• Welcome to Hair loss Experiences hair loss forum.

    Free impartial hair loss advice, hair transplant advice, hair loss medications and hair loss news.
    You can contact us directly at [email protected] if you experience any problems.

A Question for Hairtech

P

pvtpoint2010

Valued member
Likes
0
#1
About 5 years ago I went To Cole for a small FUE session .........About 750....The rightside hairline he did looks great but am now in need of more .....He recently quoted another 1000 or so .......

The only trouble i have is that I have 2 strip scars from past work and all for about 800 grafts!



Coles FUE slightly removed some rear density around the scars so feel FUE may not be the way to go unless he did several smaller sessions of say 350-500 along with a 1-1 BHT donor replenish ......

Since you worked for cole in the past did you ever get a chance to see any donor recharging patients?....

Is it a valid technique with great estetic results in the donor?

Its also a concern to me as i also have many tiny white dots!

I feel it may be my only way to due more FUE's

What do you........... "and all" .........think
 
H

hairtech

member
Likes
0
#2
ok... i am intrigued why if you went to Cole... for your procedure for FUE... and why you now are asking these questions... Obviously you are happy with your results thus far...So what are you asking for your future procedure?

1. Do you need more density? You mention white dots... why?

2. You state that Cole removed grafts at some point for esthetic reasons... cool.

3.You ask me about donor recharghing... when I worked for Cole... Donor recharging was taking body hair and placing this into the donor area... so that in theory... a body hair would grow in place of an extraction of a scalp hair. However this was/is experimental... to date... there has never been a confirmation that this works.

4. If you have white dots... in my opinion... and this is my own opinion... it is because the FUE punch used on you was greater than 1.0mm.

I think that if Cole has redesigned your hairline to your pleasure... and you feel comfortable with his work... then continue with him... he is good at what he does.

He learned about hairline design from Dr. Paul Rose... who also worked with Ron Shapiro... period.

 
Last edited:
P

pvtpoint2010

Valued member
Likes
0
#3
I went to cole for a strip to try to revise a wider scar in 2005 but he felt the FUE approach was a better fit.......

However all new consults from Feller and bernstein 2010 feel that FUE should not have been done due to it over time will thin out the donor making it harder to hide the 2 existing scars..........

I am also not crazy about the white dots ......

The only option I have in order to stay with Cole is body hair recharging the donor to keep the density as close to normal as i could while at the same time minimize future white dots.....

Just never seen any before or after pictures other then the 1 photo on his site

Cole nor his office has not as of yet given me a reply to several emails and office questions regarding this idea.........

He again refused a potential strip procedure.....
 
Bigmac

Bigmac

Administrator
Staff member
Likes
6
#4
Hi Pvtpoint,have you some pictures you can share with the forum.Be great to see the work.

Cheers bm.
 
H

hairtech

member
Likes
0
#5
pvtpoint... yes I also have not EVER seen pictures or results of a donor recharging... It is a nice idea... however... and this is my opinion... I would not pay one cent for this... it should be for free.

FUE at the right experienced clinic will not thin your donor out. Every patient has a threshold. And experinced FUE clinics know when to stop performing FUE as to not create the moth eaten look.
 
P

pvtpoint2010

Valued member
Likes
0
#6
Hairtech,

Ive unfortunately been around the block with this whole field and now feel the only way FUE should be done is by adding body hair as you remove a follicle from the donor.

I think the only way FUE should be done is to do a 1 to 2 ratio for the first 3000 FUE grafts then a 1 to 1 for the rest

In other words 1 body hair graft for every 2 FUE scalp grafts for donor recharging

Then a 1 to 1 for every graft after 3000 .....So in total the max amount of FUE's that should be taken from anyone without recharging should be 1500!

(However if this was the case there would be less candidates for the procedure as not everyone is gifted with the correct texture body hair to pull it off)

And thats only if no scars from past work are present!........If there are scars from past work then it should only be 1 body hair graft for 1 FUE scalp graft....!

