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Hello dear balding friends!

A lot of you guys asked for it so here you go! My "quick" report :D

 

I had a 2 day surgery done in Espinho, Porto, Portugal with Dr. Bruno Ferreira on 28th & 29th of January 2020.

Currently resting in my hotel and since I have all the time in the world I decided to write this up - "for whom it my concern" :D Grab a cup of coffee/tea/whateveryouintothisdays and enjoy reading!

A little bit about me

28 year old Caucasian male, Androgenic Alopecia, NW5a. Older Brother - NW 6/7, Father - NW 7-teen.

To set up a base line, here's a photo of me before any hair loss (age 18). Never had extremely straight hairline (just a fact!).

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I've been loosing hair for the last 7-8 years, obviously not extremely excited about this fact, so when I reached NW3a i became worried. I started my research for "natural cure" and tried Detumescence Therapy (vigorous scalp massages - mechanical stimulation) for 20 minutes morning and evening 6 months straight (according to researcher after doing this type of massages you can expect to START seeing some results from 6 months onward), and then just gave up as I had big lifestyle changes all at once, so couldn't manage it. I don't want to go into detail of how it works, so google for yourself, but I strongly believe it halt my hair loss progression a bit.

Years went by and I slowly started loosing more and more hair until eventually in December 2018 (that's when I began my research 24/7), when I was full blown NW5a I decided to do something about it. To keep it short, you can read my other thread on here.

While I was doing some treatments, I was also heavily researching (when I say heavily, I mean - on the way to work, at work, at lunch brake, on the toilet after lunch, on the way back home, the rest of the evening, almost all weekend) Hair Transplant surgeons until end of November 2019 when I made my decision. More on that below.

In this post I didn't want to go into much details (nobody would really read it for 3 hours straight!), so I kept it nice and short with my main candidates.

Day 0

27.01.20 - Trip to Portugal. Quick flight from London to Porto about 2 hours. Afterwards got an Uber from airport and in 25 minutes already in my hotel 1 minute away from the clinic! Booked via Booking, quite cheap. Plenty of options. Easy task.

Day 1

28.01.20 - Quick breakfast and 07:30 am @ the clinic. First impression - Super early! The whole clinic looks like closed except of Dr. Ferreira's part. In the building company Rejuvie are offering things like Aesthetic/Antiaging/Dental and many other treatments. However, don't be fooled! Dr. Bruno has his own part on ground floor where he designed everything himself from consultation room to OR. There's no other things going on in there but Hair Restoration done by Dr. Ferreira. I met his lovely team consisting of 3 nurses and Dr. Bruno himself and been directed to patients room, which is dedicated only for patients himself. They gave me a key of the door, so I wasn't worried about my belongings being there while having my operation.

One of the nurses Ricardo (btw, this guys is absolutely amazing! He will take care of you every second you spent there and you will feel like you are a super star!) gave me a surgical "uniform" to change right away and shortly after Dr. Bruno came to see me to discuss procedure. Obviously while waiting I managed to snap a quick photo :D

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We discussed bits and pieces, signed needed paperwork and headed to the other room for a photo shoot. Dr. Bruno took quite a few pictures and we started planning hairline design. It took a good 15 minutes or so to finalise it. I was actually quite amazed of his attention to detail! Not a typical hairline done in 2 seconds like you see in many videos from Turkey hahaha :D After he showed me his final proposal I didn't even want to change a thing. It looked perfect! Now when I'm thinking it's probably because I didn't see any hairline for years :D, but his final design after careful examination of my facial structures was looking amazing.

Afterwards we buzzed my hair completely, made some more pictures, Dr. Bruno took measurements of recipient and donor areas and we headed to the other room "on the table under the knife". As I'm writing this post I don't have any pictures made by Dr. Ferreira, so once I've got them I will update this thread.

Procedure

The Plan - extract and implant around 3500 grafts over 2 days

Tools used - Lion Implanters, Motorised 0.85mm punch, Manual 0.85mm punch (and probably smaller, not sure, Sorry! :D(more information coming soon)

Implantation approach - pre-made incisions + Implanters for the hairline and the rest using Lion Implanters alone (picture attached)

Area to cover - 75 cm2

Future hair transplant area to cover (crown & mid scalp) - 75 cm2, approximately 1500-2000 grafts (more information coming soon)

Donor area - around 10,000 extractable grafts, lots of multiple units (more information coming soon)

Hair shaft diameter - 51 micron

Picture below shows all extractions updated live by nurses on the screen next to the operation table.

