Finding the best surgeon

[Triple Nine]

Hey guys. Im a 26 year old argentine with a receding hairline. I've been reading this entire forum now for quite a while. My research goes back a few years now, i've been looking at patient result, reviews and insights about top notch surgeons and clinics available. 
 

As many of you can relate, when I first started doing my research I immediately went out to research Turkey, but found out what most of you all know about Turkey and the scandalous amounts of unexperienced people who put on a pair of gloves and play doctor. I'm sure there are great surgeons over there but I decided to slow down and do my research elsewhere, to avoid risks. 
 

I then moved to argentine clinics (due to proximity), but I couldn't find any outstanding work that would make me even book an appointment, not even the best of the best results. Also, i've called a few clinics and most of them wanted to perform HT two weeks from my consultation, without regarding the fact of if I was taking Finasteride or not. Didn't even recommend it so it raised a few flags for me so I kept looking. 
 

I then researched American doctors, I read about Shapiro, Bernstein and a few others but I couldn't find what I was looking for, though I didn't book a consult with neither of them. I did see Konior but I didn't see a case where the quality would justify the cost; I may be wrong though, just my personal opinion and research. 

I finally moved on to EU and found a few good doctors in Spain like Freitas, Prieto, Lorenzo and Couto. Out of them all I booked a consult with Couto. I had my appointment a few weeks ago, I'm supposed to make my first deposit this week. I've been having second guesses because I didn't get the very best impression out of the clinics employee who picks up the phone, however when I had my appointment with Dr Couto he reassured me of my second thoughts and took an hour and a half to talk with me and answer all of my questions. I am trying to pay though and get a response every other day, which is taking a while but I guess keeping up with all of the consults can't be an easy task anyway. Of the few patient reviews and the cases published on their Instagram, I love what I saw, though I did recently see that one of his patients had very low density on his hairline, but the Dr did offer a free "touch up" and I'm still waiting for the patient to post the final result. I also think that we are all human and I can't see one bad case as him being a bad Dr. I still consider him to be the best, especially because of the time he puts into patients and his work ethics, but I often do get blinded by the fact of reading so many good reviews about him and thats why im referring to you guys for an extra opinion. I read some spanish forums and they all regard him as the BEST of the BEST, not a single one has a bad thing to say. Dr Couto recommended 3000 FUE grafts implanted onto my new hairline design to restore temples and bring my hairline back to where it should be. I was prescribed Finasteride 1mg until September 2023 which is when my appointment should be. Any how, I had some questions for you guys regarding my case:

 

1) After looking at my pictures, what doctor would you say would be the best case scenario for me? I wouldn't mind price, I want to get the best of the best when it comes to my face as I get media attention. 

2) Why can't I find many patient reviews about Dr Couto? Is it because patients get the best results coming out of the clinic and don't even bother posting their cases? At first I thought maybe he didn't get a whole bunch of patients so there weren't many posting his work, but he is booked for the next 1/2 years so I scratched that off. 
 

3) Is smoking as bad as I've read about? 

Edited September 6, 2022 by Triple Nine

[HairEnthusiast101]

9 minutes ago, Triple Nine said:

Hey guys. Im a 26 year old argentine with a receding hairline. I've been reading this entire forum now for quite a while. My research goes back a few years now, i've been looking at patient result, reviews and insights about top notch surgeons and clinics available. 
 

As many of you can relate, when I first started doing my research I immediately went out to research Turkey, but found out what most of you all know about Turkey and the scandalous amounts of unexperienced people who put on a pair of gloves and play doctor. I'm sure there are great surgeons over there but I decided to slow down and do my research elsewhere, to avoid risks. 
 

I then moved to argentine clinics (due to proximity), but I couldn't find any outstanding work that would make me even book an appointment, not even the best of the best results. Also, i've called a few clinics and most of them wanted to perform HT two weeks from my consultation, without regarding the fact of if I was taking Finasteride or not. Didn't even recommend it so it raised a few flags for me so I kept looking. 
 

I then researched American doctors, I read about Shapiro, Bernstein and a few others but I couldn't find what I was looking for, though I didn't book a consult with neither of them. I did see Konior but I didn't see a case where the quality would justify the cost; I may be wrong though, just my personal opinion and research. 

