duchaine

FOR THE RECORD: Ferreira saved me.
I sent my pics and the dermoscopic images to Ferreira while I was in Ankara.
He was kind enough to reply to my email and gave me a diagnosis for free!!!!
He said that my donor was ok, I have short but healthy grafts (while pekiner said that I had retrograde alopecia) so he said that I had no problem to get an HT.
In any case, he said to wait some months to go to Lisbon, because I was shaved and he was not able to give me the best hairline design with a shaved head.

 

3 minutes ago, eze said:

You dont need a pic to see what I mean, one side is like 3mm lower than the other lol

face is not perfectly symmetrical.
Sometimes a little asymmetry makes the look more natural.
In any case, if your hair are not on your frontalis muscle, I would lower the other side.

3000

9 hours ago, UAEtoBrussels said:

"Hello everyone, I recently underwent three PRP treatments over the last three months, but instead of experiencing hair regrowth, I'm facing increased hair loss. Two years ago, I had a hair transplant performed by Bisanga. I'm currently using Finasteride, Minoxidil, and Saw Palmetto as part of my regimen. Has anyone else encountered this issue, especially after a hair transplant, and if so, could you please share your experiences and any advice on how to address it? Is it reversible? Or am I screwed?

 

I'd greatly appreciate any insights or recommendations as it's killing me. 

 

Thanks!

It happens. Sometimes it is just a telone effluvium. There is not way to stop it. Just wait.

can you take better pic?
At least, one from the same angles of the pre op pic

On 10/4/2023 at 10:07 PM, Youth_Again said:

I would either take the FUT or a full refund. 

50% refund is a joke IMO

I agree.

50% of the result is not equale to 50% of the price.
If you give me a car with 2 wheels, it is a completely useless car, not a car that I can use at 50%.
A bad tranpalnt, where you get 50% growth is a disaster. You go from bold to odd.

I had my first contact with @Dr. Espinosa Custodio.
He is amazing. I can say that it is the best online consultation I've ever had.
Hope he will take me as his patient.

1 hour ago, mister_25 said:

Why wasn't he able to determine that you were not a suitable candidate before harvesting?

And why throw away a small 200 grafts? Why not just implant and call it like that?

If other doctors were to find you as a potential candidate for their clinic, you would be 200 grafts down for literally no reason.

@EvansLawrence
He said that he could implant that FU, but the result would be "no growth".
I am not the only case in 2019/2020.
There is another guy from china that had the same experience.
I think that from then, he is asking more exams to avoid this issue.

PS: in any case, he was wrong. I got my HT 5 days later at HLC (they were kind enough to get me there in a such short period of time) at the result was great.

 

58 minutes ago, EvansLawrence said:

oh damn. Did he at least implant those 200 grafts?

no, throw my grafts into the toilet.

To be honest, I do not like the HL design.
 There are some anatomical rules for the hairline. 
The frontal temporal angle lies and remains on the lateral epicanthal line.
In your case, it doesn't happen. Hope that you will cover this mistake with a long hair cut.

who said that Bicer and Yaman are the best 2 in turkey??

7 hours ago, EvansLawrence said:

well in that case HLC did a very good job with u considering u had a previous one.

I dont mind giving them credit if they do the job right hehe. Both Couto and Pinto will make a great work on you. If u are in Spain also Cotellessa y Awada clinic or Zira in Valencia they work veeeery good

No, I didn't have an HT before HLC. I had a bad experience with pekiner that shaved me, extracted 200 Uf and then aborted the HT because said that I wasn't a good candidate.
With his words in mind, I decided to be conservative.

I live in Italy so Spain is close. Never heard of Colelessa and Zira. thanks for the input.

1 hour ago, EvansLawrence said:

Ok¡ I remember seing your case yes. 

Looks good! happy for you. 

Very conservative for my personal taste and yes small area for 2'1 k IMO but at least good survival. I think yours is a good result!

Yes I can see you definitely took good care of your hair cause there are areas that were untouched by the transplant that look thicker and fuller now. 

But are u happy? you can always lower the hairline or close the temples if you want. 

Couto does it the best imo but also Dr. Bruno Pinto in Portugal does great work. Plus has a cheaper price and a shorter waiting list

 

I am thinking to Custodio, but I live bruno pinto too.

The first time I was very conservative because I was really scared from my previous experience.

4 hours ago, EvansLawrence said:

btw can I see your case somewhere?

as you can see, I treated only the frontline but my quality improved all over my scalp

I could subscribe your review and make it mine.
They didn't "damage" me but, considering the number of grafts they used, the result is a little bit disappointing.
at 6 months I looked great but I looked great because I spent the whole "pandemic" period taking care of my hair, so the density and. the thickness improved all over my scalp.

tipically, you should stop it 4-5 days before surgery, to avoid excessive bleeding.
When the grafts are fixed (typically 48 hours) you can use it again. Some docs suggest to wait longer. I waited 10 days.

