By Dr. Cole, FUE Hair Transplant Pioneer

Patient RPE started his hair restoration in the early nineties. These strip procedures increased density up top. The grafts were placed behind the hairline. As RPE continued to age, his hairline receded. Recession exposed the doll like, toothbrush bristle grafts. His result could have looked more natural and, unfortunately, forced RPE to style his hair in a combover or wear a cap to conceal the work. For decades RPE was hesitant to pursue another procedure.

Patient Information

  • Norwood Scale: Type 5
  • Number of Grafts: 4800
  • Procedure: FUE+Scalp Repair
Patient RPE

RPE began to take a more cautious approach. Knowing his donor area was limited and unsatisfied with the result, he started researching the top physicians. His goal was to add density and conceal his pluggy appearance. Finally, in 2011 patient RPE concluded that Dr. Cole was the man for the job. Still cautious, however, RPE elected to break his procedure into multiple procedures. A smaller session comforted him, knowing that he would not be butchered should the procedure not turn out as the results published online.

Having reviewed that, there are two ways to achieve a natural hairline. The first would require removing all the previous grafts. The latter would add density and hide the bad actors. Not wanting to revert to bald, RPE chose the latter—his initial procedure composed of 1,000 grafts. The result took 1 year to come in. The results were too good to be true. The recovery was far easier, and the result was beyond expectations. Patient RPE booked a second procedure to fill in the front and top the following year.

The before and after photos depict four procedures totaling 4,800 grafts focused on the front, top, and upper crown. The front and top are comprised entirely of grafts. RPE has returned for a touch-up procedure. His goal is to fill in the crown. His donor area is depleted, and he has elected to have a body hair test session comprised of beard. Should RPE start preventatives like topical finasteride, unavailable when he began his journey, he would be in far better shape today.

Crowns are uphill battles. Unlike grafts in the front that fall on top of each other like shingles on a roof, crown grafts grow 360 degrees. Thus to achieve an entire crown, you must replicate the same density you were born with. While this is not good news, it expresses the importance of regenerative medicine or medical therapy.

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