Dr. Felipe Pittella

On 1/24/2022 at 7:12 PM, Melvin- Moderator said:

Fantastic work, you definitely deserve getting approved for our recommendation. This is a great example of how you should treat diffuse hair loss patients. I would ask if you could post some graft placement pictures, that would be fantastic.

Thank you. I'll soon post a video here with a graft placement using DNI 

PATIENTS INSTAGRAM`S PROFILE 

SURGERY DAY VIDEO POSTED 1 YEAR AGO - INSTAGRAM

Age: 39 yo

NW: 4/5

Donor Area: Average (Thin hair)

Total Number of Grafts: 5280 

Number of Sessions: 1 

Surgical Plan: Frontal and temples priority (see video). High density on frontal region and degrade to midscalp and crown area.

Rx: Topical and Oral Minoxidil, clobetazol and ketoconazol Shampoo, biotin (NO FINASTERIDE or any other 5-ARI)

MARKINGS (see video for crown area)

IMMEDIATE POST-OPERATIVE

ONE YEAR AFTER

19 hours ago, 5BetaReductase said:

Fantastic case. Do you have after pics of the occipital donor?

In the video you can view the occipital donor though I'll try to find one

On 1/24/2022 at 6:39 PM, SLA said:

The NW7 poor donor OP has a lot less left in the donor region making the top look more robust. Maybe it is just my eyes

That is true 👏. That's why I said that artistic sensibility is really important in those high NW classes.

21 hours ago, tony71 said:

Wow! This is impressive.  Maybe I can email you my pics and get consultation with you too?

Thank you. Please feel free to DM here if you might 

On 1/23/2022 at 1:56 PM, kirkland said:

Really nice work, Dr. Pittella!

You make these challenging cases look effortless.

Thank you! Indeed this one was an easy one thanks to his slightly curly hair and also a very dense donor area

57 minutes ago, SLA said:

Fantastic!

 

old but gold

1 hour ago, Mattk494 said:

What is the time frame shown for the before and after photos?

good question: 10 front, 8 crown

VIDEO - Watch this NW 6 - Full Video SOLVED Comb through (hair line detail)

Age: 39 yo

NW: 6

Donor Area: GOOD

Total Number of Grafts: 7554 

Number of Sessions: 2 

Surgical Plan: Session 1: 3952 FU increase density in and frontal areas midscalp

                        Session 2: 2470 FU From head plus 1132 FU from beard to cover midscalp and crown areas

Rx: Topical and Oral Minoxidil, clobetazol and ketoconazol Shampoo, biotin (NO FINASTERIDE or any other 5-ARI)

3 hours ago, Mattk494 said:

Have you ever done any Norwood 5/6 younger patients in their late 20’s or early 30’s? If so, can you post a result from that? 
@Dr. Felipe Pittella

I've already have the next result ready to post, but I'll post what you asked ASAP

On 1/16/2022 at 8:39 PM, aaron1234 said:

Miraculous result! 😮  @Dr. Felipe Pittella Do you see any purpose for this patient to try finasteride even though he is already a NW7?  Also, does the short length on the sides and the back contribute to the homogenous look for the donor area?  Again, beautiful work!

great question. Yes, I think it is valid to do clinical treatment because It will improve the donor area. 

About the finasteride, I usually don't prescribe 5-ARI (fina or duta) to my patients. I know almost 99% of all HT surgeons would recommend 5-ARI but I do not, so I must rely only on a well performed surgery to achieve my results. I know this is controversial and is a discussion for an entire new topic.

On 12/11/2021 at 4:52 AM, Curious25 said:

I think its incredible how you were able to extract 7815 from what was considered to be a poor donor area. 

Can you go into a bit of detail with the forum what your extraction pattern technique involves, and how you were able to execute this? 

On 12/11/2021 at 9:17 AM, Dr. Felipe Pittella said:

Maybe even over 50%. Actually I do not always rely on a very rigid surgical plan ruled by numbers and percentages. I'd rather make some of my decisions, specially on very difficult cases, based on some subjectives standards. Those are such as "color" of the remaining hair in donor; impression of homogeneity between donor and bald areas; impression of the volume of hair that I may achieve after covering an area with some density (hipotetcaly comparing with another density) and so on. 

Although there is described some mathematical formulas to try to calculate this ("coverage value" or "hair coverage index"). IMO Those are values that cannot be precisely calculated so I may trust also in some kind of "artistic feeling"/subjective judgment... 

I got literally to the limits of the donor area: to the limit next to bald area and neck, to the limit of the remaining density in the donor.
The objective was to intentionally lower the density of the donor area beyond the 'recommended' limit in order to get a uniformity/homogeneity in the areas i've covered.

I think this quotes may answer your question. Sorry for late reply.

On 12/11/2021 at 1:09 PM, SLA said:

Also interesting, Dr. Pittella  that you don’t think SMP in recipient area is a good idea. I have seen HT patients get ‘density treatments’ in recipient area with SMP with excellent results.

I’m curious to know the reasons for your thoughts.