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Now, it might look like a lot of grafts for such small area, but because my hair shaft is quite thin (~51 microns), I would need more hairs/cm2 to have great coverage.

Everything started from Anaesthesia which to my surprise was almost pain-less! Dr. Bruno was using his fingers to gently massage the area while slowly inserting the needle and to my surprise that was incredibly pain-less. I asked him how is that everyone is talking about how the most painful part is anaesthesia and I almost didn't feel a thing, he replied "I'm just being very gentle". That's when I realised the difference between caring surgeon and money-making-minded surgeon. Anyways... Back of my head numb in few moments and we jumped right into extractions. The feeling of that.. Like a very quiet clippers. I kind of liked the way it feels hahaha (i guess I'm weird :D). No pain.

Dr. Ferreira used 0.85 mm motorised punch only because after examining my donor turned out a lot of grafts are placed almost in a straight line (e.g. 4 hair graft is not in a bunch, but in a line), thus covering bigger area, thus larger punch is needed.

After all extractions been done we still had a little time before our food arrives, so Dr. Bruno decided to do some incisions for the hairline

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BTW selection of food was solid! Fish, Meat, Veg, Soup, Drinks, Dessert... I asked if it's possible to get Freshly Squeezed Orange Juice and turns out it was not a part of the deal, but to my surprise they got it for me!

While extractions went like a knife through butter, Implantation part was quite difficult and it took much longer than expected. I had a lot of popping due to my elastic skin (damn you Detumescence therapy I guess! :D) and excessive bleeding. Dr. Ferreira used "every trick in the book" (that's what he said haha) to manage the situation and by the end of the day everything looked promising.

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Post-op instruction and back to hotel... Had a great night sleep, 0 pain. Woke up just 2 times, so I used that opportunity to spray saline solution as per Dr.'s instructions.

Day 2

29.01.20 - Arrival to clinic at the same time 07:30 am. Quick check up, donor wash and right into the action. Dr. Ferreira decided to change his approach to make implantations much smoother and avoid complications.

The Plan - extract ~500 grafts and implant them immediately

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Total extracted grafts - 3611

Total extracted hairs - 9861

Total ratio - 2,73

Pardon me, I didn't make a picture of "Total" page! Hopefully will receive this information soon from Dr. Ferreira and will update this thread.

Overall day 2 was sooooo much smoother! The new approach Dr. Bruno decided to take this day worked like wonders! Almost no popping and no excessive bleeding.

Conclusion

I was extremely impressed by Dr.'s adaptability to situations. Taking different approaches "on the go" to control the process. I didn't even realised at first that he was using manual punch until one moment I was like "waaaaaaaaait a second.. Something is different!". No sound, just pure manual rotating movement. I asked Dr. Bruno - "Are you using a manual punch?" to what he replied - "yes, in some places it's easier to get into with manual punch".

The right tool for right situation. How about that?

Anyways, here's some post-op pictures. 

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I will keep updating this thread until final result. Also, once I've got a good quality pictures from Dr. Ferreira I will update that here.

Please feel free give me your opinions! I'm super excited to finally get it done (especially the fact that I can see my hairline hahaha :D).

 

Edited by Rolandas
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@Rolandas amazing report!!! 

It’s  great Dr. Bruno was able to adapt the surgery to attend to your specific skin and scalp. Nice to know he uses manual and motorized FUE as needed for each graft.
Truly remarkable and surely you will be getting an amazing result. 

Edited by Portugal25

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Thanks for submitting this report, I have been impressed by Dr. Ferreira, he seems to be doing good work. Happy growing🙂


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, Portugal25 said:

@Rolandas great report and the it’s great Dr. Bruno was able to adapt the surgery to attend to your specific skin and scalp. Nice to know he uses manual and motorized FUE as needed for each graft.
Truly remarkable and surely you will be getting a amazing result. 

Hoping for the best! Thanks a lot man!

I didn't want to go into lots of details in here as it would take days to write up! Way too many positive emotions and moments.

