Before from the front

Before from the top

Day after surgery from the top

Day after surgery from the side

Background.  I’m 47 years old and until Thursday, May 18, 2006, was pretty bare on top and had been for the past 10 years.  I started losing my hair in my late teens, with significant thinning by the time I finished college, gradually leading to what you see in my “before” picture.  I started evaluating hair transplants when I was about 25 years old, but never was convinced that I was going to get the kind of results with which I would be satisfied.  I was really encouraged about minoxidil when it was approved by the FDA, and have used it sporadically over the years with very limited results – mostly fuzz and that doesn’t count.  Until now, I never tried propecia.  By the time I was 38-40, I had resigned myself to living with almost no hair on top.  I was relatively self-conscious in my twenties, but as I got older, my baldness actually became a part of my personality, and I figured out that no one was really bothered by it but me.  In more recent years, I started buzzing my hair down with a #3 or #4 guard, and it actually didn’t look so bad to me as long as I kept it short.  I never have tried to camouflage it with a comb-over, or wearing caps all the time, nor have I ever seriously considered an artificial hair replacement system, but I can understand why anyone who has would do so.

Despite my lack of desperation, I have followed over time the achievements and advances that have been made in dealing with hair loss.  It’s amazing how much information is available on the internet, and I read lots about drug therapies, shampoos and lotions, and personal regimens and recipes.  I was struck most by the trend in follicular unit transplantation, and figured this was as close as things were going to get for the foreseeable future.  I started seriously considering a transplant in late 2005.  Once I decided to pursue this course, I started looking around for a good doctor, and found lots of valuable advice on this website.  Ultimately I was drawn to Dr. Jerry Cooley, who practices in Charlotte, North Carolina.  I found a lot of positive information on the web about his practice and approach, but I have to admit that I was most intrigued by the fact that despite his full head of hair now, he experienced baldness at an early age just as I had.  I sensed his devotion to his craft by reading about his research interests.  I first corresponded with his office about 3 years ago but, for no particular reason, never got around to following through by scheduling a consultation.  I finally scheduled a consult on May 10, 2006. 

The Consult.  I was met by Ailene Russell, Dr. Cooley’s trusted assistant and resident den mother, who in her years of working alongside Dr. Cooley, competently answered every question I raised.  Ailene and I talked for about half an hour, and then she introduced me to Dr. Cooley. Because I had done a lot of research on the web and Ailene had addressed most of my remaining procedural curiosities, Dr. Cooley mainly examined me, talked about my goals, confirmed everything Ailene had already shared (Ailene really knows her stuff), and gave me enough assurance to seal the deal.  From the outset, the consultation was relaxed, comfortable and very congenial.  There was never a time that I regarded any of the conversation as a marketing pitch – everything centered on education, solutions and expectations.  I sensed a great deal of empathy from both Dr. Cooley and Ailene – they genuinely wanted to address my concerns and help me identify and develop a plan to achieve my goals.  I never felt rushed at all.

The single concern I had going into the consult was that my new hairline result in one that was age appropriate.  I’ve seen cheesy transplants, and I sure as heck didn’t want one.  I took pictures with me that I had downloaded from the internet that showed a hairline I thought would best suit me at my age.  Basically I wanted moderate density in the middle, with a relatively high hairline at the temples and no concentration on the crown, so that the limited donor hair I had available would provide a decent hairline that looked like a 40-something guy experiencing thinning, not a 40 year old trying to look like an 16 year old.  Dr. Cooley sketched out the hairline on my scalp, took some measurements, and ultimately suggested 2200 to 2500 grafts.  I chose 2500 (just for the record, Aileen had estimated 2200).  It’s important to note a couple of commitments Dr. Cooley made to me.  One is that this single procedure would stand on its own – I wouldn’t have to commit to future procedures.  I could elect to have more, but they wouldn’t be required unless I changed my goals.  The other, and more important, he assured me that whatever we agreed on, the result would look natural.

There was no pressure by either Dr. Cooley or Ailene, nor were there any questions left unanswered.  By the time the consult ended, I knew I had chosen the right surgeon and practice, and for the first time in twenty years, I felt excited about what was to come. I left there thinking that, as much as I had credited myself with being well-adjusted to my hair loss, one of the principal deterrents to my ever having done anything about it was apprehension about confronting it head-on (there’s the pun) and then actually talking about it, particularly with a physician.  I think I’ve always been apprehensive about what the doctor would think when I discussed my hair loss.  In this case however, I suspected that because Dr. Cooley had been through the procedure himself, that he’d at least understand that apprehension.  He and Ailene were remarkably supportive, and I quickly felt comfortable talking about a subject I had for many years avoided talking about with anyone else.  I left that day wondering why in the world I hadn’t talked with them long before now.

The Procedure.  As luck would have it, Dr. Cooley’s schedule had an appointment cancellation and they offered me that slot.  About a week after the consult, I headed to Charlotte from my home in Columbia, SC, spent the night before the surgery in a hotel just a stone’s throw from Dr. Cooley’s office, and arrived at 7:00 AM to find Dr. Cooley and Amy (who I learned is Ailene’s daughter) busily taking care of details and getting the surgical room ready for my procedure.  The room was prepared impeccably and was outfitted with all of the equipment, special microscopes, and other things you would expect to see for this specialized procedure.

