Regular Member stockholmare Posted January 24, 2023 Regular Member Share Posted January 24, 2023 Hello dear forum-friends, I am posting with my heart full of hope, as I will soon leave to Madrid to touch up my first (unsuccessful) procedure with dr Couto. I am now 13 months post-op, as the first surgery was carried out in Jan 2022. For reference, you can find that thread here So, tomorrow I will undergo another procedure, with him again to add the density that failed to stem from the first surgery. Backgroud: After the 2000 grafts procedure, according to the Dr, my body failed to provide enough blood supply to the transplanted units, thus delivering low yield: the doc will assess the exact yield and needed grafts for this second surgery once I’ll be at the clinic. In my personal opinion my yield was about 30-35% (I am unsure tbh), but I hope he will bring some of his magic and not to need too many grafts, because I would like to keep some for future needs, should there be. Looking forward: I decided to go again with dr. Couto because, despite the low growth of the first procedure he struck me as a very integer person and professional, who truly cares about his patients and their happiness, and whose skills are second to none. I will update this regularly for your reference. Attached is the 13 months post op situation that I hope dr. Couto will be able to fix🤞🤞 Wish me luck!😄 4 Link to comment Share on other sites More sharing options...
Senior Member Big Rome Posted January 24, 2023 Senior Member Share Posted January 24, 2023 19 minutes ago, stockholmare said: Hello dear forum-friends, I am posting with my heart full of hope, as I will soon leave to Madrid to touch up my first (unsuccessful) procedure with dr Couto. I am now 13 months post-op, as the first surgery was carried out in Jan 2022. For reference, you can find that thread here So, tomorrow I will undergo another procedure, with him again to add the density that failed to stem from the first surgery. Backgroud: After the 2000 grafts procedure, according to the Dr, my body failed to provide enough blood supply to the transplanted units, thus delivering low yield: the doc will assess the exact yield and needed grafts for this second surgery once I’ll be at the clinic. In my personal opinion my yield was about 30-35% (I am unsure tbh), but I hope he will bring some of his magic and not to need too many grafts, because I would like to keep some for future needs, should there be. Looking forward: I decided to go again with dr. Couto because, despite the low growth of the first procedure he struck me as a very integer person and professional, who truly cares about his patients and their happiness, and whose skills are second to none. I will update this regularly for your reference. Attached is the 13 months post op situation that I hope dr. Couto will be able to fix🤞🤞 Wish me luck!😄 chin up bro, I’m 1000% sure he will be able to rectify things and give you the hair you wanted first time round, he’s incredible tbh. will be worth it in the end I’m sure 1 1 Link to comment Share on other sites More sharing options...
Senior Member TorontoMan Posted January 24, 2023 Senior Member Share Posted January 24, 2023 Very nice native hair behind the transplant. Can you take a photo less zoomed in so we can see a more encompassing photo of your situation? It's great to hear how much Dr. Couto cares for the patient and I have no doubt you'll get the result you want second round. 1 Link to comment Share on other sites More sharing options...
Regular Member Jackdaniels Posted January 25, 2023 Regular Member Share Posted January 25, 2023 14 hours ago, stockholmare said: Hello dear forum-friends, I am posting with my heart full of hope, as I will soon leave to Madrid to touch up my first (unsuccessful) procedure with dr Couto. I am now 13 months post-op, as the first surgery was carried out in Jan 2022. For reference, you can find that thread here So, tomorrow I will undergo another procedure, with him again to add the density that failed to stem from the first surgery. Backgroud: After the 2000 grafts procedure, according to the Dr, my body failed to provide enough blood supply to the transplanted units, thus delivering low yield: the doc will assess the exact yield and needed grafts for this second surgery once I’ll be at the clinic. In my personal opinion my yield was about 30-35% (I am unsure tbh), but I hope he will bring some of his magic and not to need too many grafts, because I would like to keep some for future needs, should there be. Looking forward: I decided to go again with dr. Couto because, despite the low growth of the first procedure he struck me as a very integer person and professional, who truly cares about his patients and their happiness, and whose skills are second to none. I will update this regularly for your reference. Attached is the 13 months post op situation that I hope dr. Couto will be able to fix🤞🤞 Wish me luck!😄 Good luck with your second procedure. Your first surgery with dr Couto was indeed bad with low yield which is totally unacceptable when you pay premium and you don’t want to lose any valuable grafts. I wish your second surgery with couto to be better than the first one. Keep us updated. 1 Link to comment Share on other sites More sharing options...
