Dr Camacho - 2500 grafts

[mrthirsty]

TLDR: Dr. Camacho, ~2500 grafts, crown  & midscalp only, Camacho and his team were very nice / hospitable, results seem good however I am a little concerned about placement & coverage.

Me 

Mid-30's male with thick hair, plenty of donor, and thinning only on the crown and mid-scalp

Background

I spent about 2 years researching clinics and had shortlisted Dr. Bicer, The Cortez Bros, and Dr Camacho as my three finalists.  My thinning pattern is mostly crown so I wasn't too worried about which doctor provides the best hairline aesthetic, I was mostly worried about which doctor was reputable, had good results to show, a good track record, and cost-effective.  I got quotes from all three clinics.  Bicer quoted 1700 grafts, Cortez said 1600, and Camacho said 2500.  Huge differences between the former two and the latter third, but my assumption was many clinics my undercount it until you appear in person as a bit of a sales tactic.  Also assuming it's just tough to tell with photos only.  None of the clinics offered a virtual consultation with the doctor (nor did I ask however).

I chose Dr Camacho primarily because his results posted here have been very enticing, the clinic is closer than Turkey, and the price was very reasonable.

The Procedure

Despite paying a higher rate in order to book with Dr Camacho, the design and extraction were primarily done by Dr. Pareja and her staff.  Dr Camacho did review my head/hair first thing in the morning before I got in the OR, but the actual drawing/extraction was done by Dr. Pareja IIRC.  The design was very quick, Dr. Pareja simply circled the spots on my head that needed graft and then I went to get shaved.  Dr. Camacho came in only for the implantation and actually left before implantation was fully completed.  After 2k grafts were extracted / implanted, Dr. Camacho told me he may need another 500 to cover the midscalp.  I agreed, and had to go back to the extraction table (done by a doctor whose name I don't know), and then back to implantation- all of which was done by Dr Camacho this time.

Pros

Dr Camacho and his team are very polite, hospitable, and efficient.  The location of the clinic is great, the operating room is very nice looking, and the entire operation comes off generally professional.  The work was started around 8 or 830am and was completed by 2pm.  The recovery thus far has been easy and the procedure straightforward.  Before the operation, Dr Camacho and his staff spent nearly an hour with me going over my questions.  I also came back to the clinic prior to departure from Bogota to check in and have follow up questions answered.  I have no complaints whatsoever about their communications in person.

Cons

First, let me say, my experience has been mostly great.  I mean the following only as my honest observations and as potentially constructive criticism.  That being said, there are areas that could be improved.  First, it took just under two weeks to get a graft estimate from the clinic, I had to nudge a couple times before I finally got the estimate.  Other clinics gave estimates within a couple days.  I booked my transplant on a Thursday and asked if the doctor could remove my bandages before I fly out, and was told to stay through Monday for that to happen- turns out removing bandages by yourself seems the norm (I wasn't aware/told this was the case).  Thus I spent a mostly unnecessary weekend in Bogota.  I did have a small scheduling issue for the dates I wanted but no big deal.  These are mostly communications / operational issues that are not a huge deal. 

My biggest concern however is the number and placement of the grafts.  In the images you can see my thinning is primarily crown + midscalp, but it looks like the grafts were maybe oddly placed most densely right in my donor area?   Afterwards, I was left wondering whether the Dr mistakenly packed the back/bottom of my crown (and used grafts filling my natural whorl) instead of using those grafts more towards the midscalp to future-proof my hair loss and directly attack the most thinned areas.  Given my hair is in pretty good shape except the crown/midscalp, I was surprised not only by the number of grafts, but also how they are "back-heavy" instead of "front-heavy".  There is still a bit of a thinning area around the transplanted area that I think should’ve potentially been prioritized versus the bottom of my crown & whorl.  A lot of time, effort, and resources went into this experience, and this review is my attempt at very honest feedback.  I am certainly worried, but of course time will tell what the results will be (and they could turn out to be very good which I would be happy to report within the next 12-18 months).  

I would love the feedback of anyone here that has better knowledge than myself, what do you think of the graft estimate and placements?  I spoke with the doctor and his team in person about these concerns and they were confident in the result and told me to rest assured that it will turn out great.

 

[A_4_Archan]

I understand your concern bt i guess he might have felt need to do tht after seeing your scalp ...bt anyhow he is a great surgeon and well experienced and from your pics implantation looks clean and well distributed ...your donor is healthy and hair looks thick ..you gonna get very good result ...

[mrthirsty]

Thanks for the reply Archan.  I think it’s important to trust the doctor you choose, however, just looking at the implants doesn’t make a lot of sense to me.  When I asked the doctor and team about it, I got a lot of answers but nothing that directly answered my question which made me worry even more.

[mrthirsty]

Would love some opinions here from folks that have had similar experience / thinning & transplantation.  Thank you!

