Fuexpert, 2000 grafts - 6.5 months update

[THE TRUTH]

 

Thank you. I received it. 

First of all, I am really sorry for this experience....

Man it's really hard to comment on this....

Considering Dr. Couto's aura and the fact that many  including myself would put him in "the discussion for GOAT status", I must say this result is indeed very disapointing even for only 2000 grafts....

The density is just not there....and like other members said it was obvious straight after surgery. 

I wouldn't call it a "botched job" though.

But I think the appropriate and fair term would definitely to subpar/mediocre/disappointing. 

Again this is a cautionnary tale that every clinic in the world even the very best ones have subpar results... This is something that I keep  repeating on this forum all time.  No surgery is guaranteed unfortunately and every surgery is a gamble per definition no matter who you go to. 

This is the sad reality of this industry. 

This is maybe the 3rd subpar result from Dr. Couto I see in many years...

I am glad that Dr.Couto stands by his work by immediately offering a free repair. That is a positive news and shows that he is ethical. 

I am generally not the kind of the guy to say "oh don't worry just wait till 12 months this is only 50% bla bla bla....". 

From my experience, the 6-months result is generally a lot more than just 50% and very indicative of the final results HOWEVER there is still a chance that it will improve at least marginally until 8-9 months so yes I would give it a bit more time before making a final conclusion. 

But yeah doesn't look great overall...

And  if it remains the same then obviously a 2nd procedure is going to be required... 

I generally NEVER advise people to go back to the same place which didn't deliver for their 1st surgery. 

However I do believe Couto has some of the best and most natural results I've ever seen so far thus he has a reputation to defend. I mean he isn't considered one of the best in the world for no reason, right ? 

I remember one case from the spanish hairloss forum who had a density issue from Couto and he fixed it for free and then everything looked fine. 

Did Couto mess up here ? He clearly did... No doubt about that. 

Can Couto makes this right ? I believe he can. 

Is it a good idea to go back to him ? Well....this time around I really don't know...  Every other clinic has had subpar cases so again doesn't mean that they'll necessarily do a better job than Couto. 

It's your personnal decision but there is an element of faith that you will have to put into this if you decide to go for a repair with the same doctor. 

Couto was able to repair several botched jobs from Erdogan. 

But here's what I'll tell ya if you have the slightest doubt about the outcome of a 2nd repair surgery  with the same doctor then it's  better not to go...

[stockholmare]

19 minutes ago, Gramatik said:

I feel sorry for you man. This does looks like a bad result from Dr couto. Poor yield, and too many multiple grafts were inserted in your hairline instead of single ones. Your now need a repair procedure to another doctor, that specialises in removing multiples from a hairline and putting soft single ones in order to look natural, while having high yield of grafts. Even if your doctor offers a free procedure, i would not trust the same doctor after the result you got from him. I hope you find a solution to fix this pluggy hairline. Whats the explanation of Couto for this poor result ?

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

[Melvin- Admin]

10 minutes ago, THE TRUTH said:

 

Thank you. I received it. 

First of all, I am really sorry for this experience....

Man it's really hard to comment on this....

Considering Dr. Couto's aura and the fact that many  including myself would put him in "the discussion for GOAT status", I must say this result is indeed very disapointing even for only 2000 grafts....

The density is just not there....and like other members said it was obvious straight after surgery. 

I wouldn't call it a "botched job" though.

But I think the appropriate and fair term would definitely to subpar/mediocre/disappointing. 

Again this is a cautionnary tale that every clinic in the world even the very best ones have subpar results... This is something that I keep  repeating on this forum all time.  No surgery is guaranteed unfortunately and every surgery is a gamble per definition no matter who you go to. 

This is the sad reality of this industry. 

This is maybe the 3rd subpar result from Dr. Couto I see in many years...

I am glad that Dr.Couto stands by his work by immediately offering a free repair. That is a positive news and shows that he is ethical. 

I am generally not the kind of the guy to say "oh don't worry just wait till 12 months this is only 50% bla bla bla....". 

From my experience, the 6-months result is generally a lot more than just 50% and very indicative of the final results HOWEVER there is still a chance that it will improve at least marginally until 8-9 months so yes I would give it a bit more time before making a final conclusion. 

But yeah doesn't look great overall...

And  if it remains the same then obviously a 2nd procedure is going to be required... 

I generally NEVER advise people to go back to the same place which didn't deliver for their 1st surgery. 

However I do believe Couto has some of the best and most natural results I've ever seen so far thus he has a reputation to defend. I mean he isn't considered one of the best in the world for no reason, right ? 

