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Dr. Bruno Ferreira

Dr. Bruno Ferreira | Norwood 3 | Frontal Hairline Restoration (FUE) | 5 Month Post-op Update

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Hi and thank you for having a look at this hair transplant preliminary result. My name is Bruno Ferreira and I'm a hair transplant doctor based in Porto, Portugal.

Below is the case description as well as some photographs for you to have a look. I'd love to hear your impressions on it, so please leave a comment below. If you have any questions, I'll be happy to answer them for you.

 

Note: These are 5 month post-op preliminary results. I hope to be updating and posting final results for this case soon, when this patient comes back for a final result revision.

 

On to the case:

1044160840_Capturadeecr2019-09-05s20_19_02.png.3be9985aee32c1fef80b25caa668ddcd.png

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BEFORE

492038252_Dr.BrunoFerreira-Case2-Before-3.thumb.jpg.d042c0cbe8c49fcddb0ff7ddc1c799cd.jpg

 

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5 MONTHS POST-OP UPDATE

1265601973_Dr.BrunoFerreira-Case2-5monthsupdate-10.thumb.jpg.2a5f6bb0d63eb0885cc425fd4b90c37c.jpg

 

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Thank You.

 

Edited by Dr. Bruno Ferreira
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Wow! That's awesome (especially for 5 months growth). I take it he is an early responder?

You also mention the surgery took place over 2 days? Do you have a maximum graft count you like to perform for each day (I think the total graft count is 2613?)

Such a detailed write-up! Only remaining question would be is this case a NW3 or NW3v

Would also love to see the 10 month results when they come in. Killer results already

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17 hours ago, transplantedphil said:

Wow! That's awesome (especially for 5 months growth). I take it he is an early responder?

You also mention the surgery took place over 2 days? Do you have a maximum graft count you like to perform for each day (I think the total graft count is 2613?)

Such a detailed write-up! Only remaining question would be is this case a NW3 or NW3v

Would also love to see the 10 month results when they come in. Killer results already

Hi transplantedphil,

Thanks for checking it out. I actually think that early growth is more about the surgery itself and less about the patient. Of course all patients are different and some do respond better than others, but in my opinion, if technique is perfect, there are no complications, every parameter is well controlled, etc, all patients should have early growth at 5-6 months.

Yes, I prefer to do the surgeries bigger than 2000-2500 grafts in two days (especially for hairlines, which are slower to implant) for various reasons. I actually wrote about it in my blog. You can find it here if you're curious about it:

 Why I divide my bigger cases into multiple sessions and multiple procedures

He's a NW3 as I wrote in the case study. I actually think he's more 3a than 3v. He's very stable though and should keep his native hair like this for a long time.

He's actually already over 10 months time. He's just not been able to coordinate getting to the clinic for our consultation. I'm confident it will happen soon. 😉

 

Edit: Just saw I had 3v on the tittle. haha That was a typo. 😅

Edited by Dr. Bruno Ferreira

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Fantastic write-up Dr. Ferreira, I’m really impressed. Do you do all of the extractions yourself? You seem very detailed and meticulous.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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1 minute ago, Melvin-Moderator said:

Fantastic write-up Dr. Ferreira, I’m really impressed. Do you do all of the extractions yourself? You seem very detailed and meticulous.

Hi Melvin,

Thanks, I appreciate it.

I do. All grafts are extracted and implanted by myself. (Not to take away from the crucial job the team performs before, after and during the surgery.)

Yeah, I'm pretty OCD about it, I must admit. 😅

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1 hour ago, Dr. Bruno Ferreira said:

Hi Melvin,

Thanks, I appreciate it.

I do. All grafts are extracted and implanted by myself. (Not to take away from the crucial job the team performs before, after and during the surgery.)

Yeah, I'm pretty OCD about it, I must admit. 😅

I might keep an eye on your work and see how do u progress cuz I only like Doctors who do the whole procedure themselves also my doctor is like that...the only thing that I don’t like and I’ve seen on your page is that u do motorized punch I really don’t like it...I prefer manual punch !!

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2 hours ago, Uncle drew said:

I might keep an eye on your work and see how do u progress cuz I only like Doctors who do the whole procedure themselves also my doctor is like that...the only thing that I don’t like and I’ve seen on your page is that u do motorized punch I really don’t like it...I prefer manual punch !!

