Dr. Bruno Ferreira | 1288 grafts | Jan 2023 | Hairline and temple points | Norwood 2

[Anthropos]

Hello everyone,

I’ve been a reader of this forum for years and after my surgery, I thought it was natural to write a post about my case in order to give back a little bit after learning so much from all your experiences. I hope my post can help even though it was not a big session. Please ignore my grammatical errors as English is not my first language.

 

Background 

I have been losing hair a little bit before age 20, starting with the temples. The day I was told that by someone that I lost some hair was the start of a long pain. I started with Minoxidil, that only grew velus hair on my temples. Then I started Finasteride when I was 20, and that I’m still taking.

With that regimen, I was able to regrow my hair a little bit and maintain a solid Norwood 2. But I’ve never felt good about my hair since then and I kept a haircut that hid my hairless.

I can say that I never felt good about myself and wasted a good part of my youth thinking about my hair.

 

The Choice of a Doctor

Since the beginning I have been looking at hair transplant forums (the French one first, then this one).

I quickly understood that I would have to wait at least to be 25 to be accepted by a good doctor since it appeared to be the consensus. Also, I didn’t really have to money for it and didn’t want to talk about it with my parents.

During summer 2020, it was COVID, I was between the end of my studies and a new work, I was finally 25, so I decided it was time to contact doctors.

Because of my personal graft count estimation and my budget, I wanted to stay around 3-3.5€ per graft.

My shortlist consisted in:

 

• Dr. De Freitas, for his incredible, consistent results and spectacular hairlines. Proposed 1,700 grafts.
• Dr. Lupanzula, not very present on this forum but very respected on the French forum. I was supposed to have a consultation with him, but it was canceled because of COVID. I can’t find the e-mail with his proposal, but I think it was around 1800 grafts.
• Dr. Pinto. For his very clean and meticulous work. I think my case was lost because I never received a proposal.
• Dr. Ferreira. Pf course, Mr. Rolandas was a good reason for selecting him in my shortlist, but I also was impressed by the detailed proposal that was sent to me. At that time, Dr. Ferreira was responding by himself (which is not possible anymore since he’s extremely busy). I appreciated the honest answer about my age: “Your age does raise a concern since your hair loss can progress substantially and your family history confirms this. So finasteride is basically mandatory long term if you wish to move forward with the surgery.“ He first proposed 900-1100 grafts then around 1200 when I said I would also some work on the temple points.

 

I took several months to decide and in April 2021, I decided to go with Dr. Ferreira.

He was not the safer bet at that time because of the lack of results. But he sent me a few more cases from his clinic, and I appreciated the fact that he proposed a conservative hairline with less grafts than the other doctors as I’ve always had a curved hairline, even as a child.

Surgery was first booked for January 2021, but I had to postpone to January 2022. It was my fault, I started Accutane shortly after the initial consultation, and forgot to mention it when booking the surgery. Dr. Ferreira kindly proposed the same date one year after I stopped the treatment.

I also stopped Minoxidil about a year ago (with instructions from Dr. Ferreira to taper off) since I would only apply it to my temples and only grew velus hair, so I preferred to have bald temples for the surgery (also, I hated applying it).

 

The Day of the Surgery

 I arrived in Espinho on the Wednesday 25 of January in the evening; the surgery was planned on Friday 27.

I decided to stay 10 days at the hotel (Hotel Apartamento Solverde) for extra security after the surgery. I booked a studio to have a kitchen.

On Thursday 26, I did groceries for 1 week (there is a Lidl 15 minutes away from the hotel). They have good choice and prices are cheap (around 50 euros for a week of groceries with meals, fruits, snacks, etc.).

The night before the surgery was horrible, I woke up every hour (the mattress was a little hard as well).

Then arrived the final moment. I walked towards the clinic (15 minutes walking) to arrive at 7:30.
Nurse Cristina welcomed me and presented the room where I got my surgery outfit and had some paperwork and instructions to read.

Then nurse Ricardo arrived. He’s such a wonderful and caring person. I’m sure he met dozens of stressed-out patients just like me, so he has the words to reassure you. He brought me some fruits, snacks (and Valium) for breakfast.

Doctor Ferreira then arrived with Inês, who is the patient manager. He explained to me about the surgery, post-op and answered all my questions. Then we moved to the photo room.

 

Taking pictures

The photo process is made in different steps:

• Long hair: the clinic asks you to grow your hair rather long to have a good understanding of your implantation, angles, etc. Dr. Ferreira started drawing the new hairline. He really is an artist and makes small corrections and tweaks while taking his time. He told me again that he accepted my case because I wanted a conservative hairline, and that I was on Finasteride. He says I have very straight have, rather fine.
  
