YodaHead

Thank you! I will continue to post the updates. Cheers!

Yes, exactly!

Here is the breakdown. Blue = day 1 and black = day 2.

From what i understood, the beard hair were mainly used in the mid-scalp region along with some mix of head donors. Hairline is predominantly from scalp donor. Dr. Pittella mentioned that he ensured to spread out all hair in a manner that would look natural. In my case, due to my weak side head donors, I did not have much choice. I don’t like keeping beard and not planning to..so I was fine with this plan.

Yes, 2.5k on day 1 and close to 3k on day 2. Incredible indeed! 😀

Quick Stats: 12,501 total donor grafts taken from back/side of head and beard. Around 5.5k of the total 12.5k taken from beard. About me: 37 yo South East Asian man born in India, living in the US. Hairloss history: My hair loss began around the age of 16-17. There's a history of hair problems on my mother's side, while my father's side is average. The progression has been gradual, leading to reaching NW6/7 before I decided to explore hair transplant (HT) options. I experience hair loss and thinning across the entire top region of the scalp (front, mid, crown) and possess a notably weak donor area, particularly on the sides. Premature graying has further added to my disappointment regarding the quantity and quality of my hair. My beard grows like a bear! Plenty and thick. This probably is a plus, considering poor donor on my head. I honestly don’t care much about my sides/back or even beard…I just want some density at the top of my scalp..so I have no issues taking whatever donor needed to achieve this. Medications: Taking Minoxidil oral 2.5mg daily since June 2023 (i.e. approx. 8 months prior to HT). Stopped 3 days prior to HT (as recommended by doc) and plan is to continue taking this. Took Finasteride 1mg daily for approximately 6 months to see how i respond, then stopped it 2 months prior to the HT. I learned that it definitely works for me and did not present any noticeable side effects. I only stopped it because I wanted to show the “actual” situation of my scalp to the doctor, without Finasteride help. Plan is to continue taking this to retain native hair. HT decision: Started researching HT 12 months ago (early 2023), and before I stumbled upon this site, I was focused on Turkey option. ASMED/Dr. Koray Erdogan rejected me. Dr. Bicer said my “hairloss pattern is different” and so i should visit a dermatologist first. I respect both of these responses as I would rather hear truth than false promises. Many hair mills quickly sent me cost estimates and encouraged me to book dates before the end of the ”discount” period. I saw a dermatologist and was told that my hairloss is typical male pattern baldness and I am a good candidate for HT. I learned that due to the nature of my hairloss (thinning all over the scalp) I was definitely going to need to cover pretty much the entire area of my head…that too with below average donor. Keeping in mind the cost, availability, and the scale of the HT, I shortlisted following two doctors: Dr. Felipe Pittella Dr. Das/Dr. Sethi (Eugenix) - I had even paid the booking fees. I had online consultation with Dr. Das and Dr. Pittella, and had also met Dr. Sethi when he visited US. I know Eugenix has been doing great work, but I only have one head so I had to pick one doctor. I am happy to share specifics on what impressed me more about Dr. Pittella if anyone is interested. Thanks to this forum and to all members for being so active and upfront about their opinions/experiences. After months of going through various topics on this site, plus some additional reading, I felt well-informed prior to deciding on the HT. Arrival in Vitoria, Brazil (Jan 22, 2024) I was travelling from NY to Vitoria, Brazil (with a long layover in Rio). Dr. Pittella’s clinic had booked 4 nigths of hotel (5 mins from clinic) and had also arraged pick-up/drop-off to/from Airport, and to/from hotel for the entirety of my stay. This made life a lot easier—since this part of Brazil don’t really see much tourism and so not easy to communicate; however the area is really nice & safe, and people are all very helpful. Hotel was excellent (4-star) with breakfast included and front desk spoke English so no issues. I recommend learning few words in Portugese. People really appreciate trying. One Day before HT (Jan 23, 2024). I was scheduled to meet with Dr. Pittella in the evening before surgery to to create a plan and mark the areas of implant and donor. The