Seeking Advice for the Best Hair Transplant Surgeon

[Geo]

Hi All,

 

First all, thank you all for this great forum. I have been following it for several months now, and the information and insights are great.

 

So, I decided to create an account and seek your advice on my case.

 

I have attached very recent HD pictures which I asked my barber to take after my haircut (the sides are cut to a buzz level 4). The pictures are under harsh salon lights (direct and indirect) and with a shorter hair, so in everyday life, the hair loss is not as bad as it looks in the pictures, but I wanted to show the worst case, to avoid wrong assumptions and to get a correct estimation (I could have taken pictures with indirect lights, etc. and it would have shown completely different status, but that’s not the point here).

 

Age: 40 years. I have been on Regaine 5% (topical minoxidil; 2x per day) since 15 years, and Propecia (oral, 1mg finasteride, 1x per day) since 12 years. I also take Biotin daily and use Vichy Dercos shampoo. My hair loss has largely stabilized for several years now. I had a hair transplant for the hairline area in 2013 (9 years ago) (FUE technique) and few grafts in the crown (handful, really) and the beard (the sides of the beard). I don’t remember exactly how many grafts/hairs it was, but from distant memory, I think 1,500-2,000 in the head and around 500 in the beard. The donor area is completely healed and looks untouched even a lower buzz.

 

At the time, it wasn’t a bad result, and it gave me a change in the looks. However, it always felt unnatural due to multiple hair grafts in the hairline, as well as edgy temple closures (straight lines).

 

So, I am looking for the best hair transplant surgeon to do a 5-Star hair transplant for me. Cost is not an issue at all. Location is also not an issue, but I prefer Europe due to distance and visa requirements.

 

My objectives:

 

1.     Frontal third: The distance from the lowest point in the hairline to the eyebrow is around 7 cm, so I think the forehead size is adequate. My objective is to make the hairline more natural with a better flowing closure to the temples, and fill in the frontal third so that there’s no more see through.

2.     Temple peaks: The temple peaks now are very eroded, so my objective here is to define the temple peaks, so that they, along with the hairline, are consistent. (a solid hairline with almost eroded temple peaks just stands out as unnatural)

3.     Crown: My objective here is fill in the crown area

4.     Mid-Area: I don’t know if this area requires intervention, so I will go with the advice of the doctor.

5.     Beard: My objective is to fill in the area marked in red on the pictures using the beard hair on the neck (the ones shorter than the rest of the beard in the pictures). Not expecting miracles there, but to maximize the use of those hairs which I was going to remove by laser anyway and put them for a better use in the main beard.

 

 

I have done a lot of research and read through a lot of posts on the forum, and I have narrowed down my search to few doctors, in no particular order:

 

1.     Dr. De Freitas

2.     Dr. Mwamba

3.     Dr. Bisanga

4.     Dr. Couto (almost impossible to get an appointment; I tried contacting his clinic)

 

 

Would you please advise who do you think is the best doctor for my case?

 

What do you the required number of grafts are? My rough estimate is 2,000 for the frontal third and 2,000 for the crown. As for the beard, whatever is extractable from the neck hair (below the beard).

 

Thank you for your advice.

 

Cheers,

 

Geo

 

[THE TRUTH]

Hello, 

All surgeons you mentionned are excellent choices. 

I would add Pinto, Ferreira  from Portugal anf Muresanu from Switzerland. 

I think Ximena Vila and Bijan Feriduni are also good options. 

If you are on a budget I think Bicer would be good for you even though she is not on Pinto/Bisanga/Freitas level. 

Who was your first surgeon ? Looks like you got decent growth but poor density 

 

 

[Melvin- Admin]

You have some excellent names. Are you on medication? How long ago was your surgery?

[Geo]

16 minutes ago, Nurses take over said:

Hello, 

All surgeons you mentionned are excellent choices. 

I would add Pinto, Ferreira  from Portugal anf Muresanu from Switzerland. 

I think Ximena Vila and Bijan Feriduni are also good options. 