Today I've seen Dr. Ferreira for the last time and it was kind of hard to say good bye! So far i'm extremely optimistic of the outcome!

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So jealous you got your procedure with BF!
So sad for my personal choice to go to Turkey. 
I knew of BF after I paid ...

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4 minutes ago, duchaine said:

So jealous you got your procedure with BF!
So sad for my personal choice to go to Turkey. 
I knew of BF after I paid ...

I know what you mean! Trust me, at one point I was about to send deposit to one of the Turkish doctors in August, but then decided to hold off. I'm glad I did!

Don't worry and trust your decision though! After all, you did some research and not went blindly like a lot of people! Happy growing!

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30 minutes ago, Rolandas said:

I know what you mean! Trust me, at one point I was about to send deposit to one of the Turkish doctors in August, but then decided to hold off. I'm glad I did!

Don't worry and trust your decision though! After all, you did some research and not went blindly like a lot of people! Happy growing!

If I'm not wrong, you were choosing between Pekiner and Demisory, right?

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Just now, duchaine said:

If I'm not wrong, you were choosing between Pekiner and Demisory, right?

Wow @Rolandas they couldn’t be more different in terms of technique, level of surgery and price (BF is double the price). You really dodged a bullet on this one 😜 So glad you went with BF 😊

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Just now, LonelyGraft said:

Work looks great. Did he mention if popping/excessive bleeding could affect final yield?

Unfortunately yes.

Popping could potentially compromise growth of some grafts. The more you touch extracted grafts, the more "trauma" they COULD get.

I trust dr. Bruno done everything he could in given situation. Once popping became more often he started doing some pre-made incisions as with hairline to see if that would help. Then he decided to spreading implantations apart, so they have more time to stay and "glue in". And especially that felt the next day after he completely changed approach.

Also, excessive bleeding wouldn't harm grafts, but it makes more difficult for surgeon to see where to implant next graft.

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4 minutes ago, Portugal25 said:

Wow @Rolandas they couldn’t be more different in terms of technique, level of surgery and price (BF is double the price). You really dodged a bullet on this one 😜 So glad you went with BF 😊

Pekiner has almost the same prices of BF.

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Long story short: @Portugal25 e me wrote about 30 post where we say how good BF is.
But not me or Portual are his patients nor we work for him! :D:D

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6 minutes ago, Portugal25 said:

Wow @Rolandas they couldn’t be more different in terms of technique, level of surgery and price (BF is double the price). You really dodged a bullet on this one 😜 So glad you went with BF 😊

I wasnt concerned a lot about technique, but about results and Dr. Demiesoy has proven track record of great results for great price.

However...! After I've done more research I decided to give myself the best chance I have and for me Dr. Bruno Ferreira was the best match. (More info in my previous post about why I chose him) 😁

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1 minute ago, duchaine said:

Long story short: @Portugal25 e me wrote about 30 post where we say how good BF is.
But not me or Portual are his patients nor we work for him! :D:D

Haha, I guess for now I'm the only one in this boat! I really appreciate your support!

Let's see what will happen in the next year.. 😁

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5 hours ago, duchaine said:

So sad for my personal choice to go to Turkey. 

Maybe you should not stress yourself that much and wait until you see the result for your surgery. 

You did good research and chose a great clinic. Just because Ferreira is the "flavour of the week", it does not make him better than other great clinics nor does it guarantee great results going with him. Unfortunately, no clinic can guarantee you a great result. 

Edited by Gasthoerer
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2 hours ago, Gasthoerer said:

Maybe you should not stress yourself that much and wait until you see the result for your surgery. 

You did good research and chose a great clinic. Just because Ferreira is the "flavour of the week", it does not make him better than other great clinics nor does it guarantee great results going with him. Unfortunately, no clinic can guarantee you a great result. 

I was in love with Bf before going to Turkey. The thing I like is the great passion he puts into hairline design. Considering  that I just have hairline problem (my head is full of hair), you can understand how sensitive I am for this topic.
If I had the opportunity to get my money back, I would have switch P. for BF.
That said, you are right...stop stress!

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Day 1 post-op

Overall feeling like I had a SPA treatment :D Full of energy, no pain, no itchiness, absolutely nothing extraordinary except scalp felt "weird/not normal". I was waking up though around 10 times during the night. Obviously worried if I didn't touch or scratch recipient area.

