Regular Member Diff-thinner Posted March 23 Regular Member Share Posted March 23 Lets start from the beginning... because its a very good place to start. I have seen many questions regarding Couto, How to get a consultation, waiting lists and the rest. So I would like to detail my experience from the very start in the ultimate aim of providing more information for prospective candidates. I do genuinely believe this is a wholistic treatment, not only encompassing simply hair, but rather it encompasses an element of identity, confidence, and the manner in which you will eventually seek to live your life. From future hair cuts, to style to everything else. Certainly, in this brief preface, a decline in how well I presented my self, could have been traced linearly and in correlation with the decline of my hair, and ability to style it in the way I wanted, which eventually had repercussive effects on everything else mentioned. Additionally, I wanted to make this detailed, for those who want all information possible, because this forum, has provided such an invaluable service to me, and the way people respond, advise and give care and attention, makes giving back not only a duty but a pleasure. Getting a Consultation. My advice here is be persistent, bordering annoying. I had emailed around my birthday looking for a consultation, and had a reply initially to do an online one, sending pictures of the state of my hair, when a reply was received it was decided that due to the thickness of my donor hair and the state of my recipient hair, that an in person consultation would be better, but that because bookings were closed I would have to wait until the new year to even attempt getting a consultation. This was in early 2022. So ... I waited, my gut intuition, was that this was the guy. Around October I emailed in confirming the date and time that the consultations would open in January because as soon as they opened I wanted to be the first one on the phone. January came and I had already drafted an email to them, and sent it immediately on the opening of consultations, and then proceeded to call them, to make sure they would open my email. It worked. I had got the consult .... In January... 2024. Doing my calculations, I was told that surgery would be booked for 2025, by which time I would be nearing 30, and really wanted to enter my 30's with a hairline and framed face. Oh well I said, if you want what you want, you must bide your time and wait. The consultation. It was great, but honestly not what I had expected. Dr Couto, I would describe as the 'DON', Cool, Calm, Confident. Filled with an air of self belief, that only results from success, the kind that makes you know what you are capable of. Rather than being in the hands of a surgeon, I would describe him more as an artist, sitting in front of him you get the sense that he is already designing your hair when your sitting there. He discussed my hair characteristics, and the fact that each hair was very thick, which he prefaced that he doesn't usually describe even in his videos, this i thought was great, but actually turned out it is not. This is for two reasons, one is blood supply, the thicker the hair, the more blood is needed and the more that hairs compete for blood supply, this placing more hairs densely packing it risks a lower yield. Second is the problem with the hairline, a hairline requires soft hairs, that makes the progression natural, and so having thick hair is great for behind the hairline, but not so great for arguably the part that everyone notices at first. He thus recommended 1,100 grafts initially and we were done at that. He jokingly told me to go and 'prepare for a fight' with the receptionist who does the booking so that we can get everything booked. I went downstairs preparing my monologue. I did my best, and telling her 'come on its only 1.1k grafts'. she looked at me and said, your best hope is a cancellation, but usually its a wait and see. I made sure she knew my name and that in the hopes that if someone did cancel, I would be thought of. About a week later, I got a cancellation March 19th, best believe I booked that date straight away. The surgery On the day, we did basically a second consult, a redraw of the hairline and me and Dr Couto, were surprised with the results of the topical finasteride I was using, it had yielded growth, and made him more confident to implant between hairs, the hairline he draw he said was perfect, the word perfect was used quite a few times, and I would say I am very happy with it, I dont know what norwood I would be now, any advice from you guys would be appreciated. Esteban does the extractions, dont worry, he has been trained by Dr. Couto and as you will see from my donor, im actually very happy, to the point at the beginning with photos I was quite astounded at how good the extractions were. Since it was a hairline surgery, Dr Couto does almost everything, he left only 200-300 grafts in the mid scalp to be done by the other surgeon. but everything from the site holes to the implantation was done by Dr Couto. Halfway through the surgery an about turn was made, the 1100 grafts were considered not to be enough... Why? well because of my hair characteristics once again. Because of my family history, the Dr wanted to be very conservative with my donor zone, and so while the density is 'superior' what was really bad was the graft count, mainly triples, hardly and 4 or 5 grafts, maybe only 60 for use in the safe donor zone, meaning that while there are loads of grafts available, the singular graft count was lower, meaning more grafts were needed. I cant lie, I was a little disappointed... but apparently this is typical of my genetic origin higher density, average FU's. So we had to do a second extraction of around 300 grafts, taking me to close to 1500. We started at around 10am and finished around 6:30 PM. The doctor checked like three or four times, every time I would leave the room he would call me back, take another look, and just stare and say 'perfect'. You guys can decide from the pictures. Finally we did the hightech PRP. After care They give you a little bag, with moisturising spray, a plastic spray bottle, shampoo and an after care manual. The spray is to be used every 30 mins, to keep the recipient site moist, and thats all basically. The wash, I went in two days later for the wash, got my hair washed and was told all the after care needed regarding shampooing and that on day ten to make sure that all scabs were taken off. now I sit here, waiting, and hoping that another home run has been hit. Because it is my first time, I am a little apprehensive about certain things, but im trying to be very careful. this is a long winded description but I wanted to be detailed and if anyone has any questions do let me know id be happy to answer. In any case here are the photos, let me know what you think. Over and Out Diff 3 Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 23 Author Regular Member Share Posted March 23 I just wanted to say also, I forgot to mention, the donor photos are post extraction, not pre 1 Link to comment Share on other sites More sharing options...
