Poor Result Dr. Koray Erdogan, January 2017 ( 4,500 Grafts) Brilliantly Repaired Sep 2021 Dr. Couto (1500 Grafts)

[miko]

The difference between a bad hair transplant and a good hair transplant. My hair transplant at Asmed clinic (Dr. Koray Erdogan) with 4500 grafts versus hair transplant of unknown patient performed by Dr. Jose Lorenzo with 2500 grafts. Almost twice as many grafts were used at the Asmed clinic to achieve a very poor result than at Dr. Lorenzo´s clinic to achieve a good result. 

[miko]

Hello guys. After 4 and half years since my terrible experience with Asmed clinic and Dr. Koray Erdogan and after reading a lot of stories and after seeing a lot of results, after speaking with almost 20 clinics I had my personal consultations with 3 clinics which I consider the best and from which I want to choose the doctor for my repair HT: Dr. Rafael De Freitas, Dr. Juan Couto (with him after approximately 1 year of waiting) and Dr. Jose Lorenzo. Two of them said that my hair transplant result from Asmed clinic is very bad in all ways, from unnatural bad hairline, through very low density in recipient area, through very high number of used grafts, till almost exhausted donor area. In their opinions my result was caused by combination of unexperienced technicians (nurses) and long time between extraction and implantation of grafts which caused low survivalence of grafts. The third one didn't want to speak much about reasons of my failed HT and he focused on his work and future. Dr. De Freitas estimated number of grafts which is necessary to repair my result as 2000. Dr. Couto and Dr. Lorenzo both as 1500. The best looking clinic is Clinica De Freitas. It is very nice and clean, it looks new. Fuexpert clinic (Dr. Couto) and Injerto Capillar Medilor (Dr. Lorenzo) seems to be older but also nice and clean. The best approach has Dr. Lorenzo. He checked my hair with microscope, draw the hairline also with laser, checked my hair dry and also wet and made some calculations. Dr. Couto also checked my hair with combe and with microscope, Dr. De Freitas just combed my hair. The best price offered me Dr. De Freitas. He usually asked 3,5 euro per first 1000 grafts and 2,5 euro per every next graft, but in repair cases is the price higher. But he offered me 2000 grafts for 6.000,- eur (hotel and one session of PRP included), one day operation and he usually does 3 patients in 2 days depending on difficulty. Nurses extracting grafts with micromotor and implantation does Dr. De Freitas. He schedules his patients on summer 2022. Dr. Couto usually asked 4,5 euro per graft, but in repair cases the price is 5,- eur. He offered me 1500 grafts for 7.500,- eur (nothing incuded), operation will be divided in 2 days because of he want to do it slow and perfect according low capacity donor area. He usually operates 2 patients in one day. His nurse Esteban extracting grafts manual or with micromotor and implantation does Dr. Couto personally. He said that my result will not be perfect as usually his results are, according previous HT and weak donor, but it will be much better than now. He also said that he would achieve much better result with 2500 grafts than Asmed achieved with 4500 grafts. Now he schedules his patients for summer 2022 (like e.g. Dr. De Freitas). I have luck because of some patient canceled his surgery in september 2021 and he offered me his date. Dr. Lorenzo asked 5 euro per first 2000 grafts and 2,5 euro per every next graft. He offered me 1500 grafts for 7.500,- eur (2 nights in hotel are included), one day operation and he usually operates 3 patients in 1 day. Nurses extracting grafts manually and Dr. Lorenzo implants 80% of grafts (the rests are implanted by staff!). He scheduled his patient for autumn 2021 (first aviliable dates he had in September 2021). Please, according this informations, who of these 3 doctors will you choose? Thank you for your every opinion in advance.

[Parasol]

@miko congratulations on your consults. You certainly met with 3 of the absolute best in the business. I think you can rest assured, regardless of who you choose, you’ll be setting yourself up for the best possible chance of success (which we all know too well, is never 100%).

If I was you, personally, I’d want the doctor to do the implantations fully themselves. Due to the nature of this repair, this may be your only chance at fixing this, so considering you have two other incredible options that will do the implantations fully with their own hands, I’d rule out Lorenzo for this fact alone.

Depending on your finances, it sounds like Cuoto can get you in soonest. I’d personally feel very confident with my scalp in his hands. 

No matter who you choose I wish you all the best. You’ve clearly been through hell and back and I hope a year or so from now you can come back and tell us all your success story. 

[miko]

15 hours ago, Parasol said:

@miko congratulations on your consults. You certainly met with 3 of the absolute best in the business. I think you can rest assured, regardless of who you choose, you’ll be setting yourself up for the best possible chance of success (which we all know too well, is never 100%).

