HAIR TRANSPLANT FORUM

Dr. Cole Hair Transplant Group team members are nice and you will have a pleasant experience for the most part. Now for the bad part....if you are an African American seeking a Hair transplant I would not recommend Dr. Cole for the procedure. I have had two transplants with Dr. Cole and they were not very successful. After the first transplant Dr. Cole informed me that if the procedure didn't take well, then he would do the next procedure for free. I felt good about that but then when it was time for the next procedure a little amnesia kicked in. I was not satisfied with that. I ended up having to pay full price again. Dr. Cole does good on caucasian hair but on African American hair it is a different story. Some of my donor hair ended up getting messed up also by Dr. Cole. It is best to find a surgeon who is a specialist in African American hair because curly hair is harder to do using the FUE method.

I assume your transection rate was very high? Dr. Cole had similar concerns in my case, but not the degree where he felt the transplant would be a failure (depending on your definition of such). The growth I had was decent, but given that concern, I might go another route the next time around. I had a consultation with a doctor here in Redondo Beach CA, and I was very impressed. I might go with him, but I might return to Dr. Cole, not sure yet.

btw, I'm not African-American, but my hair is somewhat wavy, and was curly as a small child. I'm not certain, but maybe curly hair follicles are more challenging to extract?

There are several ways to do a hair transplant on an African American. One is to do a strip procedure. I've not done one of these on an African American patient in since 2003. When we initially began offering FUE, in 2002 we began to see some African American patients. The initial procedures were fairly straight forward and simple. Then we saw a few with higher transection rates or follicle injury rates. As a result we began to insist on a test procedure with African American patients to insure that these individuals were good candidates for FUE. A test consisted of up to 100 grafts. If the test goes well, meaning the transection rate is quite low, we might do more at the time of this procedure.

In other words, your story does not match what we do. Furthermore, there is no such thing as a specialist who does FUE on African American patients. If there were such a physician who has excellent results in FUE with African American patients, then I would be the first person to suggest you see that person for a hair transplant.

The degree and amount of curl in an African American patient is highly variable. Sometimes it takes a great deal of time to do a hair transplant on an African American patient. Because of the difficulties in extracting grafts in African American patients, we NEVER guarantee growth to these individuals. Again, your story does not match the way I practice medicine.

Curly hair can exhibit large degrees of splay. It is not like African American patients in any other way. Curly hair can be challenging to extract, but not really all that difficult if you have the means and tools to adjust to the challenges. No physician has documented their transection rates as much as I have over the years. No physician who offers FUE has as many options available to adjust to the difficulties you might see with FUE. No physician has ever reported a transection rate average that is lower than mine.

Many African American patients who have had strip procedures, desire to perform work that conceals their strip scars. Other African American patients simply want to avoid a strip procedure. In general my growth is very good in all patients including African American patients. On rare occasions growth may not meet expectations of either the physician or the doctor. This is why we NEVER guarantee growth. Only God can guarantee anything with regard to a medical procedure. There are many reasons for poor growth. One is prior poor work that leaves the scalp very scarred. In such situations, I always tell patients in advance that the grafts may not grow. Another reason for poor growth is a prior history of a transplant that had poor growth. Another reason is someone who wears a hair piece following a procedure. I've had only a very few patients who had poor growth without prior scarring, prior poor hair transplant results, or someone who wore a hair piece. In these instances, the patients almost always have some sort of underlying skin disorder that prohibits growth of grafts. In other words, some medical conditions can prohibit graft growth.

Some physicians transect follicles on purpose because you can get growth from transected follicles. Sometimes you can get two hairs to grow from one trisected follicle. I've never done this simply because the yield will be less when you transect follicles even though some of the hair will grow. Thus, when we transect a follicle by accident, we always transplant it and up to 60% of them grow. Still, the growth will be better from an intact follicle so this is why I work very hard to keep my transection rate under 3%.

If someone has growth that does not meet their expectations, we encourage them to come back so we can determine the cause.

I also know of a physician in Redondo Beach. I do quite a bit of hair line refinement for his patients and some corrective work on his patients. He has a very poor aesthetic sense in my opinion.

When I have a patient who complains about growth, I evaluate them. The first thing I do is compare his before photos to what i see at the time of follow up. If the growth is good, but the patient does not see the result, then I show them their before and after photos. This usually puts the patient at ease. It is funny that many patients do not recall what they looked like before a transplant because the growth comes in so slow that no one notices including the patient. Only when they happen to see a photograph of themselves before the transplant, do some patients suddenly realize just how much hair loss they used to have.

As stated, rarely all physicians have poor growth in virgin cases where you can't explain it. In all cases of poor growth that I can't explain, I recommend either a very small test procedure to evaluate growth or a scalp biopsy to look for some sort of underlying skin disease. What I never do in a case of poor growth is a larger procedure because if a procedure had poor growth once, the last thing I want to do is another large procedure without knowing why the growth was poor. Many patients do not want to do a scalp biopsy because it involves removing some hair in the biopsy. For this reason, they often want to do the small test procedure that is almost always free. Scalp skin conditions will often burn out and you can safely go on to transplant them, but you don't want to do this until the condition has resolved. Unfortunately, scalp conditions can resume later on in life and that can affect the grafts. Fortunately, scalp skin conditions are quite rare.