Dr. Konior said it best: 

Quote

 

The mostly useless topic of manual versus motorized should be relegated to the trash heap.  It may have held relevance at some point in time, but it means little today.  Patients should also be leery of dogmatic statements made about how an individual conducts his or her practice as the only person who can provide definitive detail as to what is done and how it’s done is the surgeon himself.  The fact is that I use multiple devices for extracting grafts, with the device of choice depending on the situation at hand.  There are days when a motorized technique is best and days when a manual technique is best.  There are days when a straight-wall trephine is best and days when a flared-wall trephine is best.  There are days when a straight-edge trephine is best and days when a serrated-edge trephine is best.  This argument reminds me of guys arguing which is better, a straight-edge screwdriver or a Phillips screwdriver.  Of course the answer is that it depends on the situation at hand.  Also remember, there are some talented surgeons who can use every technology effectively and some who, despite having the best of the best instruments, can’t extract quality grafts on a consistent basis.  When it’s all said and done, it’s not the instrument that matters as much as the surgeon choosing the instrument to use for the situation at hand. 

If you place the world’s finest and most expensive Steinway piano in front of most people, very few would be able to generate a beautiful song.  On the other hand, place one of the world’s top five pianists in front of a Walmart special keyboard and you will probably hear some darn good tunes.

 

 


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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4 hours ago, Dr. Bruno Ferreira said:

in my opinion, if technique is perfect, there are no complications, every parameter is well controlled, etc, all patients should have early growth at 5-6 months.

That aligns with my own experience. My 1st FUE procedure was a bit of a nightmare, but the hair eventually grew at around 10 months. My 2nd FUE procedure was insanely meticulous undertaken by the best, and the hair is already growing at 4 months. It's interesting trying to figure out the art and science towards this stuff when every clinic is run so differently. 

3 hours ago, Dr. Bruno Ferreira said:

Yeah, I'm pretty OCD about it, I must admit. 😅

Considering how obsessive guys are about their hair, and how permissive this industry can be, this might be the best thing a potential patient can hear. LOL!

If this is the average result (where you seem to have lowered and filled in the hairline by around 3cm) then I look forward to your other posts :) Awesome. 

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2 hours ago, Melvin-Moderator said:

Dr. Konior said it best: 

 

I don’t  disagree exactly but I had a transplant with motorized punch and one with Manual punch and the results and the healing are day and night...for me Manual punch is the ideal with the right dr 

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@Uncle drew Were the two results with the same doctor?

For my repairs the same sized motorised punch was used for parts of my donor by two different docs ... and I believe them to be completely different results. 

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9 hours ago, transplantedphil said:

@Uncle drew Were the two results with the same doctor?

For my repairs the same sized motorised punch was used for parts of my donor by two different docs ... and I believe them to be completely different results. 

No no they were two different doctors I wouldn’t go on my first doctor ever again it was a nightmare 

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15 hours ago, Uncle drew said:

I might keep an eye on your work and see how do u progress cuz I only like Doctors who do the whole procedure themselves also my doctor is like that...the only thing that I don’t like and I’ve seen on your page is that u do motorized punch I really don’t like it...I prefer manual punch !!

Hi Uncle drew,

Thanks for checking it out. I'm glad you took interest in my work.

You're totally in your own right to prefer manual over motorized and I understand how your experience with motorized might've lead you away from it. But let me give you my personal perspective as someone who does both techniques on a regular basis:

I don't see a difference. Not in growth, not in graft quality, not in yield, not in healing time, not in post-op pain. 

I actually did both manual and motorized on the same patient recently at a World FUE Institute Workshop where I demonstrated both techniques. For manual I had a 2,70 hairs/graft ratio and for motorized I had 2,78. Which is a negligible difference in my opinion and could be attributed to extracting on different zones of the patient's donor area.

I do however think every doctor who does FUE should at least know how to do manual FUE since your machine can fail, your electricity might go out, etc and you have to know you can always fall back on good ol' manual. I recall of an episode, not long ago, when a colleague of mine called me scrambling to get another machine because both his main and backup rotors had failed and he couldn't finish the surgery.

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10 hours ago, Uncle drew said:

I don’t  disagree exactly but I had a transplant with motorized punch and one with Manual punch and the results and the healing are day and night...for me Manual punch is the ideal with the right dr 

Dr. Konior gave a perfect analogy

Quote

If you place the world’s finest and most expensive Steinway piano in front of most people, very few would be able to generate a beautiful song.  On the other hand, place one of the world’s top five pianists in front of a Walmart special keyboard and you will probably hear some darn good tunes.