[A_4_Archan]

On 3/7/2023 at 11:58 PM, mrthirsty said:

Thanks for the reply Archan.  I think it’s important to trust the doctor you choose, however, just looking at the implants doesn’t make a lot of sense to me.  When I asked the doctor and team about it, I got a lot of answers but nothing that directly answered my question which made me worry even more.

Implantation to the front is there upto the red line you have drawn ....it cannot be too dense thr as you have existing hairs there...

Bt i guess you are more concerned that they have implanted the grafts on the bottom end of the crown(between orange and blue line) where you already had enough density ...i cn understand that from pics and i feel the same...but photo angles may be sometimes misleading so do keep tht in mind...

[FluffyPanda]

I think it'll look really good once it finishes growing out. In the last photo, the angles don't quite look the same. Left photo looks more head-on and right photo looks more top-down to me, so hard for me to say the that it's truly "back loaded". I will say that even when I look at my own head, it's the very back of the crown that you can see much more easily than the top (unless someone is looking straight down at you lol), so beefing that up is never a bad choice if there's thinning in that area if you want the illusion of not thinning. Obviously they saw you in person and we didn't, so they can tell much more easily which areas were more necessary to transplant. Perhaps they're future-proofing thinning in that area. I think in 1 year time, you will be very happy with the results. I also went with Dr Camacho, and honestly if I had led the design for everything, I'd probably look way worse overall than what we ended up going with.

I know you're also worried about the density, but transplanting grafts with 3-4 hairs/graft will look much different than 1 hair/graft in that area.

[shiba1985]

I don’t see any problem. Your front still has some hair coverage (albeit miniaturized hair) so he is protecting these and back is more bald so he has placed more grafts there.

[mrthirsty]

18 minutes ago, shiba1985 said:

I don’t see any problem. Your front still has some hair coverage (albeit miniaturized hair) so he is protecting these and back is more bald so he has placed more grafts there.

Thanks for your reply Shiba.  Wouldn't the goal be to expand grafts into the miniaturized areas to future-proof that loss?  My hair loss is moving forward and not backward.  When you say protecting, do you mean not implanting to prevent something specifically? 

[mrthirsty]

7 hours ago, FluffyPanda said:

I think it'll look really good once it finishes growing out. In the last photo, the angles don't quite look the same. Left photo looks more head-on and right photo looks more top-down to me, so hard for me to say the that it's truly "back loaded". I will say that even when I look at my own head, it's the very back of the crown that you can see much more easily than the top (unless someone is looking straight down at you lol), so beefing that up is never a bad choice if there's thinning in that area if you want the illusion of not thinning. Obviously they saw you in person and we didn't, so they can tell much more easily which areas were more necessary to transplant. Perhaps they're future-proofing thinning in that area. I think in 1 year time, you will be very happy with the results. I also went with Dr Camacho, and honestly if I had led the design for everything, I'd probably look way worse overall than what we ended up going with.

I know you're also worried about the density, but transplanting grafts with 3-4 hairs/graft will look much different than 1 hair/graft in that area.

I think you're right, I think the results will look pretty good.  I just worry that, since not too many grafts were spread into the front of the midscalp, if my thinning continues, I'll be right back in the transplant office with "the halo effect" versus future proofing it with some grafts into that region ( I mentioned this to them before my op).  I think you are right with regards to some angles, the only way I will be able to tell is once the hair grows in and I can see exactly where the center of the whorl is.

Did you have similar concerns with your transplant w Dr Camacho?  I found their "design" portion of the transplant was less than one minute, which worries me a little.

[mrthirsty]

12 hours ago, Archan said:

Implantation to the front is there upto the red line you have drawn ....it cannot be too dense thr as you have existing hairs there...

Bt i guess you are more concerned that they have implanted the grafts on the bottom end of the crown(between orange and blue line) where you already had enough density ...i cn understand that from pics and i feel the same...but photo angles may be sometimes misleading so do keep tht in mind...

I think you and Panda are right about the angles... I will post another photo once the whorl grows in a bit more.  But glad you see my point on the transplantation into an area with pre-existing hair

[FluffyPanda]

3 hours ago, mrthirsty said:

I think you're right, I think the results will look pretty good.  I just worry that, since not too many grafts were spread into the front of the midscalp, if my thinning continues, I'll be right back in the transplant office with "the halo effect" versus future proofing it with some grafts into that region ( I mentioned this to them before my op).  I think you are right with regards to some angles, the only way I will be able to tell is once the hair grows in and I can see exactly where the center of the whorl is.

Did you have similar concerns with your transplant w Dr Camacho?  I found their "design" portion of the transplant was less than one minute, which worries me a little.

