Hair transplant - FUE - 2891 Grafts - Dr. De Freitas

[N1CK]

Dear community,

I just finished my hair transplant with Dr. De Freitas, and I would like to take you with me on the transplantation-journey and would like to get your feedback and opinions.

First of all, I have to say that the clinic team and the doctor are very nice and I felt very welcome and comfortable during my stay there. We had nice, funny and relaxed conversations even during the procedure.
The clinic interior is very clean and gives a very professional impression.

Through the email consultation and based on the pictures I sent some months before the surgery, the doctor estimated 2.800 grafts and I had to take oral Finasteride 1mg per day upfront to the surgery.
I could already see positive results on hair growing in the central and crown area from the 6 months of Finasteride.
Additionally I took topical Minoxidil for a couple of years before.

My hair issues is alopecia with diffuse hair loss – frontal, entrances, central, crown. – See pictures.

 

Before Finasteride:

 

 

After 6 Months Finasteride: (the hair became thicker and denser)

The surgery plan was to implant the frontal, entrances and central area.

My intervention was split in two sessions / two days. 1^st day 1.000 grafts, 2^nd day 1.800 grafts.

On the first day, the doctor looked at my hair, took pictures of my hair status and immediately said, that I have to add oral Dutasteride additionally to oral Finasteride and oral Minoxidil because of my diffuse hair loss and only with Dutasteride it will be possible to control and stabilize the hair loss in the crown and central back area.   
Additionally he said that the crown area needs to be implanted in a second surgery later on and the Dutasteride medication in preparation for that second surgery is required.

Then he started to paint the frontal hairline and the central implantation area.

 

After the preparation, the extraction session started followed by the implantation session.

And here are the results:

      

   

 

 

 

Day 1 - After HT

 

 

 Day 2 - After HT

 

Resume and questions to the community:

1)      Transplant Area:

I’m very happy so far with the frontal part and the way the doctor has set the hairline. That’s why I did choose Dr. De Freitas.

I’m a just bit wondering that at the end the central part was not completely filled out as marked/painted at the beginning with the blue lines. But the frontal part seems to be quite dense:

  

 

I saw some other transplantataion cases  with similar hair situation as mine and a similar amount of transplanted grafts/hairs (2.700 – 3.000 grafts), but the implant area was filled 2/3 over the head, with very dense results. In my case the transplanted area is just about 1/2 of my head now with the same amount of grafts.
Of course, I fully trust on Dr. De Freitas decision on that, as he has all the experience to achieve the best result at the end, considering every individual case (hair quality, density, color, head size etc.)  But I'm still wondering that the actual transplanted area is much less than initially marked on my head with the blue line.
So I probably need to do a second surgery later on to fill more of the central area plus the crown area and I hope that the difference between the dense frontal area and the less dense central and crown area will not be too obvious until I get the second surgery.

 Any experience or opinion on this?

 

2)      Medication:
As I could see already some positive effects and growing hair since I’m taking Finasteride, I didn’t expect that I have to take any additional medicine. I’m concerned to take Dutasteride (additionally to Finasteride), because of the possible side-effects.

Does any of you have some experiences with Dutasteride alone and also in combination with Finasteride?
Any opinion or advice on this situation?
Of course I want to achieve the best possible result of the hair transplant but more information about this heavy drugs and the possible side effects would be appreciated - (sure I made my own research already, however I would be interested about your experience and feedback)

 

3) Did you reveice a PRP treatment right after your surgeries? I didn't get PRP right after the HT and was wondering if a PRP is not nessecary immediatal and can be done at a later point after the HT or is it not needed at all?

 

Thank you in advance, I'm looking forward to read your comments.

I will keep you updated on the progress 🙂

  

 

Edited June 5, 2022 by N1CK
Delete images

[HappyMan2021]

1) 

33 minutes ago, N1CK said:

So I probably need to do a second surgery later on to fill more of the central area plus the crown area and I hope that the difference between the dense frontal area and the less dense central and crown area will not be too obvious until I get the second surgery.

Do you feel Dr. Freitas clearly understood your objectives? Did he relay to you you may need a 2nd surgery or is this a surprise? 

It does not sit well with me that a patient on Day 2 post-op already needs to start thinking about a 2nd surgery (need to factor in what Dr. Freitas told you, your own expectations, etc)

2) Why would you take Fin + Dut? That makes no sense. Just take one of them. If you had zero sides on Fin, replace that with Dut for even stronger protection. Case closed...

3) PRP has zero bearing on HT results. Doctors like to provide this because it sounds like a super cool innovative treatment, and is an easy way to add on more charges. Steer clear!

To be honest I think PRP is a bit of junk regardless of its application. My orthopedic doctor swore PRP would fix my tennis elbow and "all the athletes were doing it". FYI I still have tennis elbow...