  
• Short hair: my hair was cut at a length of around 2 cm. Dr. Ferreira keeps adjusting the hairline.
  
  
• Buzz cut: it took me some minutes to recognize myself as I had long hair for years. At first, I thought about asking partial shave, but I wanted the doctor to work in optimal conditions and have an opinion about the miniaturization of my scalp. Final adjustments were made, and they draw the donor zone.
  

 

Anesthesia and Extractions

We moved to the operation room. You can feel the team has been working together for years as everything gesture seems perfectly calibrated and coordinated.

Doctor Ferreira checked my hair with a camera and told me that there was some miniaturization on my scalp and that I needed to stay on Finasteride.

Doctor Ferreira started the anesthesia shots. He’s very good because you don’t feel much (he shakes his finger to reduce the pain).

At the beginning of the surgery, I was shaking, but it stopped after a moment. Doctor Ferreira tried to joke but as I was nervous, I was not very receptive (sorry Dr. 🥲). He said “I hope you didn’t feel that because this is my first surgery” 😄.

Dr. Ferreira did the extractions by himself, most of it with micromotor, but sometimes with manual punches (in more elastic zones, like the nape, for example). Micromotor allows him to be less tired. I like the fact that he chooses the right tool for the right occasion.

 

Implantation

After that, Dr. Ferreira started the implantation phase. He did a few slits in the center of my hairline (I believe it’s to be very precise when implanting grafts amongst native hair), but most of the grafts where implanted with implanter pens.

Quick lunch break (I had fish and chips) and we returned to finish the surgery with the temple points, which is one of the reasons I chose Dr. Ferreira since I saw a few great temple points results.

During the whole surgery I closed my eyes because they are very sensitive to the light and the medical light was quite strong for me. I basically was in a semi-sleeping state, so I was not the most entertaining patient 😅.

 

End of Surgery

We finished the surgery by cleaning the donor and recipient zones with saline and took pictures again. It was around 4:30 or 5PM I think (sorry, I was completely phased out at the moment).

In total I had 1288 grafts implanted. Lots of singles (424) for the hairline and the temple points so the hair ratio is not relevant in my case. Dr. Ferreira estimated my donor around 8000-8500 before the surgery, so I have a nice amount left.

Before leaving, I made the payment and bought the supplements that Dr. Ferreira recommends (Ecophane). They are affordable (80 euros for 5 months) and I appreciated the you don’t feel pushed to buy them.

 

Post-OP

I came back at the hotel with a kit (saline, aloe, neck pillow, ice pack, etc.). I took an Uber (around 3 minutes to the hotel) making sure I don’t bump my grafts in the car.

I saw that my forehead was getting of start of swelling, so I immediately applied the ice pack. A few minutes later, it was completely gone, and I have zero swelling after that.

I was extremely exhausted, so I think I went to bed at 7:30 PM.

The next day (Saturday 28), Inês asked me to send pictures. After seeing them, she said Dr. Ferreira asked to increase the frequency of saline spray from every hour to every 30 minutes. My tip: change you timer ringtone to a pleasant one because (I chose the Mozart Sonata ringtone on my Samsung phone 😊 ).

The following days were quite long but at least I had a nice sea view.

On day 4 (Tuesday 3), I went to the clinic to have my first shampoo with nurse Ana, same on the following day. On Thursday, I went one last time for a shampoo and Doctor Ferreira was doing a surgery but took 5 minutes to come checking if everything was alright (which was the case). Donor was already looking good except for a few bruising (totally normal according to Dr. Ferreira).

On day 8, all the scabs were gone and I took my flight home.

 

Day 15
I’m now at day 15, I think a couple hairs have fallen and I have a couple pimples.

Redness has faded a little (it looks redder on my phone camera than in real life, and the difference between implanted hair and native hair on the temple points is more noticeable on my phone camera as well).

I’m very impressed how natural the result is and how carefully they selected the fine single grafts for the temple points. Density looks very good as well.

From now on I’m prepared to lose the grafts and start the ugly duckling phase, but I can’t wait for the final result.

 

I would totally recommend Dr. Ferreira as he is an ethical and meticulous surgeon. His team is also fantastic and very caring.

 

I hope you found this post informative!

 

[ScottishGuy21]

Very clean work. 
 

Personally think Bruno has moved on from the rising star tag to elite Dr status now. Seen some amazing work recently that rivals anything elsewhere.

[son2]

Nice write-up. Work looks really good. I've also had surgery with Dr. Bruno Ferreira just days before yours.

