Diff-thinner

Hey 4Godot, yeah so far I cant tell where I'll be on the range, waiting for the more seasoned guys to comment their opinions, but still the same, thanks for your opinion also. Currently the before pics I have wont give you much info, they are really bad quality, but I can promise when I get the hi-res photos from the clinic that ill post them for you. Good luck with your journey also, it is exciting and something to certainly look forward to. I would describe it like waiting for Christmas as a child

I just wanted to say also, I forgot to mention, the donor photos are post extraction, not pre

Lets start from the beginning... because its a very good place to start. I have seen many questions regarding Couto, How to get a consultation, waiting lists and the rest. So I would like to detail my experience from the very start in the ultimate aim of providing more information for prospective candidates. I do genuinely believe this is a wholistic treatment, not only encompassing simply hair, but rather it encompasses an element of identity, confidence, and the manner in which you will eventually seek to live your life. From future hair cuts, to style to everything else. Certainly, in this brief preface, a decline in how well I presented my self, could have been traced linearly and in correlation with the decline of my hair, and ability to style it in the way I wanted, which eventually had repercussive effects on everything else mentioned. Additionally, I wanted to make this detailed, for those who want all information possible, because this forum, has provided such an invaluable service to me, and the way people respond, advise and give care and attention, makes giving back not only a duty but a pleasure. Getting a Consultation. My advice here is be persistent, bordering annoying. I had emailed around my birthday looking for a consultation, and had a reply initially to do an online one, sending pictures of the state of my hair, when a reply was received it was decided that due to the thickness of my donor hair and the state of my recipient hair, that an in person consultation would be better, but that because bookings were closed I would have to wait until the new year to even attempt getting a consultation. This was in early 2022. So ... I waited, my gut intuition, was that this was the guy. Around October I emailed in confirming the date and time that the consultations would open in January because as soon as they opened I wanted to be the first one on the phone. January came and I had already drafted an email to them, and sent it immediately on the opening of consultations, and then proceeded to call them, to make sure they would open my email. It worked. I had got the consult .... In January... 2024. Doing my calculations, I was told that surgery would be booked for 2025, by which time I would be nearing 30, and really wanted to enter my 30's with a hairline and framed face. Oh well I said, if you want what you want, you must bide your time and wait. The consultation. It was great, but honestly not what I had expected. Dr Couto, I would describe as the 'DON', Cool, Calm, Confident. Filled with an air of self belief, that only results from success, the kind that makes you know what you are capable of. Rather than being in the hands of a surgeon, I would describe him more as an artist, sitting in front of him you get the sense that he is already designing your hair when your sitting there. He discussed my hair characteristics, and the fact that each hair was very thick, which he prefaced that he doesn't usually describe even in his videos, this i thought was great, but actually turned out it is not. This is for two reasons, one is blood supply, the thicker the hair, the more blood is needed and the more that hairs compete for blood supply, this placing more hairs densely packing it risks a lower yield. Second is the problem with the hairline, a hairline requires soft hairs, that makes the progression natural, and so having thick hair is great for behind the hairline, but not so great for arguably the part that everyone notices at first. He thus recommended 1,100 grafts initially and we were done at that. He jokingly told me to go and 'prepare for a fight' with the receptionist who does the booking so that we can get everything booked. I went downstairs preparing my monologue. I did my best, and telling her 'come on its only 1.1k grafts'. she looked at me and said, your best hope is a cancellation, but usually its a wait and see. I made sure she knew my name and that in the hopes that if someone did cancel, I would be thought of. About a week later, I got a cancellation March 19th, best believe I booked that date straight away. The surgery On the day, we did basically a second consult, a redraw of the hairline and me and Dr Couto, were surprised with the results of the topical finasteride I was using, it had yielded growth, and made him more confident to implant between hairs, the hairline he draw he said was perfect, the word perfect was used quite a few times, and I would say I am very happy with it, I dont know what norwood I would be now, any advice from you guys would be appreciated. Esteban does the extractions, dont worry, he has been trained by Dr. Couto and as you will see from my donor, im actually very happy, to the point at the beginning with photos I was quite astounded at how good the extractions were. Since it was a hairline surgery, Dr Couto does almost everything, he left only 200-300 grafts in the mid scalp to be done by the other surgeon. but everything from the site holes to the implantation was done by Dr Couto. Halfway through the surgery an about turn was made, the 1100 grafts were considered not to be enough... Why? well because of my hair characteristics once again. Because of my family history, the Dr wanted to be very conservative with my donor zone, and so while the density is 'superior' what was really bad was the graft count, mainly triples, hardly and 4 or 5 grafts, maybe only 60 for use in the safe donor zone, meaning that while there are loads of grafts available, the singular graft count was lower, meaning more grafts were needed. I cant lie, I was a little disappointed... but apparently this is typical of my genetic origin higher density, average FU's. So we had to do a second extraction of around 300 grafts, taking me to close to 1500. We started at around 10am and finished around 6:30 PM. The doctor checked like three or four times, every time I would leave the room he would call me back, take another look, and just stare and say 'perfect'. You guys can decide from the pictures. Finally we did the hightech PRP. After care They give you a little bag, with moisturising spray, a plastic spray bottle, shampoo and an after care manual. The spray is to be used every 30 mins, to keep the recipient site moist, and thats all basically. The wash, I went in two days later for the wash, got my hair washed and was told all the after care needed regarding shampooing and that on day ten to make sure that all scabs were taken off. now I sit here, waiting, and hoping that another home run has been hit. Because it is my first time, I am a little apprehensive about certain things, but im trying to be very careful. this is a long winded description but I wanted to be detailed and if anyone has any questions do let me know id be happy to answer. In any case here are the photos, let me know what you think. Over and Out Diff