I finally moved on to EU and found a few good doctors in Spain like Freitas, Prieto, Lorenzo and Couto. Out of them all I booked a consult with Couto. I had my appointment a few weeks ago, I'm supposed to make my first deposit this week. I've been having second guesses because I didn't get the very best impression out of the clinics employee who picks up the phone, however when I had my appointment with Dr Couto he reassured me of my second thoughts and took an hour and a half to talk with me and answer all of my questions. I am trying to pay though and get a response every other day, which is taking a while but I guess keeping up with all of the consults can't be an easy task anyway. Of the few patient reviews and the cases published on their Instagram, I love what I saw, though I did recently see that one of his patients had very low density on his hairline, but the Dr did offer a free "touch up" and I'm still waiting for the patient to post the final result. I also think that we are all human and I can't see one bad case as him being a bad Dr. I still consider him to be the best, especially because of the time he puts into patients and his work ethics, but I often do get blinded by the fact of reading so many good reviews about him and thats why im referring to you guys for an extra opinion. I read some spanish forums and they all regard him as the BEST of the BEST, not a single one has a bad thing to say. Any how, I had some questions for you guys regarding my case:

 

1) After looking at my pictures, what doctor would you say would be the best case scenario for me? I wouldn't mind price, I want to get the best of the best when it comes to my face as I get media attention. 

2) Why can't I find many patient reviews about Dr Couto? Is it because patients get the best results coming out of the clinic and don't even bother posting their cases? At first I thought maybe he didn't get a whole bunch of patients so there weren't many posting his work, but he is booked for the next 1/2 years so I scratched that off. 
 

3) Is smoking as bad as I've read about? 

Cuoto is pretty good but I like Freitas as well. What did they think about 2,000 grafts? There is a recommendation list above with many great surgeons nearby so doesn’t hurt to consult a few times before making a decision.

[Melvin- Admin]

You have some great names. Dr. Cuoto and De Freitas is like comparing a Ferrari and Lambourgini. 

[Triple Nine]

3 minutes ago, Melvin- Moderator said:

You have some great names. Dr. Cuoto and De Freitas is like comparing a Ferrari and Lambourgini. 

Thanks! I've seen your HT journey. Looking good! 

[Triple Nine]

59 minutes ago, JoDimaggio22 said:

Cuoto is pretty good but I like Freitas as well. What did they think about 2,000 grafts? There is a recommendation list above with many great surgeons nearby so doesn’t hurt to consult a few times before making a decision.

Hey! Thanks for sharing. Couto suggested 3000 grafts

[HairEnthusiast101]

27 minutes ago, Triple Nine said:

Hey! Thanks for sharing. Couto suggested 3000 grafts

Well Cuoto is quality especially if you can get into him and money isn’t a factor so I’d say you are in good hands.

[rambo man]

Did he draw you a hairline in the consultation? If you are having it lower and temple points then i think 3000 is right

If you are just wanting the receded temples joining up to the central stump then I would think around 2000-2500 should be enough the rest of the hair seems ok

[Triple Nine]

2 minutes ago, rambo man said:

Did he draw you a hairline in the consultation? If you are having it lower and temple points then i think 3000 is right

If you are just wanting the receded temples joining up to the central stump then I would think around 2000-2500 should be enough the rest of the hair seems ok

Hey. It was a virtual consultation, we're going to draw the hairline design options next year. I am really looking forward to it. Thanks for your feedback

[Rahal Hair Transplant]

Triple Nine,

It sounds like you’ve done a lot of research on surgeons which is always what we suggest prospective patients do prior to undergoing the actual procedure.  I personally can’t say I’m overly familiar with the doctor you selected however, as long as you’ve seen dozens of examples of your selected doctor’s work posted by both patients and the clinic and you are satisfied, then you’ve done your due diligence.

There are a number of reasons why a particular doctor may be less visible online. Some simply don’t take the time to spread the word through the Internet and their patients may rarely decide to post their experiences and results online.  In my opinion, that makes it a lot more difficult for prospective patients to really feel confident and comfortable with that particular doctor because even if they are doing incredible work, it’s practically impossible to substantiate unless the clinic can provide you with enough information that satisfies you. Even then, the information provided is hand selected by the clinic which means you will be handed the best examples and their ideal patients to talk to.  

