3000 FUT Grafts with Dr Cooley

[CapitalCurve]

Hi all. It is day 3 since my FUT procedure with Dr Cooley in North Carolina! I am currently typing this from my phone, so I will need to add a more detailed report when I am behind a proper keyboard, but just wanted to get this thread kicked off. I first contacted Dr Cooley’s team over a year ago and after shopping around for a while I was impressed by his results and post-operative FUT scars. I had always been leaning towards FUT in order to maximize the number of total lifetime grafts I may have available for future surgeries so this was an important piece for me. 
 

I sent my pre-op photo below and I was recommended to start with an initial 3000 FUT grafts and then follow up a year later for a possible second procedure.On the day of the procedure Dr Cooley sat down with me to discuss my expectations. My primary hope for the first procedure was to add density to the existing hair, since constantly seeing my scalp through my hair was beginning to bum me out. We decided that we would reinforce and densify my current hairline and then work our way back into the mid-scalp. I have to say I was a little tempted to push for some temple work as well, but I had always intended to evaluate that as an option for a second procedure. In the end, I feel like I went with the right choice sticking with the initial decision towards a natural mature hairline. The procedure itself was about 11 hours long. Dr Cooley was there throughout basically the entire thing (he may have taken one break, I was drifting in and out of sleep so can’t be 100% sure) but overall he was making the incisions, inspecting grafts under microscope, placing grafts, directing the team, etc…. I was super impressed by how intimately involved he was at all steps of the process given stories I have heard about other clinics. After the procedure ended I stayed up to spray my head with the saline solution I was given every hour and snapped a couple photos. 

the first was taken directly after surgery. The second was about 4 hours after that. I did get a worried about some of the additional bleeding in the second photo on the mid scalp. I was feeling anxious that I may have somehow knocked out a graft. However, I was being quite careful and not sure how that would have happened? My hope is that some bleeding like this in the 8 hours after the procedure may be normal? Open to any feedback here 
 

The next day I went for my first wash, which was super gentle and definitely helped calm the area down a little bit. Dr Cooley helped me set up a program of oral minoxidil and gave me some resources to look into topical RU as a DHT blocker (given that I had tried oral finasteride unsuccessfully twice in the past). Here is the post wash photo

Now today, 2 days after the procedure, I have flown home and am awaiting getting my sutures removed in a little under 4 weeks. Normally Dr Cooley schedules for 3 weeks out but I will be in Tokyo on business at that time and the office assured me that coming 4 weeks post-op for suture removal would be ok. The most recent pictures can be found below

I am not entirely sure the exact graft count yet, since I have not received the pictures from the office or final report yet. I will continue posting my progress here. Please feel free to share any questions or honest feedback about the initial pictures (positive or negative). I do not have much feedback on the actual results of the procedure, given that it just happened and I have no experience looking at these post op photos, but overall my feedback of Dr Cooley is positive based off our interactions and his level of engagement in the 11 hour procedure.

Looking forward to keeping everyone updated over the next year.  

Edited June 3 by CapitalCurve

[CapitalCurve]

Especially curious to get any feedback on the density for 3000 grafts. Wondering if I went too far back into the back of the mid-scalp as opposed to focusing on more density in the frontal third? But generally looking for the opinion of those more experienced in looking at these photos. Im sure it is a normal part of the process, but all the random worries and anxieties setting in now that the procedure is finished! 

Edited May 31 by CapitalCurve

[CapitalCurve]

Honestly, I don't really have much idea of what I should expect. I told Dr. Cooley I did not have high expectations around recreating any sort of super youthful hairline, and wanted to add more density to the existing hair so it would look less like it was thinning. He let me know we would also not do the back part of the crown, which I was fine with.

At the end of the day, I trust his expertise until any results down the road show otherwise, he knows a lot more about this than I do. I have always intended on a second follow-up procedure after the first one settles anyways, so maybe I am just getting the post-surgery jitters. Was just wondering if I should have asked to instead go in phases (frontal third for first surgery, then address farther back in the second one), though maybe the end result from a second surgery would be the same either way. 

Anyways, maybe I am overthinking this. Was just curious to get others' opinions on the work. I will keep posting more of the post-op photos here as I take them  

[Al - Moderator]

You had a bit of thin hair in the front and mid scalp, so you'll probably be OK without going too dense with the transplanted grafts. In the long run it probably doesn't make much difference. If you concentrated more on the front then you'd be going back next year to cover the crown. Doing it the way you did and spreading grafts out all over, if it ends up being too thin then you'll go back next year to thicken it all up. Either way you end up the same after 2 sessions.

They way you did it, if you're lucky, it will be enough coverage all over and you won't need another procedure for a while.

 

[CapitalCurve]

Thanks! Dr. Cooley seems like a great surgeon so I doubt I have anything to worry about, just post-surgery jitters. I will keep this group updated with new pictures as I take them!

[CapitalCurve]

4 days post surgery

[Amiele]

Thanks for sharing your experience. Do you mind sharing which RU product Dr. Cooley suggested you use? Happy growing!

