consequence

On 10/24/2023 at 7:06 PM, airporteffect said:

I still am rocking bald photos on dating apps. I call it "reverse catfishing" 😜.

That would be .. dog walking?

I also don't see the density issues that you mentioned, would you say they've resolved or do things look different in person?

Dude you're 23. Leave it be, upgrade your medical therapy, and come back in 10 years.

Also I still think you should get that biopsy to see if there's any lichen planopilaris. You really had an odd patchy back and forth sort of progression, make sure there's not something else going on.

Day 200:

Not the thickness I was hoping for at the frontal line, though the temples look great.

One thing that is very apparent is when I comb my hair from right-to-left the density is also lacking at the widow's peak and on the right, so I think my focusing on the left was just because of the way I tend to comb my hair.

Certainly not one of the home runs we're used to seeing from Couto but better than where I started. From seeing his other cases that looked like this at 6-7 months, it's reasonable to expect that my situation will not change.

On 11/30/2023 at 11:09 PM, Kacan said:

Did you have PRP? Couto recommended it for you?

I did PRP 1 month prior and at 1 month after surgery, but I didn't inject directly into the operative bed. Couto advised against it for me because I couldn't fly back and forth to Spain each time and there was some uncertainty as to what version of PRP I'd get at other clinics (he uses an Italian kit by the name of Fidia that I haven't been able to find in the USA). He also had some thought about how it would interfere with the natural growth cycle of the hair, but then he does recommend it to other patients so it's more of a case-by-case basis.

Actually thought about purchasing the kit myself but sent multiple messages to the manufacturer and they never responded.

Couto's cases that used PRP had an average result of [9.3/10] from my own personal rankings, whereas those that didn't had an average yield of [9.1/10] so perhaps it makes a difference. That being said, the people who got PRP were usually locals (ie. Spanish) so had thick, darker hair to begin with and they were almost always getting it from his clinic directly.

I may try Emcyte with a clinic here that I've found as that kit seems to have the highest concentration of growth factors in the one small study I could find comparing different manufacturers, but I'm not expecting much either way.

If this is where my result stays, which, again, is probably the situation based on other cases I've seen like this at 6 months, I'd give it an [8/10].

I know people say wait till 12 months, and sure of course I agree, but almost every case I've seen here that looked "stringy" like this along the frontal line at 6 months just stayed there so, just, whatever.

Part of me really wonders if getting a strip from Konior would have helped avoid the density issues, but I'll never know.

If things are better at 12 months I'll post an update, but if you don't see anything from me it's safe to assume things didn't develop any further.

Good luck everyone.

On 11/23/2023 at 6:47 PM, duchaine said:

can you explain what kind of PRP he suggested?

The name of their kit is Fidia, it's from an Italian manufacturer. Not used in the USA.

There's only one study I've been able to find comparing growth factor yield with different kits and the "best" out there is Emcyte. There have been no studies comparing different kits with regards to actual hair growth.

That really sucks. Though it can happen with anyone, I've found the problem is exacerbated when going to non-English speaking, or English as second language clinics. You'll find your right surgeon, just keep looking.

Anyone have recommended surgeons for surgical or non-surgical (liquid) rhinoplasties?

15 hours ago, Calihome1 said:

Ya unfortunately this does not look good at all.  Too many Eugenix apologists here. Just admit this was a terrible result.

Watch out guys, if you criticize Eugenix too much Melvin will come shut down the thead saying "There's nothing more to be discussed" as he has multiple times in the past.

Eugenix is a middle to below average group, at least on the world scale, but they have a more open schedule and better prices than the top-10 clinics. They gave Melvin a transplant, presumably heavily discounted or for free, and pay the forum for advertising so of course they're going to be heavily favored the admin and his yes-men. Don't forget -- this isn't Wikipedia, it is a for profit website. The surgeons are the customers here, we're the product. 