Otherwise the whole FUE idea can be detrimental as the area will thin to the point of very shallow density in anyone with a norwood 3 and beyond.......

I also agree that there should be no or at least a minimal charge for the recharging technique......All FUE Dr's should follow this guideline in my opinion......

Cole is one who I feel is not promoting this idea to its fullest ........I feel he may be getting stuck on the FUE only idea without much in terms of progressing to be the best.......

Though he is offering Acell he is not willing to use it as a tactical advantage other then to say he's using it......

I will also be doing an Acell test on a few white dots as well as adding a few extra grafts into my scar with the plucking technique over the next month or so with Dr Cooley ....

FUE and body hair will be my last resort if Acell does not give what is needed for my case

Cole after 10 days still has not responded to multiple requests about this issue so i may have no choice other then to go to another FUE/body hair expert
 
H

hairtech

member
Likes
0
#7
Very interesting points PVTpoint. I see that you are very analytical with the FUE/body hair procedure.

I hope you can update us on the Cooley-Acell trial. I like Dr. Cooley and he is a straight up physician. No smoking mirrors or promotions. He has been one of the few clinics that is furthering hair transplant technology and especially in holding solutions.

As for the clinic that doesn't answer your emails... in my opinion just go with your gut feeling.

One question pvt.. Any chance you would like to post a pic or two?
 
Last edited:
Nervousnelly

Nervousnelly

The Coolest Member
Likes
0
#8
I do like the way Pvt is thinking but not sure that it is totally viable at this time. I would like to see some pics and follow this case. I too believe that Dr. Cooley is a good solid physician.

NN
 
H

hairtech

member
Likes
0
#9
As for the donor recharging... Cole has been doing this since around 2005. Now that I think about it...I wonder if we (pvtpoint) met. I was working for Cole back when you were came there.

But getting back to the donor recharging... Cole has been doing this for quite some time. He should know if it is working or not via picture evidence.

Something worth mentioning in addition to the recharging... there is an arguement on several boards concerning purposeful transectioning during extraction so that 1 or more hairs are left behind. This would benefit an extraction as to not be totally devoid. This means a doc will purposely transect a 3 or 4 haired graft. I personally do not favor this idea due to the fact that one could actually damage the follicle during transectioning.

However in my opinion, when there is a usage of punches at 1.0mm or less, the extraction spot is negligable. The larger the punch there is an exponential increase in white dotting.

We have seen several patients from other clinics that came here and white dotting was evident. Just to satisfy my own curiosity I placed a 1.0mm punch tip in the middle of the white dots... and it was clear that the punch used was in excess of 1.0mm. All FUE clinics know that post extraction... the holes shrink to half their size by 24 hrs post op. So for our 1.0mm punch in the middle of a white dot means that the punch used by that clinic was tremendous.::;mb[):h::/images/emoticons/th_15-3.gif
 
Last edited:
P

pvtpoint2010

Valued member
Likes
0
#10
In theory it should work.......

I as well as many others had FUE grafts placed into scars and it grew out..

Not sure of the total number that grew but it grew non the less so body hair if extracted properly should grow just as well ...........IMO......

Dr Umar shows many examples of this..........

Also Cooley believes that he can pluck a hair and bast it in Acell and have it re grow a single haired follicle........He showed me several before and after photo's

One picture looked just like a FUE session was done but he said it was just plucked hair grafts and no FUE at all........I was impressed!

The only concern I have is if it does re grow a follicle in a scar ware does it get the room to grow normal?...

A normal follicle is somewhat long and goes deep into multiple layers of skin...

Don't think he has done a biopsy of the grafts yet to see just how well it grew and if it grew without distortion..

However if the test works on me ( 10-20) he and I will add several hundred more

As far as BHT and FUE I think the formula i gave should be the FUE standard

I feel its not a long stretch in terms of do ability its just the top FUE doc's adding it to their basic package ........

