stockholmare

Hello I turned 4 months a few days ago. The right side is (as the first procedure) showing some signs of growth, although nothing major. The left side has almost no growt, I counted 3 hairs in the hairline and behind, which exactly what happened the first time. At this point I believe I am a bad responder to HT. There is no other explanations. Wishing all future Couto’s patient the best results (which IMO he really can deliver).

I am sure you will be satisfied. I probably am a bad responder to HT, but the doc is a very good professional (and man)

5mg Oral minox as instructed by the doc and finasteride

Hello All, not much to share at the moment. i am almost 4 months in and very few grafts have sprouted, mostly on the right side, while left is showing almost no signs of growth. I am posting pics later, but there will be no visible change vs the pre-op. I am trying to be confident that this time i will get a good result. To some of the comments: the doc did all the implantation himself, while extractions were performed by the same tech who di them in my first procedure, so not an apprentice for sure. I honestly felt very well taken care of and, as I said before, the Doc goes really above and beyond to to his job: I perceived he was not doing it for the money (he absolutely does not need it) but because he cares about his patients and his reputation above all else. I may not be happy after the second procedure and a bad respondent to HT in general, but in all honesty I would still recommend Dr. Couto to anyone who asks me: capable, trustworthy and integer professional.

thanks so much, I really hope so! The donor is looking better now and keeping my hair slightly longer helps concealing: if I went for a number 1-2 buzz cut scars would be quite visible, but I think that's normal and expected

The doc suggested I did a PRP the first time, when I asked him if that could have had an impact he said that it is unlikely given I did so after 1.5 months, but it is impossible to know because he did not perform it (I went to a clinic closer to home). I did do a PRP treatment 3 weeks prior to the surgery this time, suggested by the Doc as a "preparation session" that would have all the growth factors activated for the grafts to have higher survival chances.

Hello everyone, Sorry for the latency, I have been very busty with work and family. Today marks 10 weeks after my second procedure. Everything feels fine, I must say the pain and recovery time was way less vs the first procedure (number of grafts was also roughly 25%, so kind of expected). My temples/ hairline were the weak spots and at the moment I have not noticed any early growth/baby hair. Hopefully that will start soon, as I am now well into the 3rd month. keeping my fingers crossed 🤞 All the best

@BaldingEye@TorontoMan unfortunately I do not have pre second surgery pics that clearly show the situation: this is because I wore my hair forward in a way that would conceal the situation after my first procedure. Overall I am feeling well, trying not to think about it and waiting for the shedding and ugly duckling phase to start (saw several shafts today during the shower) I am slightly concerned as I still feel some pain in the recipient/donor, but I figure it it fairly normal at 3 weeks post op. Does anyone know if it is ok to go for (non-challenging) walks within the first 24/48 hours after surgery? I did so to increase blood circulation, but now I question my decision.

So here I am at 10 days post surgery. Scabs removed just now and normal life about to begin again ✌️ the surgery: As son as I arrived at the clinic The doctor assessed about 400 graft to fix my situation, which I was happy about. We ended up doing a bit more than that (460-470) but still very reasonable amount: the strategy was not to pack too much to avoid ultra blood-competition among implanted hairs and optimize for survival rather than perfect density. I bled a lot during the surgery, due to some dermatitis I have: this was not good and dr Couto told me that straight away: hopefully this will not affect my regrowth badly but it is not possible to tell. I must say I really felt taken care of, regardless: the doc had planned for a quick touch up of my hairline and corners, and because of the bleeding, we ended up implanting for about 3.5 hours: he did every single graft himself. He offered me a lift back to my hotel (legend) but I really had my accommodation just behind the corner 😂. We agreed I will probably need a final round in one year from now (100 grafts if everything grows back this time🤞). Now what: I will start oral minoxidil and some supplement (zinc, b complex, d, etc) tomorrow as indicated by the doc. I will start praying and hoping that this time my growth rate is in the 90% some questions for this community: is it normal to have some hair shafts come out with the scabs during the scab removal washing? is it normal to feel some pain (bruise-like pain) in the recipient area at this stage? Pics below the pre op, immediate post op, 7 days and 10 days (most recent pics are last).