Edited May 29, 2022 by HappyMan2021

[sukh123]

Intresting he said to switch to dut  since your responding to fin, if I was personally responding to fin I don’t see why there’s a need to hop on to dut  so quickly since it’s usually used for people who don’t respond to fin or plateau 

[Min12]

Fin only blocks 1 type of DHT whilst Dut blocks both. I’m a diffuse thinner and I have recently added dut on with fin and waiting to see the results….

ALL relevant studies show Dut is significantly better in hair count increase and thickness compared to fin.

Just a few questions:

I’m planning on going there next year, how was the accommodation sorted by you or the clinic?

how painful was the anaesthetic?

did you have much input on where the hairline would be?

 

 

Edited May 30, 2022 by Min12

[Melvin- Admin]

The work looks extremely clean. Happy growing 🙌🏼

[N1CK]

8 hours ago, HappyMan2021 said:

1) 

Do you feel Dr. Freitas clearly understood your objectives? Did he relay to you you may need a 2nd surgery or is this a surprise? 

It does not sit well with me that a patient on Day 2 post-op already needs to start thinking about a 2nd surgery (need to factor in what Dr. Freitas told you, your own expectations, etc)

2) Why would you take Fin + Dut? That makes no sense. Just take one of them. If you had zero sides on Fin, replace that with Dut for even stronger protection. Case closed...

3) PRP has zero bearing on HT results. Doctors like to provide this because it sounds like a super cool innovative treatment, and is an easy way to add on more charges. Steer clear!

To be honest I think PRP is a bit of junk regardless of its application. My orthopedic doctor swore PRP would fix my tennis elbow and "all the athletes were doing it". FYI I still have tennis elbow...

Thank you for your feedback HappyMan.

Yes I assume that the doctor and the team understood my objective.
Alraedy upfront to the surgery when I contacted the clinic I described my objective  "I would like to improve the hairline in front, the overall density on top and all areas based on doctors consultation and recommendation."
The doctor evaluation and answer was:  the surgical strategy will consist of repopulating the frontal area, the central area and the entrances, with an extraction of 2.800 follicles (5.600 hairs approx.).

I additionally asked: "As also my crown area is having less hair, would is be possible to transplant some hair into the crown area as well? Do you have a recommendation based on my pictures?"

And the answer was that for the crown, I have to wait a year for the evolution of the first implantation.

So I was alraedy aware that the crown area will not be done in the first surgery, what was fine for me. I wanted to decide later on if I even need a second surgery for the crown, as the front and central area will be covered alraedy.
So the second surgery was not a total surprise but more eventually.

And also the painting of the planned implanting area on the central part was ok for me as 2/3 would have been covered and was going up until the crown area.
But now with more open space still on the central area, it is more likely that I need the second surgery to not only cover the crown but also more of the central area.

It is not a critic.
I was just wondering if any of you had similar experience that not the whole area which was marked before was then actually fully implanted and what your result was.

 

2) Regarding Fin + Dut.
The medication plan I received from the doctor is:
Dut 0,5mg on Monday, Wednesday, Friday + Fin 1mg on Tuesday, Thursday, Saturday and Sunday + Minox 5 MG every day.
That's why I was wondering if any of you has experience with this medication plan and what results on hair growing you did achieve and if you experienced any side-effects.

3) PRP - ok. I might get e PRP or Meso when I vist for the 3 - or 12 Months post-OP check up.

 

Beside all the above topics, I'm strictly following now the very detailled and precise guideline which I received from the clinic. This is very helpfull and I can't wait so see it growing 🙂

[N1CK]

9 hours ago, sukh123 said:

Intresting he said to switch to dut  since your responding to fin, if I was personally responding to fin I don’t see why there’s a need to hop on to dut  so quickly since it’s usually used for people who don’t respond to fin or plateau 

The explanation was that only with dut the needed effect of stabilizing can be achieved.

[N1CK]

4 hours ago, Min12 said:

Fin only blocks 1 type of DHT whilst Dut blocks both. I’m a diffuse thinner and I have recently added dut on with fin and waiting to see the results….

ALL relevant studies show Dut is significantly better in hair count increase and thickness compared to fin.

Just a few questions:

I’m planning on going there next year, how was the accommodation sorted by you or the clinic?

how painful was the anaesthetic?

did you have much input on where the hairline would be?

 

 

Thank you fro your comments.

The clinic supported me with the accomodation. It was just 5 min taxi drive from the hotel to the clinic, which was very comfortable.
Thanks again to Dr. De Freitas and the team for the support on this.

The anaesthetic was just a little painful, but easy to take. They used a vibrator which make it less painfull. 
after this I didn't feel any pain.

