Taking the Plunge... Finally - Circa 1500 Grafts with Dr. Juan Couto @ Fuexpert

[Diff-thinner]

3 hours ago, Rawkerboi said:

Cobblestone appearance has to do with the size of the grafts during placement.  If the grafts are large or they have excess skin one might get a cobblestone appearance.  With the smaller size of todays punches used to harvest the grafts ie 0.8 or 0.9 mm, the cobblestone appearance is a non-issue. 

What was the punch size used in your case? I guess your hair shafts are thicker hence there is some issue.

Generally fine single hair is used on hairline frontal zone

Hi, it was an .8mm punch size, thats why im confused, and theyve just appeared over the last couple of weeks, i dont know where they have come from, the hair isnt even at full thickness yet as others have said

 

[Diff-thinner]

Small update, I have a video call with Dr Couto to hopefully discuss the issue and solutions, One positive thing is that they actioned the complaint quite expeditiously, hoping this can get sorted though   

[hairyelswhere]

17 hours ago, Diff-thinner said:

Hi, it was an .8mm punch size, thats why im confused, and theyve just appeared over the last couple of weeks, i dont know where they have come from, the hair isnt even at full thickness yet as others have said

 

Could it have anything to do with prp by any chance

[Diff-thinner]

7 minutes ago, hairyelswhere said:

Could it have anything to do with prp by any chance

Hey, not 100%, i never thought about it but lets see what the DR says. 

[Diff-thinner]

Between Month 5 & Month 6 exactly, Not exactly sure if this is normal density for the time or not, could do with some feed back, and the Cobblestoning is super bothering me right now not going to lie about it. 

As I have said ive got a video appointment on Tuesday and we will see what happens... Heres some photos after a trim I took about 30 mins ago

 

 

[Konsole93]

So I have thicker hair and also with more frizz and have had no problems with cobblestoning, it is usually up to the doctor how deep he makes the channels.

Couto takes very few grafts compared to others, so they certainly save extremely many grafts which can be very important and right for the future.

The downside, in my opinion, is that it looks very row-like behind the hairline and you sometimes see thicker grafts a little further ahead. As a result, it often looks a bit wiry in my opinion. So I often noticed this with couto and with de Freitas but I am also wrong.

 

[Diff-thinner]

1 hour ago, Konsole93 said:

So I have thicker hair and also with more frizz and have had no problems with cobblestoning, it is usually up to the doctor how deep he makes the channels.

Couto takes very few grafts compared to others, so they certainly save extremely many grafts which can be very important and right for the future.

The downside, in my opinion, is that it looks very row-like behind the hairline and you sometimes see thicker grafts a little further ahead. As a result, it often looks a bit wiry in my opinion. So I often noticed this with couto and with de Freitas but I am also wrong.

 

Well i mean im just wondering why its suddenly appeared, its really bothering me. 

regarding the implanting in rows, If you look at the initial implantation, I dont think hes done that for me, i was quite happy with the implantation, direction wise, let me know your thoughts also i may be wrong. 

On the wiry aspect, Ive heard it will be wiry until the hair matures later in the 12 months, but maybe im wrong?

[Rawkerboi]

11 minutes ago, Diff-thinner said:

Well i mean im just wondering why its suddenly appeared, its really bothering me. 

regarding the implanting in rows, If you look at the initial implantation, I dont think hes done that for me, i was quite happy with the implantation, direction wise, let me know your thoughts also i may be wrong. 

On the wiry aspect, Ive heard it will be wiry until the hair matures later in the 12 months, but maybe im wrong?

It's because of thicker hair shafts, my hair is also similar to yours, and that's what Dr. Pradeep Sethi is said.

Implanting fine nape hairs on the hairline is the trick.

Give your case some time and hopefully it will go.

[Diff-thinner]

Just now, Rawkerboi said:

It's because of thicker hair shafts, my hair is also similar to yours, and that's what Dr. Pradeep Sethi is said.

Implanting fine nape hairs on the hairline is the trick.

Give your case some time and hopefully it will go.

does it tend to go away ?

 

[Rawkerboi]

Just now, Diff-thinner said:

does it tend to go away ?

 

If its bumps it tends to disappear after few months but if its cobblestone then No.

I believe Dr. Couto is the best person to comment on this , as you have an appointment with him, and while you wait, be patient.

[Steeeve]

3 hours ago, Diff-thinner said:

does it tend to go away ?

 

I experienced the same bumps early on during my first transplant around the same time that you are now. They only lasted a few months and are now completely gone. I didn't experience any during my second transplant. I don't think I saw anything past 8-10 months post-op.