Hi again all, I hope you're all doing well, Ive got my appointment coming up on the 19th for my HT and I was just wondering about prp before the surgery. I heard its recommended as it prepares all areas for the trauma about to happen. Is there any info from you guys on this, and should I go on monday for the PRP, or should i just do the three sessions after? thanks in advance Diff

Zarev is God tier as well, i messaged him, and got told consultations are in 2026 I believe if i remember right, also imo I would only use Zarev for a mega session! Couto does hairlines, and he is pretty much the best at it, with from what ive seen IMO, Rahal and Munib Ahmed right next to him, To my knowledge Munib is the only one who does everything from start to finish, apart from organising the grafts, Since my HT is concerned with the hairline mainly, Couto is perfect, and as others have said graft utilisation is perfect, I was just wondering how 1,100 grafts would be used to fill my space, but im going to take the leap! consult with Couto is Free Graft price is 4 euro Deposit is 50%, I havent seen a cancellation policy, basically because I dont think anyone cancels

Pm'D

Also he said because my donor hair is naturally v thick and dense with loads of multiples, dense packing may cause an issue between grafts for blood flow and nutrition, when he looked at my donor he said dont be happy its so thick because hairlines need thinner hairs

He recommended PRP with the treatment do you think in his idea it will sort out the diffuse as well as protect the new transplant, with the 1.1k grafts ? the hair loss progression is v slow, i am nearing 30's and was unmedicated with hairs coming back, so do you think thats what he may be thinking ?

I think I am diffuse, There wasnt much clarity on that, but i was told I am norwood 3, anterior pattern, But i do think my hair generally has gotten thinner as well as the recession you see

Saw Couto in person yes, Rahal was online, its true, i have had some regrowth in the hair loss areas, ill post a photo for you to see and give an opinion. they are only baby hairs on the sides, but they were going almost completely before the treatment

this is what my instinct is saying, i see his results and just think wow, and to get a date so soon after the consultation, I just believe its a go with it kinda situation, what do you think the difference of the 1 k grafts would be based on in your opinion?

Hi all, I have had two consultations with two top doctors, One suggested that i needed a total of around 1.1k grafts with the option if they see fit on the day to increase, the other suggested 2k grafts, with an increase to a potential to 2.5 K, the first doctor is Cuoto, who I have waited for over a year to have a consult and a date booked for surgery in the next month, having paid a deposit, the second is Rahal, who i am also a big fan of! Both in regards to hairline are awesome, but i would say Cuoto is world renowned and that people would die for an appointment with him, which luckily i have gotten. I am just wondering, what you guys would be thinking in this situation, i am hoping to have a little discussion, in the aim of trying to get a better idea, simply because the two opinions are so different i am a norwood three for back ground info and have posted images before, i dont mind posting more pics, with an update now that ive been on fin for 5 months best DIFF