Still can't get over the fact that they're named after a Nazi genetic cleansing movement that was used to justify genocide. They've really got to brush up on their 20th century history; what a horrible choice for a practice name.

And yes, the cheerleading and ulterior motives have gotten a bit out of hand as of late, admins in the past were more hands off. But what alternative do we have? If we don't like it we should start our own forum, which no one here has the time or motivation to do.

And Eugenix does have some solid results, they're just not consistent. I still think the yield wasn't bad and that you're much better than where you started. You can fix it with a repeat procedure. Go to one of the tops for high volume sessions. Focus on patient posted pictures, make a Google sheets and Growly notes and come up with your own ratings. Do not trust the opinions of a bunch of keyboard warriors, use data. There are too many ulterior motives on the site.

Needs more patient posted results. Anyone can make their instagram page/clinic postings look good by cherry picking cases.

Not saying he's not good, but the list will become meaningless if surgeon submitted cases are the criteria for including surgeons on the list.

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12 hours ago, hairman4321 said:

give it a few more months and have some hope, lots of cases keep pulling through really strongly until month 8 that i've seen. 

re a second procedure: i've just been to Laorwong and had next to 0 swelling. There was a tiny bit the day after, and then the day after that near one of the temples, but by day 3/ 4 it was undetectable. it could be that your body just had a reaction to something, or it could be that the Drs all have different techniques to combat swelling. I had a head band and anti-swelling drugs for 5 days or so afterwards all provided by the clinic. Whatever it was, it was incredible. Your day 3 photo is really insane so i'd understand why you'd be put off a second. Do you know what happened or is it still a mystery? still, you could go for a 2nd procedure with a different doctor who's patients you've noted have little to no swelling. 

theres still the annoyance / dealing with wanting to hide from the world for 4 months after though; thats very understandable. 

Thanks for the advice. Laorwong seems very strong, I'll review his patient submitted cases more carefully if I want to go back in for a second pass.

I really don't care about the swelling. I imagine it would be much better with a revision as it would be just a few grafts hopefully. Alot of the edema isn't actually "inflammation" it's literally fluid from the lidocaine used for anesthesia. Esteban may have used more with me because I kept feeling the extractions. The amount of lidocaine would presumably be much less the second time around.

My main annoyance/reason for hesitation at going back is the whole not being able to use hair dye afterwards. Some people say wait 1 month, other people say wait 12 months, no one really knows the answer. I've waited this time till 6 months though probably will dye it around month 8. It's just hard to convince myself to go through another procedure with the possibility that I may not get a significant improvements and so much of my life was disrupted by the restrictions afterwards. Also second passes seem to be less consistently successful than virgin scalps, at least from looking at the cases here.

Either way, pretty disappointed with my left side as it seems to have plateaued. Other cases like mine that level off around 6 months don't really seem to get much better. Every case I've found here that looks like mine from months 4-6 just kind of stays there.

If there's a miracle, great, but I don't think anythings going to change at this point.

Whatever. I did my best and went to a surgeon that seemed to have a decent track record, ultimately can't control what I can't control. That's just life.

Some have suggested the density could be better. Here is my post op shot:

The density of graft placement does seem a little more spaced out on the left than the right. Perhaps Couto was trying to conserve grafts, I'm not sure.

This may have contributed to  to the more sparse appearance I'm seeing on the left now.

38 minutes ago, Kacan said:

Was it in the low valid limit? Do you have the values?

And by the way, do you think that your scalp didn’t accept some grafts, or not enough grafts were implemented on the left side?
 

The grafts grew, just not thick in caliber. There is one spot on the left where there is gap and you can see a double behind, so I assume a single didn't grow in front of it because I couldn't imagine Couto would make such a rookie slip.

Never gotten this question before or seen it discussed, but below is my most recent CBC with diff. I'm smack dab in the middle for everything:

7 hours ago, Kacan said:

 

Could you please share what are the values of Hemoglobin, Hematocrit and RBC on your last blood test?

