Dr De Freitas 2635 grafts transplant - NW2 (maybe 2.5?) - March 27th/28th

[deeznuts]

I had my intervention a couple days ago. Just posting this to get started. I don't have any photos just yet but I've requested them from the clinic. I'll take some later but I've kinda been avoiding taking them since I'm not really a fan of how I look at the moment lol. 

Patient (i.e. me) Characteristics

Ethnicity: East Asian

Age: 31

Hair type: Coarse black hair, good donor (average 2.37 hairs per graft which seems quite good)

Meds: None yet

Norwood level: 2, maybe 2.5? Doctor said 2, but online consults have doctors saying 2/3

Numbers look like this.

1 hair grafts - 276

2 hair grafts -1164

3 hair grafts - 1132

4 hair grafts - 252

Total: 2635 grafts

Total hairs: 6252

Average hairs/grafts: 2.37

Punch size is 0.8mm.

The clinic noted that I had a lot of 2's and 3's which is really nice. The average hairs per graft was 2.37 which is a blessing since I'm East Asian and I expected a significant number or 1's and 2's. Not 2's and 3's. My hairs are also quite coarse typical of Asian hair which is also nice. Compared to my girlfriend (who's mixed white), there's a stark difference between our hair. Dr. De Freitas noted I had a good donor (quick visual inspection, not microscope or anything). And given all the factors above, I think I have a very good hair for transplantation due to the coarseness and the number of hairs/FU. I think I have pretty good density too honestly but can't say for sure.

Why I chose Dr. De Freitas

1. I was thoroughly impressed by his hairlines which seem to have fantastic density and look amazing when combing through the hair. As someone who's NW2 (as diagnosed by the doctor), it made sense to go to a hairline specialist

2. He had a couple "real" results on here with BjornBorg and Adam87. I was impressed by both of them since they both had fantastic yield and very aesthetic hairlines. They didn't look like shills either given that they had established post histories - though they still could be I guess lol. In my mind though, Dr De Freitas was 2/2 here and quite good on the Spanish forums as well. He had a couple hiccups in the spanish forums but he seemed to have fixed them in the second try. It was nice having real results to look at. Compare that to some posters here where they have 1 post and somehow document 12 months of their hair transplant journey in that 1 singular post... And of course these patients always have home run results in their 1 post 🤣. Of course, BB and Adam could be shills... But it takes a lot of effort to create an account like that as opposed to doing it shotgun style. 

3. I thought I would be a good fit for the implanter pen given my thick straight hair which the implanter pen seems to have been designed for as it was initially created for East Asian hair anyway.

4. His rates are quite cheap while delivering top quality. He's able to offer lower rates because the cost of living in Spain is much lower. Obviously you don't want cost to be a factor but it's always a great perk.

5. I also consulted with Hasson and Wong but the rep quoted me 3k or 4k grafts which I felt was too much for what I needed. i.e. temple work.

Initial consult

I messaged the De Freitas clinic on here and set up a consultation. Took a month or two iirc to actually get the consultation. I was diagnosed as NW2 (or was it NW2/NW3?) by Dr De Freitas. All communication was handled by a rep since Dr. De Freitas is quite busy and is a popular guy. Might be a turn off for some people but the estimate ended up being more or less the number of grafts the clinic said was extracted. The clinic estimated 2600 grafts and I the clinic said I got 2635 so pretty on the mark here. Can't say I was counting though but I'll give the clinic the benefit of the doubt. 

I was able to talk to the pre-op team at any time which was really nice

Travel to Valencia

I churned a bunch of credit cards so the plane tickets were basically free. Got in on the AMEX platinum 150k point offer which more or less paid for my flight and lounge access the entire way. Definitely recommend churning a card here. But yeah the trip took 7 or 8 hours to Zurich, 10 hour layover, and then another 2 hour flight to Valencia. We spent the entire trip eating all you can eat food at airport lounges (thanks AMEX plat) making our lives a lot easier. Another 20 or 30 minutes by cab after to our hotel. All the buildings and houses here have metal grates or metal garage doors. And tons of graffiti everywhere giving the feel of a low trust society though given the issue that many european countries have with petty theft maybe its understandable. But everything here is super cheap and the city is extremely walkable. You never feel like you need a car here - in fact it's preferable to just walk. You really get a good feel for why Europeans are a bit slimmer than Americans 🤣. There's also a tax on junk food here I think... A 12 pack of coke is like 10 euro iirc. Also, water isn't free at restaurants 😡. I got 3 waters my first night and got robbed 4.50 euro

