Consultation with Dr Cuoto -Fuexpert

[Diff-thinner]

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 

[Melvin- Admin]

Impossible to provide input without pictures of your hair. 

[Diff-thinner]

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

[Diff-thinner]

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 

 

 

[Melvin- Admin]

I think you will need more grafts to restore your hairline, unless you want to keep the same shape. I agree with him about going in between native hair. This could potentially lead to shock loss and you could look a lot worse for a marginal benefit. Are you on medication?

[Diff-thinner]

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 

[Melvin- Admin]

2 minutes ago, Diff-thinner said:

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 

You need to give it at least 12 months for the medication to work. Currently, the hairs aren’t strong enough for the trauma. You will inevitably look balder for many months and by 12 months you might end up only slightly better. Have you considered dutasteride with mesotherapy with Dr. Vaño in Madrid? 

[Diff-thinner]

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 

[Diff-thinner]

9 minutes ago, Melvin- Admin said:

I think you will need more grafts to restore your hairline, unless you want to keep the same shape. I agree with him about going in between native hair. This could potentially lead to shock loss and you could look a lot worse for a marginal benefit. Are you on medication?

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 

[Melvin- Admin]

18 minutes ago, Diff-thinner said:

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 

Dr. Bisanga does it in Belgium. Awesome results. You do it every 3 months. I think that would be enough to strengthen the diffuse thinning. 

[1978matt]

That side on, dry hair picture looks as though the front forelock is minaturising.  To me it sounds like the doc wants to work around the perimeter of it and not in between as you suggested.

I guess youre not that old.  30 ish?  Probably better to air on the conservative side at this stage.  You will probably need another HT in 10-15 years anyway, if not sooner.

The crown just isnt thin enough to make the risk/reward ratio viable.

[Melvin- Admin]

Im guessing he wants to keep this shape

I would imagine that would need more than 1,100 grafts. But he’s seen you in person, so im sure he knows better.

[Hairy Henderson]

Side note: how long did it take for you to get the consult?

[Diff-thinner]

On 1/9/2024 at 7:35 PM, 1978matt said:

That side on, dry hair picture looks as though the front forelock is minaturising.  To me it sounds like the doc wants to work around the perimeter of it and not in between as you suggested.

I guess youre not that old.  30 ish?  Probably better to air on the conservative side at this stage.  You will probably need another HT in 10-15 years anyway, if not sooner.

The crown just isnt thin enough to make the risk/reward ratio viable.

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 

 

 

 

 

 

[Diff-thinner]

On 1/9/2024 at 9:30 PM, Calihome1 said:

Side note: how long did it take for you to get the consult?

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 

[Diff-thinner]

On 1/9/2024 at 7:39 PM, Melvin- Admin said:

Im guessing he wants to keep this shape

I would imagine that would need more than 1,100 grafts. But he’s seen you in person, so im sure he knows better.

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 

[FutureHT1208]

Sorry just scrolled up and seen the answer on this question I asked! - Hi man off topic but how did you get a consultation with him? Was it a long wait? I submitted my case 6 months ago and still not heard anything? Every time I message they say they haven’t reviewed it yet 

Edited January 15 by FutureHT1208

[Diff-thinner]

16 hours ago, FutureHT1208 said:

Sorry just scrolled up and seen the answer on this question I asked! - Hi man off topic but how did you get a consultation with him? Was it a long wait? I submitted my case 6 months ago and still not heard anything? Every time I message they say they haven’t reviewed it yet 

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 

 

[Diff-thinner]

18 hours ago, Diff-thinner said:

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 

 

 

 

 

 

If anyone has thoughts on this would be so appreciative