On 10/15/2023 at 12:46 AM, mxnprettynice said:

@Calihome1 I hadn't realized the graft count was only 1500, it seemed denser. I had a transplant with Dr. Turan and received 2400 grafts for a smaller area. In Turkey they typically aim for high density though.

some thing for me.
I got an HT at HLC, smaller area for 2000 FU.
 

9 hours ago, BLE123 said:

Hi guys, not been on here for a while but just wanted to share something that I found helped by hair so may be of benefit to others.

So my hair situation isn't too bad, I'm early 30s and about an NW2-2.5. About a year ago however I noticed a pretty drastic decrease in the overall health and quality of my hair. Over the course of a few months my hair went from looking just fine, albeit slightly receded, to now looking really quite bad. My hair was weak, thin, dry etc and especially the sides of my head were looking extremely sparse. I almost looked like I'd had an overharvested FUE despite never having a transplant. I also remember when I shaved the sides short, my scalp had scaly red marks and it frankly just looked flat out awful.

I remember looking online and everything just seemed to point to good old MBP but my situation just didn't seem to fit with everything I was seeing. I came across a post on reddit where a guy said taking vitamin D helped him so I thought I may as well give it a try. Although I've never had my levels tested, I live in the UK so it wouldn't be much of a surprise if they were a little low.

So I bought a year's supply of Vitamin D(4000 IU). I didn't expect much but at one month in I already noticed an improvement, my hair was looking a little better and I already started to worry less about it. Two months in and my hair was noticeably thicker and healthier, my hair no longer felt dry and lifeless. By three months my hair was probably back to 95% of how it was beforehand and in the months that followed my hair has stabilised and remained thick and healthy.

Obviously this will only help if you have a vitamin D deficiency and isn't a cure for MPB but if you've noticed a steep decline in the overall quality of your hair then maybe it's something worth trying. The Vitamin D I bought has Vitamin K2 combined with it as Google told me you need to pair the two together or something. I also started taking a generic multivitamin at the same time but I'm pretty sure it's the Vitamin D that did all the work.

Anyway, I hope that helps someone.

Maybe you just had a telegen effluvium and was recovering from it when you started to take vitamin d.

On 9/26/2023 at 8:44 AM, baddecisions said:

I don't agree. I'm new to this forum, but I have been around other "regional" ones for years and the few existing patient reviews from Custodio's cases are not very positive: lack of naturality and doubles and triples where they should not be. In addition, it seems that there is poor communication among his team since, according to one patient's review in the Spanish forum, a patient was prescribed ketokonazol 2 days after the procedure "by mistake" and it was the forum users who prevented him from using it and made the patient ask the clinic again, then they just said "oops, a mistake". The case is still accessible for those who can read Spanish. 

Finally, at least two of his cases have been repaired by a famous dr in Madrid specialised in repairs, as can be seen in his videos.

I can't see double and triples in all the pics I saw but I agree in part with you about the "naturally". I can't see a good transition zone/sentinelle hairs. the hairline starts thick and dense.

In any case, I trust @Melvin- Admin and I am sure he checked on the other forums to see "real life"results.
 

On 10/31/2023 at 8:57 PM, consequence said:

•  

Thanks for sharing your perspective. In how many injections does Dr. Couto usually give the PRP? Does he do microneedling at the same time? 

Couto varies a bit with whom he recommends PRP depending on their medical history. For 2nd surgeries like yours it seems he really seems to favor it, possibly because scar tissue can impede blood supply and cause caliber/thickness issues. 

I spent a good amount of time comparing his cases between here and recuperar, and it seems in general his patients that get PRP have slightly better outcomes than those that don't. A limit of this comparison was that sometimes people may just forget to mention that they got it. Not the most "scientific review" but it subjectively felt like there was a consistent effect.

The patients that got it usually did so with Couto himself at his clinic, which means they were more often Spanish and had thicker darker hair to begin with. His older cases (like before ~2018) don't ever seem to mention PRP, so I think maybe his clinic started offering it around 2020. There were only one or two cases of his that I could find where an international patient was getting it with a local MD instead of going back to Couto.

The reason the specific clinic giving the PRP is important is there are a lot of protocol variations because there are no "best practices" for hair growth yet. For example, one of the things Dr. Couto emphasized to me was that his machine employed a very gradual increase in the blood centrifuge rate over time, not an abrupt increase to maximum speed all at once. The clinics near me don't have the same PRP equipment and their devices seemed to abruptly accelerate to maximum speed, though I'm going to ask to observe the centrifuge next time I go in.