[Big Rome]

3 hours ago, Anthropos said:

Hello everyone,

I’ve been a reader of this forum for years and after my surgery, I thought it was natural to write a post about my case in order to give back a little bit after learning so much from all your experiences. I hope my post can help even though it was not a big session. Please ignore my grammatical errors as English is not my first language.

 

Background 

I have been losing hair a little bit before age 20, starting with the temples. The day I was told that by someone that I lost some hair was the start of a long pain. I started with Minoxidil, that only grew velus hair on my temples. Then I started Finasteride when I was 20, and that I’m still taking.

With that regimen, I was able to regrow my hair a little bit and maintain a solid Norwood 2. But I’ve never felt good about my hair since then and I kept a haircut that hid my hairless.

I can say that I never felt good about myself and wasted a good part of my youth thinking about my hair.

 

The Choice of a Doctor

Since the beginning I have been looking at hair transplant forums (the French one first, then this one).

I quickly understood that I would have to wait at least to be 25 to be accepted by a good doctor since it appeared to be the consensus. Also, I didn’t really have to money for it and didn’t want to talk about it with my parents.

During summer 2020, it was COVID, I was between the end of my studies and a new work, I was finally 25, so I decided it was time to contact doctors.

Because of my personal graft count estimation and my budget, I wanted to stay around 3-3.5€ per graft.

My shortlist consisted in:

 

• Dr. De Freitas, for his incredible, consistent results and spectacular hairlines. Proposed 1,700 grafts.
• Dr. Lupanzula, not very present on this forum but very respected on the French forum. I was supposed to have a consultation with him, but it was canceled because of COVID. I can’t find the e-mail with his proposal, but I think it was around 1800 grafts.
• Dr. Pinto. For his very clean and meticulous work. I think my case was lost because I never received a proposal.
• Dr. Ferreira. Pf course, Mr. Rolandas was a good reason for selecting him in my shortlist, but I also was impressed by the detailed proposal that was sent to me. At that time, Dr. Ferreira was responding by himself (which is not possible anymore since he’s extremely busy). I appreciated the honest answer about my age: “Your age does raise a concern since your hair loss can progress substantially and your family history confirms this. So finasteride is basically mandatory long term if you wish to move forward with the surgery.“ He first proposed 900-1100 grafts then around 1200 when I said I would also some work on the temple points.

 

I took several months to decide and in April 2021, I decided to go with Dr. Ferreira.

He was not the safer bet at that time because of the lack of results. But he sent me a few more cases from his clinic, and I appreciated the fact that he proposed a conservative hairline with less grafts than the other doctors as I’ve always had a curved hairline, even as a child.

Surgery was first booked for January 2021, but I had to postpone to January 2022. It was my fault, I started Accutane shortly after the initial consultation, and forgot to mention it when booking the surgery. Dr. Ferreira kindly proposed the same date one year after I stopped the treatment.

I also stopped Minoxidil about a year ago (with instructions from Dr. Ferreira to taper off) since I would only apply it to my temples and only grew velus hair, so I preferred to have bald temples for the surgery (also, I hated applying it).

 

The Day of the Surgery

 I arrived in Espinho on the Wednesday 25 of January in the evening; the surgery was planned on Friday 27.

I decided to stay 10 days at the hotel (Hotel Apartamento Solverde) for extra security after the surgery. I booked a studio to have a kitchen.

On Thursday 26, I did groceries for 1 week (there is a Lidl 15 minutes away from the hotel). They have good choice and prices are cheap (around 50 euros for a week of groceries with meals, fruits, snacks, etc.).

The night before the surgery was horrible, I woke up every hour (the mattress was a little hard as well).

Then arrived the final moment. I walked towards the clinic (15 minutes walking) to arrive at 7:30.
Nurse Cristina welcomed me and presented the room where I got my surgery outfit and had some paperwork and instructions to read.

Then nurse Ricardo arrived. He’s such a wonderful and caring person. I’m sure he met dozens of stressed-out patients just like me, so he has the words to reassure you. He brought me some fruits, snacks (and Valium) for breakfast.

Doctor Ferreira then arrived with Inês, who is the patient manager. He explained to me about the surgery, post-op and answered all my questions. Then we moved to the photo room.

 

Taking pictures

The photo process is made in different steps:

• Long hair: the clinic asks you to grow your hair rather long to have a good understanding of your implantation, angles, etc. Dr. Ferreira started drawing the new hairline. He really is an artist and makes small corrections and tweaks while taking his time. He told me again that he accepted my case because I wanted a conservative hairline, and that I was on Finasteride. He says I have very straight have, rather fine.
  
  
• Short hair: my hair was cut at a length of around 2 cm. Dr. Ferreira keeps adjusting the hairline.
  