Senior Member Zinedine Posted January 25, 2023 Senior Member Share Posted January 25, 2023 15 hours ago, stockholmare said: Hello dear forum-friends, I am posting with my heart full of hope, as I will soon leave to Madrid to touch up my first (unsuccessful) procedure with dr Couto. I am now 13 months post-op, as the first surgery was carried out in Jan 2022. For reference, you can find that thread here So, tomorrow I will undergo another procedure, with him again to add the density that failed to stem from the first surgery. Backgroud: After the 2000 grafts procedure, according to the Dr, my body failed to provide enough blood supply to the transplanted units, thus delivering low yield: the doc will assess the exact yield and needed grafts for this second surgery once I’ll be at the clinic. In my personal opinion my yield was about 30-35% (I am unsure tbh), but I hope he will bring some of his magic and not to need too many grafts, because I would like to keep some for future needs, should there be. Looking forward: I decided to go again with dr. Couto because, despite the low growth of the first procedure he struck me as a very integer person and professional, who truly cares about his patients and their happiness, and whose skills are second to none. I will update this regularly for your reference. Attached is the 13 months post op situation that I hope dr. Couto will be able to fix🤞🤞 Wish me luck!😄 Nice to see you will be doing a touch-up with Dr Couto, can't think anyone better than him... One thing, with the photos you post it we can not really see a real-life hair transplant result... I mean, camera is way too close and focusing on just a number of follicles ... to have a better idea of your overall result, could you post some photos with the camera at least 1 meters or so... and could you share some photos of your donor? ... Best of luck these days and thanks for sharing your experience. Link to comment Share on other sites More sharing options...
Regular Member stockholmare Posted February 4, 2023 Author Regular Member Share Posted February 4, 2023 So here I am at 10 days post surgery. Scabs removed just now and normal life about to begin again ✌️ the surgery: As son as I arrived at the clinic The doctor assessed about 400 graft to fix my situation, which I was happy about. We ended up doing a bit more than that (460-470) but still very reasonable amount: the strategy was not to pack too much to avoid ultra blood-competition among implanted hairs and optimize for survival rather than perfect density. I bled a lot during the surgery, due to some dermatitis I have: this was not good and dr Couto told me that straight away: hopefully this will not affect my regrowth badly but it is not possible to tell. I must say I really felt taken care of, regardless: the doc had planned for a quick touch up of my hairline and corners, and because of the bleeding, we ended up implanting for about 3.5 hours: he did every single graft himself. He offered me a lift back to my hotel (legend) but I really had my accommodation just behind the corner 😂. We agreed I will probably need a final round in one year from now (100 grafts if everything grows back this time🤞). Now what: I will start oral minoxidil and some supplement (zinc, b complex, d, etc) tomorrow as indicated by the doc. I will start praying and hoping that this time my growth rate is in the 90% some questions for this community: is it normal to have some hair shafts come out with the scabs during the scab removal washing? is it normal to feel some pain (bruise-like pain) in the recipient area at this stage? Pics below the pre op, immediate post op, 7 days and 10 days (most recent pics are last). 1 Link to comment Share on other sites More sharing options...
Senior Member Hairy Henderson Posted February 4, 2023 Senior Member Share Posted February 4, 2023 I don’t understand, the first surgery result was due to lack of blood supply whereas the second surgery you had excess bleeding? Link to comment Share on other sites More sharing options...
Regular Member Rafael Manelli Posted February 4, 2023 Regular Member Share Posted February 4, 2023 Couto sounds like a good doctor and an honorable guy. Nice to hear he’s trying to play it safe for you. You have great hair caliber. I’m confident this will go well for you. Good luck and happy growing 2 Link to comment Share on other sites More sharing options...
Regular Member BaldGuy Posted February 7, 2023 Regular Member Share Posted February 7, 2023 From the Pre op pic, it is obvious that there are visible gaps in your transplanted area. So your first surgery with Dr Couto was bad due to the low growth of your transplanted grafts. When a first surgery is not succesful with a surgeon, i would not feel very confident to select the same surgeon for the second time, but you did... Anyway i wish you good luck and happy growing. Link to comment Share on other sites More sharing options...