If you are on a budget I think Bicer would be good for you even though she is not on Pinto/Bisanga/Freitas level. 

Who was your first surgeon ? Looks like you got decent growth but poor density 

 

 

Hi,

 

Thank you for the additional recommendations. Budget is not an issue at all. I am looking for a top class, 5-star result. I forgot the name of the doctor, but it was a chain of hair transplant clinics, which I would prefer not to put the name here, as it may reflect poorly on them. Yes, the growth is fine, but the density is poor. However, the dense area behind the hairline that you see in the picture is my native hair. The transplanted area is only the hairline. Thanks

[Geo]

10 minutes ago, Melvin- Moderator said:

You have some excellent names. Are you on medication? How long ago was your surgery?

Thanks. Yes, I am on Regaine 5% (oral minoxidil) 2x per day, Propecia (1mg finasteride) 1x per day, Biotin 1x pill per day, and I use Vichey Dercos Shampoo.

 

My surgery was 9 years ago. 

 

Budget is not an issue at all. I am looking for a top-class, 5-stars results from a top surgeon. 

[THE TRUTH]

Just now, Geo said:

Hi,

 

Thank you for the additional recommendations. Budget is not an issue at all. I am looking for a top class, 5-star result. I forgot the name of the doctor, but it was a chain of hair transplant clinics, which I would prefer not to put the name here, as it may reflect poorly on them. Yes, the growth is fine, but the density is poor. However, the dense area behind the hairline that you see in the picture is my native hair. The transplanted area is only the hairline. Thanks

I see I think who you're talking about. Yes they have many bad results unfortunately. 

Another recommendation in the US would be Dr. Konior from Chicago. He is one of the very best but his prices are absolutely ridiculous. 

No problem and all the best ! 

You are on the right track for sure

[Geo]

5 minutes ago, Nurses take over said:

I see I think who you're talking about. Yes they have many bad results unfortunately. 

Another recommendation in the US would be Dr. Konior from Chicago. He is one of the very best but his prices are absolutely ridiculous. 

No problem and all the best ! 

You are on the right track for sure

Thank you. I prefer not to go to the US due the distance. I think Europe has some excellent options. 

[Jon2345]

I don't see a direct picture of your hairline. But do you feel that grafts may need to be taken out and placed further back? I would consider also reaching out to Cooley, I consider him the king of repairs. And I also saw an amazing repair job of Gabel recently as well. Consult with those and the other people on your list. See how they would approach this.

[Geo]

6 minutes ago, Jon2345 said:

I don't see a direct picture of your hairline. But do you feel that grafts may need to be taken out and placed further back? I would consider also reaching out to Cooley, I consider him the king of repairs. And I also saw an amazing repair job of Gabel recently as well. Consult with those and the other people on your list. See how they would approach this.

Attached is a direct picture. I think the placement of the hairline is fine and not aggressive (7 cm from lowest point of hairline until the eyebrow). I am no expert, but I think the surgeon may end up removing some of the doubles from the hairline, redraw the hairline with singles to make it “wavy” instead of straight, and fill the area behind it (the frontal third). Sounds reasonable? 
 

Thanks for the recommendations. I will check them out. 

[Dillpickle123]

All those options are excellent I’ve only seen mwamba do beard out of those names but they’re all great choices for hairlines 

[MachoVato]

Bisanga or De Freitas. Both are doing world-class work!

[Geo]

5 hours ago, MachoVato said:

Bisanga or De Freitas. Both are doing world-class work!

Thanks. Great results you got from HLC and Dr. Bisanga ! 

[Mike10]

I think 2000 grafts might be over the top for the crown area. But it is a little disappointing to see teh crown area with all this medication you're taking. Especially Propecia was supposed to do the job there. 

[NARMAK]

9 minutes ago, Mike10 said:

I think 2000 grafts might be over the top for the crown area. But it is a little disappointing to see teh crown area with all this medication you're taking. Especially Propecia was supposed to do the job there. 

OP has been on it for 12 years, so it's probably a good indication had he not been it and Minoxodil how much more adverse it might have looked. That said, might be a consideration for OP to switch to Dutasteride. 