Regarding your other questions, it is always best to follow your doctors preoperative and postoperative instructions which includes not smoking before and after surgery. The truth is, smoking can thin the blood which only serves to complicate surgery and could affect the healing process post-op.  So while some patients may continue to smoke before and after surgery and have no problems, the risks are definitely higher which is why it is always best to follow your doctor‘s instructions.  This will ensure you receive the best possible result.

Since you are still asking about the best doctors, if you have not fully decided, I do suggest considering following the below steps which I tell everybody who is considering a hair transplant. At the end of the day, it involves research, consultation and careful selection based on evidence and proof and not facets like price, location and likability all the doctors personality, etc.  I’m not suggesting that the latter aren’t important or relevant but they are certainly less important than proof that a particular surgeon and clinic regularly produces outstanding results and can actually meet your overall short and long-term hair restoration goals. So without further due, here are the steps I tell everybody considering hair transfer surgery regarding physician selection

1.  Start by looking at the surgeons recommended by this community, in particular the Coalition of Independent Hair Restoration Physicians.  Surgeons recommended by this community have met a demanding set of standards and are approved based on meeting those high standards.  Many online hair surgeon memberships don’t have any criteria other than to pay a membership fee.  Furthermore, physician members of the coalition have met an even higher and more demanding set of standards and have proven to be amongst the best of the best in the profession.

2. Now even amongst a list of outstanding surgeons, not all surgeons are created equally. Therefore, while it’s tempting to select a surgeon based on price or location, try to avoid this as many individuals travel great distances to undergo surgery with an elite surgeon they are most impressed with. Thus choose a surgeon based on their proven ability to produce outstanding results rather than because of cost or location.

3. Narrow your selection down to 3 to 5 surgeons you are most impressed with.  You can do this by using this discussion forum and others to view examples of patient results posted by both the clinic and their patients.  Speak with and meet with real patients in person if possible. If not, video chat works pretty well.

4. Come up with a list of consult questions to ask each surgeon/clinic you are considering. I’ve created several different posts on this forum with good questions to ask doctors.  If you need help coming up with a list of good questions, please let me know.

5. Consult with each doctor you are considering and ultimately, choose the surgeon you feel can best meet your goals.

I hope this helps  

Rahal Hair Transplant

Edited September 6, 2022 by Rahal Hair Transplant

[Big Rome]

14 hours ago, Triple Nine said:

Hey guys. Im a 26 year old argentine with a receding hairline. I've been reading this entire forum now for quite a while. My research goes back a few years now, i've been looking at patient result, reviews and insights about top notch surgeons and clinics available. 
 

As many of you can relate, when I first started doing my research I immediately went out to research Turkey, but found out what most of you all know about Turkey and the scandalous amounts of unexperienced people who put on a pair of gloves and play doctor. I'm sure there are great surgeons over there but I decided to slow down and do my research elsewhere, to avoid risks. 
 

I then moved to argentine clinics (due to proximity), but I couldn't find any outstanding work that would make me even book an appointment, not even the best of the best results. Also, i've called a few clinics and most of them wanted to perform HT two weeks from my consultation, without regarding the fact of if I was taking Finasteride or not. Didn't even recommend it so it raised a few flags for me so I kept looking. 
 

I then researched American doctors, I read about Shapiro, Bernstein and a few others but I couldn't find what I was looking for, though I didn't book a consult with neither of them. I did see Konior but I didn't see a case where the quality would justify the cost; I may be wrong though, just my personal opinion and research. 