If I was you, personally, I’d want the doctor to do the implantations fully themselves. Due to the nature of this repair, this may be your only chance at fixing this, so considering you have two other incredible options that will do the implantations fully with their own hands, I’d rule out Lorenzo for this fact alone.

Depending on your finances, it sounds like Cuoto can get you in soonest. I’d personally feel very confident with my scalp in his hands. 

No matter who you choose I wish you all the best. You’ve clearly been through hell and back and I hope a year or so from now you can come back and tell us all your success story. 

Thank you very much. Yes, also for me Dr. Couto seems to be the best option.

[Smash]

Dr. Lorenzo does his own surgeries; can confirm as recent as 2020. Looking to work with him again in 2022.

[A Fue Good Men]

On 7/29/2021 at 9:14 AM, Smash said:

Dr. Lorenzo does his own surgeries; can confirm as recent as 2020. Looking to work with him again in 2022.

Lorenzo does not do extractions- it’s all technician led. He also does 4 surgeries a day 

[miko]

Yes, Dr. Lorenzo does not do exctractions. I asked during the consultation how many patients they operate per one day and who do extractions and implantations and I got answer that they operate 3 patients per day, extractions do technicians and 80%, sometimes 85% of implantations does Dr. Lorenzo personally and the rests his team.

[miko]

Hi guys. Few days ago I came back from Madrid where I underwent repair surgery at Fuexpert clinic, Dr. Juan Couto. Now I know exactly what was the reason of my terrible result from Asmed clinic. It was caused by low survivalence of implanted grafts which was caused by unexperienced nurses/technicians and long time between harvesting of grafts and their reimplantation. I am attaching a picture where left is my recipient before repair surgery and right is my recipient area 10 days after surgery at Asmed. On the left picture you can see how many grafts survived from grafts on the right picture. There is less than 50%. Asmed promises and also promised to me min. 90% grafts survivalence... But when I sent them my result they wrote me first that my result is normal and than that my result was caused by stopping using finasteride. Also they asked 6.250,- eur for repair surgery.

The 2nd thing is that my donor area has been totally destroyed by Asmed´s nurses/technicians.

You can find all the essentials in my thread. Now everyone can form own opinion.

Edited September 27, 2021 by miko

[shadowcast]

Wow. Well, obviously Couto will leave you much better than he found you. Do you have any idea of how long you waited between extraction/implantation at Asmed? I didn't go to Asmed but felt like I was waiting quite a while between phases of my surgery...

[miko]

15 hours ago, shadowcast said:

Wow. Well, obviously Couto will leave you much better than he found you. Do you have any idea of how long you waited between extraction/implantation at Asmed? I didn't go to Asmed but felt like I was waiting quite a while between phases of my surgery...

I hope so. I remember that extracting started every day at 8.00 in the morning and finished around 12.00, then lunch and around 1.00 p.m. starting implantation. Which means that between extraction and implantation of first grafts it was min. 5 hours. If they didn't have the grafts sorted according to the time of harvesting, it could have been even more. Theoretically, it could have happened that the grafts harvested in the morning were implanted late in the evening. Apart from the above, it is clear that my very poor result was due to low graft survival and that Asmed lied when claiming that the result is normal or that the discontinuation of finasteride after 18 months since surgery was behind it.

[shadowcast]

4 hours ago, miko said:

I hope so. I remember that extracting started every day at 8.00 in the morning and finished around 12.00, then lunch and around 1.00 p.m. starting implantation. Which means that between extraction and implantation of first grafts it was min. 5 hours. If they didn't have the grafts sorted according to the time of harvesting, it could have been even more. Theoretically, it could have happened that the grafts harvested in the morning were implanted late in the evening. Apart from the above, it is clear that my very poor result was due to low graft survival and that Asmed lied when claiming that the result is normal or that the discontinuation of finasteride after 18 months since surgery was behind it.

Is it true that you stopped taking Fin? If so, did Couto make you start it again before having surgery with him?

[ITA]

@mikoCould you also post pics of the entire procedure with Doctor Couto?

[miko]

On 9/24/2021 at 3:36 PM, shadowcast said:

Is it true that you stopped taking Fin? If so, did Couto make you start it again before having surgery with him?

Yes it is true. I stopped using finasteride 18 months since surgery because of I didn´t see any difference between my result in 12 month and in 18 month (I am attaching pictures). I started using finasteride again in December 2019 because of thinning in my vertex area. Dr. Couto just asked me if I am taking finasteride and how long. Also he told that finasteride is very important for me because of destroyed donor area and after repair HT there is very few grafts for possible 3rd HT and I can´t afford to lose more hair. When I underwent personal consultations with Dr. De Freitas and Dr. Lorenzo, they both considered finasteride as very important. 

