys with lots of hair loss are not just going to get a new hairline. That’s stupid. And it is good to know what a result like this will look like with a bald butt crown sticking out so it does not matter if it was done or not, we need to see what the result looks like. You have the pics so let us see them.

I wish there s a way to know to what extent the results are due to acell and prp enhancement.

[quote][postedby]Originally Posted by CueBallBob[/postedby]
Looks good… but it’s difficult to see how much coverage there is without a top-down photo. The zone one might only be an inch deep.[/quote] +1

Great, natural-looking result. I’m sure this patient was very pleased. I can’t wait to see the pics in 2015 with the additional grafts to the crown.

I don’t think the issue is whether the crown has been worked on yet; the issue is that phase one of this person’s transplant plan cannot be fully evaluated - in and of itself - without showing the “other side” of the frame, i.e., the backside of zone one. Thanks.

Here is a photo of our patient immediately after his first CIT procedure with Dr. Cole (photo taken 11 months before the results images posted above). The purpose of posting this photo is to show how far back we grafted during this first pass. The grafts extend back with an irregular placement on average of about 4 1/2" or about 11cm. I spoke briefly with Dr. Cole this morning and he believes it will take a total of 4,000+ grafts to the crown to get a full appearing coverage. Remember, this patient has thick, dense donor hair. Beard hair is an excellent option for men with less than “homerun” scalp donor.

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

Our patient addressed his crown with 1807 grafts on 02-20-2014 and returned today, 03-12-2014 for an additional 1272 grafts. ACell helps reduce hypopigmentation at the very least. The closeup of a small random area of our patient’s donor reveals no visible scarring or white dotting.

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

Even if you did not do work on the top, you should still post it because what matters is the overall cosmetic result, not just the part where you did work. It is unethical and painfully typical of HT clinics to just post hairline photos.

I agree with Aran. The whole head really should have been posted originally. If you don’t post the whole head then don’t give out graft numbers either, because one without the other can easily be misleading regardless of intent.

As for Acell - how much good does it do for pigmentation loss in the recipient area? If the improvement is as good as it is in many of these donor area shots then you’d think it would be standard procedure for all HTs, or even for other kinds of cosmetic surgery in the broader sense.

[quote][postedby]Originally Posted by Aran Linvail[/postedby]
Even if you did not do work on the top, you should still post it because what matters is the overall cosmetic result, not just the part where you did work. It is unethical and painfully typical of HT clinics to just post hairline photos.[/quote]

We worked on the top 02-20-2014 and 03-12-2014. As I mentioned in a previous post in this thread, we grafted the frontal area back about 4 1/2". Some men don’t care about hair loss in the back, while others do. Our patient’s goal is to reasonably cover his entire balding area. The photo below shows his 11 month result indicated by long hair compared with his pre-op photo. His semi-final result will not be available until March of 2015. After March, 2015, our patient stated he is motivated to address any remaining thin appearing areas.

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