I finally moved on to EU and found a few good doctors in Spain like Freitas, Prieto, Lorenzo and Couto. Out of them all I booked a consult with Couto. I had my appointment a few weeks ago, I'm supposed to make my first deposit this week. I've been having second guesses because I didn't get the very best impression out of the clinics employee who picks up the phone, however when I had my appointment with Dr Couto he reassured me of my second thoughts and took an hour and a half to talk with me and answer all of my questions. I am trying to pay though and get a response every other day, which is taking a while but I guess keeping up with all of the consults can't be an easy task anyway. Of the few patient reviews and the cases published on their Instagram, I love what I saw, though I did recently see that one of his patients had very low density on his hairline, but the Dr did offer a free "touch up" and I'm still waiting for the patient to post the final result. I also think that we are all human and I can't see one bad case as him being a bad Dr. I still consider him to be the best, especially because of the time he puts into patients and his work ethics, but I often do get blinded by the fact of reading so many good reviews about him and thats why im referring to you guys for an extra opinion. I read some spanish forums and they all regard him as the BEST of the BEST, not a single one has a bad thing to say. Dr Couto recommended 3000 FUE grafts implanted onto my new hairline design to restore temples and bring my hairline back to where it should be. I was prescribed Finasteride 1mg until September 2023 which is when my appointment should be. Any how, I had some questions for you guys regarding my case:

 

1) After looking at my pictures, what doctor would you say would be the best case scenario for me? I wouldn't mind price, I want to get the best of the best when it comes to my face as I get media attention. 

2) Why can't I find many patient reviews about Dr Couto? Is it because patients get the best results coming out of the clinic and don't even bother posting their cases? At first I thought maybe he didn't get a whole bunch of patients so there weren't many posting his work, but he is booked for the next 1/2 years so I scratched that off. 
 

3) Is smoking as bad as I've read about? 

how did you manage to get a consultation with DR Couto? I have been trying since May 😩🤣

[Hairy Henderson]

8 hours ago, Big Rome said:

how did you manage to get a consultation with DR Couto? I have been trying since May 😩🤣

Good question

[Hairy Henderson]

Looks like a lot of forehead, so definitely closer to 3k

[Triple Nine]

On 9/6/2022 at 12:43 AM, JoDimaggio22 said:

Well Cuoto is quality especially if you can get into him and money isn’t a factor so I’d say you are in good hands.

Thanks Jo!

[Triple Nine]

20 hours ago, Big Rome said:

how did you manage to get a consultation with DR Couto? I have been trying since May 😩🤣

Hey Big Rome. I sent an email in June and got a consult for September 1st. I thought it was weird since I've read that his waiting times are very very long. I just payed my first deposit for my procedure to be September 2023! I'll be sharing my results and updates when I get there

[Triple Nine]

22 hours ago, Rahal Hair Transplant said:

Triple Nine,

It sounds like you’ve done a lot of research on surgeons which is always what we suggest prospective patients do prior to undergoing the actual procedure.  I personally can’t say I’m overly familiar with the doctor you selected however, as long as you’ve seen dozens of examples of your selected doctor’s work posted by both patients and the clinic and you are satisfied, then you’ve done your due diligence.

There are a number of reasons why a particular doctor may be less visible online. Some simply don’t take the time to spread the word through the Internet and their patients may rarely decide to post their experiences and results online.  In my opinion, that makes it a lot more difficult for prospective patients to really feel confident and comfortable with that particular doctor because even if they are doing incredible work, it’s practically impossible to substantiate unless the clinic can provide you with enough information that satisfies you. Even then, the information provided is hand selected by the clinic which means you will be handed the best examples and their ideal patients to talk to.  

Regarding your other questions, it is always best to follow your doctors preoperative and postoperative instructions which includes not smoking before and after surgery. The truth is, smoking can thin the blood which only serves to complicate surgery and could affect the healing process post-op.  So while some patients may continue to smoke before and after surgery and have no problems, the risks are definitely higher which is why it is always best to follow your doctor‘s instructions.  This will ensure you receive the best possible result.

Since you are still asking about the best doctors, if you have not fully decided, I do suggest considering following the below steps which I tell everybody who is considering a hair transplant. At the end of the day, it involves research, consultation and careful selection based on evidence and proof and not facets like price, location and likability all the doctors personality, etc.  I’m not suggesting that the latter aren’t important or relevant but they are certainly less important than proof that a particular surgeon and clinic regularly produces outstanding results and can actually meet your overall short and long-term hair restoration goals. So without further due, here are the steps I tell everybody considering hair transfer surgery regarding physician selection

1.  Start by looking at the surgeons recommended by this community, in particular the Coalition of Independent Hair Restoration Physicians.  Surgeons recommended by this community have met a demanding set of standards and are approved based on meeting those high standards.  Many online hair surgeon memberships don’t have any criteria other than to pay a membership fee.  Furthermore, physician members of the coalition have met an even higher and more demanding set of standards and have proven to be amongst the best of the best in the profession.

