2098 grafts with Dr. John Cole (1st of potentially 3 procedures)

zerafian

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Looks legit man, how old are you? You're front is further gone then mine but my crown has started as well. I want to go through the same procedure in the next 1-2 years. Based on the fact that you wrote 2-3 procedures, how many graphs will you end up with?

On finasteride? Maintaining?

Edit** I see you're 36 and did maintain on finasteride. Bit older then me (I'm almost 28) and I'm not really maintaining on finasteride, so I guess we have our differences! Wonder if I'd be a poor candidate.

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In the end to get what I want, I expect to be around 4500-5000 grafts. I expect he'll do another 2000 to give me the result at the front that I want. I also have hair loss in my crown area which will most likely be around 1000.

I ahve been taking procia 0.5mg since late 2014. I have been using rogaine since 2012. Heres a thread I made a couple years ago with an update on my propecia use and such.

I stopped taking propecia about 3 weeks ago. Im now on a topical finasteride/ minoxidil blend. The amount of finasteride in the topical is about 8x more than what was in my propecia. The topical, according to multiple studies, has had ZERO side effects on mens prostates and pretty much zero side effects at all. Where as we all know that the pill has dozens of side effects. I only suffered from one side effect from propecia, a weaker stream when peeing which was obviously a sign of something that could get WAY worse over time. Hence why getting off that pill was something I was ready and willing to do. I couldnt be happier that Dr.Cole made me aware of that topical.


I wouldnt personally use your reaction to finasteride as a way to base how youll react to a transplant. You know, kinda like comparing a bandaid over a wound to stitches over that same wound.
 
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zerafian

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trialAcc

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In the end to get what I want, I expect to be around 4500-5000 grafts. I expect he'll do another 2000 to give me the result at the front that I want. I also have hair loss in my crown area which will most likely be around 1000.

I ahve been taking procia 0.5mg since late 2014. I have been using rogaine since 2012. Heres a thread I made a couple years ago with an update on my propecia use and such.

I stopped taking propecia about 3 weeks ago. Im now on a topical finasteride/ minoxidil blend. The amount of finasteride in the topical is about 8x more than what was in my propecia. The topical, according to multiple studies, has had ZERO side effects on mens prostates and pretty much zero side effects at all. Where as we all know that the pill has dozens of side effects. I only suffered from one side effect from propecia, a weaker stream when peeing which was obviously a sign of something that could get WAY worse over time. Hence why getting off that pill was something I was ready and willing to do. I couldnt be happier that Dr.Cole made me aware of that topical.


I wouldnt personally use your reaction to finasteride as a way to base how youll react to a transplant. You know, kinda like comparing a bandaid over a wound to stitches over that same wound.
Good stuff man, thanks for the reply. Although I don't understand your analogy at the end haha
 

zerafian

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Good stuff man, thanks for the reply. Although I don't understand your analogy at the end haha
propecia is only a temporary solution that if you stop your body reverts back to its natural state, causing hair to fall back out. A hair transplant is a permanent fix. bandaid only temporary closes a deep cut where stitches fix the cut permanently. My fault for being so vague :)
 

trialAcc

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propecia is only a temporary solution that if you stop your body reverts back to its natural state, causing hair to fall back out. A hair transplant is a permanent fix. bandaid only temporary closes a deep cut where stitches fix the cut permanently. My fault for being so vague :)
I'd like to hope so! My main hesitation is that if its a permanent fix, what will the quality of the hair for me be when it's only the transplanted hair left. You're 8-9 years older then me and probably have a much better idea. Our hair looks pretty similar right now (mine a bit better prior to the hair transplant), but I could be headed for NW7 for all I know when I'm your age while you seem much more likely to settle into a reasonable pattern 4/5 pattern, which can be done well with a hair transplant.
 

zerafian

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I'd like to hope so! My main hesitation is that if its a permanent fix, what will the quality of the hair for me be when it's only the transplanted hair left. You're 8-9 years older then me and probably have a much better idea. Our hair looks pretty similar right now (mine a bit better prior to the hair transplant), but I could be headed for NW7 for all I know when I'm your age while you seem much more likely to settle into a reasonable pattern 4/5 pattern, which can be done well with a hair transplant.
Its definitely the job of the surgeon to make you aware of how he/she can properly place grafts, to help with blending the transplant to make it look natural, once youve lost more of your natural hair. I have VERY LITTLE experience with it since Ive just begin my hair transplant "journey". I know that by my 50s, Im sure Ill need to go back to get more density from where my current, natural hairs, will end up falling out. I feel like preparing yourself for the future and getting another procedure to further fill in areas, will be necessary. Its also something we have to be responsible for too. Knowing that we will most likely lose the non transplant hairs and we either live with the result or prepare to spend the money on get more grafts transplanted later in life.
 

trialAcc

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Its definitely the job of the surgeon to make you aware of how he/she can properly place grafts, to help with blending the transplant to make it look natural, once youve lost more of your natural hair. I have VERY LITTLE experience with it since Ive just begin my hair transplant "journey". I know that by my 50s, Im sure Ill need to go back to get more density from where my current, natural hairs, will end up falling out. I feel like preparing yourself for the future and getting another procedure to further fill in areas, will be necessary. Its also something we have to be responsible for too. Knowing that we will most likely lose the non transplant hairs and we either live with the result or prepare to spend the money on get more grafts transplanted later in life.
Which is fine with me, so long as it looks decent.
 