Tbh, I feel like most people who get a HT will eventually need another one at some point down the line. Honestly, if you do have to go back, it will be pretty clear where to put the grafts anyway so I wouldn't worry too much. Plus tbh, that area isn't an area a lot of people are going to be looking at so you get a little more breathing room there.

So I when I went with Dr. Camacho, yes the design portion was pretty fast. However, he's been doing this I think nearly 20 years. I would imagine after doing a hairline design per day for nearly 20 years, you probably know instantaneously how the design should go. I mostly attributed the quickness of it to him being an expert who has done this plenty. I did express my concern that my hairline might be too high, but he explained why it was important to be more conservative with it. I'm sure the design would have taken longer if I had more questions or a lot of concerns, but I was ok defaulting to the opinion of an expert, so I really didn't have concern about what they felt would look best on me.

Honestly, it's probably normal to be concerned when the process doesn't look exactly like you'd expect, and this is certainly an  anxiety-inducing process no doubt. But like I said, I think yours will look good and you'll be happy with the final result, even if the placement isn't exactly what you had in mind

[A_4_Archan]

6 hours ago, mrthirsty said:

I think you and Panda are right about the angles... I will post another photo once the whorl grows in a bit more.  But glad you see my point on the transplantation into an area with pre-existing hair

Yeh sure...

[mrthirsty]

10 hours ago, FluffyPanda said:

Tbh, I feel like most people who get a HT will eventually need another one at some point down the line. Honestly, if you do have to go back, it will be pretty clear where to put the grafts anyway so I wouldn't worry too much. Plus tbh, that area isn't an area a lot of people are going to be looking at so you get a little more breathing room there.

So I when I went with Dr. Camacho, yes the design portion was pretty fast. However, he's been doing this I think nearly 20 years. I would imagine after doing a hairline design per day for nearly 20 years, you probably know instantaneously how the design should go. I mostly attributed the quickness of it to him being an expert who has done this plenty. I did express my concern that my hairline might be too high, but he explained why it was important to be more conservative with it. I'm sure the design would have taken longer if I had more questions or a lot of concerns, but I was ok defaulting to the opinion of an expert, so I really didn't have concern about what they felt would look best on me.

Honestly, it's probably normal to be concerned when the process doesn't look exactly like you'd expect, and this is certainly an  anxiety-inducing process no doubt. But like I said, I think yours will look good and you'll be happy with the final result, even if the placement isn't exactly what you had in mind

This is a great perspective, appreciate your write up here.  +1 on the comment around his experience and knowing what he’s doing.  I suppose if their clinic had better communication to explain the design choices and debrief it would be helpful (maybe that was different when you were there).  I mostly spoke with who I presume to be the marketing and public relations guys (they never properly introduced themselves) instead of getting direct medical opinion from the doctor - which I would’ve preferred

[Bobby212]

I had a very similar experience with Dr Camacho a couple weeks ago for my procedure.

- Communication is great, travel logistics were thorough and very helpful

- Very brief consultation and hairline design

- Paid for package that makes it look like Dr Camacho does some amount of extractions (“Extractions: Dr Camacho & Dr Pareja”) - he didn’t.

- Grafts we’re placed in an area of full density - I even specifically told him to avoid the dense middle hairline area where I have no recession.

- Other questionable issues with the clinic from my perspective but I’ll create a new thread to lay out my full experience.

[mrthirsty]

9 minutes ago, Bobby212 said:

I had a very similar experience with Dr Camacho a couple weeks ago for my procedure.

- Communication is great, travel logistics were thorough and very helpful

- Very brief consultation and hairline design

- Paid for package that makes it look like Dr Camacho does some amount of extractions (“Extractions: Dr Camacho & Dr Pareja”) - he didn’t.

- Grafts we’re placed in an area of full density - I even specifically told him to avoid the dense middle hairline area where I have no recession.

- Other questionable issues with the clinic from my perspective but I’ll create a new thread to lay out my full experience.

I wonder with their newfound popularity and growth (they are opening a third operating room) they are getting a bit loose with their process / performance.  I was certainly upset about the fact Dr Camacho not only did not do my extractions at all, but left before the implantation was even done!  There is a bit of a false advertisement there.

 

Please link your post in the comments here when you write it, I would like to see if you had a similar experience to mine

[FluffyPanda]

Heh, reading the comments here have me nervous about what my own results will end up being. Granted it's been 4 months since my procedure so it's not like I can change anything, but my anxiety is now higher lol 

[Melvin- Admin]

Hey guys,

I understand you have some concerns. I’m sending you two pms to get your name and date of surgery. I will reach out to the clinic for their response. 

[Iceee222]

On 3/11/2023 at 9:52 AM, mrthirsty said:

I wonder with their newfound popularity and growth (they are opening a third operating room) they are getting a bit loose with their process / performance.  I was certainly upset about the fact Dr Camacho not only did not do my extractions at all, but left before the implantation was even done!  There is a bit of a false advertisement there.