Edited September 27, 2021 by miko

[miko]

On 9/24/2021 at 5:40 PM, Egy said:

@mikoCould you also post pics of the entire procedure with Doctor Couto?

I was very tired, I didn´t take pictures step by step. Dr. Couto did pictures before/after surgery. I attached a few from which I have. But I want to attach pictures from my progress in the future.

Edited September 27, 2021 by miko

[bw77]

Couto's work looks great to me. I know it's been a long haul, but I think you'll be really happy with the final result. Second passes by good docs often make all the difference in the world. Even though your previous HT didn't meet your expectations, it likely provided some base level density that will make Couto's work look great. I look forward to seeing your growth in the coming months. I bet you'll have a fantastic outcome!

[Gasthoerer]

Great that you finally are on the path to keep things resolved. Fingers crossed for your growth.

Was also the hairline design changed or was the focus "just" adding density?

 

[ITA]

@mikoI am also convinced that you will have an excellent result.  You could continue your thread above maybe, indicating the strategy that Dr. Couto has adopted, perhaps indicating the details such as how many grafts he managed to take from your now devastated donor area, etc ... etc ... Thanks

[miko]

On 9/26/2021 at 11:47 AM, bw77 said:

Couto's work looks great to me. I know it's been a long haul, but I think you'll be really happy with the final result. Second passes by good docs often make all the difference in the world. Even though your previous HT didn't meet your expectations, it likely provided some base level density that will make Couto's work look great. I look forward to seeing your growth in the coming months. I bet you'll have a fantastic outcome!

Thank you very much. I saw almost every published result of Dr. Couto on Instagram and Youtube I trust him. He is really passionate about his work. He works every day until late in the evening and it is clear that he really enjoys the work. I really hope it will be much much better. But also I am scared because of not many grafts left for 3rd surgery, maybe 500.

[miko]

On 9/26/2021 at 12:19 PM, Gasthoerer said:

Great that you finally are on the path to keep things resolved. Fingers crossed for your growth.

Was also the hairline design changed or was the focus "just" adding density?

 

Thank you very much. Yes, my hairline was terrible, because we decided to reshape it a little, but no so much because of not wasting of grafts. First we wanted to add some grafts also to vertex area, but we decided to put grafts to hairline and after 1 year Dr. Couto will check my donor again and if will be possible to harvest another grafts he will improve also vertex.

[miko]

23 hours ago, Egy said:

@mikoI am also convinced that you will have an excellent result.  You could continue your thread above maybe, indicating the strategy that Dr. Couto has adopted, perhaps indicating the details such as how many grafts he managed to take from your now devastated donor area, etc ... etc ...

Thank you. I want to continue. Dr. Couto found 1500 grafts possible to harvest in the higher part of my donor area. First we decided to split them between hairline and vertex, but later we decided to reshape hairline a little bit and improve just the hairline and if after one year will be another grafts possible to harvest (approx. 500), he will improve also vertex area. I agreed with it because my hairline was really terrible and didn´t fit my face at all. I saw it right after it was drawn at Asmed and it remained so until the second operation. Now my front line is much better and for the 10th day I am not unhappy every time I look in the mirror.

[Curious25]

I’m glad you were able to find a solution within Dr Couto - since there is such demand for patient posted results of his on here, would it be possible if you could make a separate thread documenting your journey with him? Or even ask if @Melvin- Moderator could change the title of this thread to include his name also? 

[miko]

On 9/27/2021 at 12:58 PM, Curious25 said:

I’m glad you were able to find a solution within Dr Couto - since there is such demand for patient posted results of his on here, would it be possible if you could make a separate thread documenting your journey with him? Or even ask if @Melvin- Moderator could change the title of this thread to include his name also? 

I will be thinking about it but if not, you (and everyone else) can find all informations in this thread or just enter name of Dr. Couto to searching.

[Melvin- Admin]

On 9/27/2021 at 3:58 AM, Curious25 said:

I’m glad you were able to find a solution within Dr Couto - since there is such demand for patient posted results of his on here, would it be possible if you could make a separate thread documenting your journey with him? Or even ask if @Melvin- Moderator could change the title of this thread to include his name also? 

I would rather @mikocreate a separate thread documenting his surgery with Cuoto. We only have one other review here and it was excellent.

[Britanium]

15 minutes ago, Melvin- Moderator said:

I would rather @mikocreate a separate thread documenting his surgery with Cuoto. We only have one other review here and it was excellent.

Agreed, wish the other Couto thread would get updated though 

[miko]

Hello guys. I am attaching pictures from 15th day since my repair HT with Dr. Couto at Fuexpert clinic in Madrid, Spain. I hope everything will be ok. Dr. Couto is satisfied with progress.