If anyone has thoughts on this would be so appreciative

Hey dude, i was quite persistent, i emailed in regularly and yes i had to wait a while, i would recommend emailing in, october times, because he seems to release consultations in january i believe, so if you start emailing in october and ask for consultation dates opening you might have some luck

Hi Melvin he said he wants it a little straighter than that it will be a little lower at the temple sides, i do have a feeling he will end up going with more grafts

It took roughly 1.5 years I kept checking in, and eventually they gave me the consult but took from like the summer to the end of the year until they told me, they will open consults in Jan and then I booked

I just turned 29, the thing is I’ve had some good growth since those pictures were taken, so I’m not sure, but basically these are my thoughts 1. I’m on topical fin, he says it doesn't work but I have had growth in the bald areas 2. he says he doesn’t need to dense pack because of the thickness of the hair, the density and the fu’s I have that 1,100 should be enough 3. he says that once he shaves my hair if he does see any places that need touch ups he will obviously do it but preliminarily because the hair loss is not extensive that there is no point in wasting grafts 4. the surgery has been scheduled for march 4th this year, and to be quite honest in my opinion this guy is an artist and the best in the business for hairlines, and I do t really want to give up the date because he is the best and an appointment is like gold dust, im just not sure what to do, do I have the treatment and then bolster with someone else or do I do the treatment see how it goes and then decide from there? Kind of confused and some experienced advise would be so great and kindly appreciated

I don’t want to keep the same shape, he suggested a hair line that was awesome there was no disagreement on that it was just the 1,100 hair quote that got me

Hi yes that’s fair enough, that’s what I understood also, because he books surgeries a year after, so I thought by that time I would be ready! no I haven’t, I don’t currently live in Madrid I live in England! Would it have to be regular ? I’m not so familiar with meso therapy or dutasteride. do you think it’s weird he did not notice the vertex ? To be fully honest I have had some good growth in the 3 months that has grown some at the hairline and some in the crown so it looks a little bit better than what I’ve sent you

Hi Melvin, he says because my donor hair is in his opinion thick and dense that 1,100 should do the trick. on the medication aspect, I’m taking topical finasteride for the last three months and oral minox for 1 year. would the native hair not be strong enough for the grafts as now it’s all wispy impossible to style and just feels like straw

Hi Melvin, here are the pictures, these were taken before I started oral minox and topical fin, the oral Minox I’ve been taking for a year, and the finasteride for only 3 months but already seeing results, i can see the frontal recessions filling out. what is weird is that when I sent him these pics he mentioned vertex thinning but today he said that wasn’t happening, but that he thinks it’s anterior pattern. im kinda confused now because under harsh light I can see the vertex thinning and there are clearly huge spaces to me between the hairs where there has been thinning because my hair never used to act in a wavy manner it was just thick and straight. any opinion from you Melvin would be greatly appreciated best

Hi Melvin, I was hoping you would see this, sure I will upload pictures so we can discuss

Hi all, I recently had a consultation with dr cuoto, but I left the consultation with more questions after sitting and thinking about everything. So I was wondering what to do and throught I would post about it. I went to Dr cuoto and he inspected my hair, and told me that it is naturally very thick and dense in the donor areas, he said my donor was perfect, but that actually my hair was maybe too thick and that would cause difficulties when looking to reinstate the hairline where I have had recession. This is not the problem for me as he advised on 1,100 grafts for the hair line and the recession, which he said because the hair is thick, that it would not require a dense pack, as it would space out which seems reasonable. the second issue was the thinning on top, whereby I think my hair is so thin it has actually become wavy when it never used to be, it’s thinning diffusly, when I asked him about placing grafts in between the original hairs to replicate overall density, he rejected the idea because the implanted hair would be so thick it would compete with the original hairs for blood and oxygen. the problem is I’m so unsatisfied with the hair thickness on top, it’s wavy and thin and I can’t style it how I used to and I was hoping that due to the density on top, extra grafts would return the hair to close to an original state, the question therefore is what do I do? Should I go with the hair transplant for just the hairline and see what happens later, considering I’m dead set on him and waited a long time for just the consultation, or do I consider seeking other opinions that may align with my own view of a broader thicker transplant any advise would be greatly appreciated thanks