I would also add in Microneedling OP, the crows a black hole of grafts so whatever you can recover there via those methods would be 10x better for you. Perhaps an idea would be to concentrate your operation on the frontal hairline first and then re-evaluate the crown 12 months down the line after possibly upgrading to Dutasteride and Microneedling. 

[Mike10]

1 minute ago, NARMAK said:

OP has been on it for 12 years, so it's probably a good indication had he not been it and Minoxodil how much more adverse it might have looked. That said, might be a consideration for OP to switch to Dutasteride. 

I would also add in Microneedling OP, the crows a black hole of grafts so whatever you can recover there via those methods would be 10x better for you. Perhaps an idea would be to concentrate your operation on the frontal hairline first and then re-evaluate the crown 12 months down the line after possibly upgrading to Dutasteride and Microneedling. 

Or it could look the same? we do not know.  I do not take Propecia and  do not have any loss in the crown area. I am about the same age as him.

[NARMAK]

3 minutes ago, Mike10 said:

Or it could look the same? we do not know.  I do not take Propecia and  do not have any loss in the crown area. I am about the same age as him.

Usually in cases like yours it seems you may follow more of a typical pattern of hair loss that's from the front moving backwards then, whereas OP seems to follow the V pattern on the scale where the frontal area recedes but then also the crown area. The speed of which ends up random between people but the pattern is there. 

Myself for example looking at it, i've got a just off centre crown area and i believe my family history leans towards crown hair loss too even when the frontal area seems to appear okay-ish, so i'm hoping the Dutasteride will continue to help shore the area up given my hair loss didn’t appear visually at least to be massively aggressive over the 10+ year period i wasn't on it. Long term studies also seem to show Finasteride can work well over 10 years, but i guess given the billions of men out there, we can still lose ground and things happen. Still, i think it would be worth OP now switching to Dutasteride and adding Microneedling into the mix. 

[Fue3361]

If I was sticking to that list, I'd probably go with Freitas.  Always worth trying multiples times to get in touch with Couto though.  Sometimes persistence wins.

[Mike10]

2 hours ago, NARMAK said:

Usually in cases like yours it seems you may follow more of a typical pattern of hair loss that's from the front moving backwards then, whereas OP seems to follow the V pattern on the scale where the frontal area recedes but then also the crown area. The speed of which ends up random between people but the pattern is there. 

Myself for example looking at it, i've got a just off centre crown area and i believe my family history leans towards crown hair loss too even when the frontal area seems to appear okay-ish, so i'm hoping the Dutasteride will continue to help shore the area up given my hair loss didn’t appear visually at least to be massively aggressive over the 10+ year period i wasn't on it. Long term studies also seem to show Finasteride can work well over 10 years, but i guess given the billions of men out there, we can still lose ground and things happen. Still, i think it would be worth OP now switching to Dutasteride and adding Microneedling into the mix. 

I think you may be right

[Geo]

3 hours ago, Mike10 said:

I think 2000 grafts might be over the top for the crown area. But it is a little disappointing to see teh crown area with all this medication you're taking. Especially Propecia was supposed to do the job there. 

Thanks; yes, you’re right, maybe 1,500 for the crown. Well, I think it would’ve been worse without the minoxidil and finasteride. At least, it is stabilized now for several years. 

[Geo]

3 hours ago, NARMAK said:

OP has been on it for 12 years, so it's probably a good indication had he not been it and Minoxodil how much more adverse it might have looked. That said, might be a consideration for OP to switch to Dutasteride. 

I would also add in Microneedling OP, the crows a black hole of grafts so whatever you can recover there via those methods would be 10x better for you. Perhaps an idea would be to concentrate your operation on the frontal hairline first and then re-evaluate the crown 12 months down the line after possibly upgrading to Dutasteride and Microneedling. 

Thanks for the feedback. I’ll ask the short listed doctors if I should switch to Dutasteride and microneedling. And, probably by the time I book the appointment, etc, it’ll be already 1 year, so I can go all in one trip.  