Regular Member 4Godot Posted March 23 Regular Member Share Posted March 23 From what I know of these things, this looks great to me! Also, even if it is closer to 1500 he's done a lot with it. I have a consultation with Dr Couto next month so fascinated by your account and to see how it progresses. Couto's results that I have seen, with very very few exceptions, seem to range from amazing to very very good, so I'd be very confident if I was you. Do you have any before pics? Best of luck with everything! 1 Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 23 Author Regular Member Share Posted March 23 13 minutes ago, 4Godot said: From what I know of these things, this looks great to me! Also, even if it is closer to 1500 he's done a lot with it. I have a consultation with Dr Couto next month so fascinated by your account and to see how it progresses. Couto's results that I have seen, with very very few exceptions, seem to range from amazing to very very good, so I'd be very confident if I was you. Do you have any before pics? Best of luck with everything! Hey 4Godot, yeah so far I cant tell where I'll be on the range, waiting for the more seasoned guys to comment their opinions, but still the same, thanks for your opinion also. Currently the before pics I have wont give you much info, they are really bad quality, but I can promise when I get the hi-res photos from the clinic that ill post them for you. Good luck with your journey also, it is exciting and something to certainly look forward to. I would describe it like waiting for Christmas as a child Link to comment Share on other sites More sharing options...
Regular Member 4Godot Posted March 23 Regular Member Share Posted March 23 Thanks man! Just curious, did you feel like he slightly lowered the middle of the hairline, even from where it is naturally? Just something I've noticed from some up close pics of his other surgeries, I guess he's mainly reinforcing the hairline, but seems to often go a little beyond that with lowering/ framing. Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 23 Author Regular Member Share Posted March 23 Yes he did, if you see the 5th picture, we discussed lowering the hairline a smidge, because I felt like it had receded quite significantly, and affected the proportions of my face, but we did not end up going as low as that, if you look at the implantation pics, its just before the line rather than on the line. The Hairline was outstanding for me, when i looked at it in the mirror and was really happy. But he discusses it with you and is open to suggestions, based on how he believes your hairloss is progressing and will progress. He stated that I was stable, from where the hair was considered miniaturised, and from the fact that I had regrowth in areas that when we had the consultation a few months before, were less filled. But I would say, make your opinion known and it will be heard 1 Link to comment Share on other sites More sharing options...
Regular Member 4Godot Posted March 23 Regular Member Share Posted March 23 cool, great to know. Appreciate the advice! I'm definitely leaning towards a more "conservative" approach. Thanks again 1 Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 24 Author Regular Member Share Posted March 24 Update - 5 days post transplant Donor area and Implanted area 1 Link to comment Share on other sites More sharing options...
Regular Member Phillyman1996 Posted March 24 Regular Member Share Posted March 24 3 hours ago, Diff-thinner said: Update - 5 days post transplant Donor area and Implanted area How many cm is your hairline from the midpoint of eyebrow to hairline? Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 24 Author Regular Member Share Posted March 24 6 minutes ago, Phillyman1996 said: How many cm is your hairline from the midpoint of eyebrow to hairline? Not 100% sure yet, head is still kinda bulging so cant measure accurately, but will measure when all the swelling has subsided Link to comment Share on other sites More sharing options...
Senior Member EvansLawrence Posted March 26 Senior Member Share Posted March 26 Wow you were lucky! getting the appointment and then the cancelation...! haha congrats! I agree with everything you say about Couto. You feel him more like an artist than a surgeon. I like the design. Like it doesnt even look conservative to me. Eager to see your progress here! 1 Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 26 Author Regular Member Share Posted March 26 Hey Evans Lawrence Agree with all you say also, I think the design is great, its a little lower than original but only marginally, and hopefully will frame the face, have you met Couto? Link to comment Share on other sites More sharing options...
Senior Member EvansLawrence Posted March 26 Senior Member Share Posted March 26 1 hour ago, Diff-thinner said: Hey Evans Lawrence Agree with all you say also, I think the design is great, its a little lower than original but only marginally, and hopefully will frame the face, have you met Couto? Nice! Yes man! I am now 5months and a half from my surgery with him! everything is looking great. I still need more density but for month 5 I believe its going good. I see progress. Just yesterday I had a haircut and my barber told me it is the best hair trainsplant she ever saw in her life. I was like nice cause I still have 6 more months to grow haha. I had the surgery in the old clinic and last PRP on the new one. 1 Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 26 Author Regular Member Share Posted March 26 thats awesome, ill check your thread, if you have time can I PM you for some questions I have. BTW the new clinic is awesome!!! Link to comment Share on other sites More sharing options...