  
• Buzz cut: it took me some minutes to recognize myself as I had long hair for years. At first, I thought about asking partial shave, but I wanted the doctor to work in optimal conditions and have an opinion about the miniaturization of my scalp. Final adjustments were made, and they draw the donor zone.
  

 

Anesthesia and Extractions

We moved to the operation room. You can feel the team has been working together for years as everything gesture seems perfectly calibrated and coordinated.

Doctor Ferreira checked my hair with a camera and told me that there was some miniaturization on my scalp and that I needed to stay on Finasteride.

Doctor Ferreira started the anesthesia shots. He’s very good because you don’t feel much (he shakes his finger to reduce the pain).

At the beginning of the surgery, I was shaking, but it stopped after a moment. Doctor Ferreira tried to joke but as I was nervous, I was not very receptive (sorry Dr. 🥲). He said “I hope you didn’t feel that because this is my first surgery” 😄.

Dr. Ferreira did the extractions by himself, most of it with micromotor, but sometimes with manual punches (in more elastic zones, like the nape, for example). Micromotor allows him to be less tired. I like the fact that he chooses the right tool for the right occasion.

 

Implantation

After that, Dr. Ferreira started the implantation phase. He did a few slits in the center of my hairline (I believe it’s to be very precise when implanting grafts amongst native hair), but most of the grafts where implanted with implanter pens.

Quick lunch break (I had fish and chips) and we returned to finish the surgery with the temple points, which is one of the reasons I chose Dr. Ferreira since I saw a few great temple points results.

During the whole surgery I closed my eyes because they are very sensitive to the light and the medical light was quite strong for me. I basically was in a semi-sleeping state, so I was not the most entertaining patient 😅.

 

End of Surgery

We finished the surgery by cleaning the donor and recipient zones with saline and took pictures again. It was around 4:30 or 5PM I think (sorry, I was completely phased out at the moment).

In total I had 1288 grafts implanted. Lots of singles (424) for the hairline and the temple points so the hair ratio is not relevant in my case. Dr. Ferreira estimated my donor around 8000-8500 before the surgery, so I have a nice amount left.

Before leaving, I made the payment and bought the supplements that Dr. Ferreira recommends (Ecophane). They are affordable (80 euros for 5 months) and I appreciated the you don’t feel pushed to buy them.

 

Post-OP

I came back at the hotel with a kit (saline, aloe, neck pillow, ice pack, etc.). I took an Uber (around 3 minutes to the hotel) making sure I don’t bump my grafts in the car.

I saw that my forehead was getting of start of swelling, so I immediately applied the ice pack. A few minutes later, it was completely gone, and I have zero swelling after that.

I was extremely exhausted, so I think I went to bed at 7:30 PM.

The next day (Saturday 28), Inês asked me to send pictures. After seeing them, she said Dr. Ferreira asked to increase the frequency of saline spray from every hour to every 30 minutes. My tip: change you timer ringtone to a pleasant one because (I chose the Mozart Sonata ringtone on my Samsung phone 😊 ).

The following days were quite long but at least I had a nice sea view.

On day 4 (Tuesday 3), I went to the clinic to have my first shampoo with nurse Ana, same on the following day. On Thursday, I went one last time for a shampoo and Doctor Ferreira was doing a surgery but took 5 minutes to come checking if everything was alright (which was the case). Donor was already looking good except for a few bruising (totally normal according to Dr. Ferreira).

On day 8, all the scabs were gone and I took my flight home.

 

Day 15
I’m now at day 15, I think a couple hairs have fallen and I have a couple pimples.

Redness has faded a little (it looks redder on my phone camera than in real life, and the difference between implanted hair and native hair on the temple points is more noticeable on my phone camera as well).

I’m very impressed how natural the result is and how carefully they selected the fine single grafts for the temple points. Density looks very good as well.

From now on I’m prepared to lose the grafts and start the ugly duckling phase, but I can’t wait for the final result.

 

I would totally recommend Dr. Ferreira as he is an ethical and meticulous surgeon. His team is also fantastic and very caring.

 

I hope you found this post informative!

 

brilliant, in depth write up. DR Ferreira is top notch ⭐️ 

[JP28]

That’s gonna be a good one, great density and clean work! 

[Hairy Henderson]

Where did Dr harvest the grafts used for the temples?

[GeneralNorwood]

Impressive donor managment

[Anthropos]

32 minutes ago, Calihome1 said:

Where did Dr harvest the grafts used for the temples?

I think he extracted them from the lower part of the donor. He didn't harvest from the sides and around the ears at all, which is a good thing for a touch up and further surgeries.