Valued Contributor A_4_Archan Posted February 7, 2023 Valued Contributor Share Posted February 7, 2023 Best of luck for this touch up surgery ...and wish u all the growth... Good tht the doctor was graceful enough to accept ths and gave u a free touch up..surgery cn go wrong cause of many factors involved in it bt an ethical surgeon like him will always do this to help patient who trusted him so much.. 1 Check Out My Hair Transplant Journey --> My Thread 3611 FUE Grafts With Dr Kongkiat Laorwong | Norwood 5 | 2nd May 2023 Link to comment Share on other sites More sharing options...
Regular Member Rafael Manelli Posted February 7, 2023 Regular Member Share Posted February 7, 2023 2 hours ago, BaldGuy said: From the Pre op pic, it is obvious that there are visible gaps in your transplanted area. So your first surgery with Dr Couto was bad due to the low growth of your transplanted grafts. When a first surgery is not succesful with a surgeon, i would not feel very confident to select the same surgeon for the second time, but you did... Anyway i wish you good luck and happy growing. It grew better at the hairline for some reason. I’ve seen this many times. I wish I knew why. Link to comment Share on other sites More sharing options...
Regular Member BaldGuy Posted February 7, 2023 Regular Member Share Posted February 7, 2023 (edited) 2 hours ago, Rafael Manelli said: It grew better at the hairline for some reason. I’ve seen this many times. I wish I knew why. Something must have been done wrong in the procedure, either by Couto or his tech, which resulted in lower yield of grafts. Edited February 7, 2023 by BaldGuy Link to comment Share on other sites More sharing options...
Regular Member Rafael Manelli Posted February 7, 2023 Regular Member Share Posted February 7, 2023 4 minutes ago, BaldGuy said: Something must have been done wrong in the procedure, either by Couto or his tech, which resulted in lower yield of grafts. Sure, maybe. But why did the hairline grow better? Link to comment Share on other sites More sharing options...
Regular Member BaldGuy Posted February 7, 2023 Regular Member Share Posted February 7, 2023 1 minute ago, Rafael Manelli said: Sure, maybe. But why did the hairline grow better? We cant know that because we were not in the surgery room to see what went wrong either in extraction or implantation of those grafts. Link to comment Share on other sites More sharing options...
Regular Member Rafael Manelli Posted February 7, 2023 Regular Member Share Posted February 7, 2023 2 minutes ago, BaldGuy said: We cant know that because we were not in the surgery room to see what went wrong either in extraction or implantation of those grafts. Yes obviously but I'm just curious since it is something I've seen before There must be something different about hairline grafts. Link to comment Share on other sites More sharing options...
Senior Member OliverAtom Posted February 7, 2023 Senior Member Share Posted February 7, 2023 (edited) 6 hours ago, BaldGuy said: From the Pre op pic, it is obvious that there are visible gaps in your transplanted area. So your first surgery with Dr Couto was bad due to the low growth of your transplanted grafts. When a first surgery is not succesful with a surgeon, i would not feel very confident to select the same surgeon for the second time, but you did... Anyway i wish you good luck and happy growing. I have to disagree with you, and this is my humble opinion. I rather think that when a HT has poor growth in the hands of a world-class doctor like Couto, no one better than the doctor himself to face the challenge of finding a solution to the lack of success on the previous procedure. And why I say this? Because he could already know what the patient´s difficulties may be. Moreover, an unsuccessful HT, especially when this happens on procedures performed by renowned doctors, does not depend on the work done by the doctor and his team. However, most of the time, there are personal conditions that, in certain circumstances, do not favor good growth. And this is why HTs are not procedures that can be guaranteed. Knowing Couto´s experience on hair transplants, without any doubt, you will always have a better chance of securing a successful outcome with a doctor like him. We should also mention Dr Couto´s attitude, offering a touch-up at no additional cost, which should be an example for many other doctors around here. Edited February 7, 2023 by OliverAtom 5 Link to comment Share on other sites More sharing options...