Hotel Room

The doctor books you 4 nights stay at the Silken Puerta Valencia. It's a decent enough hotel - it's not the Four Season but the doctor pays for your buffet breakfast (for 2 people/4 days in my case) and it made the transplantation process A LOT better not having to worry about getting some food to eat. It's low stress because you can just go down and eat. Food is pretty good, but the Spanish have a crazy obsession with pork which manifested itself in half the breakfast dishes. They had Jamon, bacon, scrambled eggs with ham, sausages, more sausages, sliced sausages in a deli meat style, and probably more varieties that I forgot. Overall though I can't understate how nice it is to not have to worry about eating. It was also a 5 euro cab ride to the clinic. 

Clinic

I'm sure it's been noted by everyone else but it's very clean, very fancy looking. Lots of marble (?) or at the very least some sort of very polished stone. It looked luxurious and expensive. Especially since Valencia isn't like a North American with the city having lots of graffiti everywhere and many buildings being less modern/a bit more beat than the 40 story all glass buildings you see in a city like Toronto. The city does look a bit poorer... On the flip side though the clinic puts many Toronto buildings to shame. You can tell the doctor takes pride in his place of work. I went to a consultation with a Toronto doctor and he had a dingy kinda office by comparison.

Staff

All of them are super friendly ladies. No one was rude or unpleasant. One or two of them spoke English

Pre-transplant consultation (in-person) 

I don't think I spent too much time talking to the doctor and I really regret how I handled this part of the process. I rushed through it and I wonder if I should go back some time and get more work done or if I'll be happy. I wonder if I wasn't "greedy" enough though I wouldn't say I was very greedy at all since I just remember this forum always talking about being conservative. Though with my limited level of loss and decent donor, I wonder if I should have been greedier. On the flip side though, maybe I'll think I made the right decision down the line... Regardless, I feel like an absolute idiot not asking the doctor the tradeoffs of each hairline that was drawn. i.e. How many grafts it would take, if I had a lot of donor to support it, what would have to happen if I wanted to get this done later down the line etc. The language barrier made it a bit harder here too. 

The doctor doesn't speak English aside from a couple phrases here and there so everything was done through a translator.  I just remember filling out some forms, getting into scrubs, and then going to meet the doctor. He took some pictures, diagnosed me with dermatitis, and then noted I had a good donor and was "level 2" which I presume is Norwood II. He drew a hairline which I thought was very low. My original hairline is maybe ~8cm above my glabella? His proposed hairline was maybe 5.5 or 6 cm above the middle of my glabella by my estimation. I asked him to move it higher. He moved it halfway between my hairline and his original line which maybe is 6-6.5cm. I asked him to move it higher again since this forum keeps telling people to be conservative and I just remember thinking maybe I should be conservative here to save grafts. I also remember being happy with my hairline at age 27 so I figured lowering my hairline by a mere ~1cm or so to 7-7.25 cm would be ideal. I don't actually have a ruler so I'm using my samsung galaxy as a reference point. He offered to do some temple peak work which I asked if it would have consequences later as I lost more hair. I think I turned him down since I figured I could always get it done later. Again, I regret this since I should have asked the tradeoffs and inquired more. I took ~5 minutes during this process when I wish I took ~15 mins or even ~30 mins. At the end of the day though, I settled with lowering my hairline by about 1cm and filling in my temples. The hairline drawn was a bit diagonal which bothered me but the doctor assured me that it would be resolved when the transplant happened. I think it got better but it's hard to tell with the swelling at the moment.

Extraction

Not much to say here. Local anesthetic. Didn't hurt much aside from the anesthetic injections. There was 1 tech extracting, and 2 on the side cleaning the grafts from what I assume. They were storing my grafts in some sort of holding solution that they poured out of a plastic container. The tech extracting was friendly but didn't speak English much. She was operating a motorized punch from what I could see since she had her foot on a pedal. I kinda just lay face down on the gurney (not sure if that's the right word) and she went to work. She liked to listen to music. Once she started working, she seemed like she focused on her job which was nice. Also she used microscope glasses which is a plus. The nurses gave me valium but honestly I'm not an anxious person so didn't need it. 

Break time

They fed me a ham and cheese sandwich lol. Everything in this country is just ham and cheese.