Wolf Pack

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Him not going aggressive with it was100% my doing. I told him I did not want a major graft harvest, being my first procedure. Word for word I said "I want a distinct hairline, NOT a hair gradient in under 2000 grafts. I was also very nervous about paying all that money and my body reacting poorly to the procedure. The difference between getting what I WANT in the end and this initial procedure was essentially double the cost. I wanted to be sure that this would actually do what I was hoping or that it would work at all.

As for forehead height, I have 6.3 to 6.4cm in that yellow line and 7.6-7.8cm in the red line. I have a wider, more roundish/square head and the camera focal length obviously messes with things.

Ah right. Well if it was your desire that's fine and Dr Cole is great so you're in safe hands. His hairlines always look natural and he does what he thinks is best with minimal scarring due to his technique of extraction. So I was correct and you're a Norwood 2.5 because if you're centre is 6.3ish then your corners should be about 7cm as a maximum but they're a little beyond the highest mature point. I restored my corners and like you I have a naturally good shaped forehead so I'm at 5.5-6cm all round which was well worth it. Since I got on finasteride before I lost the hair behind the hairline, it's still maintaining it well. You'll end up NW1-2 (hairline wise) after your second procedure easily but your hair won't be like native hair unless you can grow more on finasteride/minoxidil especially with medium calibre hair. Still, you're winning in my book and a pretty good candidate for surgery.

His hairlines look natural and normal from any angle!


propecia is only a temporary solution that if you stop your body reverts back to its natural state, causing hair to fall back out. A hair transplant is a permanent fix. bandaid only temporary closes a deep cut where stitches fix the cut permanently. My fault for being so vague :)

If you take Propecia early and have a slow pattern, it is permanent at maintaining native density (or close to it) as long as you take it forever. Can always blend in 1-2k grafts all over if needed. Hair transplant may be advertised as permanent by some Drs but that's not exactly true. If you're not on finasteride it can be lost in aggressive baldites later down the line, it may have been taken out of the safe zone which can happen with the more procedures you have as well as scarring/balding that damages the donor aesthetics. And it rarely looks fully natural/native, unless you can dense pack the minimally lost areas, with reasonable hair calibre and a skilled surgeon. Better to use both approaches if it's possible - medication and minimal surgery. It's far easier to maintain 70k hairs on top with finasteride then think surgery will give you that back with no sides. The only area which finasteride can't maintain is the hairline even if you start early (usually seems to be the case as it's so dht sensitive) so it's worth transplanting a thick frontal band which goes a long way in aesthetics. Free hairstyles for a start and facial framing which will match full heads even if the density behind takes a hit.
 

zerafian

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Ah right. Well if it was your desire that's fine and Dr Cole is great so you're in safe hands. His hairlines always look natural and he does what he thinks is best with minimal scarring due to his technique of extraction. So I was correct and you're a Norwood 2.5 because if you're centre is 6.3ish then your corners should be about 7cm as a maximum but they're a little beyond the highest mature point. I restored my corners and like you I have a naturally good shaped forehead so I'm at 5.5-6cm all round which was well worth it. Since I got on finasteride before I lost the hair behind the hairline, it's still maintaining it well. You'll end up NW1-2 (hairline wise) after your second procedure easily but your hair won't be like native hair unless you can grow more on finasteride/minoxidil especially with medium calibre hair. Still, you're winning in my book and a pretty good candidate for surgery.

His hairlines look natural and normal from any angle!

yeah, he didnt go as low in the corners as I thought he would be I saw the graft amount he put up my sides and middle, he seemed to want to make this first coverage as "bullet proof" as possible. I did mention that he would have preferred to have another 400-600 to work with. I was like "next time!"

I definitely want to get the sides down by around 1.5cm. Mainly due to my wide head, the sides are extremely important to shaping my face in a for flattering way. Im throwing out arbitrary guesses that Ill be in store for another 2000 grafts, maybe a little more.

He made me very aware that there was a bit of, what Ill reword as, a "penalty" to not going all the way that I want. He'll have to go back into the 1st transplant area, at the hairline, to add 2s and 3 follicle hairs so there will be overlapping. In the end he did what he thought would be smart to do, in the event I change my mind about coming back but he did encourage the idea that I wont be 100% satisfied with the hairline probably. Mainly because he knows what I want.

I did originally go in saying 1200 grafts but realizing that wasnt going to do nearly enough, I had pull the trigger on the 2k+

Thanks for the feedback Wolf, you seem to have been around here much longer than me and have way more experience with this than I do.
 

Wolf Pack

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yeah, he didnt go as low in the corners as I thought he would be I saw the graft amount he put up my sides and middle, he seemed to want to make this first coverage as "bullet proof" as possible. I did mention that he would have preferred to have another 400-600 to work with. I was like "next time!"

