I just had my transplant yesterday so I can't say anything overly meaningful about results yet, but here are my high level thoughts:
I cannot recommend Dr Nader enough. He is compassionate, professional, ethical, genuinely invested in your success and just a nice guy to hang out with for a day. When I sent him my pictures before the op, he counseled me to start taking Minoxidil in addition to Finasteride which was hugely helpful and made the op substantially smaller.
Dr Nader's work is 1/5th the price of the well known doctors in the US, but I struggle to see how any doctor could possibly have given better service or expertise than Dr Nader.
The procedure itself is easy-peasy. It was long - like a full 8-9 hours - but as far as pain / discomfort - I never hit more than a 2 out of 10. I fell asleep multiple times throughout (which is fine, even preferable) and watched 8 episodes of Money Heist. I would rate this procedure as far more tolerable than say having a cavity filled at the dentist.
Dr Nader is very booked out. When I booked, it was an 11 month wait. While it can be hard to get in touch prior to the appointment, after the appointment he gives you his personal WhatsApp and will personally communicate with you daily.
Lots of people have written about the experience in great detail so I'll keep it short-ish and Dr Nader does a great job explaining everything ahead of time before you start as well.
Prep Notes
Do a lot more research than what I'm saying here but my extra things to remember would be:
Pack shirts/sweaters with buttons or zips so you don't have to pull anything over your head
Pack a large loose hat - you're able to wear it in the airport the next day and it will keep things cleaner as you're going through the airport
Travel to the Clinic
I flew to McAllen, stayed at the Cambria Hotel (which is what Nader recommends). Modern/very comfortable hotel. The breakfast is meh so I would over-order on dinner so you have stuff for the morning. The following morning Mirtha picked me up at 8am to cross the border and head to the clinic. Mirtha doesn't speak a single word of English but is lovely and I got some free Spanish lessons :). Crossing the border and getting to the clinic took probably 30 minutes but I found out it's always possible if the crossing is very busy it could be as much as two hours.
The Procedure
Step 1 - Consultation - 30-60 min
The clinic is clean - just a non-descript secon floor medical clinic. You fill out some paperwork then meet Dr Nader. You'll chat with him for 30-45 minutes getting to know each other, answering questions, he'll tell you the plan for the day, and then work on drawing your hairline in Sharpie. He'll give you plenty of input and take your time but truthfully I didn't have much to add. It looked good and I figured the doc is much more adept at designing a hairline than I am! The main considerations were about how youthful to make the look. I'm 35 and chose a hairline that would look more natural for that age (i.e a 35 year old with a full head of hair rather than an 18 year old). Once you've decided, he'll draw the grid which is how he estimates the number of grafts required. For me he estimated 2,688 and we ended up with 2,732 - so quite close to the estimate. You also get the choice if applicable to leave your hair longer or buzz it. I asked the Dr what he prefers and he said buzzing because it's a little easier to work with so I went with that. I would much rather whatever gets the best results over the vanity of the next few weeks.
Step 2 - The Buzz - 15 min
Once you're happy, you go to room 1 - just a dentist-style chair with a TV. You take a muscle relaxant and get an anti-inflammatory injection in your arm. They buzz your hair. I will say - I was super happy with even the level of attention here. For example, I have a beard and the ladies faded the buzz on the side into my beard like a barber would.
Step 3 - Extraction - 4 hours
Off to room 2 - you lay on a sort of massage table and periodically turn your head. They inject lots of little anesthetic shots into the back of your scalp, and they start the extraction. Dr Nader chooses the grafts and excises around them, and someone he works with pulls them out. They get handed to a small team that sorts them and puts them in a medium to keep them healthy. This is probably the least comfortable portion of the procedure. It's long and it's mostly that you're lying still in not the most comfy position for several hours but I did fall asleep a couple times so can't have been that bad.
Step 4 - Lunch & Meds - 30 minutes
Back to room 1 - you get either beef tacos or a chicken salad. The beef tacos were delicious. This is so you get some food but more so that you line your stomach before starting the meds you'll be on for the next week - somewhat high duty antibiotics and pain medication (later you add anti-inflammatory as well). The doctor will also come tell you how the extraction went (all good in my case!).
Step 5 - Implantation - 4 hours
The doctor & team come back in and start to do the implantation. You lie back on the chair with a neck pillow and put whatever you want on Netflix. They bandage up around your head and get to work - more anesthesia injections and the implantation. At any point if it starts to hurt you can ask for more anesthesia - the doctor is very clear that this is not a procedure you need to or should be in pain for. They plug away for several hours while you watch TV and when they're done, they clean you up, apply bandages and a surgical cap, let you change back into your clothes and send you off to talk to the doc for post-op.
Step 5 - Post-Op & Payment - 30-45 minutes
Doctor Nader will tell you how it all went - how many grafts were inserted, how many hairs per follicular unit. You want lots of high density (3-4 hair FUs) but you actually also need a chunk of single-hair FUs because those are what look more natural at the front of the hairline and framing the face. I got lucky and had a high proportion of high density FUs:
386 one-hair FUs
894 two-hair FUs
1,144 three-hair FUs
308 four-hair FUs
For what it's worth I think this has little to do with the doctor and more with your hair structure. The doctor gives you detailed follow-up instructions and how to stay in tough with him - things to look out for, things to avoid, meds, washing routines, etc etc. He gives you the meds, shampoo, and a spray to apply regularly.
At that point you pay - and that's it! On the payment front, I was concerned about my cards getting declined for fraud because it's a large unusual payment - and that's exactly what happened. However I knew to expect that, so I waited for the alerts from my credit card provider, authorized the transaction and repeated it - and then everything was fine.
With it being a long day and your head going through a lot, I was pretty exhausted at this point but overall feeling good.
Back to Texas
Mirtha took me back to the hotel. I ordered from Costa Grill (not bad) so I would have food to take my meds with and enough leftover for breakfast and that's it! Currently in the airport flying back the day after. I'm wearing my had - but it's over the bandaging and you can clearly tell something has happened, getting some looks and questions but nothing too dramatic.
Pics!
PRE OP & PRE MINOXIDIL
PRE OP & POST MINOXIDIL
HAIR DESIGN
Post Op (One Day After)