Of course with body hair, you cannot predict yields. These can be quite poor so one should always do a test procedure first.

The only reason I would ever charge a patient full price following a transplant would be if the growth was good in the first transplant. Just because you are not happy with a great result is not a reason to expect free work the next procedure. There is nothing about this posting that suggests you are one of my patients. Furthermore, I cannot recall an African American patient complain about growth to me in a decade. That is because I know what I'm doing when I treat African Americans and I know how to consult with them prior to surgery. What I never do is tell an African American that i guarantee the results.

Knowing how to treat an African American means knowing what to do and what not to do. For instance, I had an African American recently who had three prior procedures with me. I knew his donor area was getting low. Therefore, when he consulted me for more hair and wanted to add over 1000 more grafts, I told him that I would not do a procedure that large on him because it was not wise to do a procedure that large given that he'd had so much taken already. He then said he would just go somewhere else to get the work done. Perhaps he did and perhaps he is happy, but it was not a risk I was willing to take because he is still a young man with many more years of hair loss. He needed to proceed more cautiously at this point to insure that he did not over harvest his donor area at a young age or put grafts in an area that was not wise at this point in his life given his limited donor supply and potential for future loss.

Rambo , Although we are trying to keep this forum open and free to all comments and opinions one have to remember that it is a doctor's forum and anyone can easily write false comments here.
I am not saying that you guys do that but just to be sure, Your story does not match what we do in the office or how we treat african american patients or patients with curly hair.
Also i couldn't find your names and emails that you registered on this forum on our patient database.
Thus, i suggest that you submit photos in this thread or identify yourselves by sending me a PM (private message) with the emails and/or names that you used to contact our office,
If not we will unfortunately need to delete his posting.

Thank you.

My own interpretation of this was perhaps the waviness of my hair had presented a bit of a challenge. Dr. Cole never said anything or suggested the transection rate could be higher than usual as a result. I simply caught Rambo's post on Facebook and replied to it - NOT because I'm dissatisfied, but was merely speculating on his case, and nothing more.

I had a lower number of grafts (about 1100), and I do not know for certain how many grew and how many did not. That said, I'm a satisfied client of Dr. Cole's, as his work is undetectable, aesthetically pleasing and I basically received the coverage that I believed was possible with 1100 grafts - again, I have no real way of measuring this, but as stated, I would definitely consider returning for more work. In fact, whenever the topic arises, I proudly inform others that Dr. John Cole in Atlanta performed my transplant.

I'm curious to know, how does my story - if you can call it that - not match what you do in your office?

I just sent a PM

Thanks Rambo, Disregard my previous comment, i was just checking because anybody can come here and post. i just wanted to make sure and i think it's more appropriate to know how you are so we can respond accordantly.
Creds1, this was a copy paste mistake...disregard it too.

Creds1, curly hair can be a real challenge. That's why I've come up with a number of solutions on how to handle it. When cases are difficult, the objective should be on quality grafts. This often means that you must work very slow to get high quality grafts. I've not found it necessary to do test procedures on people with curly hair, however.

With African Americans, I always do a test procedure because the extractions can be quite difficult and the follicle transection rate can be quite high. Then again, the follicle transection rate can be quite low. Because you cannot predict the outcome in African Americans, I always recommend a test procedure first. Because one cannot predict the outcome, one never guarantees a result to African Americans.

Rambo, we have reviewed your photos. I saw you before and after photo on our system and was very surprised to see excellent growth for such a small amount of grafts!. In fact you had so little hair loss that we did only 340 total grafts for you on your hairline that consisted mostly of single hair grafts. You wanted more surgery from us, but we refused to offer surgery you did not need. We would be happy to post your photos showing how little hair loss you had and how good your response was to the first 200 grafts. Of course, we need your permission to do this.

This is a forum for patient information. It is not a place for patients with excellent results to post false and malicious content simply because we refuse to do surgery that they do not need. We value you as a patient, but we cannot allow you to simply post false content.

forhair wrote:Rambo, we have reviewed your photos. I saw you before and after photo on our system and was very surprised to see excellent growth for such a small amount of grafts!. In fact you had so little hair loss that we did only 340 total grafts for you on your hairline that consisted mostly of single hair grafts. You wanted more surgery from us, but we refused to offer surgery you did not need. We would be happy to post your photos showing how little hair loss you had and how good your response was to the first 200 grafts. Of course, we need your permission to do this.

This is a forum for patient information. It is not a place for patients with excellent results to post false and malicious content simply because we refuse to do surgery that they do not need. We value you as a patient, but we cannot allow you to simply post false content.

I saw my photos and it does look like I had some growth. I guess Dr. Cole didn't want to pack in much density because I could lose more hair. Dr. Cole wanted to perserve my donor hair for more operations if I needed them.

Show us some pics...