Dr. Cooley took pictures, reviewed the sketches on which we had agreed previously, drew the guidelines on my scalp, and shortly thereafter we were ready to go.  I had worn comfortable clothes as Ailene suggested – a button-up shirt, long athletic pants and tennis shoes – ready to settle in for the long haul.  Shortly after, I changed my shirt for a surgical gown, and Dr. Cooley told me to kick off my shoes, which set the tone for the rest of the day – I was completely comfortable from that point forward.  They did things like take my vital signs and Dr. Cooley spent a few minutes taking measurements for his research – he explained he’s always conducting some kind of research – and not long after finishing these preliminaries, I got into the chair for my surgery.

Dr. Cooley gave me a dose of oral valium and an antibiotic.  I lay face down in the chair, received an injection of another drug for comfort and relaxation, and shortly thereafter, I felt the first stings of the anesthetic injections in the donor area – not much pain at all – a pinch and slight burn – and very short in duration.  Then, I felt him moving hair around, heard the buzz of the razor, and then felt hair moving around again.  Oddly, I never even knew when he actually made the incisions or lifted out the donor strip.  I was still waiting to feel the slide of the knife when he told me to turn over.  I couldn’t believe that part was already done.  Believe it or not, I was awake the whole time (or at least I’m pretty certain I was), I didn’t feel anything but hair shuffling around on the back of my head, and the whole process didn’t take long at all.

He then started to inject anesthetic into the recipient area – similar stinging or pinching but no real pain, and then shortly thereafter, the top of my head felt like it was covered with a tight-fitting thick rubber helmet.  You could have hit me in the head with a hammer and I think it would have bounced off.  He took a lot of time preparing the donor sites, and meanwhile I eavesdropped on the conversations behind me where five very pretty southern ladies (Ailene of course, Brandi, Amy, Lissa and Angie) were preparing the grafts.  I never got interested in watching a movie or listening to music.  The conversation in the room was much too captivating and entertaining, and I jumped in whenever I had a question or something to offer (probably strongly influenced by the valium).  I had a great time talking, laughing and joking with Dr. Cooley and the ladies, who peppered him with more than a few affectionate jabs about his little idiosyncrasies.  At some point I heard him quietly mutter something about having to occasionally remind them who the boss is, cautiously out of earshot of the ladies – I think so as not to start a feud or a contest.  I have the impression that there’s no mistaking who the boss is, but this is clearly a team that works well together, and the atmosphere is dynamic and communication is open.  All of them treat and refer to each other as family, including Dr. Cooley and, surprisingly, the patient.  No one’s afraid to speak up, and the entire effort is cooperative and completely focused on the patient.  Dr. Cooley clearly respects his people for the professionals they are, and they in turn are clearly devoted to him and an exceptional outcome for the patient. While the atmosphere was very relaxed and jovial, they stayed on task and there was no question but that they took the work very seriously.  I also learned at some point that not only does Dr. Cooley frequently attend and lecture in professional conferences, his assistants also attend and participate – and since many of those conferences are international, they are quite an investment in his staff that I’m sure adds value to his practice and results in additional benefits for his patients.

After Dr. Cooley prepared the recipient site, Brandi (another of Ailene’s lovely daughters) came over and assisted Dr. Cooley in placing the grafts.  The two of them worked on me together the rest of the day and they make a great team, although Brandi had to admonish Dr. Cooley to stay on his own side (and to keep his spray bottle under control).  Maybe it was the drugs, but from that point forward, I had a constant, perhaps silly, grin that didn’t go away until I left.  Everyone in the room worked carefully but furiously, despite the light and congenial atmosphere.  Sometime after 11:00 AM, one of the ladies announced that she was starving, which started a chain reaction.  While everyone agreed that it was time to order lunch, there was not as much agreement on what was to be ordered.  At some point agreement was reached, we ordered and it was delivered.  I took Dr. Cooley’s recommendation for this chicken fiesta Greek thing with a great tsaziki sauce – quite tasty – the man knows good food.  I’m relatively certain that Dr. Cooley picked up the tab for all of us.

After lunch Dr. Cooley gave me more valium and antibiotics, and everyone went back to work.  I dozed a couple of times in the afternoon, and snored – Brandi said that’s a good thing – she knew I wasn’t in pain.  Sometime late in the afternoon, I started to feel a little discomfort in the donor area (you lay on the closed donor incision as they are placing the grafts) and I started to get restless from the discomfort.  I had a little more local anesthetic and the remainder of the day was a breeze.  Very late in the afternoon, I heard one of the ladies say “yay”, which I took as a signal that finally they had finished splitting the hairs.  Not long after, the staff started trickling out to go home to their families and take care of their duties there.  Both Amy and Brandi stayed way past their appointed time, and Ailene always stays much later as does Dr. Cooley.  These are tremendously devoted people.  Dr. Cooley finished up with me after 7:00 PM, which meant that he had been there more than 12 hours, and still had cleaning up to do.  I looked around the room when he finished, and saw what a huge production this all had been.  It was amazing how many supplies and how much effort had gone into my surgery.

