Dr. Rafael de Freitas - 2406 grafts - 14th of December 2023

[Kraki77]

Greetings ladies and gentlemen,

The day has come to publish my case after many years of researching on this forum and many others. Of course, without all of the inputs I would never be able to reach proper decision and for that I'm eternally grateful. Special thank you goes to the fellow de Freitas patients that offered invaluable insight about every single thing before and after procedure. This procedure was booked in April of 2022 but I've intentionally wanted this date at the end of this year because it suits me very well. As far as I can remember, they offered me first date in March of this year, waiting list is not very long.

I've arrived in Valencia two days prior to visit the town as much as possible and to get familiar with the surroundings. Before I describe the procedure itself I would like to give you few basic informations.

Location: CLINICA DE FREITAS - Valencia, Spain (C/ de Sorní, 34)

Date of surgery: 14th of December 2023

Grafts: 2409

Hair/graft ratio: 2,29

Method: FUE with motorized punch 0,8mm and implanter pen

Doctor involvement: Implanting 100% doctor. Extraction is done completely by one head nurse.

ABOUT ME:

Age: 30

Ethnicity: Croatian

Hairloss: Started to lose hair when I was 21 years old but it never progressed quickly. I would say it's an intermediate diffusion pattern which is constant, at least for now. Upon inspection at the clinic I was told that I have good donor and "very thick" hair. Crown is still in relatively good shape, there are some minor signs of loss.

Family balding history:

Father - has also diffuse alopecia in NW6 pattern but he has never taken anything to counteract that.

Brother (24) - had an incredibly aggresive hairloss that started when he was 19 and by 22 years of age he could be categorized as Norwood 6.

Medication:

Oral minoxidil - every day of the week (5mg)

Oral finasteride - Tuesday, Wednesday, Thursday, Saturday, Sunday

Oral dutasteride - Monday and Friday

Accommodation:

Hotel Silken Puerta - 7 nights (almost 700€) - Avinguda del Cardenal Benlloch, 28

 

Day of the operation:

It's still very warm here for this part of the year so I wanted to walk to the clinic to at least have some kind of light exercise before the procedure. It takes 15-17 minutes and it's really easy to remember, not too many crossroads. I had to arrive around 07:45 but just to be sure I was there 15 minutes prior. They still weren't open so I've decided to knock on the door. I was greeted by nurse that spoke only Spanish but she was very polite and showed me room with my name. Upon entering the room I had to sign the paper that allows doctor to carry out procedure and remove my clothing (leaving only pants and socks on). Instead of my clothing I was given sanitary pyjamas. After that, it was time for head washing which calms your nerves additionally if you have anxiety left by then. Toilet is adjacent to the room and you can use it anytime you want. I don't have to mention how good the clinic looks from the inside, that was already mentioned by many patients.

Doctor arrived soon after that with English speaking nurse that was translating everything. He used the comb, looked my donor all around and told me that I don't have to worry about anything. Doctor took pictures from every angle imaginable and drew a line that he corrected later when I was completely shaven. He measured distance from glabella to be sure that we can satisfy rule of thirds which we both agreed upon. He told me that he'll later check my diffusion by magnifying glass which he did. My estimate is that the hairline was lowered for more than 1 cm and we wanted to reduce the size of my forehead to better frame the face since that was my biggest worry and reason why I opted for the procedure. As soon as the corners started to recede my looks started to suffer, unfortunately.

Extraction is done completely by one nurse that speaks English very well, and she is very polite, as soon as you feel pain she will add more anesthetic. First extraction phase lasted for about hour and a half. I didn't feel needles to much because of the vibrator but I have generally felt less pain in my occipital area. After that it's only a waiting game because doctor is working on another patient. After approximately one hour it's time to do the implantation which is actually not that painful and motions are pretty repetitive so that calms you down even more combined with gaze that they put on your head. You only feel pain when it's all done and you have to get up for breakfast. That's when it hurts the most, but you'll receive more painkillers and it will subside.

Second extraction zone was done around 17:00 by the same nurse and grafts were extracted from temporal areas. Again, this hurts a bit more but it's nothing unbearable. Harder is probably the lying itself because everything lasted for basically two hours. Doctor told me to take a rest before final and longer implantation phase. This one lasted from 19:30 until 21:30 and honestly I was on wobbly legs, my legs were shaking from all the medications that were inside of me. Again, pictures were taken, I was very pleased with I was seeing in the mirror, doctor told me that I don't have very hard skin, which was good to hear. Another nurse gave me post op instructions, neck pillow, receipts for medicaments, pills (gastric protector, antibiotic and antiinflammatory) along with some shampoos for donor area. The same nurse called a taxi and escorted me all the way to the street with the bag from the Clinic.