Regular Member BaldGuy Posted February 8, 2023 Regular Member Share Posted February 8, 2023 (edited) 1 hour ago, OliverAtom said: I have to disagree with you, and this is my humble opinion. I rather think that when a HT has poor growth in the hands of a world-class doctor like Couto, no one better than the doctor himself to face the challenge of finding a solution to the lack of success on the previous procedure. And why I say this? Because he could already know what the patient´s difficulties may be. Moreover, an unsuccessful HT, especially when this happens on procedures performed by renowned doctors, does not depend on the work done by the doctor and his team. However, most of the time, there are personal conditions that, in certain circumstances, do not favor good growth. And this is why HTs are not procedures that can be guaranteed. Knowing Couto´s experience on hair transplants, without any doubt, you will always have a better chance of securing a successful outcome with a doctor like him. We should also mention Dr Couto´s attitude, offering a touch-up at no additional cost, which should be an example for many other doctors around here. My opinion is that when you get low growth from a surgeon and the surgeon doesn't know what happened and you got low growth, then its a bit risky to go again to the same doctor since it may happen again if the surgeon did not find his fault. To offer a free repair was the least that Dr couto could do on that case, because his patient lost valuable grafts and he has to suffer by doing a second repair surgery for a small problem which should have been finished in one surgery with no losses at all, especially for the high price he paid. Anyway, i hope the OP solves his hair loss problem this time with no need for another procedure. Edited February 8, 2023 by BaldGuy Link to comment Share on other sites More sharing options...
Valued Contributor A_4_Archan Posted February 8, 2023 Valued Contributor Share Posted February 8, 2023 10 hours ago, OliverAtom said: I have to disagree with you, and this is my humble opinion. I rather think that when a HT has poor growth in the hands of a world-class doctor like Couto, no one better than the doctor himself to face the challenge of finding a solution to the lack of success on the previous procedure. And why I say this? Because he could already know what the patient´s difficulties may be. Moreover, an unsuccessful HT, especially when this happens on procedures performed by renowned doctors, does not depend on the work done by the doctor and his team. However, most of the time, there are personal conditions that, in certain circumstances, do not favor good growth. And this is why HTs are not procedures that can be guaranteed. Knowing Couto´s experience on hair transplants, without any doubt, you will always have a better chance of securing a successful outcome with a doctor like him. We should also mention Dr Couto´s attitude, offering a touch-up at no additional cost, which should be an example for many other doctors around here. Yeh i agree with you on ths thng... Check Out My Hair Transplant Journey --> My Thread 3611 FUE Grafts With Dr Kongkiat Laorwong | Norwood 5 | 2nd May 2023 Link to comment Share on other sites More sharing options...
Senior Member Zinedine Posted February 10, 2023 Senior Member Share Posted February 10, 2023 On 2/8/2023 at 1:50 AM, BaldGuy said: My opinion is that when you get low growth from a surgeon and the surgeon doesn't know what happened and you got low growth, then its a bit risky to go again to the same doctor since it may happen again if the surgeon did not find his fault. To offer a free repair was the least that Dr couto could do on that case, because his patient lost valuable grafts and he has to suffer by doing a second repair surgery for a small problem which should have been finished in one surgery with no losses at all, especially for the high price he paid. Anyway, i hope the OP solves his hair loss problem this time with no need for another procedure. So are you saying that every single graft should ALWAYS grow if a surgeon/technician does a perfect implantation? Right? ... From your response, you are deliberately making the doctor and his team responsible for the poor growth... don't you think Dr Couto knows better? As far as I know, poor growth may be due to many different variables, patient hair/skin characteristics, blood supply, patient post-op care or complications, etc... and yes, it could also be a bad job from a surgeon/technitian... but it's not something just related to the surgeon or the technician doing the job. By your response, I am not sure you knew about this. World-class clinics and doctors obtain world-class recognition based on their HT experience, results, consistency, and care for their patients...Dr Couto and his team are among a selected group... Now, just ask some of the greats like Dr Konior, Dr Bisanga, Dr Shapiro, Dr Zarev, Dr Sethi, Dr Hasson & Wong, to name a few, if they will guarantee a HT result ... I doubt any would do it. From my experience, which I mostly got from this an other Hair Forums, every case is unique, and every case will have different challenges. A hair transplant's final result can never be guaranteed, even if you pay millions per graft. Sometimes it's important to do some research before offering an opinion... if not, your opinion will look poor and negative without any foundation at all... and this Forum is the opposite of that. 1 1 Link to comment Share on other sites More sharing options...