 

Please link your post in the comments here when you write it, I would like to see if you had a similar experience to mine

Would u not recommend him anymore. I have been looking at him for years ?

[Iceee222]

On 3/11/2023 at 3:09 PM, Melvin- Moderator said:

Hey guys,

I understand you have some concerns. I’m sending you two pms to get your name and date of surgery. I will reach out to the clinic for their response. 

Any update on what the clinic said and any thoughts. Was really considering him!

[mofo]

Hi guys, thanks for sharing all the info! 
 

im going in 3 weeks (April 4) for my surgery (Dr Pareja) This is def an anxiety producing event. I don’t think anyone gets this far without a lot of thought, research, and bit of gambling involved. But even with all the research etc, I’m still nervous. Every time I’m totally confident about have this done (procedure and clinic), little waves of anxiety and mild panic make me want to back out!!

thanks again and please keep us posted!!

[mofo]

On 3/10/2023 at 10:09 PM, Melvin- Moderator said:

Hey guys,

I understand you have some concerns. I’m sending you two pms to get your name and date of surgery. I will reach out to the clinic for their response. 

Awesome, please let us know their reply!

[A_4_Archan]

3 minutes ago, mofo said:

Hi guys, thanks for sharing all the info! 
 

im going in 3 weeks (April 4) for my surgery (Dr Pareja) This is def an anxiety producing event. I don’t think anyone gets this far without a lot of thought, research, and bit of gambling involved. But even with all the research etc, I’m still nervous. Every time I’m totally confident about have this done (procedure and clinic), little waves of anxiety and mild panic make me want to back out!!

thanks again and please keep us posted!!

I cn understand ...bt you have to be confident at the end...same situation is with me...bt thn i thought we have to back our decision ...evry doctor has few bad cases here and there...and this thng is nt just abt the skills of doctor only...there are many factors involved in surgery and we have to accept it...no surgery is risk free...wht we cn do is do lot of research abt the doctor and see all the real patients reviews...and based on tht we will choose a doctor ...we can do only this much and we are doing it and choosing the best one within our limitations....

[GoliGoliGoli]

13 hours ago, Iceee222 said:

Any update on what the clinic said and any thoughts. Was really considering him!

Yep, was considering him for any 2nd HT I may get, but definitely having second thoughts now. 

[Melvin- Admin]

Dear Community,

 

I have contacted @Bogota Hairlines who advised that they are speaking with the patient. They will respond to his concerns shortly.

I do want to chime in. They did the right thing by reinforcing the outer edges, clearly showing miniaturization. Usually, we have the opposite complaint. A patient will have surgery and later see a thinning area that should have been transplanted. This is the first time I've seen a complaint about a thinning area that has been transplanted. If you examine the pre-op photo, you see the bottom is thinning.

The problem with this example is that the angles are different. The left side is facing forward at eye level. The right side faces downward from an upward angle, so matching the lines doesn't work. Because tilting your head downward will expose the upper part of the crown more than facing forward will. 

When you compare these two photos, you can see the area outlined on the right is an area that is visibly thinning. Now, this isn't easy to detect because the hair is long. However, once you close up, you can see a lot of miniaturization. The common problem is that surgeons won't transplant this area, which leads to a visible gap as hair loss progresses. The so-called' donut hole' effect is one of the biggest problems with transplanting a crown at this stage. The only way to avoid this issue is to reinforce the outer edges that are miniaturizing. They did the right thing by reinforcing these edges. This will ensure the longevity of the hair transplant as you continue to lose more hair. 

 

[Bobby212]

9 hours ago, mofo said:

Hi guys, thanks for sharing all the info! 
 

im going in 3 weeks (April 4) for my surgery (Dr Pareja) This is def an anxiety producing event. I don’t think anyone gets this far without a lot of thought, research, and bit of gambling involved. But even with all the research etc, I’m still nervous. Every time I’m totally confident about have this done (procedure and clinic), little waves of anxiety and mild panic make me want to back out!!

thanks again and please keep us posted!!

Hey mofo, 

I think it's good that you're scheduled with Dr Pareja's package. Despite my issues with the clinic,  I can't complain at this point about the quality of work with my procedure. And Dr Pareja was certainly more active in my procedure than Dr Camacho.... she did the extractions and more than half of the implantation. I think you're in good hands.

A big regret of mine was not pushing for enough information during the planning phase. Asking these questions would likely have eliminated some of the issues I experienced:

• How did they arrive at the graft count?
• Are they assuming a certain grafts/cm2 density?
• What is the full implantation zone they have scoped out?
  • If they plan to extend grafts into an area that they can see is thinning - they should communicate that plan. Nobody wants a surprise when they see the results after the surgery is already done.
  • In my case: Dr Camacho only drew the front hairline - no backstop where grafts would become less dense or stop.