I remember one case from the spanish hairloss forum who had a density issue from Couto and he fixed it for free and then everything looked fine. 

Did Couto mess up here ? He clearly did... No doubt about that. 

Can Couto makes this right ? I believe he can. 

Is it a good idea to go back to him ? Well....this time around I really don't know...  Every other clinic has had subpar cases so again doesn't mean that they'll necessarily do a better job than Couto. 

It's your personnal decision but there is an element of faith that you will have to put into this if you decide to go for a repair with the same doctor. 

Couto was able to repair several botched jobs from Erdogan. 

But here's what I'll tell ya if you have the slightest doubt about the outcome of a 2nd repair surgery  with the same doctor then it's  better not to go...

You have absolutely no idea what you’re talking about, and everyone here knows you’re a troll. Disappointing results, THIS IS BARELY 6 MONTHS! What on earth are you talking about. Having members like you spout off nonsense sets a dangerous precedent for the forum. I’m giving you a 2 month vacation. If you come back and keep trolling and changing names. You’ll be gone for good!

[BaldReaper]

1.Arent there before pics from the clinic?

2.How old are you and are you on medication?

3.How much donor you have left?

[stockholmare]

22 minutes ago, THE TRUTH said:

 

Thank you. I received it. 

First of all, I am really sorry for this experience....

Man it's really hard to comment on this....

Considering Dr. Couto's aura and the fact that many  including myself would put him in "the discussion for GOAT status", I must say this result is indeed very disapointing even for only 2000 grafts....

The density is just not there....and like other members said it was obvious straight after surgery. 

I wouldn't call it a "botched job" though.

But I think the appropriate and fair term would definitely to subpar/mediocre/disappointing. 

Again this is a cautionnary tale that every clinic in the world even the very best ones have subpar results... This is something that I keep  repeating on this forum all time.  No surgery is guaranteed unfortunately and every surgery is a gamble per definition no matter who you go to. 

This is the sad reality of this industry. 

This is maybe the 3rd subpar result from Dr. Couto I see in many years...

I am glad that Dr.Couto stands by his work by immediately offering a free repair. That is a positive news and shows that he is ethical. 

I am generally not the kind of the guy to say "oh don't worry just wait till 12 months this is only 50% bla bla bla....". 

From my experience, the 6-months result is generally a lot more than just 50% and very indicative of the final results HOWEVER there is still a chance that it will improve at least marginally until 8-9 months so yes I would give it a bit more time before making a final conclusion. 

But yeah doesn't look great overall...

And  if it remains the same then obviously a 2nd procedure is going to be required... 

I generally NEVER advise people to go back to the same place which didn't deliver for their 1st surgery. 

However I do believe Couto has some of the best and most natural results I've ever seen so far thus he has a reputation to defend. I mean he isn't considered one of the best in the world for no reason, right ? 

I remember one case from the spanish hairloss forum who had a density issue from Couto and he fixed it for free and then everything looked fine. 

Did Couto mess up here ? He clearly did... No doubt about that. 

Can Couto makes this right ? I believe he can. 

Is it a good idea to go back to him ? Well....this time around I really don't know...  Every other clinic has had subpar cases so again doesn't mean that they'll necessarily do a better job than Couto. 

It's your personnal decision but there is an element of faith that you will have to put into this if you decide to go for a repair with the same doctor. 

Couto was able to repair several botched jobs from Erdogan. 

But here's what I'll tell ya if you have the slightest doubt about the outcome of a 2nd repair surgery  with the same doctor then it's  better not to go...

thanks 

Edited July 27, 2022 by stockholmare

[Melvin- Admin]

2 hours ago, stockholmare said:

Hello and thanks for the replies so far.

I do not have pics from the clinic but can potentially post the invoice I got from the clinic, if that helps building trust.

I chose Couto because I wanted a "great" job but apparently this is not even going to be an "average" job - I am pretty sad about that.

The doctor said he is also disappointed and that will be providing a repair for free (and surely I will need that), but I am afraid of getting another poor result and further depleting my donor.

PS: Also I must say, when I went for the check up a couple of days after the procedure I saw and met a number of his past patients, some of them showed me pics of how thy looked and I was mind blown - some truly incredible results!! I do not intend to discredit anyone here, I am merely looking for help.

While I can appreciate the doctor offering a free touch-up this early on. It is too early. I’m shocked he would even offer that this early. Perhaps he’s used to his patients growing all at 6 months, but every one is different, and it is 12 months for this reason. 

You have absolutely no reason to lose hope halfway through the procedure. Do not listen to these “BRO this is a botch job” guys here, they have no clue what they’re talking about. I have been here nearly a decade and have seen hundreds, if not thousands of cases. 

