TheGreatPretender

Outstanding. From the way it looks in a few months no one will be able to tell you were once bald. 

I really hope to know that feel of victory. When I get there I promissed myself to play the "victory fanfare" theme from Final Fantasy just to celebrate. 😁

1 minute ago, Vann said:

communication shouldn't be your final decision i think at this stage you are nearly complete with a good amount of surgeons with a close graft count (about 3k). At this point I would just say go for results and purely results. 

But honestly, I think you have a good set of top 3's and youre making a really strong choice.

Also, could you post some photos of your scalp, donor zone, beard (if you plan on getting extractions)?

I can drop you by PM if you wish to. 

5 minutes ago, NARMAK said:

Ultimately each doctor gives you a graft count based on what they envision is required for your particular hair loss objectives and can be achieved with their own methodology. 

I think you do seem pretty set on Dr De Freitas and that's fine and all, but properly sit down, look at all the one's you consulted with and start eliminating the one's you think aren't as good till you have 2-3 and then do the same again with any others you consult with. 

Ultimately the results they showcase are always cherry picked on their own sites so scrape through here for real patient reviews and testimonials to find cases similar to you and who maybe better fits too. 

I have been paying visit to this forum alongside some spanish and italian ones aswell to try and gauge them too. 

I have taken the time to consult with other doctors outside my big 3 list (De Freitas, Ferreira, Pinto) and to be honest I don't feel like there is anyone standing and since the other two are based in my home country it would make comunication at lot much easy with the staff alongside other things if I went in that route, and I think this is what is keeping my hand frum pulling it.

So previously I have made a few posts with the conslutations I had with the different doctors so far from my shortlist and now I feel like I have a better understanding of the bigger picture. Thing is I am currently still undecided about which clinic to chose because even though I was happy with one of them I am still not sure if this is what I would really want to go for or at least feel like it would be the most confortable path.

So my situation is the following:

Current Baldness level - Norwood V (Diffuse)

Medications: Finasteride 1MG daily + Minoxidil 5% twice a day (Regaine) + Nizoral 3 times a week

Objectives: Restoration of the density in order to be able to perform long hairstyles.

So here is the feedback I got from different consultations.

Dr.Bicer - Was told that I would need 3200 for the frontal part but that I could be looking at more than 3800 if I was looking to restore the crown in total, howeaver she was willing to go to 3800 max. The doctor was also happy with the density within the donor. 

Dr.Lorenzo - Was told that my baldness was quite advanced and that I would require over 6000 grafts total in order to achieve the desired results, this would require two sessions, I presume this would be somewhere between 3000 + 3000 in two years. They would require me to go to the clinic though to evaluate the donor. 

Dr.Ximena Villa - Recommended me to start Oral Minoxidil (5MG) and continue Finasteride for an aditional year before going to a surgery. Howeaver she estimated that over 3000 frontal grafts would be initially required for the frontal part, also advised a visit to the clinic for donor evaluation.

Dr.DeFreitas - Probably on my top tier list currently, recommended 3000 grafts which would be distributed in the frontal, entrances and middle of the scalp within one session split in two days. I also asked if the 3000 would be enough to restore the required density to which the answer seemed positive, howeaver they noted that if the crown required transplantation this would require a second session which would be quoted later. But from my understanding it seems like De Freitas was confident that he would be able to restore enough of the ilusion of density within my scalp with these 3000 hairs without the need of a second intervention, also from the hairlines I have seen of him he seems quite capable of doing it so.

What is keeping me from pulling the trigger you ask?

Same thing is it was before, there is still the temptation on my part to go for De Freitas because I like his hairlines and his artistry he seems to be one of the best if not really the best surgeon in the world for many but at the same time I feel like I didn't consult with my other two top tier surgeons which are more location friendly in terms of their location which are obviously Bruno Pinto + Ferreira.
Also I know that the quotation from De Freitas lasts only 3 months, which would have the deadline placed sometime at the following month and this is one of the things that is making me procrastinate because I know the clock is ticking on this. I also recognize that taking forced decisions with these kind of procedures is not really a good thing, which is why I am still taking my time to decide.

Working from home has  been making things a bit easier as well because I rarely go out but as soon as I know I have to step out of the doorstep I know I need to have either my hat or the fibers on which gives me the dreaded reminder of how far I am gone with my head of hair.

So my question is, even though one of the doctors team have been really great with the coms and feedback is it worth pulling the trigger now or is it always the best to wait until the other two are open for consultations in order to make a so to say "more informed decision"?