I could give input on the hairline, but I also trusted on the doctors opionion and experience to achieve a natural look.

[Antlor]

People say Dr. Rafael de Freitas does great natural hairlines. Can't wait to see your final result in 1 to 1.5 years.

[Min12]

Did you bring your own blood test results or have them done in Spain?

[N1CK]

Just now, Min12 said:

Did you bring your own blood test results or have them done in Spain?

I sent my own blood test which I took before at a hospital.

[drawdownfx]

Hey man great work by Dr Freitas, i was quoted the exact grafts from him too. I started dutasteride about 2 weeks ago doing 1 day dutasteride and one day finasteride so far everything has been good!

[N1CK]

17 hours ago, drawdownfx said:

Hey man great work by Dr Freitas, i was quoted the exact grafts from him too. I started dutasteride about 2 weeks ago doing 1 day dutasteride and one day finasteride so far everything has been good!

How did you choose this medication plan, combining dut and fin? Just by yourself based on some research and results or by advice from a doctor?

[drawdownfx]

3 hours ago, N1CK said:

How did you choose this medication plan, combining dut and fin? Just by yourself based on some research and results or by advice from a doctor?

I actually took that advice from dr pintos assistant. It’s also mainly until my finasteride finishes and then il do dutasteride 5x a week. If you are good with 1mg finasteride everyday you should be fine with dutasteride. I just put my deposit down with dr freitas today so fingers crossed 🤞 

[Min12]

22 minutes ago, drawdownfx said:

I actually took that advice from dr pintos assistant. It’s also mainly until my finasteride finishes and then il do dutasteride 5x a week. If you are good with 1mg finasteride everyday you should be fine with dutasteride. I just put my deposit down with dr freitas today so fingers crossed 🤞 

What month did you manage to book in by?

[Jackdaniels]

Great choice. Freitas is hight quality surgeon. I do like a lot his hairlines as they are very dense..Good luck!

[drawdownfx]

On 6/2/2022 at 8:53 PM, Min12 said:

What month did you manage to book in by?

I have a date for February 2023

[A Fue Good Men]

On 5/29/2022 at 7:54 PM, Min12 said:

Fin only blocks 1 type of DHT whilst Dut blocks both. I’m a diffuse thinner and I have recently added dut on with fin and waiting to see the results….

ALL relevant studies show Dut is significantly better in hair count increase and thickness compared to fin.

Just a few questions:

I’m planning on going there next year, how was the accommodation sorted by you or the clinic?

how painful was the anaesthetic?

did you have much input on where the hairline would be?

 

 

Fin doesn’t “block dht.” It reduces type II 5 alpha reductase which turns test into dht

[N1CK]

Update:

Status - 9 Days after HT

 

[Jtoorrees]

Looks good man! I’m heading there in October of next year. Where are you from, and how long did you stay after the surgery? Do you think you would’ve been able to travel the day after the surgery?

[Min12]

7 hours ago, N1CK said:

Update:

Status - 9 Days after HT

 

How’s the donor looking at day 9? As I’m intending of keeping the hair at this length for a few months after the surgery.

Edited June 5, 2022 by Min12

[N1CK]

4 hours ago, Jtoorrees said:

Looks good man! I’m heading there in October of next year. Where are you from, and how long did you stay after the surgery? Do you think you would’ve been able to travel the day after the surgery?

Thanks man!

I did fly the day after the surgery to Germany.

But if you have a longer flight to overseas I would recommend to stay 1-2 more days in Valencia before you take the flight.

[N1CK]

1 hour ago, Min12 said:

How’s the donor looking at day 9? As I’m intending of keeping the hair at this length for a few months after the surgery.

looks like this:

  

[HappyMan2021]

On 5/29/2022 at 4:11 PM, N1CK said:

I’m a just bit wondering that at the end the central part was not completely filled out as marked/painted at the beginning with the blue lines.

before surgery was there any kind of agreement to allow Freitas to use as many grafts as possible and bill you for them?

Perhaps he ran out of grafts and just stopped. 

Not sure if you had an in-person consult or not. It's quite common for graft counts to be underestimated in virtual consults or using photos. 

[N1CK]

On 6/6/2022 at 11:38 AM, HappyMan2021 said:

before surgery was there any kind of agreement to allow Freitas to use as many grafts as possible and bill you for them?

Perhaps he ran out of grafts and just stopped. 

Not sure if you had an in-person consult or not. It's quite common for graft counts to be underestimated in virtual consults or using photos. 

no there was no agreement before to use more hair if needed. but he used some more as initially planned.

as per the clinics feedback it turned out during the intervention, that my head is bigger than expected.
Before the transplant, I had an online consultation via photos to estimate the graft amount.