Hello dear forum-friends, I am posting with my heart full of hope, as I will soon leave to Madrid to touch up my first (unsuccessful) procedure with dr Couto. I am now 13 months post-op, as the first surgery was carried out in Jan 2022. For reference, you can find that thread here So, tomorrow I will undergo another procedure, with him again to add the density that failed to stem from the first surgery. Backgroud: After the 2000 grafts procedure, according to the Dr, my body failed to provide enough blood supply to the transplanted units, thus delivering low yield: the doc will assess the exact yield and needed grafts for this second surgery once I’ll be at the clinic. In my personal opinion my yield was about 30-35% (I am unsure tbh), but I hope he will bring some of his magic and not to need too many grafts, because I would like to keep some for future needs, should there be. Looking forward: I decided to go again with dr. Couto because, despite the low growth of the first procedure he struck me as a very integer person and professional, who truly cares about his patients and their happiness, and whose skills are second to none. I will update this regularly for your reference. Attached is the 13 months post op situation that I hope dr. Couto will be able to fix🤞🤞 Wish me luck!😄

could you elaborate?

H thinks the main reason is that my blood vessels did not re-vascularise well enough to sustain the transplanted grafts. He will do a touch up with lower density, in order to allow for every graft to survive. He also suggested to do "activated PRP" 20-25 days before the HT, to prepare the tissues.

pics here

Hello All, some time has passed and I wanted to give an update about my case. Posting 2 pics taken a couple of weeks back (so roughly 9.5 months) and it is now clear that I will need a repair. No major aesthetic change vs 6.5 months. I would like to get opinions on what could have gone wrong, below some things that I am "suspicious of": I washed out the scabs with 2-3 days delay vs what suggested by the clinic I have always had some dandruff: the Dr was not concerned about it and I did not have any post-procedure infection, but I wander if that may have played a role I did a PRP session 1.5 months after the procedure: could an unexperienced nurse damage the grafts during a PRP session? I had a sense of slight pain when touching the recipient area well through month 4 - I thought it was normal but by reading around, it seems not the case. Please let me know what your opinions are and fee free to ask any question. Thanks By the way I would like to point out that the doctor is kind and professional and offered an afternoon session at the beginning of next year for me to be satisfied.

I am trying not to think about it, the Doctor also recommended to do so - it's not always that easy thou

a tech

a bit less than 2 years

thanks for posting this case and for your comments, Garmatik to your Q of why the doctor has already said I will probably need a "touch up": the way I got to "know him", he struck my as an ultra-perfectionist that takes huge pride at what he does. And when I say pride, this person lives of pride, literally: he needs no money, no fame, nothing. You should have seen him with his former patients, there were at last 7-8 of them in the clinic for check ups: he was taking me to each of them and showing me their progress like they all were his creatures. I really wish I could be one of those one day

Thanks for your comment Fue, I also thought that when posting, but the left pic is at 10 days post op, before removing the scabs:I think some grafts were actually "hidden" by the thick scab/skin layer I removed after taking the pic. If I compare the left pic with a post op one, the post op looks denser to me.

1. I do not have them, will ask 2. 38, fina since 10 years (zero side effect) and oral minox since 1 month post op (as prescribed by the clinic) 3. I am not sure, the doctor said we need to see how I heal before judging that - I feel I healed very well btw

Thanks Melvin, your support and experience is much appreciated. The doctor however said he is also disappointed by this result and explained a "touch up" could be needed. I am stuck with the question of why this below average likely result: Looking back: I did not loos a single graft I did do the PRP treatment a couple of week after the suggested date (6.5 weeks vs. 1 month post op) I not go to saunas or swimming pool for 6-8 weeks Did not smoke (ever) nor drank much alcohol for 3 months I did not change anything specific in my diet, just added some multivitamin and biotin I did wait 4 weeks before lifting weights and did not play contact sports So I cannot think of any other reasons than: a) high transection rate: would that be possible? a motorized punch was used b) the method (pen implanters) does not suit me c) I do not respond well to HT in general What are your thoughts, what else should I look at/think of?

thanks

I believe the multiple grafts in the HL may be a consequence that the very first line did not grow, thus making it look so (?) Regarding the reasons provided by the doctor, he said it could be "the dense packing" and the competition for blood among transplanted hair follicles: I do not think the packing was so dense, but I also started to take oral minoxidil after 4 weeks of the procedure, as per prescription from him

thanks Vann, this is very helpful - I'm reading those stories for sure!

you may be right, however I am not getting a much of a growth despite the grafts are spaced out