Implantation

The doctor was watching youtube videos (or was it TV?) while implanting. Maybe for background noise or passive listening. Every once in a while he would grab the remote and switch the channel. There were two techs loading his implanter pens for him. Every so often he would examine the work and gauge what needed to be done. I didn't think he was careless or anything... I imagine the act of transplantation is just kinda boring. He'd grab an implanter, pick a location and angle and just put it in. I don't know if there's much to say. Didn't hurt much... Started to hurt a tiny bit near the end but it was whatever. I'm pretty good with pain apparently. I was able to pick his brain a bit here and ask about topical dut (he doesn't believe in it and thinks it doesn't work). He strongly encouraged oral minoxidil as well. I mentioned that I read studies about minox lowering collagen but he didn't agree with that either. He likes formula 1 apparently, but given that he's brazilian, it makes sense. He talked about driving a 2.5 million dollar ferrari lol. I interpreted it as him being a driven person who is an overachiever type.

Lunch

I ordered a light meal which was free. Grilled chicken (pretty juicy), cheesecake (absolutely delicious), and a salad. Doctor came in after I finished lunch and saw my used scrubs and threw them in the trash. It's not a lot on the surface but it seemed like he cared enough to do something like that rather than leaving it to his staff to clean the room. i.e. He owned the process and was willing to do things himself.

Went home after lunch. Day started at 9 and ended at maybe 2 each day. With breaks in between for lunch and a ham and cheese sandwich snack.

Day 2

Same as day 1 honestly. Just no lunch 😡. In total, about 2600 grafts over 2 days. I noticed one other patient each day. 

Post transplant

I was able to have a brief ~5 minute conversation with the doctor before leaving. I asked him how many grafts it would be for one of the lower hairlines he drew. He said 2800... I kinda kicked myself for not going for a lower one and not asking.

Will be going in for my first wash on the 5th of April.

Aftercare

The clinic has a post-op care number which is really nice being able to communicate with them if there are issues.

I've got no pain, no discomfort. Head is a bit swollen. Have to sleep with a cervical pillow. The back of my head was oozing the first couple nights. But after that it's been great. I have to spray some solution (saline?) on my recipient area every hour.

Scalp itches like hell because I can't wash it and my dermatitis is itching like hell. I usually use shampoo and wash my hair with hot water at the very least. Not being able to wash my scalp is miserable. I kinda compromised by rubbing shampoo and water on the non-transplant areas to relieve the itching. The scabs are kinda itching a bit now too.

I also need to pick up oral minox (5mg), fin (5 days a week), dut (2 days a week) according to the doctor. Also ketoconaczole for my dermatitis. Seems like the clinic is trying to nuke my DHT levels to that of a prepubescent girls. I'm not sure I want to take oral minox though but the doctor strongly recommended it.

Some final thoughts

Doctor seemed very busy. I would have liked to be able to spend more time with him and discuss tradeoffs

Doctor was friendly and a nice guy. Only knew a couple things in English though so most of the time he would just say "Let's go". 

Some things were lost in translation but you can always ask the question again. There is a nurse who speaks English quite well. It takes a bit longer to ask some questions but communication was pretty decent for the most part. Never had an issue where we didn't know what was going on

The clinic was very impressive and clean... Sterile maybe even. Especially in contrast to Valencia

The staff were friendly and nice. Seemed like they cared about you

The processes seemed very up to date. Implanter pens, holding solutions, motorized punch, microscope extractions, up to date prescriptions (oral minox). It's clear that the doctor attempts to implement best practices and do what's best

The clinic removes all the stress with the hotel booking with free buffet breakfast

 

I'll probably write more details later and add pictures

Edited April 2, 2023 by deeznuts

[Melvin- Admin]

You've been on our forum for a while now, happy to see you pull the trigger on one of the best surgeons in the world. I can't wait to follow your progress. Happy growing.

[Mike10]

interesting write up. waiting for the photos.thanks

[TheGreatPretender]

Great review, curious for the photos. 

The communication part kind of sucks when you don't understand what the doctor is saying, fortunately this shouldn't be a problem in my case since he's fluent in my mother tongue (portuguese) so I hope I can do a bit better in that regard. 

I shouldn't really need a translator to communicate since I should be able to fully understand him, this is one of the reasons why I felt it to be important to chose a doctor that speaks portuguese. It helps alot in getting the right ideas for the op.

PS: Booked for June so not long to go.