I know loads of people that went through hair transplant have gone through the same process as I and It has been only a few months since I started my reesearch. I also don't pass my whole days looking at the doctors results meticulously as I already seen the ones that interested me for the most part but I also know I need to decide sooner or later because a surgery is just waiting down the road and the only question at this stage for me is with whoom.

4 minutes ago, Mike10 said:

No you are the one who is misinformed! There is no study which proves that Fin works in the temples region. 

 

You are right there isn't just one that concludes that it works for every single hair folicle affected by DHT. I'l rest my case.

4 minutes ago, Mike10 said:

I have MPB since age 23 and I have been doing very well without Fin. I am on PRP since 4 years and my hair is stable, There is not just black and white and you should be more open minded. There are different forms MPB (light aggressive) and the same goes for hair loss prevention therapies. Wherever one can avoid Fin I advise to avoid..

Here in this case as I said, this poster has only very slight temple recession and Fin does not work in lot of cases for temples recession.  

Again, you are going under the simple assumption that OP wont recede further without medication. That "light aggressive" form of MPB that you describe could very well get more aggressive by day without OP even noticing that by itself is a risk that he has to be willing to run in case he gives up on his medication. 

PRP is a good therapy but the evidence for countering hair loss is not as significant as for Finasteride and Minoxidil. I would say best case scenario its a superior therapy to Microneedling.

And that last statement is also false, Finasteride works in every single place where there is hair, just like Minoxidil and it works to prevent further loss of hair better than regrowing but its effects are universal within the hairline.

14 minutes ago, Mike10 said:

Did you even read what I wrote? Well you do whatever you do. I stand by my position.  

Yes I did and my argument stands. 

The process is simple, once you see that you have MPB you start medication and if you find side effects you stop it, its as simple as it is. 

Having MPB at an early age and plan to take it later only increases the risk of being it too late once you start having real trouble to the point you cant even style your hair appropriately while going outside. You would rather start early than late, especially considering that the majority of people does respond well to the medication and barely has any issues while taking it. 

The only reason I find advisable to delay starting is if you still havent matured or havent finished puberty, other than that there arent any good reasons to the point I can recommend people not try it.

Another thing, Finasteride is good for every single part of your hair, not only the crown or Middle and it has been proven time after time that is the best medication available to stop Hair Loss at its tracks. Your case is an optimistic one because you started receding by 23 at the temples, a lot of people lose everything by then in that area from all sides like me. Why run the risk if you are likely to benefit from a medication that is intended to give you the peace of mind that you need for years to come in protecting your hair?

1 hour ago, Mike10 said:

Because Fina has sides and you basiscally have a full head of hair. Finansteride works best in the middle and the crown. in a lot of cases  it does not even work for temples recession. 

And based on my experience. Temples started to recede at age 23. At 40 I still only have temples recession, like NW2,5. And I never took Fin

 

If one has MPB and is losing hair than Finasteride is an absolute must unless for any reason this is not the case. 

Anyway I am 27, I became prety much a NW5 diffused at 20 so dont count starting later as a guarantee to not lose any further. 

Also, after puberty it is more than safe to start treatment, ideal even especially if you start losing at such an age.

The truth about Hair Loss is that it is unpredictable, it can strike at any age young or old especially with a family history of parents,uncles,cousins that hold such a problem. 

Starting Finasteride is the best thing OP did and the decision to hold on the transplant for now is even better. I am sure he will be more than happy to keep his hair for years to come down the road. 

8 minutes ago, Charlie said:

I understand where you are coming from, I think it’s clear my hair loss will be slow and progressive having no bald relatives. it’s just something that bothers me everyday, when I can use that mental energy to use elsewhere in my life. So if having to pay 5k~ for some mental peace for 5-10 years Id take that 

You may not bald at all. My stance on your case is mostly due to the work that goes in getting the right call when doing a surgery. 

Remember that there are no guarantees when doing a HT and if for example it fails that means you have a % of hairs that you would permanently lose as part of that even if the doctor agrees a touch up. 

There is also shock loss which may happen in your donor and/or recipient in which the native follicles get through trauma for a specific amount of time before coming back. If you chose a poor/unethical clinic you may even face serious health issues as this isn't like going to a dentist to get your teeth done. 

I am not obviously trying to fearmonger or force a decision upon you, at the end of the day it's your call. 