[Hairy Henderson]

Do you know how many grafts went into the temples?

[Anthropos]

1 minute ago, Calihome1 said:

Do you know how many grafts went into the temples?

I didn't ask but I would say between 80 and 100 for both temple points, maybe 20-30 in the center and the rest on the temples (so around 580 on each temple).

[Hairy Henderson]

I really like Ferreira, just seems impossible to get in with him

[Anthropos]

10 minutes ago, Calihome1 said:

I really like Ferreira, just seems impossible to get in with him

Yes, I'm lucky to have contacted him when he was still available. Now he's extremely busy but I hope you will find a way.

 

6 hours ago, ScottishGuy21 said:

Very clean work. 
 

Personally think Bruno has moved on from the rising star tag to elite Dr status now. Seen some amazing work recently that rivals anything elsewhere.

 

6 hours ago, son2 said:

Nice write-up. Work looks really good. I've also had surgery with Dr. Bruno Ferreira just days before yours.

 

3 hours ago, Big Rome said:

brilliant, in depth write up. DR Ferreira is top notch ⭐️ 

 

1 hour ago, JP28 said:

That’s gonna be a good one, great density and clean work! 

 

25 minutes ago, GeneralNorwood said:

Impressive donor managment

Thank you everyone. I'm waiting patiently for the results and will keep you updated. 

[Hairy Henderson]

Keep us posted, appreciate it

[CharlesBarkley]

Design and temples look amazing. Keep new photos coming please.

[rambo man]

This looks good work. You should be happy in twelve months 

[Anthropos]

Hi everyone,

Please find pictures at Day +30.

Grafts don't seem to fall anymore despite washing my hair twice a day as per Dr. Ferreira's instructions.
I try not to look at myself too much in the mirror as I feel horrible... Hopefully in a few months my hair will cover the recipient area.

I'm starting to think about taking oral Minoxidil next year (at very low dosage 1.25mg per day) to improve density. I'm a little scared of skin aging and collagen losses. I will talk about it with Dr. Ferreira later since it's out of stock in my country right now apparently.

Have a nice day!

[jay80]

Looking great so far. Your hairline will be amazing.

Your hair is growing so fast, you'll be able to cover the recipient area in no time

[Hairy Henderson]

It’s super early but do the temple points seem to be too straight?

[Anthropos]

9 minutes ago, Calihome1 said:

It’s super early but do the temple points seem to be too straight?

I hope not 😕

But I think the illusion of straightness is because the red dots are aligned. Hopefully they will disappear in a few weeks/months.

I sent these pictures to Dr. Ferreira for the 1 month post-op follow-up and he said that everything looks good so far so I will try not to panic yet 😅.
 

[FITA]

On 3/1/2023 at 7:23 PM, Anthropos said:

I hope not 😕

But I think the illusion of straightness is because the red dots are aligned. Hopefully they will disappear in a few weeks/months.

I sent these pictures to Dr. Ferreira for the 1 month post-op follow-up and he said that everything looks good so far so I will try not to panic yet 😅.
 

It’s just the redness. Nothing to worry about I don’t think. Looks amazing so far!

[stephcurry30]

This is going to be an insane result!

[Jayson1361]

On 3/1/2023 at 12:31 PM, Anthropos said:

Hi everyone,

Please find pictures at Day +30.

Grafts don't seem to fall anymore despite washing my hair twice a day as per Dr. Ferreira's instructions.
I try not to look at myself too much in the mirror as I feel horrible... Hopefully in a few months my hair will cover the recipient area.

I'm starting to think about taking oral Minoxidil next year (at very low dosage 1.25mg per day) to improve density. I'm a little scared of skin aging and collagen losses. I will talk about it with Dr. Ferreira later since it's out of stock in my country right now apparently.

Have a nice day!

Looks good. You could wear a hat for a bit. Can’t say I’ve experienced advanced aging or collagen loss from oral Min. I do take care of my skin though as I’ve had some minor skin cancer removed. Can’t say I’ve heard of allot of people reporting aging or collagen loss either. 

[Syn187]

Excellent write-up and happy growth @Anthropos

Do you know how much Dr. Ferreira charges per graft these days?

[Anthropos]

Hi !

Thanks for your message.
Yes, the clinic told me that current price is 4€/graft up until the first 4000 grafts. After that, it goes down to 3,5€. 

Hope this helps
Have a nice day
 

[Hairy Henderson]

On 3/18/2023 at 3:14 AM, Syn187 said:

Excellent write-up and happy growth @Anthropos

Do you know how much Dr. Ferreira charges per graft these days?

Impossible to even get a consult with him