Edited March 31, 2023 by TheGreatPretender

[Berik]

I think it's always better to not lower the hairline if you don't need to. Don't regret that part at all, as you can always add more grafts. Much harder to punch grafts out. 

[BaldGuy]

Very good choice. Freitas is a great surgeon. I'm waiting for your post op photos

[deeznuts]

Man i got a really round head 🤣. 

Pictures taken today so about 5 or 6 days post op. 

Post op reps haven't gotten my pics yet but I got some progress pics for now

Donor looks a bit sparse, you can see where it looks like hair was removed but looks kinda clean to me at this point? Skin is reddish /white? Looks pretty okay to me thus far

That looks like 2635 grafts right? Jw if my transection rate wasn't too high. 

Edited April 2, 2023 by deeznuts

[deeznuts]

On 3/31/2023 at 9:28 PM, Berik said:

I think it's always better to not lower the hairline if you don't need to. Don't regret that part at all, as you can always add more grafts. Much harder to punch grafts out. 

Yeah my worry is that if you do it in two goes you're building two hairlines. I.e. If you need 1 cm of density for a hairline and you do that twice, maybe that's 2cm of hairline. But maybe that's an inaccurate assumption

Though with the swelling going down a bit i think having my hairline be about 4 fingers width above the glabella for me is good for me. Just as long as I can not have a 5 head 🤣. I remember feeling pretty good about my hair even 3 or 4 years ago (before COVID) so the 1cm should bring me back and a bit more

Edited April 2, 2023 by deeznuts

[deeznuts]

On 3/31/2023 at 1:32 PM, TheGreatPretender said:

Great review, curious for the photos. 

The communication part kind of sucks when you don't understand what the doctor is saying, fortunately this shouldn't be a problem in my case since he's fluent in my mother tongue (portuguese) so I hope I can do a bit better in that regard. 

I shouldn't really need a translator to communicate since I should be able to fully understand him, this is one of the reasons why I felt it to be important to chose a doctor that speaks portuguese. It helps alot in getting the right ideas for the op.

PS: Booked for June so not long to go.

Yeah I think the communication wasn't a major issue. The reality is the nurses spoke quite good English but sometimes you have to clarify things a couple times. Though being able to speak natively with the doctor is a great benefit for sure. My bigger regret is not going into the hairline drawing phase with a checklist of questions. I think I was too graft conscious as well when I'm not really losing that much hair - I rejected temple peak work when I think I should have gone for it.

On 3/31/2023 at 12:17 PM, Melvin- Moderator said:

You've been on our forum for a while now, happy to see you pull the trigger on one of the best surgeons in the world. I can't wait to follow your progress. Happy growing.

Yeah I just thought I'd pay it forward... I didn't know I'd be stuck with the name deeznuts for 3 years though lol.

I'd never have gone through with it if I didn't have a community of people who I could see doing the same thing.

Also one thing that helped a massive amount is having a supportive girlfriend since she took care of a lot of the planning for everything. I'll also add that having someone with you, if they can remove stress, is a huge boon since you're stressed about the procedure, have a huge mental checklist, need someone to take care of you a bit, and plus you're in a foreign country so it's really great having someone who can be there.

[Mike10]

do you have pre op pics with longer hair? thanks

[Met]

On 4/2/2023 at 9:16 AM, deeznuts said:

Man i got a really round head 🤣. 

Pictures taken today so about 5 or 6 days post op. 

Post op reps haven't gotten my pics yet but I got some progress pics for now

Donor looks a bit sparse, you can see where it looks like hair was removed but looks kinda clean to me at this point? Skin is reddish /white? Looks pretty okay to me thus far

That looks like 2635 grafts right? Jw if my transection rate wasn't too high. 

When did the scabs go away? When can you go back to work without noticing it?

[Spring15]

De Freitas is one of the best good luck

[Met]

update bro?

[Mr-Frosty]

update? considering this doc as well

[Gavinlee]

“I also need to pick up oral minox (5mg), fin (5 days a week), dut (2 days a week) according to the doctor. Also ketoconaczole for my dermatitis. Seems like the clinic is trying to nuke my DHT levels to that of a prepubescent girls. I'm not sure I want to take oral minox though but the doctor strongly recommended it.“

Has anyone with any experience with this doctor got any idea why his medication proposal is so elaborate?  

[Wesgrifin]

Any update? I have this dr on my list 

[hairupgrade]

Update please?

[Melvin- Admin]

Yes, please give us an update 🙏