If you are looking to do some research for some good clinics look for some recommended names here for Europe and avoid the UK if possible, I know it's hard because I live in there as well but there are far Better options for yourself overseas. Bruno Ferreira/Bruno Pinto for Portugal, Lorenzo, De Freitas, Ximena Villa for Spain just as examples. Turkey has Dr Bicer.

These are just some examples, there are more if you search in this forum. 

7 minutes ago, Charlie said:

If you’re certain I will maintain what’s wrong with touching up the hairline and adding a few grafts?

I feel like it's to early of a stage for you though even in that aspect. 

For one you mentioned that you have been on Fin for 10 months, I would say it can take until two years to get optimal results. Even if not likely you may even regrow at that time making a potencial surgery pointless. 

But even adding some small grafts does come with a risk not even to mention the cost I'm which the trade-off from pros and cons I think it's not worth taking the surgical route atm. 

No way. 

I wish I had as much as you have at your age. A hair transplant will not make your hair look like it did before or even as good by rule of thumb, a hair transplant is in essence the ilusion of density rather than the density itself. UK clinics are the last place where you want to be for HTs too but at your age you are fine. Also you are already on Finasteride which can even give you improvements until 24 months alongside oral Minoxidil (if you can tolerate). 

Honestly in my understanding if you are on medication at this stage I am prety certain you will be set for life with no need of surgery in one lifetime and if you feel like you lack hair in certain spots you can always grow it longer to conceal it without much effort.

5 hours ago, Skimzee said:

Had a bit of a crazy week. Really impressed with the growth, just waiting for the hairline to kick in! Just over 2 months now 

 

 

Thats insane for just two months! Keep going.

Wow! Absolutely stunning, tremendous delivery by Mwamba, you literaly came back from the dead. 

This is one of those cases that really gives me the pleasure to see. 

15 hours ago, Ant763 said:

I am trying to fight that and there is family history , I was just worried about potential side effects of fun, mainly Ed happening if used 

Very unlikely. 

You can stop if you feel them or even decrease dosage (3x a week .025mg) but usually it's very tolerable for more than 90% of who uses it. 

Bear in mind that for MPB (1mg) the dosage is far less than used for Prostate issues (5mg). 

Keep yourself active in the meantime and do some exercise which could help you counter them anyway. 

21 hours ago, SadMan2021 said:

I see a 31 yr old NW 1.5 giving himself anxiety because his mature hairline does not look like it did when he was 16. 

I feel like you are going to get declined by a lot of doctors. There is barely any work to be done. 

In your case the risks of a poor outcome infinitely outweight any miniscule benefit. 

This, I am 27 and you dont want to know how bad my degree of baldness is. Needless to say I would "kill" to be at the estage that you are. 

If fighting MPB is what your're after then Finasteride should be started ASAP, you might even regrow in the process, and if you feel like you need more you call also commit to Minoxidil but a hair transplant at your stage is something I wouldn't recomend. 

You could even grow the hair longer to get that covered and that would be it. 

2 hours ago, Jtoorrees said:

Your progress is looking great Joe! I think you made the right choice for you. Then again I don’t think you could’ve gone wrong with either Dr. 

 

I think so too! Both are putting out great results IMO. Dr. De Freitas isnt doing video consults but his staff sent back my assessment. I had a video call with Dr. Cuoto and he’s putting out great results as well and does the whole surgery. Cuoto’s prices are a lot higher but I think the video consult and the fact that he does the whole surgery himself is making the decision harder. 

 

Same boat man! I really like De Freitas’s results, it just looks like hairline density is a common theme with all his post op pics and videos. That or it’s just a lot more visible/noticeable in his photos. Not sure how much of a factor that will play in the final results but I think it helps. I have a feeling he’ll probably get my deposit in the end. 

 

I was emailing with Tamara. As of mid Feb they were booking for May 2023. That’s after an assessment. 

 

Ah! This is where it gets interesting! I really like Ferreira’s work, I’m sure weve all seen Rolandas’s results as well as the ones posted by the forum members and they look great and the ones I’ve seen are progressing nicely. I was actually guilty of almost commuting to the Turkey hair mill route until I saw Rolandas’s videos and wanted to go with Ferreira instead. And that further research led me down the rabbit hole again and onto other doctors like De Freitas and Cuoto.

But what are we measuring in terms of “falling short” on? Like for me if I were going off finished results I’m leaning towards De Freitas, haha as to why? I’m not really sure, it just seems like his has a lot of wow factor, not saying the other doctors don’t as they certainly do. Like for Cuoto I’ve noticed he can do a lot without a high number of grafts based on some of his videos! I don’t know if my observation is correct but I do notice he could be a little more conservative on the hairline than Freitas? Or I might just be imagining that. But I really don’t mind him stretching out a 3000 graft operation over 3 days to get things perfect. 