FUE is better then strip as far as scar detectability if done with the correct size tools but is inferior to strip as far as the number of grafts that could be removed without drastically lowering the donor density

But my body hair formula will give several thousand more grafts making it a close call

Yes Hairtech i am being totally analytical in my input.... this industry must be based on esthetics and pure analysis of ALL available options in order to get the best result possible....
 
P

pvtpoint2010

Valued member
Likes
0
#11
As far as sending a few Pictures I will try and get some shortly......

Hairtech can i send them to you to post?

In general my hair loss is a general thinning in a norwood 3 pattern but still have about 25-30% density from existing hair and past work....

My crown and rear third is still more or less full

i has 250 linier punch grafts from the bullshit Long island medical (hitzig's old company) 1996

I had about 100 or so removed and dermabraded down but still have many pits and chicken pock indentations in my lower hairline and front 1/3

I had 550 mini/micro's from Eastwood medical that was ok for the time period 1998

started proscar 2.5 mg daily,revivogin and rogain and my hair thickened up dramatically and held for several years

in 2005 i did 750 or so FUE from Cole plus about 80 or so into my higher/wider scar

My hair up till early this year was still holding its own but i was trying to have a baby and my doc recommended i stop the proscar for a few weeks and i did for 6-8 weeks...

after this period i re started it again but noticed that my hair started to re thin in placed i have not seen since i first started taking the meds......

So I'm not sure if it will re thicken or if i actually lost ground ....its been about 4 months since i restarted the meds.....

In the mean time I re started my research on new and improved techniques as well as the upcoming Acell ideas ...........JUST IN CASE!
 
Sparky

Sparky

Valued member
Likes
0
#12
Cole couldnt even post a single picture of a scar revision on his website, hes useless. He also wanted to charge me $12,000 to remove 400 grafts from my hairline!

Always seems to be white spot scarring from him aswell.
 
P

pvtpoint2010

Valued member
Likes
0
#14
At this point i will refrain from commenting on Cole's office until the end of this week.

As I'm still waiting for a reply to my questions .......About 2 weeks ago I spoke to several staff members and even emailed Cole himself .......At first Cole replied but then never heard back since with my follow up questions....

I did mention that i was disappointed in him due to his office wanting to charge me $6000 for a half day session to remove 50 or so small FUE sized pits....!

The first email I sent to him was to see if he would do a strip instead of FUE's but his reply again was NO!.....

Then i suggested my FUE plan as stated above but I never got a response....

Like I said I will give it till the end of this week before I contact his office again with discontent......



Cooley is doing a plucking technique that is based on the Acell's ability to regenerate body tissue and scaffolds......He's been testing a method ware a single hair is tweezed/plucked then set it in Acell and planted into a scar......... Acell has shown over his research (1.5 years) to re grow a single haired follicle from the plucked hair

The area it was plucked from also grows back!

Its however NOT 100% .....

He is also just now starting to do larger sessions ....In my case i'm going to test it on about 10 FUE white dots, 10-20 in my larger scar as well as just using Acell on a few small Pit marks to see if it re grows normal non scared tissue in its place

If it works I will then try 300-400 more over a few sessions....
 
M

Mountain

Valued member
Likes
0
#15
If you're talking about removing the follicle, bulb and all, I don't see how you just pluck it out. It would have to be cut out, like FUE, to remove it. If you don't remove the bulb, you don't have anything.
 
P

pvtpoint2010

Valued member
Likes
0
#16
If you're talking about removing the follicle, bulb and all, I don't see how you just pluck it out. It would have to be cut out, like FUE, to remove it. If you don't remove the bulb, you don't have anything.

No this technique is like cloning!.....you do not need to take out the bulb as with FUE......

Read up on Acell........However its still experimental

We should know more in a few years as the technology progresses.......

Hopefully by then not just single follicles can be regenerated but whole follicular units as well..
 
P

pvtpoint2010

Valued member
Likes
0
#18
Hi Hairtech

Im my case yes and no .......For the initial test it will be a very small amount as far as cash....