Prior to my flight I bought a memory foam travel pillow, which is quite wide, thus covering/supporting bigger area of the neck/head. Also Dr. Ferreira gave me a pillow protectors, or what I call "nappies" which I put on my travel pillow before going to sleep. Primary function is obviously to keep the donor area as sanitary clean as possible. Secondary function is to keep you in hotel without extra charges for ruined pillows :D

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Dr. Bruno instructed me to spray saline solution more often, every 30 min or so as was developing a bit of extra fibrin (yellowish liquid around the grafts). He explained it's just the way my body heals, nothing paranormal :D So I was spraying saline on my recipient area every time I was waking up.

Got my breakfast @ hotel, got ready and 11:30 am in the clinic for my donor wash.

Dr. Ferreira had another patient "under the punch" while one of his nurses Ricardo left the OR and came to wash my head. He straight away noticed that my occipital donor area looks quite good for just 1 day post extractions.

While my head been washed, he took some pictures and shortly after Dr. Bruno joined us for a quick check up. He noticed that fibrin was keep building up, so he decided to wash it off with a ton of saline solution and here was the result.

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Nice and clean!

Everything else was looking normal so I went back to my hotel where I spend the rest of my day under "lock down". Thanks god I decided to buy a lot of fruits and snacks the day before my surgery, so I don't need to see outside world and focus on recovery (mainly watching some Netflix haha). Also room service food was quite handy! Continued spraying saline every 30 min and following other post-op instructions.

Edited by Rolandas
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@Rolandas looking good. Ty for sharing, I will be following your journey closely. 
 

Do you know why there is so big differences in the amount off grafts extracted in around a hour. The amount varies from 40 to 400 to 800ishh. 

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17 minutes ago, Jijypuru said:

@Rolandas looking good. Ty for sharing, I will be following your journey closely. 
 

Do you know why there is so big differences in the amount off grafts extracted in around a hour. The amount varies from 40 to 400 to 800ishh. 

If I understand correctly you are talking about first day extraction 3 pass where is 800 grafts?

If so, Dr. Bruno mentioned he asked his nurses to dissect multiple grafts into singles, hence why it looks like he was extracting almost twice faster, but in reality it was the same + dissected grafts done under microscope in the mean time. Dont remember the exact reason why he chose not to extract singles, perhaps I didn't had a lot, but I actually like this idea. Saved me over 300 holes in my head! 😁

 

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Day 5

Back home. Stopped spraying saline solution and started washing recipient area with shampoo and applying aloe vera gel afterwards twice a day since yesterday. Scabs look soft! I feel like I will not have any problems removing them. Also recipient area looks pinkish as opposed too red. The only issue I have is I can't really see hairs from the scabs. I know my grafts are on a smaller size, perhaps that's the reason?

So far I'm super impressed of my donor area, especially the back of my head... I mean just look at this. Day 5 and it almost doesn't look like there was something done except few red dots (dried blood). Overall extractions are super tiny, you can literally count every single one of them and that's not something I've normally seen during my 1 year research. Feels like It's been taken only 1000 grafts or so :D

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Looks great. It seems like many of the scabs in the donor have fallen. Were u given a special shampoo ?

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Day 10

Feeling great! After came back home I completely recovered and by day 7 been feeling like a million bucks!

Few things to note though. Since day 6-8 I started feeling some pain in my donor after rubbing/touching it. Even if I just rest my head on the leather sofa it starts to feel sensitive. Dr. Bruno said donor is healing well and pain is possibly coming from nerves. They are not happy for some reason. I've been instructed to massage area behind my ears few times a day and take ibuprofen every 12h if pain persists. So far, seems like massage is helping. Anyways the pain is not unbearable, so I don't take any painkillers.

Until day 9 I still had quite a lot of scabs, so today I scrubbed my recipient area much longer and slightly harder and quite a lot of scabs fell out!

I had quite a lot of multiple grafts (especially 3s and 4s), so if you zoom in, you can see them on the picture. Looks amazing to me!

P.S. Vertex looks much worse than it actually is. Picture doesn't really reflect finer hair correctly. For some reason in few places on my scalp (donor and vertex) hair looks like didn't grow at all! It's so much shorter than any other surrounding hairs. Weird! 😁

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Edited by Rolandas
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