[Geo]

3 hours ago, NARMAK said:

Usually in cases like yours it seems you may follow more of a typical pattern of hair loss that's from the front moving backwards then, whereas OP seems to follow the V pattern on the scale where the frontal area recedes but then also the crown area. The speed of which ends up random between people but the pattern is there. 

Myself for example looking at it, i've got a just off centre crown area and i believe my family history leans towards crown hair loss too even when the frontal area seems to appear okay-ish, so i'm hoping the Dutasteride will continue to help shore the area up given my hair loss didn’t appear visually at least to be massively aggressive over the 10+ year period i wasn't on it. Long term studies also seem to show Finasteride can work well over 10 years, but i guess given the billions of men out there, we can still lose ground and things happen. Still, i think it would be worth OP now switching to Dutasteride and adding Microneedling into the mix. 

Yes, I think you’re right, but the good thing is that mu hair loss has mostly stabilized for several years now, so seems the medication is working. Plus, it seems in the family, father’s side, most don’t seem to to bald, but thin over time. 

[Geo]

1 hour ago, Fue3361 said:

If I was sticking to that list, I'd probably go with Freitas.  Always worth trying multiples times to get in touch with Couto though.  Sometimes persistence wins.

Dr. Freitas does unbelievable hairlines; top notch. Dr Couto is a magician from the results I have seen. I will definitely keep trying with him. 

[NARMAK]

13 minutes ago, Geo said:

Thanks for the feedback. I’ll ask the short listed doctors if I should switch to Dutasteride and microneedling. And, probably by the time I book the appointment, etc, it’ll be already 1 year, so I can go all in one trip.  

In terms of Dutasteride, some mat suggest it, some may say to stay on Finasteride based on the sort of reply you gave. Personally i think given the situation, you would benefit from the switch and should recover ground where possible more quickly on Dutasteride. Although you may have to be aware that with the switch, you can end up having a new shed. 

9 minutes ago, Geo said:

Dr. Freitas does unbelievable hairlines; top notch. Dr Couto is a magician from the results I have seen. I will definitely keep trying with him. 

Dr Cuoto is definitely a surgeon who shows off great results but it's always on a pretty specific type of candidate it seems. 

 

11 minutes ago, Geo said:

Yes, I think you’re right, but the good thing is that mu hair loss has mostly stabilized for several years now, so seems the medication is working. Plus, it seems in the family, father’s side, most don’t seem to to bald, but thin over time. 

Yeah, usually that's why people look at family history as an indicator but medication can help sort this out for a longer time by delaying the speed at which hair loss affects you. Potentially with some medication, you could stop hair loss depending on your genetics. 

[Geo]

2 hours ago, NARMAK said:

In terms of Dutasteride, some mat suggest it, some may say to stay on Finasteride based on the sort of reply you gave. Personally i think given the situation, you would benefit from the switch and should recover ground where possible more quickly on Dutasteride. Although you may have to be aware that with the switch, you can end up having a new shed. 

Dr Cuoto is definitely a surgeon who shows off great results but it's always on a pretty specific type of candidate it seems. 

 

Yeah, usually that's why people look at family history as an indicator but medication can help sort this out for a longer time by delaying the speed at which hair loss affects you. Potentially with some medication, you could stop hair loss depending on your genetics. 

Thanks for the tips!

[Hairy Henderson]

4 hours ago, NARMAK said:

In terms of Dutasteride, some mat suggest it, some may say to stay on Finasteride based on the sort of reply you gave. Personally i think given the situation, you would benefit from the switch and should recover ground where possible more quickly on Dutasteride. Although you may have to be aware that with the switch, you can end up having a new shed. 

Dr Cuoto is definitely a surgeon who shows off great results but it's always on a pretty specific type of candidate it seems. 

 

Yeah, usually that's why people look at family history as an indicator but medication can help sort this out for a longer time by delaying the speed at which hair loss affects you. Potentially with some medication, you could stop hair loss depending on your genetics. 

What specific type of person?  Hairline/temples only with a low NW #?