clinic is neat & clean, and the entire staff is incredibly welcoming! From the moment I entered, everything appeared meticulously organized, and I never experienced a moment of uncertainty or worry. Although I had thoroughly researched Dr. Pittella through his interviews & patient reviews, and was convinced about him, I was still nervous about the rest of his staff. However, it turns out he has assembled a dream team! The entire staff works seamlessly, displaying high professionalism and organization. This immediately put me at ease. Met Dr. Pittella for the first time and immediately you get a very positive vibe. The guy is very humble and great communicator. He took his time in taking pictures of my head from all directions and upload into the software he uses to design everything including density, graft estimates, etc. Dr. Pittella took his time looking at my scalp and hairline very closely and kept me involved in the process. He marked my scalp and beard with a marker (dang! I was planning to go to town for a dinner but it looked like my 3 yr old niece went wild with a marker while i was asleep..so idea dropped). I left his office feeling very good about the decision I had made. Fyi, according to his software my precise baldness grade is 7.35. HT day 1 Arrived at the clinic at 6:30 AM, they trimmed my head and beard, gave me some medications, and provided a room for me to change into comfortable clothes and keep all my stuff. This is where I would come during bathroom breaks and for lunch/dinner. At around 7 AM walked into the operating room and met with the entire team. Everyone welcomed me with happy faces and the vibe was so positive and ensuring that it immediately put me at ease. I slept for most of the procedure and got a break during lunch (you can ask for break whenever you want). The lunch was ready in my room exactly as i selected from the menu a couple days in advance. The day ended at around 7PM with 6k grafts extracted/implanted and the dinner. I was pretty happy that Dr. Pittella was truly involved throughout the day. Surprisingly, I did not feel any pain at any point during the entire process. Dr. Pittella said I had very high pain tolerance, but I give a lot of credit to his team for putting me at ease and taking good care of me. HT day 2 Day 2 was no different than the first day. Same process. Same routine. Additional around 6k grafts were extracted/implanted! Both days, I had to be very careful not to touch the bandage once at hotel and had to sleep in a sitting position with a neck pillow. Because there was no pain or discomfort, this was not a huge problem for me. By the way, they had even trained my driver to keep reminding me when getting in/out the car to watch my head (talk about attention to details!). Post-op (day 3, 4, 5). Every day until my flight back, the team ensured I was picked up for a careful head wash. Dr. Pittella personally visited me each day, engaging in discussions with both me and my wife about any topics I wanted to address. They provided me with a post-op care kit, including painkillers, antibiotics, baby shampoo, etc., along with precise instructions on what to do and not to do for the next two weeks. Dr. Pittella wrote a letter attesting that I was fit to travel…just in case if airline staff were worried with anything (i had some swelling as expected and was advised not to wear hat or anything for two weeks). I was travelling with my wife, who is also a Physician in US so the entire journey was completely worry-free for me. Thoughts on Dr. Felipe Pittella and his team: Dr. Pittella is everything I wanted in my HT surgeon. Experienced, skilled, knowledgeable, patient, honest, humble, and detailed oriented. You can tell that he loves what he is doing and his positive attitude has trickled down to his team. Every single person on his staff—whether a receptionist, account manager, anesthesiologists, technician, or a nurse—they all treated me very well and were very accommodating of anything i needed/asked. Everyone looked happy to be there and seemed to know their role very well. I am still months away from seeing any results, but regardless, I think it is only fair that I express my appreciation for the services and hardwork of this clinic now rather than waiting 6 months. ——— If you have any questions/comments or even any type of criticism for me, please do not hesitate. This forum has given me a lot of good information and it is only fair that I give back. I will continue to report on my progress!