What happened afterwards in the hotel is the cautionary tale for everybody else. I've had dinner and swallowed all the pills that were prescribed along with Paracetamol for pain. What ensued after that is a real nightmare. I was vomiting all over the bathroom on separate ocassions and my donor area started to bleed from all of the stress on my head. As you can imagine it was impossible to sleep during that time but at least I'm spraying saline solution all the time.

That's it for now folks, if you have more questions, let me know, I will gladly answer when I can. Now it's time to attach some photos.

 

 

 

God bless you

 

             

 

 

[thetdog666]

Good to see another de freitas case. Great right up and will be following. All the best

[Belve]

Happy growing. You selected a great surgeon  who specialises in high density hairlines! 
I would like to ask you what was the cost of your hair transplant per graft ?

[Kraki77]

1 hour ago, thetdog666 said:

Good to see another de freitas case. Great right up and will be following. All the best

Yeah, I wanted to add more details where it was possible because I wanted to have them before operation and I know that it will help other people that are considering de Freitas.

[Kraki77]

14 minutes ago, Belve said:

Happy growing. You selected a great surgeon  who specialises in high density hairlines! 
I would like to ask you what was the cost of your hair transplant per graft ?

It was exactly 7000€. Two nights at hotel included. 7000€ for 2400 grafts.

[Kraki77]

Here are some pictures 8 days after operation, started to remove all of the scabs. What do you think, it seems to me that everything is fine. I was wondering if somebody thinks that temples should be recreated, too. I've opted not to do them in order to preserve grafts for the future and I was worried that it won't look age appropriate later in life. Plus, I have seen so many botched temples that I wasn't comfortable with that decision in the first place. It can always be done, later down the road.

[Kraki77]

14 days post OP

Here are the latest pictures before shedding starts. Nothing major happened but redness is becoming less visible. Slight tension on the scalp is still noticeable but that's to be expected. Rosehip oil is definitely great for itchiness, as I did not feel almost anything after 10th day. I don't wear hat or cap but still nobody noticed that I had procedure, not even people that see me every day. This is important milestone because after two weeks I don't have to use other medications besides DHT inhibitor, Oral Minoxidil and Complidermol. I can also start to exercise lightly and sweat is not that big of an issue anymore (I'll avoid gym for 1 month just for precaution and that warning is listed on paper that Clinic gave me).

Next update will be 1 month after procedure.

If you have any questions, let me know.

[Will_the_way]

Congrats man!!! This is going to look amazing 🤩 

[Kraki77]

4 minutes ago, Will_the_way said:

Congrats man!!! This is going to look amazing 🤩 

Thank you. To you I owe much of the praise for every single information that I have received through private messages. They were essential for my piece of mind and many of them proved to be decisive when dealing with minor anxiety. That's one of the reasons why I did not have any doubts prior and during procedure.

[Kraki77]

1 Month UPDATE

Shedding started 16 days after procedure and it is still in full swing. I have decided not to go to the gym until tomorrow and I cannot wait to continue with strength training. Nothing major to report, still no visible signs of shock loss, pimples are not that prominent. 

Basically nobody noticed anything and I'm not wearing hat or cap, I feel pretty good about myself already since the surgery, like huge weight was lifted from my shoulders.

I'm sending you few pictures, wasn't able to take them during daylight and they could have been better but they are enough to show that everything is under control.

My major tip would be to avoid looking yourself every day and comparing your state with others. It does nothing for mental hygiene. Do whatever you can to distract yourself from that.

Redness is also not that bright anymore it's slowly subsiding. Itchiness disappeared after two weeks and I don't feel any tension or numbness in recipient area.

[Belve]

Everything looks right on track for month 1. Freitas is a great surgeon and im sure you will be totally satisfied with your result. Just be patient 👍

[Kraki77]

2 MONTH Update

Shedding lasted all the way up until week 5 after surgery. From than on, there were sometimes only two or three hairs on my hands during showering. Redness has subsided to some degree and I don't feel any pain in recipient or donor area. I think that I was able to notice some early signs of growth last week which is evident on photos that I'm about to post. Longer hairs that have survived shedding are also clearly visible. However, mentally I'm not expecting anything during next 30 days and I avoid looking in the mirror.