It’s our job as a community to keep members from judging results prematurely. I understand this very well. 6.5 months can feel like an eternity. But it’s only halfway. Now, I don’t know if you’re going to be satisfied in the end. Only time will tell, but I do know it’s too soon to call this a failure. 

Here’s an example of a patient at 6 months vs. 10 months.

[stockholmare]

13 minutes ago, Melvin- Moderator said:

6.5 months is hardly enough time to judge a result. Do not listen to forum trolls. There’s growth, and it’s improving. You’re only halfway there, so definitely too soon to judge the result. 

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?

 

[stockholmare]

10 minutes ago, BaldV said:

1.Arent there before pics from the clinic?

2.How old are you and are you on medication?

3.How much donor you have left?

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

[Britanium]

Some people don’t respond well to a hair transplant and/or lag behind the usual timeline. It’s good to see that Dr Couto is standing behind his work and is willing to do another procedure to improve on it. Personally I think it will continue to improve, and it would be great if you continue to post the progress 🙏👍🏽

[Melvin- Admin]

5 minutes ago, stockholmare said:

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?

 

He may be disappointed thus far, but it is far too soon to call it a failure. We simply don’t know how it’s going to end. I have seen cases that look drastically different from 6 months to 12 months. The problem is you’re asking “why did I get a below average result” at a time when you don’t know how the result will turn out. 

It’s possible that you’re a slow grower, meaning you don’t start growing until 6 months. I’ve seen these cases before. I wouldn’t start judging the results yet. Give it time, monitor your progress, and be patient. At 12 months if things don’t change, then that’s when you can start questioning all these things, but as of now. It’s too premature.

[BaldReaper]

14 minutes ago, stockholmare said:

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

You have an appropriate age and are on medication, a repair will fix your case easily ,keep us updated please

[AlexMeister21]

2 hours ago, Big Rome said:

i was thinking exactly the same thing! surely this can’t be couto’s work

I didn't even read the full post or know that OP was concerned about his current results. I saw the graft photos and thought "oh, I'm not sure about that." I think it's perfectly fine for you to begin setting up consultations at this point, OP, maybe even go back to Couto. Couto seems to be an ethical and consistent doctor, so I feel like he'd get it right the second time.

[Fue3361]

44 minutes ago, Melvin- Moderator said:

He may be disappointed thus far, but it is far too soon to call it a failure. We simply don’t know how it’s going to end. I have seen cases that look drastically different from 6 months to 12 months. The problem is you’re asking “why did I get a below average result” at a time when you don’t know how the result will turn out. 

It’s possible that you’re a slow grower, meaning you don’t start growing until 6 months. I’ve seen these cases before. I wouldn’t start judging the results yet. Give it time, monitor your progress, and be patient. At 12 months if things don’t change, then that’s when you can start questioning all these things, but as of now. It’s too premature.

I'd usually agree with you here Melvin, but looking at this here:



I'm not an expert by any means and accept than I could be wrong, but does the density not strike you as very low post in this post op picture for an area that has zero natural hairs growing there?  There's no tape measurer to judge exact grafts/cm2, but that looks like 20 to my naked eye (area right above new hairline).

As to OP's concern, I'd say still wait the 12 months, and if you need the touchup/revision surgery, go back with Couto.  He's still world class, and you can't find much better hands than his.

 

[Melvin- Admin]

10 minutes ago, Fue3361 said:

I'd usually agree with you here Melvin, but looking at this here:



I'm not an expert by any means and accept than I could be wrong, but does the density not strike you as very low post in this post op picture for an area that has zero natural hairs growing there?  There's no tape measurer to judge exact grafts/cm2, but that looks like 20 to my naked eye (area right above new hairline).

As to OP's concern, I'd say still wait the 12 months, and if you need the touchup/revision surgery, go back with Couto.  He's still world class, and you can't find much better hands than his.

 

I agree the density looks low, but it also appears that some shedding has occurred. It also appears that OP has very thick hair. Another good reason to wait 12 months is to find out whether the procedure itself failed, or the plan failed. 

[sukh123]

16 minutes ago, Fue3361 said:

I'd usually agree with you here Melvin, but looking at this here:



I'm not an expert by any means and accept than I could be wrong, but does the density not strike you as very low post in this post op picture for an area that has zero natural hairs growing there?  There's no tape measurer to judge exact grafts/cm2, but that looks like 20 to my naked eye (area right above new hairline).

As to OP's concern, I'd say still wait the 12 months, and if you need the touchup/revision surgery, go back with Couto.  He's still world class, and you can't find much better hands than his.