I think its a lot to do with your gut then anything else since there are so many variables that come when doing a transplant. 

Usually you would try and make sure that the results you see are from people that were in your scale of baldness which could relate to it. I am currently a diffused NW5 so I really need someone who is able to get it done in 1 session and if required just do a small touch up for the second proccedure on the crown but De Freitas basically recommended 3000 grafts for me on that level. I loved Tamara when exchanging emails, she was very patient even when I was being a bit anoying throwing questions out of the blue due to my ongoing anxieties and insecurities. And they got back to me quite quickly too. 

Anyway, let us know what choice you make whichever it is and good luck. 

5 minutes ago, JoeMan said:

I think Dr. De Freitas advertises more as well. He posts more results. I'm pretty sure on Spanish forums that you can find a bunch from Dr. Pinto. I definitely think that Dr. De Freitas has more name recognition at the moment. He's also a forum recommended Dr. I believe Dr. Ferreira is going to be more recognized in another 6-12 months. Plenty of people currently posting results. 

Yeah, you might be right. 

Maybe in the end it is a matter of personal preference, I feel like by the time you narrow it down to the best surgeons you hit a so called "grey area" where you got to make a choice and commit to it. 

3 minutes ago, JoeMan said:

What area of Portugal are you from? I have such wonderful memories of my stays there. 

I am originally from Lisbon, but am currently residing in the UK. I do own a house in Lisbon though so it would be a 2/3H jump to my home. 

There would be an option to travel back to Lisbon post surgery I guess and recover there.

2 minutes ago, JoeMan said:

If I lived in Portugal then Dr. Pinto would be on my list as well. I see you mentioned him earlier but I like his work as well. 

Yep, he is on the list but also busy. Though I have seen more movement from Ferreira as he seems to be a bit better though.

The thing that seems consensual among most people around is that even though both Ferreira and Pinto are great at their craft they still fall short in comparison with De Freitas though but I am not sure if this is just because of personal preference or if his technical skills are better for most patients.

1 minute ago, JoeMan said:

I ended up doing an online fast track consultation but then I also met with him in person because I wanted to see the facility and put a face to the person I was trusting my procedure with. I made a vacation out of it so it was worth it for me but I think they will open Fast Track well before September. 

I got contacted by lorenzo asking some better quality pictures back which were sent too a week back but no answer came from his assistant. 

Oh well, at least it reduces down my options currently. I like De Freitas work a lot but I think Ferreira would be a bit more of my comfort zone because the surgery would be done in my own country, although he is a tad more expensive now.

2 minutes ago, JoeMan said:

Actually I believe he took that option down for the time being if I'm not mistaken. He told me during my surgery that he's been wanting to open it back up but figured what's the point since I'm a year booked. This was in late November and to my knowledge it hasn't opened up yet. 

That option is down too sadly, I am not sure how long it will take as Alexandra (his assistant) told me that it "might take a few months". The option where you pay for a face to face consultation in Porto for 75€ only starts in September. Hopefully the online ones wont take that long but only time will tell.

29 minutes ago, drawdownfx said:

Thanks yh I saw your post so it's roughly a year currently. Damn these wait times lol 

I would expect it roughly a year to be honest. All great clinics are saddly facing high volumes of trafic so its a bit of a miracle if you are able to find something in less then a year so one year is not too bad. Plus you got the time to spare all that money in so its not too bad. 

6 hours ago, MachoVato said:

You're comparing Bicer to De Freitas?!

Never said that. I only did a consultantion with bicer that's all. But I would like to have with pinto and Ferreira since these are on my top shortlist too. Problem is they are too busy atm. 

Similar dilema here between Pinto,Ferreira and Freitas. I consulted with both Bicer and De Freitas a few months back. 

I feel like a lot of it depends on your gut/intuition. But I am slightly leaning in for De Freitas but there is something that is keeping me from pulling the trigger.

Absolutely stunning! Kind of jealus, not gonna lie. 

2 minutes ago, Raymond92 said:

does this mean that 2% is also more effective for hair loss?

I watched some videos on Youtube and all I saw was the 1% version that people use

Honestly there shouldnt be much difference, its just one percent less. I think they should share similar effects overall, just bear in mind that Nizoral is the third of the "Big 3" treatments out there so for hair loss so Finasteride and/or Minoxidil should be tried first.