1700 FUE with Couto on 5/29/23 - My Amazing, Remarkable, Not Bad, Very Good Day in Madrid

[consequence]

On 7/22/2023 at 8:40 PM, cloudyhaze said:

@consequencehow did you go about scab removal? My doctor's office instructions were that it's ok to massage head with shampoo/water right after the 3rd day, while I see other doctors recommend to not touch the scabs and let it fall out on it's own. I'm currently 10 days post op and just been sticking to dumping water/shampoo mixture on head, and not touching it at all.

This probably isn't an active question for you anymore but in case anyone else has the same -- at around 10 days my scabs became brittle and came off with relatively light pressure for about 85% of them. Over the next few days the remaining 15% came off with just a gentle pressing motion. Melvin has a video floating around somewhere on YouTube where he shows the actual pressing technique to remove the scabs that I thought was helpful.

Edited September 4, 2023 by consequence

[consequence]

On 7/22/2023 at 7:56 PM, Kacan said:

I know that Dr. Couto has an assistant for the implantation part. Did you see him, or Couto did the whole part?

Couto did the entire implantation himself. He is extremely meticulous and careful.

[hairman4321]

damn that was a lot of swelling! interesting how some doctors don't get the swelling, that would freak me out. maybe more cos it was over two days? design looks good anyway. your profile photo makes me laugh

Edited September 5, 2023 by mark91

[Youth_Again]

Did you bring a wide hat?

They are telling me to bring a button down and a wide hat, is it necessary ?

[consequence]

On 9/8/2023 at 8:24 AM, Youth_Again said:

Did you bring a wide hat?

They are telling me to bring a button down and a wide hat, is it necessary ?

I brought surgical caps (like you can get at a convenience store or on Amazon). I stayed in my room mostly afterwards so didn't need them, but did use them on the flight back to the USA.

[consequence]

4 month update. Not much has changed, hard to tell from the pics maybe but coming in on the right, a bit stringy/sparse on the left:

 

[Rawkerboi]

Exciting times ahead 

[Youth_Again]

you are giving me hope to look decent around month 3/4.

The first few weeks are really tough

[consequence]

On 9/26/2023 at 9:59 AM, Youth_Again said:

you are giving me hope to look decent around month 3/4.

The first few weeks are really tough

This whole thing is such a rollercoaster. Important not to keep a baseball bat in your emotional tool kit in the beginning. If you figure out how, let me know. 😅

Edited October 5, 2023 by consequence

[consequence]

Here's another shot as I think some of the last posts' were a bit blurry. The density of the left frontal line and further back is still sparse but nothing else to do but wait.

 

[Gatsby]

Early days @consequence. Looking good. 👌

[wprevil]

Hi consequence,

Hope you're well. I'll be seeing Couto in 2 months and need your feedback. Would you please reply to my thread linked below? Would appreciate it a lot.

 

[consequence]

On 9/30/2023 at 11:25 PM, wprevil said:

Hi consequence,

Hope you're well. I'll be seeing Couto in 2 months and need your feedback. Would you please reply to my thread linked below? Would appreciate it a lot.

 

Yes I responded there as well. Good luck man, you're in good hands.

[Youth_Again]

Any supplements you are taking aside from your fin/OM regiment?

I decided not to do the PRP since Dr.Couto said if I don't pick a good clinic it could result in damaging the new implanted hair, so not gonna take the chance.

how long did you use the rosa mosqueta for as well

Edited October 10, 2023 by Youth_Again

[wprevil]

On 10/6/2023 at 3:20 PM, Youth_Again said:

 

I decided not to do the PRP since Dr.Couto said if I don't pick a good clinic it could result in damaging the new implanted hair, so not gonna take the chance.

 

Would you consider getting PRP after your hair grows?

[Youth_Again]

5 minutes ago, wprevil said:

Would you consider getting PRP after your hair grows?

No, useless 

[wprevil]

1 hour ago, Youth_Again said:

No, useless 

Wow really? I thought PRP would help.

[hairman4321]

On 9/28/2023 at 4:08 PM, consequence said:

This whole thing is such a rollercoaster. Important not to keep a baseball bat in your emotional tool kit in the beginning. If you figure out how, let me know. 😅

better a baseball cap than a baseball bat!

the idea of melatonin sounds great. how much were you using to knock yourself out? i'm also not a back sleeper so will need some help!

[consequence]

Just now, hairman4321 said:

better a baseball cap than a baseball bat!

the idea of melatonin sounds great. how much were you using to knock yourself out? i'm also not a back sleeper so will need some help!

I used 5 mg gummies I believe. Also being in a different time zone was tricky. Those first 2 weeks were pretty rough.

5 hours ago, wprevil said:

Wow really? I thought PRP would help.