They were within normal range. No anemia or polycythemia. Why do you ask?

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1 hour ago, consequence said:

Wish they had done it with something that acted more like scalp soft tissue (ie. a banana or half boiled potato) but the demonstration is compelling. It suggests that some pens have more motion in the translational x-axis as opposed to a straight z-axis puncture like you see in the second row.

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My actual 6 months (180 days):

Still having density issues at the center/left hairline that haven't changed, and even the right looks a little sparse from the side.

From looking at (several) cases similar to mine on the forums it seems about 30% are behind me at this month and 30% are ahead, with about 40% being just where I am.

For the people who are at my level, it seems most of them stayed about the same through the end. So yes I've got 6-12 more months for caliber but I'm not holding my breath at this point. Time will tell, but my hunch is that it's unlikely.

The good news is I can style my hair a little and disguise it, at least from the front:

Hair combed from left to right:

More chaotic neutral:

I've been looking into microneedling that @mxnprettynice suggested though I know others have debated about its benefits. The Dr. Pen that seems popular on Amazon is appealing, but according to that 700+ page thread on Hair Loss Talk, the Derminator may be best. This is from a comment there:

Quote

Just be careful with the Dr.Pen as they are actually just re purposed permanent make-up pens and have the potential to cause micro tearing which can cause permanent damage to your skin. Most people agree that the Derminator is the best but it's a bit more expensive.

Here's a video from the Derminator manufacturer that goes into more detail:

And an image from their website:

Wish they had done it with something that acted more like scalp soft tissue (ie. a banana or half boiled potato) but the demonstration is compelling. It suggests that some pens have more motion in the translational x-axis as opposed to a straight z-axis puncture like you see in the second row.

Still, I wish they had the Derminator on Amazon so I could see some user reviews. The pen's inventor himself has kind of weak diffuse thinning in that video which makes me wonder from whom I'm taking advice.

And regarding PRP, Dr. Couto's kit is from an Italian manufacturer that I've not been able to find in the US. I sent them a message on their website to see if I could purchase the machine for myself but haven't heard back. If they don't follow up, I am going to go with Emcyte as that has the highest and most consistent concentrations of platelets/growth factors according to the study I linked above. Who knows if this means they get better results. Studies that have compared PRP with saline wounding suggest that the majority of the benefit is the wounding itself, so.. whatever.

More than anything, I just don't want to go through a second procedure -- the first was such a painful rollercoaster. Not being able to dye my hair has isolated me from the dating scene for the last 6 months and I don't want to go through that again. Still, surgery may be the only option after a year and perhaps it's not as bad the second time around, but I'm trying less extreme solutions first. Second procedures can also fail or not provide improvement too.

Alrighty then, onwards and upwards.

That is a HEAVY hormonal dose you're taking there. Good luck. Let us know if any side effects from dut + spironolactone.

And that facial hair growth on your cheeks and around your eyebrows/glabella is just wild.

Keep us updated.

On 11/15/2023 at 11:02 PM, mxnprettynice said:

I agree @consequence 

If you didn't know, microneedeling helped @TorontoMan case as well. 

To be honest, sometimes I revisit this thread and comparing my results month by month dreaming to end up with results like his

Yeah, seriously.

It's interesting that he didn't use topicals for 24 hours after microneedling as opposed to minoxidil right afterwards. 

On 1/4/2021 at 1:20 PM, TorontoMan said:

Microneedling - 1.5mm 1x a week, no topicals for 24 hours after session. 

- I use Dr. Pen microneedling device 
- Apply it all over my scalp other than my recipient area for the time being. 
- Takes me around 10 minutes, and I rather enjoy it oddly enough its therapeutic for me 

Fantastic result. If you ever come back -- did you use microneedling during recovery as well?

How about the rest of your regimen? CB, dut, minox other topicals etc. When did you restart after surgery?

Another Ferreira case done at 6 months. Thank you for sharing. Are you going back in for the crown?