Hair transplant surgeons are not created equal their skill, talent vary, as do their results. Tools are just tools, it is the person using the tool that makes the difference.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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When you take into account into account each patient has different skin and hair characteristics, and that different parts of the donor have different types of hair [above the ear and nape area are finer, as opposed to say the core of the donor ), you start to realise as much as it is about the tools used, it's always more about the surgeon's skill. It just feels safer to say one type of tool works better for you given a certain experience.

DrK's analogy pretty much explains everything anyone needs to know, and considering he was the one that did my repairs it more than proves it. Given how personal a HT is I think such things just take a lot of effort to prove and filter down into common knowledge. 

Always an interesting topic though

Edited by transplantedphil
fixed

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41 minutes ago, Dr. Bruno Ferreira said:

l. I recall of an episode, not long ago, when a colleague of mine called me scrambling to get another machine because both his main and backup rotors had failed and he couldn't finish the surgery.

Are you really going to leave us on a cliffhanger LOL. Did the surgeon manage to finish the operation successfully?

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1 hour ago, transplantedphil said:

Are you really going to leave us on a cliffhanger LOL. Did the surgeon manage to finish the operation successfully?

Haha! Well, I lent him one of mine, so he was able to finish the surgery. 😉

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1 hour ago, Melvin-Moderator said:

Dr. Konior gave a perfect analogy

Hair transplant surgeons are not created equal their skill, talent vary, as do their results. Tools are just tools, it is the person using the tool that makes the difference.

I fully agree with Dr. Konior.

I'm a musician as well (guitar player) and one of the things you'll hear a lot is how "tone is in your fingers" and how, for example, Slash playing through someone else's guitar and equipment still sounds like Slash.

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26 minutes ago, Dr. Bruno Ferreira said:

I fully agree with Dr. Konior.

I'm a musician as well (guitar player) and one of the things you'll hear a lot is how "tone is in your fingers" and how, for example, Slash playing through someone else's guitar and equipment still sounds like Slash.

Dr Bruno Ferreira how long after hair transplant do u normally tell the patient to start use minoxidil again? 

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@Dr. Bruno Ferreira

I dont know what is more impressive, the result or the documentation. Both are fantastic. Congratulations,

Presenting results in this way with such information has great value. The community thank you for this.

Very good and natural result. The patient must be thrilled.

Just to add an extra opinion regarding manual and motorised punches.

Many Drs/Clinics try selling themselves as only manual harvesters and claim it is superior. It’s a sales tool. The other thing they talk about is small punches. But small punches are great for the right patient in the right situation. However, there is much more follicle injury with small punches used in the wrong patient and in the wrong situation. The main thing is to avoid very large punches. Manual and punch size are sales tactics that a lot of clinics use to scare patients and encourage them to schedule with them. In reality, anytime a clinic pitch all manual punch or only small punch sizes, it is a clinic that you should probably avoid.  

One has to correctly match the equipment and procedure to the patient. No two patients are exactly alike so it is important to have a selection of tools and a variety of methods to succeed in ALL patients. Therefore if a clinic "sells" one method and one punch, they are going to fail a lot of the time. Every aspect of your procedure has to be individualised to your needs.

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Patient Advisor for Bisanga Cole Hair Transplant Clinic - Athens, Greece

Consult: https://bchairtransplant.com/online-consultation/ - bc2@bchairtransplant.com -  WhatsApp - + 34 642 37 03 83

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

My Hair Loss Website - Hair Transplant with Dr. Rahal

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@Raphael84 can you write all my posts for me? There aren't many clinics reps i enjoy reading but the ones I've seen from you lately all seem to smack the nail right on the head.

Agree with the documentation here being as equally as important as the results, and I only wish all such clinic postings on this forum followed a similar vein.    

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Great patient presentation and work, Doctor. The growth for 5 month on your patient looks very very good, hope to see further results and cases!

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@transplantedphil

Thanks. I appreciate that. "Clinic rep" has such a bad feeling to it. I do represent a clinic but I wouldn't want to be labelled as like the majority. Im a patient first and foremost and spent hours and hours over many years on this and such forums educating myself and communicating with hundreds of people, both patients and Doctors.  There is already too much politics and blatant lies in the industry, I want to portray in complete honesty how I see and understand it.