Regular Member BaldGuy Posted February 10, 2023 Regular Member Share Posted February 10, 2023 (edited) 12 hours ago, Zinedine said: So are you saying that every single graft should ALWAYS grow if a surgeon/technician does a perfect implantation? Right? ... From your response, you are deliberately making the doctor and his team responsible for the poor growth... don't you think Dr Couto knows better? As far as I know, poor growth may be due to many different variables, patient hair/skin characteristics, blood supply, patient post-op care or complications, etc... and yes, it could also be a bad job from a surgeon/technitian... but it's not something just related to the surgeon or the technician doing the job. By your response, I am not sure you knew about this. World-class clinics and doctors obtain world-class recognition based on their HT experience, results, consistency, and care for their patients...Dr Couto and his team are among a selected group... Now, just ask some of the greats like Dr Konior, Dr Bisanga, Dr Shapiro, Dr Zarev, Dr Sethi, Dr Hasson & Wong, to name a few, if they will guarantee a HT result ... I doubt any would do it. From my experience, which I mostly got from this an other Hair Forums, every case is unique, and every case will have different challenges. A hair transplant's final result can never be guaranteed, even if you pay millions per graft. Sometimes it's important to do some research before offering an opinion... if not, your opinion will look poor and negative without any foundation at all... and this Forum is the opposite of that. A doctor would never admit that him or his team did a a fault in the procedure which resulted in lower growth to his patient. He would say that the cause would be less blood suply and simillar excuses. But in most cases in the second procedure the patient gets maximum growth, so on that case the blood supply suddenly increased? From that you can understand that doctors find excuses to their faults. If everything would be done perfectly then above 95% of grafts should survive, which mean no visible gaps like the ones we can see in this Couto's patient. A cause of low growth might be thinning on donor (DUPA), which case does not apply to this patient. Also less blood supply may be happen if the surgeon implants very high density above 60-65 grafts/cm2, which also does not apply on that case. You just know general stuff but you have to do better research when you try to make general statemens without specific details, bacause this will result to poor and wrong statemens. Have a nice day. Edited February 10, 2023 by BaldGuy Link to comment Share on other sites More sharing options...
Senior Member BaldReaper Posted February 13, 2023 Senior Member Share Posted February 13, 2023 Good luck, but the low yield wasn't the problem, even if 100% of the hairs were to grow the result would be bad solely because the amount of transplanted hair transplanted was extremely insufficient to start with. Link to comment Share on other sites More sharing options...
Regular Member BaldingEye Posted February 14, 2023 Regular Member Share Posted February 14, 2023 On 1/24/2023 at 9:53 PM, TorontoMan said: Very nice native hair behind the transplant. Can you take a photo less zoomed in so we can see a more encompassing photo of your situation? It's great to hear how much Dr. Couto cares for the patient and I have no doubt you'll get the result you want second round. Dr Couto is by far the best and your result would be great. @stockholmare as TorontoMan is asking you, could you take a photo less zoomed in so we can see a more encompassing photo of your situation? Could you share some indoor or outdoor photos? How is it going? As you know, it's time to be patient. From week 3 till month 4, I was extremely nervous. But time goes by really quick. Link to comment Share on other sites More sharing options...
Senior Member Mike10 Posted February 14, 2023 Senior Member Share Posted February 14, 2023 30%? I think the Dr needs to give you the money back at least partially Link to comment Share on other sites More sharing options...
Regular Member stockholmare Posted February 15, 2023 Author Regular Member Share Posted February 15, 2023 On 2/14/2023 at 2:50 PM, BaldingEye said: Dr Couto is by far the best and your result would be great. @stockholmare as TorontoMan is asking you, could you take a photo less zoomed in so we can see a more encompassing photo of your situation? Could you share some indoor or outdoor photos? How is it going? As you know, it's time to be patient. From week 3 till month 4, I was extremely nervous. But time goes by really quick. @BaldingEye@TorontoMan unfortunately I do not have pre second surgery pics that clearly show the situation: this is because I wore my hair forward in a way that would conceal the situation after my first procedure. Overall I am feeling well, trying not to think about it and waiting for the shedding and ugly duckling phase to start (saw several shafts today during the shower) I am slightly concerned as I still feel some pain in the recipient/donor, but I figure it it fairly normal at 3 weeks post op. Does anyone know if it is ok to go for (non-challenging) walks within the first 24/48 hours after surgery? I did so to increase blood circulation, but now I question my decision. Link to comment Share on other sites More sharing options...
Senior Member Spring15 Posted February 18, 2023 Senior Member Share Posted February 18, 2023 Dr Couto produces some amazing results, hoping the second time brings you a better result "Does anyone know if it is ok to go for (non-challenging) walks within the first 24/48 hours after surgery?" - Walking is fine. I spent my first day after surgery walking between air port terminals for 4 flights home lol Link to comment Share on other sites More sharing options...
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