 

Yes agree it’s the post op pic thats worrying and shows a lack of density that is not associated with couto. There was an identical one on Spanish forum from de Freitas where the post op looked similar, clear lack of density and it turned out sparse at  12 months . Even the best have off days and sub pars . But after 12 months a overall consensus can be established so will have to wait as Melvin said 

Edited July 27, 2022 by sukh123

[stockholmare]

18 minutes ago, Fue3361 said:

I'd usually agree with you here Melvin, but looking at this here:



I'm not an expert by any means and accept than I could be wrong, but does the density not strike you as very low post in this post op picture for an area that has zero natural hairs growing there?  There's no tape measurer to judge exact grafts/cm2, but that looks like 20 to my naked eye (area right above new hairline).

As to OP's concern, I'd say still wait the 12 months, and if you need the touchup/revision surgery, go back with Couto.  He's still world class, and you can't find much better hands than his.

 

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.

Edited July 27, 2022 by stockholmare

[BaldReaper]

1 hour ago, Melvin- Moderator said:

While I can appreciate the doctor offering a free touch-up this early on. It is too early. I’m shocked he would even offer that this early. Perhaps he’s used to his patients growing all at 6 months, but every one is different, and it is 12 months for this reason. 

You have absolutely no reason to lose hope halfway through the procedure. Do not listen to these “BRO this is a botch job” guys here, they have no clue what they’re talking about. I have been here nearly a decade and have seen hundreds, if not thousands of cases. 

It’s our job as a community to keep members from judging results prematurely. I understand this very well. 6.5 months can feel like an eternity. But it’s only halfway. Now, I don’t know if you’re going to be satisfied in the end. Only time will tell, but I do know it’s too soon to call this a failure. 

Here’s an example of a patient at 6 months vs. 10 months.

The only difference I see is the lighting

[Gramatik]

Guys if you check the graft placement of Dr couto's results in youtube and compare them with this case of the OP, you will see that the graft placement density is similar to the OP's graft placement density, but his result lacks of density while these on youtube do not and they do look too dense. Dr Couto follows the same plan in simillar cases of small norwoods and so the graft placement density is simillar to every of them.

Anyway he should wait some months until 12 months maybe to see if it gets improved, other wise he will do a second hair transplant to fix the lack of density. But why Dr couto already admitted to the OP, that he is dissapointed with the result ?

 

 

Edited July 27, 2022 by Gramatik

[Melvin- Admin]

1 minute ago, BaldV said:

The only difference I see is the lighting

The growth and texture is vastly different to a trained eye. 

[stockholmare]

19 minutes ago, Gramatik said:

Guys if you check the graft placement of Dr couto's results in youtube and compare them with this case of the OP, you will see that the graft placement density is similar to the OP's graft placement density, but his result lacks of density while these on youtube do not and they do look too dense. Dr Couto follows the same plan in simillar cases of small norwoods and so the graft placement density is simillar to every of them.

Anyway he should wait some months until 12 months maybe to see if it gets improved, other wise he will do a second hair transplant to fix the lack of density. But why Dr couto already admitted to the OP, that he is dissapointed with the result ?

 

 

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

[Vann]

1 hour ago, stockholmare said:

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?

 

I think you’re asking great questions just at the wrong time. Just kick back and relax, regardless of any touch up you do, repair, or anything you want to remedy your current situation. The best thing you should do is wait. Just remember you already took the first step in getting a hair transplant so let it reach that 12 month potential then call it a success/failure.

 

melvin is a good example to reference for his slow growth in ht’s. As a matter of fact his most recent one shows some massive growth in his crown in the last month compared to before. 
 

just remember you cannot undo anything so what’s done is done. However, you could continue to stress yourself currently without anything to result from it since your best option would be to wait nonetheless. 
 

but remember no matter what answer you get from why it is currently not 100% wouldn’t make a difference because even if you know the answer your full potential for the procedure can’t yield that fast and there’s nothing you can currently change unfortunately. So I would just recommend you continue your daily life and try not to overthink it (you’re past the ugly duckling phase) so enjoy your present.

[sukh123]

Hi how long after consultation we’re you able to schedule the procedure ?

[Gramatik]

5 hours ago, stockholmare said:

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 (?)

Isn't it the very first line the one that is shown in this picture ? I think your very first line has grown a bit. Do you see single or mutliple grafts in the very front line of this part shown in the picture?

 

Edited July 27, 2022 by Gramatik

[A Fue Good Men]

Who extracted your grafts? A tech or couto himself?

[stockholmare]

13 hours ago, sukh123 said:

Hi how long after consultation we’re you able to schedule the procedure ?

a bit less than 2 years