I contacted two clinics and received two very different plans

[Jenova]

Hi 🙂

I got guidance from the community on how to choose a clinic and I narrowed my list down to two, Bruno Pinto and Rafael De Freitas. Both seem ethical with good reputation and lots of patient reviews on the spanish forum. Freitas has been around for longer, is more known and has more reviews but Pinto is up and coming. I sendt them my case and they both replied and have given me an offer to book the arrangement. My dilemma is that they have quite a different approach as to what they want to do. I was hoping their evaluation of my case would match better as that would have given me the confirmation I felt I needed before making a decision.

De Freitas wants to do the following:
Repopulate the frontal area, the mid scalp and the receding hairline, with 2.800 follicles (5.600 hairs approx.).

Pinto wants to do the following:
Restore the hairline and crown with a total of 3000 grafts (1200 for the hairline and 1800 for the crown). I was told my frontal third and mid scalp has too much density to perform a hair transplant without damaging the native hair.

I have attached the picture of myself I got back from Pinto showing the suggestion on how they want to restore my hairline with 1200 grafts.

Personally I was under the impression that I would need two surgeries since they both operate with a maximum of around 3500 grafts over two days. But since De Freitas does not mention my crown at all in the reply I got, and Pinto thinks my frontal third and mid scalp is too dense then I’m not sure what to do.

Going with Pinto would be nice since the area they want to repair (hairline and crown) is what bothers me the most. But then again my frontal third and mid scalp is thin and I thought it would be safe to transplant there.

What would you do in this situation?

I have been on Finasteride for years and my hairloss has stabilized.

I have pictures and videos on my google drive here: https://drive.google.com/drive/folders/1UCuCUzA22lsyMpNlRXDmciTLVo1NC1f8?usp=sharing
Especially the video 7 and 8 shows the frontal third and midscalp.

It is greatly appreciated if someone has the time to take a look and give input on safety regards to transplanting in my frontal third and mid and what they would have chosen to do in this situation 🙂

[John1991]

Those videos don't tell as as much as a few better framed pics of you from the front and overhead (to fully see the crown) would.  Your donor appears fine.  And you have fine hair that appears to be neither super thick by fine hair standards nor super thin by fine hair standards.  

[Jenova]

Thanks for replying. The photos are in the picture folder. May not be the best but it's what I managed to do with what I had 🙂

[shadowcast]

It's up to you to tell your doctor which areas you want to tackle in the first surgery. Did you tell Freitas you want your crown done?

I'm a little surprised that Pinto doesn't want to implant into your midscalp. He implanted into my forelock, which is probably about as thick as your midscalp, and I didn't lose any native hair there as far as I can tell. Did you send him dark or flattering photos? Maybe he can't really see your hair loss. Of course he could easily be seeing something that me or your average forum poster can't. I would trust his opinion 100%, as long as you sent him clear photos.

[1978matt]

I think Pinto has the numbers about right.

I would factor having to go back in a couple of years and address the midscalp area, just in case that gets shocked out for any reason.

[Jenova]

3 hours ago, shadowcast said:

t's up to you to tell your doctor which areas you want to tackle in the first surgery. Did you tell Freitas you want your crown done?

I'm a little surprised that Pinto doesn't want to implant into your midscalp. He implanted into my forelock, which is probably about as thick as your midscalp, and I didn't lose any native hair there as far as I can tell. Did you send him dark or flattering photos? Maybe he can't really see your hair loss. Of course he could easily be seeing something that me or your average forum poster can't. I would trust his opinion 100%, as long as you sent him clear photos.

I put the hairline and crown as my main concern to both doctors and sendt them the pictures that are in my folder. Based on what I've seen and read about them they seem great, so I found it a little odd they had differing opinions. Hopefully any "too dense areas" will get picked up on during design and preparation no matter who I choose. Just trying to do this right the first time so it's great to have input on here. Thanks for the reply 🙂

[Jenova]

2 hours ago, 1978matt said:

I think Pinto has the numbers about right.

I would factor having to go back in a couple of years and address the midscalp area, just in case that gets shocked out for any reason.

Thanks for chiming in. I will keep that in mind 🙂

[Alex94gasp]

Dr. Bruno Pinto gives feedback? I tried, but only with appointment in person.

[Hairy Henderson]

I thought Freitas was fully booked and not doing consults?

[Jenova]

19 minutes ago, Alex94gasp said:

Dr. Bruno Pinto gives feedback? I tried, but only with appointment in person.

Maybe I have been lucky. I did have to follow up with a lot of pics and videos that the coordinator asked for before I got the feedback. Hence why so many in my folder.

[Jenova]

10 minutes ago, Calihome1 said:

I thought Freitas was fully booked and not doing consults?

I sendt them an e-mail a while ago with links to all the stuff I knew they would need, and also told them I can be available on short notice if they got any cancellations. Maybe my availability helped my case.

[shadowcast]

1 hour ago, Alex94gasp said:

Dr. Bruno Pinto gives feedback? I tried, but only with appointment in person.

Yes, his clinic won't book you until he's reviewed your case, even if it's just the photos/video/information you send over. Then if/when you go there in person, he'll do another consultation/review with you before the procedure starts.

Edited August 21, 2022 by shadowcast

[Vann]

I think it doesnt matter, once you get there they will evaluate. If you want your crown worked on address it with them and tell thme you would like both done. Express the concern for collateral damage and provide different photos in different sun light?, its best to get as much info to them (the surgeons) before anything is done. Of course youll have a live consultation before your surgery and will readdress your concerns. But its always nice to get this done before hand if possible. It doesnt mean its guaranteed, however, I think youll appreciate the effort you put in prior.

As for which surgeon, I think youre in good hands regardless of the pick.

[Gatsby]

The most important factor for me when it comes to surgery is communication. Don't be afraid to bring this up with both doctors and ask them why they stand by their decision? When I was researching and communicating with Eugenix a couple of years ago I received two different responses also between Dr Pradeep and Dr Arika. Each surgeon has their own view point. Some are more conservative while others are more creative, etc. All the best!

[LatinBald]

On 8/20/2022 at 10:30 PM, 1978matt said:

I think Pinto has the numbers about right.

I would factor having to go back in a couple of years and address the midscalp area, just in case that gets shocked out for any reason.

Totally agree.

Dr Pinto's planning is the right one, and try to cover the crown and hairline in 1 surgery.

I wouldn't want Dr Freitas' planning for me. Jenova's crown is too big to wait to be covered more than 2 years.