[Diff-thinner]

1 minute ago, Steeeve said:

I experienced the same bumps early on during my first transplant around the same time that you are now. They only lasted a few months and are now completely gone. I didn't experience any during my second transplant. I don't think I saw anything past 8-10 months post-op.

Hey steeve, that awesome thank you for the feed back, do you know why they came or what happened, also if you have a thread or pics i would really appreciate it

[Steeeve]

Just now, Diff-thinner said:

Hey steeve, that awesome thank you for the feed back, do you know why they came or what happened, also if you have a thread or pics i would really appreciate it

Here’s the thread for my first transplant. I don't think I documented it the bumps but I can't remember, though. I remember noticing it and seeing a lot of cases with guys also experiencing it at the time.

Someone said that it often happens as the grafts are breaking through the skin which eventually settles back down and looks normal.

I don't think I even reached out to my doctor. I've seen it quite a lot here over the years and maybe only one or 2 cases where it persisted post 12 months and those guys weren't documenting their journey-they just got on the forum to ask for help once they saw that something was wrong after 12 months. It was really bad on those guys, though. I don't have any links to them but it was all throughout their transplanted area. 

I don't think you have anything to worry about by looking at what you've shown us. I think the doctor will put your mind at ease. 

[Diff-thinner]

@Steeeve youre a legend thank you, I was just going through yours, but your doing a lot to put my mind at ease already 

 

[Al - Moderator]

As I posted earlier, I think most, if not all, of the bumps will flatten out and disappear over time. Give it at least a full 12 months. 
 

As for the density I think it looks good. Don’t expect full density as if you never lost any hair. That’s not realistic. 
 

[Diff-thinner]

Question, is the density normal for this stage between months 5 and 6 ? 

[Rawkerboi]

16 hours ago, Diff-thinner said:

Question, is the density normal for this stage between months 5 and 6 ? 

Yes

[Diff-thinner]

Hey Guys, 
Just updating on this. 

Had a chat with Dr Couto, as always I cant speak highly enough of his attentiveness. He told me definitively its not cobblestoning, this is because it would have appeared near to the beginning of the transplant and that rather that its most likely to be dermatitis. He does want to see me, but because of scheduling it may be around month 8 that I will go to see him. 

I explained that the issue seems to come and go, for example today I can see any of the things we discussed before in the photos before, so it seems not  to be what was suspected. 
 

Regarding density, he said what you guys are saying, that its completely normal and that the hairs are immature, but even if im not happy with density at the end he will offer a free touch up at 12 months. I hope i dont have to to be honest but lets see what happens

I guess if anything, this is one of the aspects you pay for when you go to the top ! 


Have a great day guys 

[Al - Moderator]

Great. It's always a good idea to speak with the Dr if you have concerns. Hopefully you will be more relaxed about it now and able to sleep at night without it worrying you. Hair transplants can be mentally draining the first 6 to 9 months. Yours is turning out very nice. You'll be fine.

 

[Diff-thinner]

3 minutes ago, Al - Moderator said:

Great. It's always a good idea to speak with the Dr if you have concerns. Hopefully you will be more relaxed about it now and able to sleep at night without it worrying you. Hair transplants can be mentally draining the first 6 to 9 months. Yours is turning out very nice. You'll be fine.

 

Thanks AL, always appreciate 

[CharlesBarkley]

On 9/10/2024 at 10:30 AM, Diff-thinner said:

Hey Guys, 
Just updating on this. 

Had a chat with Dr Couto, as always I cant speak highly enough of his attentiveness. He told me definitively its not cobblestoning, this is because it would have appeared near to the beginning of the transplant and that rather that its most likely to be dermatitis. He does want to see me, but because of scheduling it may be around month 8 that I will go to see him. 

I explained that the issue seems to come and go, for example today I can see any of the things we discussed before in the photos before, so it seems not  to be what was suspected. 
 

Regarding density, he said what you guys are saying, that its completely normal and that the hairs are immature, but even if im not happy with density at the end he will offer a free touch up at 12 months. I hope i dont have to to be honest but lets see what happens

I guess if anything, this is one of the aspects you pay for when you go to the top ! 


Have a great day guys 

 

Thanks for this update. Your experience here is showing how important it is to have good communication with the doctor after a hair transplant. It is really nice to hear that Dr. Couto took the time to talk to you directly. It makes a big difference when the doctor himself takes time to answer the questions, because many times after the surgery patients do not get to speak with the doctor, only with the nurses or other staff. You are right, the support after the transplant is also what we are paying for, not just the surgery.

Waiting for more photos of the evolution.