I definitely want to get the sides down by around 1.5cm. Mainly due to my wide head, the sides are extremely important to shaping my face in a for flattering way. Im throwing out arbitrary guesses that Ill be in store for another 2000 grafts, maybe a little more.

He made me very aware that there was a bit of, what Ill reword as, a "penalty" to not going all the way that I want. He'll have to go back into the 1st transplant area, at the hairline, to add 2s and 3 follicle hairs so there will be overlapping. In the end he did what he thought would be smart to do, in the event I change my mind about coming back but he did encourage the idea that I wont be 100% satisfied with the hairline probably. Mainly because he knows what I want.

I did originally go in saying 1200 grafts but realizing that wasnt going to do nearly enough, I had pull the trigger on the 2k+

Thanks for the feedback Wolf, you seem to have been around here much longer than me and have way more experience with this than I do.

Good thing about Cole is he will listen to what you want but in the end the hairline design will be what he thinks is best. He's not the kind of guy to leave someone with a fake looking straight line and that's a good thing. I don't think you have a very wide head but if that's the case some curvature is essential to make it look natural and that's what he'll do like you can see in his videos. I haven't been around for a while but definitely I'm a veteran and I come from a science background too, thanks.

If the sides come down 1.5cm, that means they are around 6.5cm. In which case you can't have a centre that's 6.3 as it's way too flat and you would need to get the centre down to 5.6cm or something. I think that's manageable and natural on your forehead. Curious on Cole's final design! If I'm not too active, hit my PM at the time you do it! Happy growing bro.
 

zerafian

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So here is my 8 week update. Ive decided to let me hair grow out at this point. Its been 3 weeks since I've buzzed my hair with the clippers on the 1 setting.

I clearly still redness, which Im not overly concerned about. My head isnt sore anywhere and hasnt been for about 5-6 weeks.


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zerafian

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Also, a few people were curious so I took this pic and drew in what Ill be pushing for, in my second procedure. You can tell a lot of hairs are still trying to grow in the area I want my second procedure.

Ill also be starting my 5%minoxidil /1% finasteride topical next week. I stopped taking propecia, 0.25mg/day pill, as of 7 weeks ago and am relying 100% on this new topical. MY first perscription was 5% minoxidil/ 0.1% finasteride, but having not experienced any side effects from the topical, I asked the doctor to increase it to the normal 1%
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Selb

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Looks solid. The topical mix should give you maintenance so the hairs behind the transplants don’t fall out.
 

zerafian

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Looks solid. The topical mix should give you maintenance so the hairs behind the transplants don’t fall out.
Only time will tell! Ill take that optimism for sure. Maintaining is really all Im hopeful for.

Iam curious to see, with how strong this topical will be, if it helps the hairs in the green area that still have some color but are clearly not strong follicles. Along with helping my crown area out over the next year. Right now it looks like I need around 1000 grafts in the back, but Im holding off for a while to see what happens.

From my research, 1% topical finasteride is more potent than taking a full 5mg finasteride pill, so the DHT resistance should be higher. Fingers crossed.
 

Selb

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Only time will tell! Ill take that optimism for sure. Maintaining is really all Im hopeful for.

Iam curious to see, with how strong this topical will be, if it helps the hairs in the green area that still have some color but are clearly not strong follicles. Along with helping my crown area out over the next year. Right now it looks like I need around 1000 grafts in the back, but Im holding off for a while to see what happens.

From my research, 1% topical finasteride is more potent than taking a full 5mg finasteride pill, so the DHT resistance should be higher. Fingers crossed.

Should actually help more with scalp dht too. Keep us posted
 
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zerafian

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So I just passed my 3 month mark. At this point its hard to tell whats transplant growth and whats my original hair.

I can see tons of new hairs growing in and a handful of hairs that are obviously transplant hairs, due to them being super curly or much much thicker, in an area that has nothing but thinner/ finer hairs

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whatintheworld

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Your skin still seems inflamed, which may be normal if you are fairer skinned which it seems you are.

Did you ask Dr. Cole if that is expected at this point?
 

zerafian

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Your skin still seems inflamed, which may be normal if you are fairer skinned which it seems you are.

Did you ask Dr. Cole if that is expected at this point?
yeah, even after 3 months, theres a shade of red to the area still. Though no pain, tenderness, or feel of temp increase to the area. I get a couple random pimples but thats nothing out of the ordinary.

They did ask me to come in so they could take a look. Though they said they arent concerned but want to be 100% certain. Mainly because theres no visual evidence its anything serious.
 

zerafian

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Iam unsure if its possible that the topicle finasteride/minoxodil is causing it. I used rogaine for 6 years but only recently started using the topical finasteride/minoxidil. After finally getting off propecia
 

whatintheworld

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Iam unsure if its possible that the topicle finasteride/minoxodil is causing it. I used rogaine for 6 years but only recently started using the topical finasteride/minoxidil. After finally getting off propecia

I have seen some transplant cases have this redness for quite a while, it doesn't mean your yield will be comprised, just something that might be a good idea for the doctor to look at. Try to avoid direct sunlight for a while until the tone gets more to your original skin color.
 
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