I would imagine the more gradual incease in spin rate causes less physical trauma to the blood sample, and presumably less blood sample activation/inflammation. If trauma makes cells burst, for example, they're going to release all sorts of inflammatory debris. The infamous "shock loss" or telogen effluvium. So when you say "It can't hurt." part of me says, "Can we really say that?" 😇

The question clinical trials would answer is whether, in the post-surgical setting:

1. PRP's growth factors rescue and strengthen borderline follicles or
2. Its inflammatory component (ie. physical trauma, incomplete effectiveness of white blood cell removal by centrifuge, etc.) inhibits growth and damages follicles.

My guess is when done correctly it is the former, even after surgery. The only time I think it is definitely pointless to get it is at the time of surgery itself, because the actual operation is a several-fold more potent version of endogenous PRP than plasma injections ever could be, so it would be redundant.

There are other variables as well. If the clinic uses single needles with evenly spaced injections or numerous mini-injections, the distribution and depth of trauma would vary. Usually the depth of the roller needles is supposed to be too superficial to directly contact the root, which may not be the case with needle injections. On the other hand, some inflammation is needed for growth (which is the reason microneedling is theorized to work). Some places also use Acell or stem cells to augment the PRP, though there's really no evidence either of these have an effect. There's no evidence they don't work either, but that's a slippery slope of a thought process. 

Also, in the US, PRP is usually offered at private practice beauty clinics, either in surgical or dermatological type settings. From what I've seen, usually the supervising physician farms out their actual injection work for these to their NP or PA. This can make it near impossible to discuss theory or protocol modifications directly with the MD (ie. to make them closer to those of FUExpert). And even if you can talk with them, they're unlikely to know as much about hair as Dr. Couto. My hunch is they're usually just following the directions that came with the PRP kit. These are are unlikely to be as well thought out as what they're doing at FUExpert, and may be more designed for facial PRP (about which there is more research, but skin is very different than hair).

At the end of the day, I'm leaning strongly towards getting a few rounds because my follicle survival percentage seems decent but the caliber is low. I think I could go back to Couto, but I'm hesitant to take a 22-hour round trip flight to Spain every 3-6 months. My neurosis wonders if the stress of the flight would increase the WBCs in the PRP sample. 🙃 Also it's a lot of effort for something that could potentially not even matter. Who knows though, maybe. I'll send a message to the clinic and take it from there. 

 

The nflamatory component of PRP and its effects on hair growth (ie: does it stimulate hair growth or does it increase hair loss?)  appears to be a very interesting topic.
The question is  similar for muscle growth and protein synthesis in general.
inflammation are crucial for protein syntesis but are catabolic as well. So, should we avoid inflammation?
As some researches pointed out, age should play a crucial.
For older people, that have high inflammation naturally, reducing inflammation increases protein synthesis while the opposite is true for younger people, that have low inflammations.
I'm not aware of researches comparing the effects of PRP on young and old people but I would not be surprised if they are totally different.

10 hours ago, mxnprettynice said:

I use a 1.5mm needle for microneedling once a week. Immediately after microneedling, I will spray minoxidil and then wear a hat because of a study suggesting that most of the minoxidil evaporates from the skin before it can be absorbed topically.

don'y you think it will be absorbed by the hat?

On 11/9/2023 at 9:01 AM, mxnprettynice said:

Yes, @consequence adding microneedeling will revive dormant hair follicles. I'm quite confident you'll get a new growth phase. Typically, it takes about 2-3 months to get results from microneedling, so patience is key. I've included my progress photos after adding microneedling to my minoxidil and finasteride.

Microneedeling: depth and frequency please
do you use something on the scalp after MN?

I becaome bald often in September and I have a CIA head the next April.
Telogen effluvium sucks. Learn to live with it.

55 minutes ago, O_O_O_O_O said:

Thanks. Did the above protocol helped you at the hair growing cycles ? Meaning that you might have shed less transplanted hair, got the transplanted hair start growing sooner than normal (less than 3 month) ?

I can't answer to this question.
To say yes or no, I needed a twin brother, making the exact some HT and not taking anything.
What I can I say, I had good results.

PS: from my personal experience, do not be scared of early shedding.
The earlier you shed, the earlier is the regrowth.
I had an early shedding but after 4-5 months, I was full regrowth.

My case was similar.
I have HT only on the front.
1 week after HT, I continued to take oral minoxidil and oral finasteride.
14 days after HT, I added use topical minoxidil in nor recipient areas (middle and crown)
after 1 month, I  added topical monoxidil all over my scalp.