If I like the result we will work on the price depending on the number of grafts I would like implanted into the scar......

My goal would be 300-400 grafts.........the scar is 1/4 inch wide by 7 inch long

so thats a total of 1.75 inches.............. the number sounds about right give or take a few...

However the treatment also needs to be cost effective aswell otherwise a scar revision would be the better option.... then again stretch back will always be a concern



So who knows???!!!
 
P

pvtpoint2010

Valued member
Likes
0
#19
Regarding Follicular group regeneration:

Im sure someone is looking it to it already but just my 2 cents..

if A whole 3 haired (more or less) FUE graph was taken from the scalp,clipped in 2 then half placed back into the original donor site and the other placed into the recipient after basting both in Acell......it may grow a full follicular group in theory anyway.......just as long as enough of the remodeling code are present in both parts.....IE...... A GOOD TEST for the future!

I think the best recipient site incision should be similar to H&W's lateral slit technique....giving the hair a layering effect after it exits the scalp......

The only trouble I could see is not just the fact it may not work at all but the donor site half may get buried under the skin and cause an abscess..........So maybe closer to 2/3, or even 3/4 of the cut follicle should be tested as well ......The closer to the skin exit the better........IE without compromising the recipient graft......

I never read about it yet.......Again just my 2 cents

 
P

pvtpoint2010

Valued member
Likes
0
#20
The Following is a series of questions, statements and replies from another point of view





My Reply......

Ive unfortunately been around the block with this whole field and now feel the only way FUE should be done is by adding body hair as you remove a follicle from the donor.

I think the only way FUE should be done is to do a 1 to 2 ratio for the first 3000 FUE grafts then a 1 to 1 for the rest

In other words 1 body hair graft for every 2 FUE scalp grafts for donor recharging

Then a 1 to 1 for every graft after 3000 .....So in total the max amount of FUE's that should be taken from anyone without recharging should be 1500!

(However if this was the case there would be less candidates for the procedure as not everyone is gifted with the correct texture body hair to pull it off)

And thats only if no scars from past work are present!........If there are scars from past work then it should only be 1 body hair graft for 1 FUE scalp graft....!

Otherwise the whole FUE idea can be detrimental as the area will thin to the point of very shallow density in anyone with a norwood 3 and beyond.......

I also agree that there should be no or at least a minimal charge for the recharging technique......All FUE Dr's should follow this guideline in my opinion......

My Question .........Why aren't more FUE specialists offering this technique?







The Reply €¦ €¦ €¦ €¦.

Body hair transplantation is still only practiced by a handful of surgeons worldwide because it requires special instruments and techniques, is extremely time consuming, and the results and yield can be quite unpredictable. Though it would be wonderful, I don't foresee a point in the near future where doctors will offer donor recharging for free, or even at a minimal charge. In addition to the fact that many doctors don't have the experience or desire to perform BHT to begin with, even those who are comfortable working with it feel that there are many limitations to the medium, and find the extraction process extremely tedious and labor-intensive. For this reason, most BHT doctors discourage patients from using body hair unless it's a last resort, and when they do perform procedures with body hair, they charge a premium.

__________________





My Reply €¦ €¦

Well its a shame that only a few Dr's offer this technique because FUE alone in my opinion will not work on larger norwood scales...!

And yes I know Cole's motto of "LESS IS MORE"

I personally use a rule of thumb that states each norwood scale needs around 1250-1750 grafts depending on the hair shaft diameter and overall density in the donor area

So in a nut shell ....
A norwood 2 would need 1250-1750 grafts
A norwood 3 would need 2500-3500 grafts
A norwood 4 would need 3750-5250 grafts
A norwood 5 would need 5000-7000 grafts
Ext......

So without recharging with body hair or some other means then how can any FUE doc feel they could help a norwood 3 and beyond BY fue ALONE!