It was a good day.

Post Op.  I went back to the hotel and slept pretty well the night of surgery.  I took the valium and slept without pain.  I showered carefully and returned the next morning for Dr. Cooley to check everything.  He took some more photographs, zapped a couple of spots on my face he noticed during surgery, and then wrote me a prescription for propecia.  One of the things he said as I left struck me – he described my transplant as a joint investment – he, his staff and I all had a vested interest in my good outcome.  I think it’s this principle that creates the foundation for the true value and distinction of his practice.  I made some very good friends that Thursday.  I was sad as I left the office.

I checked out of the hotel, left Charlotte right after, drove myself and arrived home in Columbia about mid-day on Friday.  That day, I lounged around, answered e-mails from work, and returned some telephone calls.  I slept in a recliner the first two nights at home and followed all of my instructions.  No pain at all on Friday.  Friday night, the donor site started itching.  I took a shower, carefully washed my hair, then applied the anti-itch foam Dr. Cooley gave me in my take-home care package.  The itching stopped shortly thereafter.  Saturday (2^nd day post op) I woke up, worked on stuff I brought home from the office, and took a couple of naps during the day.  No swelling, no complications, no pain, slight itching in just two places in the donor area, which was abated by more of the foam.  Saturday night I felt fine.  Still no swelling, no noticeable scabbing.  Sunday morning (3^rd day post op) I was close to 100%.  No itching, no swelling, no pain.  Redness started fading.  If there were any scabs on the recipient area, I couldn’t see them.  I applied Dr. Cooley’s secret formula green spray religiously.  I scheduled vacation time from work for the next week, but as a practical matter I’m sure I could have easily returned to work on Monday following surgery on Thursday.

Random Thoughts.  I went to the consultation thinking this was such a personal, private matter.  I actually discussed this with Ailene and Dr. Cooley, who understood and said my sentiment was pretty common.  Now that I’ve been through the surgery, and since I had such a great surgeon and overall positive experience, I’ve changed my mind about that, for a couple of reasons.  This experience has already made a personal difference for me.  I can see the possibilities from the very short little hairs on my head where I used to see shiny skin.  After more than 20 years, already I don’t dread looking in the mirror from the eyebrows up – now mostly because I’m curious about these little hairs, but over the long term I’m sure it will be because I’m better satisfied with my overall appearance.

The other, most important thing is to give Dr. Cooley his due credit and recognition.  He is genuinely a good man.  He’s a master technician, a skilled craftsman, an artist and all the things that are critical to a successful outcome from the procedure.  More than that though, he has the best bedside manner of any physician with whom I’ve come in contact in my adult years.  He is passionate about his work, and he truly understands the complex, very personal issues that attend hair loss.  That sensitivity surely must distinguish him from many of his peers.  He clearly cares about his staff (and they are completely devoted to him), and I think that promotes collective personal investment and pride in the outcomes for each of the surgical procedures they perform together.

I advise anyone who is sitting on the fence about a transplant to schedule a consultation with Dr. Cooley.  If you live in the Carolinas or their contiguous states, it’s an easy drive by interstate to his office.  If not, Charlotte has a wonderful airport just a few minutes away that literally connects to the world.  I’m really glad I made this decision, and am so fortunate that I happened upon the talents of the great Dr. Cooley.  I am his devoted fan, I highly recommend him, and am happy to share any additional details of my personal experience with anyone else who might be considering his special skills and services.

A Note About Cost.  Although I’m happy to discuss any aspect of my experience, the one topic I’d rather not discuss is the cost of my procedure.  I think that’s a personal matter for the patient and a business matter for Dr. Cooley.  I will say that the cost of my procedure was entirely in line with pricing I saw disclosed elsewhere on the internet.  For what it’s worth, early on I decided that I was not going to quibble over a few dollars here or there, particularly at the risk of potentially getting less than my money’s worth.  I’m a firm believer in receiving good value for good money.  Botched up transplants abound as evidenced by any number of before and after photographs on any number of internet sites, and correcting unsatisfactory outcomes can only result in wasted money and precious donor hair.  I realized early on that I had limited financial and donor resources and could not afford to waste either.  I am absolutely confident that both of those risks have been significantly mitigated by choosing Dr. Cooley.

Other Entries:

May 18, 2006 - The Big Day | May 25, 2006 - Week 1 | Jun 6, 2006 - Week 2 | Jun 16, 2006 - Week 4 | Jul 10, 2006 - Week 7 | Jul 22, 2006 - Week 9 | Aug 8, 2006 - Week 11 | Aug 16, 2006 - Week 13 | Aug 29, 2006 - Week 15 | Oct 1, 2006 - Week 19 | Oct 22, 2006 - Week 22 | Jul 31, 2008 - 50th Birthday | Profile page