2. Now even amongst a list of outstanding surgeons, not all surgeons are created equally. Therefore, while it’s tempting to select a surgeon based on price or location, try to avoid this as many individuals travel great distances to undergo surgery with an elite surgeon they are most impressed with. Thus choose a surgeon based on their proven ability to produce outstanding results rather than because of cost or location.

3. Narrow your selection down to 3 to 5 surgeons you are most impressed with.  You can do this by using this discussion forum and others to view examples of patient results posted by both the clinic and their patients.  Speak with and meet with real patients in person if possible. If not, video chat works pretty well.

4. Come up with a list of consult questions to ask each surgeon/clinic you are considering. I’ve created several different posts on this forum with good questions to ask doctors.  If you need help coming up with a list of good questions, please let me know.

5. Consult with each doctor you are considering and ultimately, choose the surgeon you feel can best meet your goals.

I hope this helps  

Rahal Hair Transplant

Thank you very much for taking the time to reply to my post with amazing detail. I think I did my research but the more you dig the more you find, it's a great journey. I will keep you updated! I just payed my first deposit to the clinic

[Big Rome]

2 hours ago, Triple Nine said:

Hey Big Rome. I sent an email in June and got a consult for September 1st. I thought it was weird since I've read that his waiting times are very very long. I just payed my first deposit for my procedure to be September 2023! I'll be sharing my results and updates when I get there

what email might that be good sir 🤣 😉 

[Triple Nine]

16 minutes ago, Big Rome said:

what email might that be good sir 🤣 😉 

Lol. Thats true though. I introduced myself on the first email I sent and was very kind to the team from the start, maybe that helped. When they replied they sent me a form to fill out and told me to send pictures, which I did the very next day. They then told me that the wait time was long and that I needed to wait, to which I showed my disappointment and kindly asked them to tell me whenever a spot cleared. As soon as it did they sent me an email and luckily it wasn't that long

[Big Rome]

40 minutes ago, Triple Nine said:

Lol. Thats true though. I introduced myself on the first email I sent and was very kind to the team from the start, maybe that helped. When they replied they sent me a form to fill out and told me to send pictures, which I did the very next day. They then told me that the wait time was long and that I needed to wait, to which I showed my disappointment and kindly asked them to tell me whenever a spot cleared. As soon as it did they sent me an email and luckily it wasn't that long

so you didn’t have to attend a consultation in person? when was this btw? could you DM me the email you enquired on please? 

[Triple Nine]

2 hours ago, Big Rome said:

so you didn’t have to attend a consultation in person? when was this btw? could you DM me the email you enquired on please? 

This was three months ago. Sure, i'll DM you the email.

[Triple Nine]

2 hours ago, Big Rome said:

so you didn’t have to attend a consultation in person? when was this btw? could you DM me the email you enquired on please? 

I can't send any DM's, maybe because my acct is new. I'll post them on here. 

First email: 

Buen dia,

Actualmente resido en (fill in where you live). Quisiera saber la posibilidad de tener una consulta con el Dr Juan Couto para coordinar un transplante capilar en Madrid. Sera posible coordinar un turno  asi viajo para alla?

Muchas gracias por su atencion,

 

(Sign your name)

Then they replied with an attached form to fill out, including my pictures, name, age, etc. Hope this helps!

 

[HairRun]

If he's a Spanish doctor, then you'll probably find more reviews on a Spanish forum than on this one. 

[Big Rome]

14 hours ago, Triple Nine said:

I can't send any DM's, maybe because my acct is new. I'll post them on here. 

First email: 

Buen dia,

Actualmente resido en (fill in where you live). Quisiera saber la posibilidad de tener una consulta con el Dr Juan Couto para coordinar un transplante capilar en Madrid. Sera posible coordinar un turno  asi viajo para alla?

Muchas gracias por su atencion,

 

(Sign your name)

Then they replied with an attached form to fill out, including my pictures, name, age, etc. Hope this helps!

 

i got an email response from the guys at FUEXPERT this week saying they will re-open consultations in Jan 2023 with the aim of having the procedure done in 2024 🤯