If that many grafts were to be taken out of anyone's donor area it will at some point start to become extremely thinned out and wispy regardless of the starting density

Also If there is an existing scar in the donor that's well hidden what do you personally think will happen at that point?........Yes it will stand out like a sore thumb

Listen all im trying to say is I'm not an advocate of strip ether especially in the wrong hands but FUE can be the better option if done correctly (proper sized tools) and donor recharging

If it comes down to a Dr not wanting to do what should be done for the esthetic result and for the patient due to BHT being a more tedious and tiring procedure then he should think again!.......And that goes for all Doc's

Telling a future norwood 6 who is at a norwood 3 that he is in good shape with a 2500-3000 graph donor area is in my opinion being lied to.

Don't get me wrong this has nothing to do with Dr Cole personally as a matter of fact I think Dr Cole is extremely artistic and does fantastic work but if i'm not mistaken he only does CIT now ......and does not like to do strip anymore ether.....

And that's ok but he needs to fill the larger needed numbers in some other way

This should also go to all other FUE practitioners in the business...BHT RECHARGING IS A MUST WITH THIS TECHNIQUE!.........PERIOD!!!

Its just simple math!!

FUE HAS POTENTIAL TO BE A MUCH

BETTER TECHNIQUE BUT NOT AS IS....





The Reply

I understand what you're saying but I still think there are just too many limitations and challenges to using body hair for donor recharging for it to become more commonplace.

Men who are at later stages on the Norwood Scale, and opt for hair restoration surgery, simply cannot (at this point in time) expect completely pristine donor areas- whether they opt for strip or FUE procedures. However, even without donor recharging, I believe the donor aesthetic post-FUE harvesting is superior to strip because you are not dealing with the linear scar and distorted hair grow angles along the closure. Dr. Cole's objective in performing FUE is to achieve an overall appearance whereby the density on top of the head is similar to the back- he does this by thinning out the back subtly and uniformly, while improving density on top and up front. Whereas, with a strip procedure, you €™re clearing out a center section of scalp but leaving a dense section of hair above and below the scar- permanently limiting your hair length and styling options.

FUE with donor BHT recharging is fabulous in theory, and we have had great success using it on certain patients, but it is still too unpredictable of a procedure to be more widely adopted, or to be a standard part of FUE work. It is further complicated when we get patients who have already had strip procedures who want to hide these scars in addition to desiring further work in front or up top. We do a lot of scar grafting procedures but, again, grafts to not 'take' to scar tissue as well as they do to virgin scalp and it can therefore take more than one pass (and additional donor scalp or body hair) to achieve desired coverage.

So, essentially, there is not yet an 'ideal' solution which allows hair to be transplanted to the recipient area while still maintaining a 100% pristine donor area in the back (and if this is someone's goal, we'd advise them never to get started with hair restoration surgery). However, we have come a long way already and we continue to study how we can make further improvements with the use of new technologies, such as ACell.

__________________





My Reply

What type of results can more or less be expected then?

Can you show some more before and after photo's from your clinic?
Im sure most on this site are interested in seeing more!

There are only 2 pictures of BHT on the site and only 1 of recharging....

My question is also if the idea is talked down to only a very very rare few why does the clinic recommend it the first place as a viable option on the site?

As this would be my procedure of choice at this point........Several smaller sessions of 350-500 scalp CIT with the same number BHT replenish .....So that's several sessions of 700-1000 grafts

The technique does work as Dr Umar is doing more and more BHT FUE and only started a few years ago....

Cole on the other hand has been progressing the technique for up to 7 years!

Unfortunately, In my case it would be the only way to go........ a 1 for 1.....

And I regret not using Cole as I think Cole does very good work on hairline reconstruction,,,....

As far as Acell Dr Cooley is doing some ground breaking research with actual follicle regeneration ....As of now its only single haired grafts but is starting to test larger numbers for scar coverage...

He's testing follicular plucking .....A hair would be plucked/tweezed then set in Acell then planted into a scar .........Acell has been shown to regenerate a complete follicle .....The end result looks like a FUE scar grafting session was done....Though its not 100% it seems like a great start.....