On 12/12/2021 at 12:09 PM, Ryan Rap said:

Would also like to know why you do not recommend SMP to add density to top of head? Great result by the way! 

sorry to take so long to answer. Why I do not like SMP in recipient area: my thoghts are if a patient is looking for a HT he wants real hair to cover the baldness, natural hair. He wants his own hair back. And that is possible even in the most advanced classes of norwood. Of course the higher the class, more grafts are going to be needed. SMP may give a good "density" effect in a picture, but pacient wont have the 3D effect in reality and also won't have the feeling of volume when he combs it with his hand.

PS: are there 'impossible' cases? Yes there are. But especially on those cases, SMP is not even going to help.

11 hours ago, Gatsby said:

I'm becoming a huge fan of your work Dr Pitella! Another great result! 🙏

thankyou!

11 hours ago, 5BetaReductase said:

@Dr. Felipe Pittella I see you prescribe clobetasol to many of your patients. How often do they use it? Since it is a super potent class corticosteroid, can it have the possibility of thinning the skin over time?

great question.

twice in week. Since there is no deposit of cobetasol under the skin, i.e., the foam is rapidly washed away after 5 minutes in the shower, there is no significant tissue alteration. 

33 minutes ago, SLA said:

Also, what dose of oral minoxidil do you prescribe- 2.5mg or 5mg?

Men starting with 2,5 and then up, if well tolerated

24 minutes ago, SLA said:

I notice how it seems NONE of your patients are taking any 5-ARI. Do you think it is possible to stop the progression of baldness only with what you have been prescribing including Topical and Oral Minoxidil, clobetazol and ketoconazol Shampoo and biotin?

Indeed I don't like to prescribe Fina or Duta because of the possibility of one losing his libido. If so happens, the patient will give up using any rx at all.

For that reason I do not rely on 5-ARI to get a good result. 

I must admit that it is much more dificult to stop baldness progression without it (5-ARI). In some cases when the genetical target is not so "strong" for baldness, it may be possible to stop progression (with oral minoxidil). 

VIDEO - Watch this NW 4a - Full Video SOLVED Comb through 

Age: 52 yo

NW: 4a

Donor Area: GOOD

Total Number of Grafts: 4554 

Number of Sessions: 1 

Surgical Plan: Lower the hairline with good density, increase density in midscalp and crown areas.

Rx: Topical and Oral Minoxidil, clobetazol and ketoconazol Shampoo, biotin (NO FINASTERIDE or any other 5-ARI)

7 hours ago, Gatsby said:

Do you know how many of the chest grafts didn’t survive? Also how far apart were each of the three surgeries carried out? It’s an incredible result! 

This pacient came from Spain, so I had to plan the 3 procedures according to his travels. When he first came to Brazil, we did 2 FUE (6 weeks apart) and the other one 10 months later. 

About the chest grafts, I can't tell you precisely. The fact is that if the technique is performed properly, and there is no accidents in the post op (graft avulsion or infection), there is no reason why the grafts should not grow. Chest grafts indeed have a very poor coverage value... But in a case like this, there was no other option. BTW, this pacient asked me not to harvest grafts from noble beard areas (face, mustache etc), so I only had left the neck area (fortunately it was "enough"). 

12 hours ago, SLA said:

How do get to know more about you such as years in the business, who trained you, how to have a consultation, etc?

My early masters were Dr Roberto Trivellini and Dr Marcelo Pitchon. After some years I've developed my own ways to optimize the surgeries. 

I need to update my profile. Melvin is really asking me my bio. I'll soon update it. 

To schedule a consultation Whatsapp +55(27)98119-0577 

12 hours ago, SLA said:

Correct me if I am wrong, but I think that is advantage of FUE in that one can 'over-harvest', yet if homogenized it looks 'normal' and scarring is prevalent, a good SMP artist can usually conceal well.  

That is correct. Although I've never needed SMP for my FUE pacients donor area (maybe because of punch size or only good healing from my pacients) I would recommend if scarring was visible. What I DO NOT recommend is SMP for the bald area. I believe bald area must be covered with hair, not ink. 

11 hours ago, SLA said:

Wonderful!!! What percentage of the donor area did you extract? I am assuming it was well over than 40%, no?

Sure it was. Maybe even over 50%. Actually I do not always rely on a very rigid surgical plan ruled by numbers and percentages. I'd rather make some of my decisions, specially on very difficult cases, based on some subjectives standards. Those are such as "color" of the remaining hair in donor; impression of homogeneity between donor and bald areas; impression of the volume of hair that I may achieve after covering an area with some density (hipotetcaly comparing with another density) and so on. 

Although there is described some mathematical formulas to try to calculate this ("coverage value" or "hair coverage index"). IMO Those are values that cannot be precisely calculated so I may trust also in some kind of "artistic feeling"/subjective judgment... 

I understand this may sound controversial though.

Idk if I made myself clear... 

9 hours ago, Dr. Felipe Pittella said:

What you mean? Sorry I didn't understand. Thank you 

1 minute ago, Dr. Felipe Pittella said:

Who is zarev? 

I'm joking! 😂 Indeed I've heard a lot about him. A great surgeon. Thus I'm very flattered with you compliment! Thank you! 

6 hours ago, RandoBrando517 said:

Forget about zarev you the real deal that’s what I mean 

Who is zarev?