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Patient Advisor for Bisanga Cole Hair Transplant Clinic - Athens, Greece

Consult: https://bchairtransplant.com/online-consultation/ - bc2@bchairtransplant.com -  WhatsApp - + 34 642 37 03 83

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

My Hair Loss Website - Hair Transplant with Dr. Rahal

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On 9/6/2019 at 1:06 AM, Dr. Bruno Ferreira said:

Hi and thank you for having a look at this hair transplant preliminary result. My name is Bruno Ferreira and I'm a hair transplant doctor based in Porto, Portugal.

Below is the case description as well as some photographs for you to have a look. I'd love to hear your impressions on it, so please leave a comment below. If you have any questions, I'll be happy to answer them for you.

 

Note: These are 5 month post-op preliminary results. I hope to be updating and posting final results for this case soon, when this patient comes back for a final result revision.

 

On to the case:

1044160840_Capturadeecr2019-09-05s20_19_02.png.3be9985aee32c1fef80b25caa668ddcd.png

1296724246_Capturadeecr2019-09-05s20_35_03.png.470945b145a47985beb8eb19d23205f1.png

 

345483189_Capturadeecr2019-09-05s20_22_39.thumb.png.6ca321244e5fa926bf117ad36420a3dd.png

 

693133887_Capturadeecr2019-09-05s20_22_48.thumb.png.e35d15026de62f2ac30bca8dc8319ba9.png

 

754018666_Capturadeecr2019-09-05s20_22_55.thumb.png.6d2aa20bdf6dafa084f8fb5f53342910.png

 

470553522_Capturadeecr2019-09-05s20_23_04.thumb.png.524cb657dff1b936bc8a4a5a0ca2fed0.png

 

BEFORE

492038252_Dr.BrunoFerreira-Case2-Before-3.thumb.jpg.d042c0cbe8c49fcddb0ff7ddc1c799cd.jpg

 

141145717_Dr.BrunoFerreira-Case2-Before-2.thumb.jpg.663f8b26797054ca980473f501c4d16d.jpg

 

1789930239_Dr.BrunoFerreira-Case2-Before-1.thumb.jpg.0aad15656bdfff2f3cac065a82fae113.jpg

 

 

5 MONTHS POST-OP UPDATE

1265601973_Dr.BrunoFerreira-Case2-5monthsupdate-10.thumb.jpg.2a5f6bb0d63eb0885cc425fd4b90c37c.jpg

 

1843078541_Dr.BrunoFerreira-Case2-5monthsupdate-6.thumb.jpg.96050dbf2c3138f0a7992d2e27d7ae1f.jpg

 

665304337_Dr.BrunoFerreira-Case2-5monthsupdate-9.thumb.jpg.c9d0382c9d60c9ae89a05bf2a7e7d8de.jpg

 

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591156584_Dr.BrunoFerreira-Case2-5monthsupdate-8.thumb.jpg.50c4abd083f1cf0d86dba397dcb8029b.jpg

 

1274373388_Dr.BrunoFerreira-Case2-5monthsupdate-4.thumb.jpg.5b8bcfeb3fdf557f7837d3f0438775cf.jpg

 

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Thank You.

 

Beautiful results.

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Counsellor at Eugenix Hair Sciences

Dr. Arika Bansal & Dr. Pradeep Sethi

https://www.youtube.com/channel/UC5crlGyTac2hlU1gHneADzQ

 

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It would have been nice to see the full face of the patient.  I've glanced this for a few days now....and the thought that it is two different patients has crossed my mind.  If you observe closely, the before photo - look at the forehead.  Wrinkles.  The after, no wrinkles.  Color of the skin totally different.  Lighting? Perhaps.

Now look at the area just below the temporal points. The hair just decided to grow different on that particular day?

Even the eyebrows look different....

Consistency with photos...same angles, same lighting....Please be mindful to avoid this kind of thing.

Next....5 months? Incredible density.  These are results typically obtained after 1 year.  Did he do PRP? This would then make sense.

This was only one procedure? Impressive.  Can you elaborate on the placement of grafts to achieve such shingling?

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On 9/7/2019 at 6:18 PM, Uncle drew said:

Dr Bruno Ferreira how long after hair transplant do u normally tell the patient to start use minoxidil again? 

After 15 days they can resume using it.

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