Senior Member EvansLawrence Posted March 27 Senior Member Share Posted March 27 20 hours ago, Diff-thinner said: thats awesome, ill check your thread, if you have time can I PM you for some questions I have. BTW the new clinic is awesome!!! yeah sure! feel free to DM me. It is so gorgeous yesss. Funny thing is that I have family living next to the clinic and last time I went there I spent the day at my family home and went there walking, just 10 mins hahah. 1 Link to comment Share on other sites More sharing options...
Regular Member ScottishGuy21 Posted March 27 Regular Member Share Posted March 27 Thanks for the updates Couto consistently makes so few grafts go so far. Is there a more economical surgeon in the world? Only other one that I can think of that rivals him in this area is Dr Ahmad. 1 Link to comment Share on other sites More sharing options...
Regular Member Otis james Posted March 27 Regular Member Share Posted March 27 I really like his work. Had in not gone to Pinto, I would have pushed for Cuoto. pinto was very complimentary of him too. You had a bigger area to cover than me and received less grafts. Normally I’d question that, but with Couto, it’s going to be outstanding. Not sure how he does it really! 1 Link to comment Share on other sites More sharing options...
Senior Member EvansLawrence Posted March 27 Senior Member Share Posted March 27 3 minutes ago, ScottishGuy21 said: Thanks for the updates Couto consistently makes so few grafts go so far. Is there a more economical surgeon in the world? Only other one that I can think of that rivals him in this area is Dr Ahmad. Im a fan of dr. Ahmad as well but specially when It comes to giving natural outlooks. I dont like tho that he is too conservative IMO. 1 Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 27 Author Regular Member Share Posted March 27 30 minutes ago, Otis james said: I really like his work. Had in not gone to Pinto, I would have pushed for Cuoto. pinto was very complimentary of him too. You had a bigger area to cover than me and received less grafts. Normally I’d question that, but with Couto, it’s going to be outstanding. Not sure how he does it really! Im hoping so, but his NW2/3 results with lower grafts always seem to be good, but wont know until I go through it 27 minutes ago, EvansLawrence said: Im a fan of dr. Ahmad as well but specially when It comes to giving natural outlooks. I dont like tho that he is too conservative IMO. Dr Ahmed is awesome, but I got a quote from him and it was around 30-35k which is worth it sure i wont deny because he is involved in everything, but at the same time, Couto's hairlines for me and my face + his approach to placing the hairlines are more inline, meaning I didnt have to end up shelling that amount of money. But if it wasn't going to be couto, it would have been Munib Ahmed Link to comment Share on other sites More sharing options...
Senior Member OliverAtom Posted March 27 Senior Member Share Posted March 27 Great insights and information. Your design looks beautiful. Keep those updates coming! 1 Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 29 Author Regular Member Share Posted March 29 I have a quick question regarding doubles placement? Is it normal for doubles to be placed after the first row in the hairline or would this be regarded as a mistake, I am going to post my pictures after scab removal, but was just wondering as I think I may be able to see a double, maybe one row or one and a half rows after the hairlines singles? Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 30 Author Regular Member Share Posted March 30 Hi Everyone, I just wanted to update after scab removal, which I completed yesterday, today is day 11 and as instructed I have started to apply Aloe Vera non-alcoholic gel in the morning and Rosehip Oil in the evenings for the redness, which surprisingly in my opinion is not too great at the moment. In my opinion it is mainly more prevalent in the first couple of 'hairline' rows. Other than that its nice to see the design and the directionality of the hair is inline with my existing hair. I have taken some pictures under a harsh flash and some without to provide both options to everyone. Thanks Diff 2 Link to comment Share on other sites More sharing options...
Regular Member 4Godot Posted March 30 Regular Member Share Posted March 30 This looks amazing to me man, both the recovery and the shape/density. 1 Link to comment Share on other sites More sharing options...
Regular Member Diff-thinner Posted March 30 Author Regular Member Share Posted March 30 Just now, 4Godot said: This looks amazing to me man, both the recovery and the shape/density. Thank you dude means alot... I am surprised by the lack of redness tbh, it was something I thought may affect me, but surprisingly I would simply put it down to the Dr's carefulness with the way he treated my head, I have shed some hairs also, but nothing major, but getting ready for the shed 😢 Link to comment Share on other sites More sharing options...
Regular Member 4Godot Posted March 30 Regular Member Share Posted March 30 Yeah this is very encouraging for me, as I was kindof vacillating slightly on Couto for treatment for a few months there (after years of thinking he was the holy grail of HTs). You've inspired me to push ahead as we're in similar positions. One thing i forgot to ask you, did he mention anything about implanting amongst existing hairs? To add density? I've seen him do it in some cases but not others Link to comment Share on other sites More sharing options...
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