[CapitalCurve]

On 6/2/2024 at 1:56 PM, Amiele said:

Thanks for sharing your experience. Do you mind sharing which RU product Dr. Cooley suggested you use? Happy growing!

RU-58841 5% PG + Ethanol. Was a little surprised he did not suggest the topical fin solution as a first option, but he let me know he has seen enough evidence of the topical fin going systemic for it to not be the only option. 

Edited June 3 by CapitalCurve

[Amiele]

On 5/30/2024 at 9:56 PM, CapitalCurve said:

I had tried oral finasteride unsuccessfully twice in the past

Perhaps there was a miscommunication, and he thought that you had given oral finasteride a year and your hair continued to significantly thin versus stopping after a few months due to adverse side effects? If you clearly communicated that side effects were the issue then I’m curious as to why he didn’t suggest you use topical dutasteride. 🤔 

Where are you supposed to get the RU from? 

[CapitalCurve]

23 hours ago, Amiele said:

Perhaps there was a miscommunication, and he thought that you had given oral finasteride a year and your hair continued to significantly thin versus stopping after a few months due to adverse side effects? If you clearly communicated that side effects were the issue then I’m curious as to why he didn’t suggest you use topical dutasteride. 🤔 

Where are you supposed to get the RU from? 

Maybe, but I really don’t think so. I said I tried oral finasteride twice and stopped due to sexual side effects. Was pretty clear on it. He told me he really did not like Hims and Keeps brand topicals and said I could look deeper into trying this 🤷. I can ask him more when I get my stitches out in 3 weeks! Not gonna apply any topicals til then anyways.

He said I could order it from anageninc 

Edited June 3 by CapitalCurve

[davidn]

18 minutes ago, CapitalCurve said:

Maybe, but I really don’t think so. I said I tried oral finasteride twice and stopped due to sexual side effects. Was pretty clear on it. He told me he really did not like Hims and Keeps brand topicals and said he’d rather I try this 🤷. I can ask him more when I get my stitches out in 3 weeks! Not gonna apply any topicals til then anyways.

He said to order it from anageninc 

Lol never Heard a Hair surgeon recommend a Research chemical 😅😅😅😅

[CapitalCurve]

44 minutes ago, davidn said:

Lol never Heard a Hair surgeon recommend a Research chemical 😅😅😅😅

Yep. A bit surprising, but gonna give it a shot. Will ask him more when I go back in 3 weeks and keep this group updated 

Edited June 2 by CapitalCurve

[Ccd99]

14 hours ago, CapitalCurve said:

RU-58841 5% PG + Ethanol. Was a little surprised he did not prescribe a topical fin solution (since I had only mentioned having tried the oral before) but this was his first recommendation 

Really surprised to hear a doctor prescribing RU-58841 which is not a licensed drug... have you queried him about that and what are his thoughts?

Having said that I know plenty of people have used RU with success. I have been using it for almost 2 months now and have experienced 0 side effects, not sure if it has done much but I will wait until the 6 months mark before deciding whether or not to ditch it.

[CapitalCurve]

Not much to report today, but wanted to drop this anecdote. Went to my normal Dr. today for a check-up and she took a look at the FUT incision just to check on it. She was shocked by how tight and clean the incision looked! Her exact words were "this guy is definitely an artist who cares about his craft"! 

[CapitalCurve]

8 hours ago, Ccd99 said:

Really surprised to hear a doctor prescribing RU-58841 which is not a licensed drug... have you queried him about that and what are his thoughts?

Having said that I know plenty of people have used RU with success. I have been using it for almost 2 months now and have experienced 0 side effects, not sure if it has done much but I will wait until the 6 months mark before deciding whether or not to ditch it.

Just to clarify. Dr Cooley did not "prescribe" RU, he just suggested I look into it as one of the potential options for myself. I don't want to give the impression that this is something he wrote a prescription for or said I needed to use, it was just something he suggested I look deeper into as a potential DHT blocker if oral finasteride was not well tolerated. 

[CapitalCurve]

Hi all. Healing is still going well! Have not experienced any issues. Will post some new pictures after washing off the scabs this week. Just received my official graft count from Dr. Cooley and it clocked in at 3354.

[CapitalCurve]

Hi all! Making a quick update here. I am planning to have my stitches removed tomorrow at 4 weeks post op after being out of the country for 2 weeks. I washed off the scabs around day 8 and this is how the area looked immediately after:

Since then, I have had major shedding of both transplanted and native hairs and this is how things are looking at 4 weeks post-op.

 

Hoping that the shedding will slow down and I will have some stabilization soon! Will keep everyone updated. 

[Al - Moderator]

Shedding sure does suck 🙁

It will get better though.

[CapitalCurve]

11 minutes ago, Al - Moderator said:

Shedding sure does suck 🙁

It will get better though.

Any risk of the shock lost native hairs not growing back as strong, since I was not on a dht blocker prior to surgery? I am planning to start one post-surgery but could this shock loss have pushed a few of those existing surrounding hairs over the edge already? Or should I expect them to grow back along with the transplanted hairs?