There's not much known about PRP in the post op setting. Dr. Couto said it would interfere with the natural hair growth cycle, but then he has recommended it to some of his patients from what I've heard, so I think he takes it on a case by case basis. Also the risk of damaging the new follicles through the physical trauma of the needle, though this could be avoided by injecting above and letting gravity allow the liquid to diffuse down (and hold it in place with a mild elastic tourniquet for an hour or so).

My left frontal line is looking a little corn-rowish which is making me strongly consider it. Generally the feedback you'll get here is people will say "give it till a year and then consider" or "PRP doesn't work" (though I think the data is reasonable that it does help with density in the non-surgical setting).

My hunch is that in the post op setting it increases density but not yield. No one knows if it's more effective within the first year or waiting till afterwards, this is all just inductive reasoning (read: broscience) at this point. I suspect it doesn't matter.

No strong peer reviewed double blinded and adequately powered research one way or the other at this point. The studies would not be difficult to do and not that expensive as you're using the patient's own blood, so just machine time. But a surgeon, or group of surgeons, needs to actually take initiative and do the d*mn thing. Perhaps at a future international conference, but that's not in a time frame that's helpful for me.

Similar thought process applies to using lasercaps, though as their mechanism might be similar to minoxidil I'm not sure they would have much of an impact either way. Again really pathetic the absence of good research and standardization as far as technique and recovery in surgical hair restoration. Very backwards field in a lot of ways.

If my density hasn't improved at 6 months, I may consider it. Still on the fence.

[wprevil]

Hi Youth_Again,

Will you consider seeing Couto again to help with your frontal part? Maybe he can redo it for free?

[consequence]

7 hours ago, wprevil said:

Hi Youth_Again,

Will you consider seeing Couto again to help with your frontal part? Maybe he can redo it for free?

Was this question for me? I don't think I'm at the point yet to consider a touch up -- way too early at 5 months. I'll wait till a year and reassess, will cross that bridge when the time comes.

On 10/6/2023 at 8:20 AM, Youth_Again said:

Any supplements you are taking aside from your fin/OM regiment?

how long did you use the rosa mosqueta for as well

I really didn't use the mosqueta for more than a day as my redness went away on its own pretty fast. No supplements other than avodart, ketoconazole and oral minoxidil that would relate to hair loss. Generally following a carnivore/mediterranean diet with organ meats and vegetables.

Edited October 12, 2023 by consequence

[wprevil]

1 hour ago, consequence said:

Was this question for me? I don't think I'm at the point yet to consider a touch up -- way too early at 5 months.

5 Months? I think you may be a it too early. I'd say wait 2 - 3 more months and see. I noticed something about your front. Try growing it out a bit and maybe that way you'd be able to see density imho since it looks too short. That may help.

Btw I'm trying to find the cheapest flights from USA to Madrid. Could you provide any websites that can help with that?

Edited October 12, 2023 by wprevil

[Youth_Again]

13 hours ago, consequence said:

Was this question for me? I don't think I'm at the point yet to consider a touch up -- way too early at 5 months. I'll wait till a year and reassess, will cross that bridge when the time comes.

I really didn't use the mosqueta for more than a day as my redness went away on its own pretty fast. No supplements other than avodart, ketoconazole and oral minoxidil that would relate to hair loss. Generally following a carnivore/mediterranean diet with organ meats and vegetables.

one month in, still got some redness. 

I guess I will just send the clinic an email asking when I should stop using it

[George Clooney]

On 9/4/2023 at 3:38 PM, consequence said:

 

@stockholmare's hair

I don't want to worry you but I have to second what @Giddylot said earlier. The density unfortunately seems a bit low. For example, compare to @stockholmare's pics below with yours above. He ended up having a sparse result and was lost to follow up after his revision. Your follicle distribution looks almost identical to his.

I think Couto is able to get away with less dense packing with his Spanish/Portuguese patients because of their dense thick hair and darker hair and skin color, but I don't think it always translates well for his international patients. There have been a few cases (~8 or 9 between here and recuperar out of maybe 50 or 60) where things ended up looking a little stringy at the end for similar reasons. His artistry is excellent though, no doubt about that.

Your yield so far looks excellent, the stringiness is because the transplanted hairs just haven't thickened up and the packing is a bit scant. I hope things beef up, but if not there's always PRP and revisions. Please keep us updated.

 

[consequence]

5 months:

Overall it looks good on the right, still thin on the left. It seems like most of the hairs have grown, just immature caliber. Even feeling them, they're more "silky" like baby hairs -- they will hopefully coarsen up. Hopefully left follows the right, but if not will consider a minor touch up.  

  

On 10/11/2023 at 8:44 PM, wprevil said:

Btw I'm trying to find the cheapest flights from USA to Madrid. Could you provide any websites that can help with that?

Google's ITA matrix and Skiplagged to see what's out there, then Cheapoair, Momondo and Kayak for specific tickets.