@Gatsby

I just use Nizorale brand 2% in US. Works for me. His prescription mentions 2% ketoconazole.

It is difficult to find a skilled plastic surgeon who is also humble and willing to spend as much time with the patient without giving any indication of rushing. This combination is rare…and Dr. Pittella is one such doctor. Speaking from my very recent experience.

I am currently sitting in Brazil (day 2 post-op). Got it done with Dr. Pittella. Traveled from US. I will be detailing my journey in a few days here. I am super happy so far with my experience with Dr. Pittella and his entire team. They are next level! I had also met Dr. Sethi and talked to Dr. Das from Eugenix. Happy to answer any specific questions. I might take longer to respond since I am focused on resting for next couple days and also flying back tomorrow. Cheers!

Do Minoxidil and Finasteride for at least 10 months before thinking HT in your case. In my opinion.

Incredible!! Total 6095 grafts including both HTs or just the first one? EDIT: Never mind, i re-read the thread. So it’s about total 11000 grafts (6000 + 5000).

It would be interesting to know what Dr. Pittella has to say about this case. That is, A) what he would have done differently (if anything)—although in retrospective we all would have better ideas. B) what can be done now and what result can be expected.

I don’t think you will move back a grade. You are at an advanced stage of NW and pretty much nothing at the top to protect. Having said that, are you still continually losing hair or has it stabilized? The only benefit meds would probably do in your case is to help protect the hair that you are going to continue to lose until you have reached your stable point. If you are going to get a HT, then the meds will help—if the donor hair are taken from the outside of the “safe” donor zone. If all your donor are taken from the “safe” zone (low back/sides, beard, chest) the meds will not add much value. One example where this was discussed was here:

I checked. I wouldn’t spend a penny on this.

Absolutely 👍🏼 I have pretty much seen all of his results online and have even talked to him. Dr. Pittella is sincere, upfront, and detailed oriented. Cheers!

@KeepGrowing - I am also same age as you and also started loosing hair around the same time. Our bald pattern is similar, however, the difference is that you have a lot better donors than me, and i have some more hair left at the top (but i am still losing thise rapidly). 1. I say you are NW 7 2. Yes, you are a candidate in my opinion. 3. I recommend you look into Eugenix (India) and Dr. Pittella (Brazil). Do a video consultation with both. These are solid options for people with advanced NW. Since you do seem to have good donors, plus hopefully good beard—you should be able to get good enough coverage all across if you go with a conservative hairline. Of course, video consultation with the clinics i mentioned above will give you a lot better idea.

@Yabala Will it help your existing hair (on crown, mid-scalp, front, back, everywhere) look healthier/thicker and delay the process of male pattern baldness? Yes. Will it reverse your loss and fill your head with a densely packed hair? Nope. So whether something is worth it or not depends on your goal and expectations.

Some great suggestions so far. One open ended type question i like to ask at the end is this: ”As an experienced HT surgeon, you must have had patient results you were extremely pleased with (i.e above avg) and may have seen some below avg results. For those few below avg results in your practice—what key factors do you attribute to such results?” I ask this to know if they are transparent, and also helps to know in advance what to do/not to do.

Yes, after seeing the pictures, i say it is definitely worth it. You still have some hair at the top worth protecting. Especially if you do HT, it will add to the density.

I would look into all the docs recommended by this forum; however, it would be easier to see some photos to suggest based on your specific situation.

I once heard a HT surgeon saying that your grand mother’s (maternal) hair is usually a good indicator.

@Yabala You will probably find some discussions on the similar topic on this forum. The answer is not a yes or no, but somewhere in the middle depending on the individual situation. The main purpose (as I understand) of finasteride is to help protect/save/improve existing hair that are outside of the so called safe zone (ie. back and sides) that if not treated will eventually die. For instance, Person A: Has not much left at the top—so much so that even with a HT, the existing few hair will not help with the density. Person B: Is on the way to NW 6/7 but has diffuse thinning at top and still have many thinned hair—which if become healthy could add to the density, especially in combination with the HT. And everything else being equal (eg no major side effects), then I think person B should definitely use Finasteride, while person A is not going to get much help. I use the word “much” help, is because i keep hearing from people that Finasteride could also help the transplanted hair to grow faster—although I don’t know if it really does. Similar topic discussed here:

I do not disagree. Happy to move on to the topic at hand, however, I hope that people are not being discouraged from sharing on this forum if a particular surgeon/staff did infact make racist comments, so that others can decide for themselves whether to go there. A person can be a scammer AND a racist—it’s not mutually exclusive. Cheers!

I am not sure what exactly @RB12 said to have his post edited, however if he/she believed his bad experience had to do with the racism based on some specific things he/she heard firsthand, then why should anyone challenge or censor this, especially when we weren’t there. Let the other party come and respond if they want to.