On my job I have to wear helmet most of the time and almost nobody from my colleagues noticed that I had something done on my head. In the gym, I'm not wearing hat and most of the experiences were positive with some people even approaching me and asking questions. However, when ugly duckling phase really showed it's worst period there were some weird looks. Some girls politely asked me what kind of disease that is, haha.

Personally, I don't find this ugly duckling phase demanding on my psyche. Honestly, since surgery day I have that pleasant feeling in my stomach and huge burden was lifted from my shoulders. That feeling when you know that you did something great for yourself to eliminate thing that bothered you deeply. It almost feels like I was depressed prior to surgery and had that state of mind for a long time. It wasn't just an emotion of sadness that would come and go, it seems to me that I was affected rather dangerously and consumed with mental warfare inside my head.

WARNING for people that have costochondritis as long COVID symptom:

I have felt tremendous amount of pain from week 5 up until week 8. I have felt difference immediately after surgery, however pain was very much manageable at first. I did not expect this, some medicine that was given to me probably triggered some kind of inflammatory response. Pain was even more accentuated on workout days. It came to a point where it was difficult for me to sleep and I was only able to do so in certain positions. If somebody reads this and has similar issues before surgery, be wary of possible consequences.

 

 

[Will_the_way]

Looks right on track! Exciting days ahead!! 😄

[Kraki77]

3 MONTH Update

Nothing major to report. Since I did not expect anything there are hardly any surprises currently, I'm still in ugly duckling phase. There are some visible sprouts and things are getting better slowly but it's best to avoid mirrors in order to save mental health. Some hairs that survived shedding became longer and they are creating the illusion of more growth but in reality there are only some minor groups of grafts that are starting to grow. Middle of the hairline is still sleeping and there are many gaps where you only see skin and nothing else. I have seen many de Freitas patients on this forum that have looked better during this point. However comparing things does not make any sense because we're all different. I would like to see some growth in the coming weeks and I certainly do hope that worst part is behind me now. Honestly, I don't remember when was the last time that I've felt so good about myself. The fact alone that I have finally pulled the trigger and did something about issues that were bothering me, is simply enough to lift my spirits and ensure peace of mind.

The truth is that I don't need to wear hats or helmets anymore. My hair is long enough to hide recession when there's no wind around, haha. Redness is fading day by day and it's not that prominent, it looks better in reality compared with pictures on the phone. Pain or itchiness are also part of the history, for a long time already. Flakes aren't present on my scalp, I'm still following routine prescribed by the doctor.

Looking forward to April, I believe that improvement is on the horizon.

Without further ado, I'm sending you few pictures for archive and to assess the situation.

 

Edited March 14 by Kraki77

[Kraki77]

4 MONTH UPDATE

Growth is definitely slowly progressing.  I really do hope that worst period is behind me. In comparison with some other posters from de Freitas my growth is not that impressive. Next two months should be more exciting and I firmly believe that everything will be alright. Only two things worry me slightly: First few rows don't have as much progress when compared with the rest of them. Secondly, there are some grafts that look like they are frozen since the shedding phase, they've stayed the same.

All in all, there's no reason to question anything at this point or to be disappointed. It can be said that I'm not early grower but everything else looks to be on point. Usually I've noticed more pronounced growth for other patients after 4 months, we will see if that will be the case here.

 

[StayThick36]

You’re showing signs of serious life. Try to avoid comparing yourself to a few other Freitas success stories on here. You’re progressing well and you can expect more and more growth in the weeks and months ahead.

I’m also a Freitas patient myself. I just hit 3 months last Friday so you’re a month ahead of me. My progress looks very similar to your current state.  I’ve looked at every Freitas patient on here and a lot of magic tends to happen between month 4-6.  Some early bloomers out there for sure, but stay positive brother. 
 

Are you taking and staying consistent with the medication Freitas prescribed? 

Edited April 17 by StayThick36

[Kraki77]

Thank you for the encouragement.

It generally helps if you are avoiding mirror for first few months as much as you can because it can cause you mental stress. Constant checking and wishful thinking can do a lot more harm to you than good. I'm definitely staying positive, maybe words that I have used made someone think that I'm starting to be concerned but that's not the case.

As long as there is clear growth and visible progress there's no reason for anyone to overthink.

I'm taking absolutely everything that he has prescribed and I was taking it for many years prior to the surgery.

We will see what the future has in store. Maybe I'll forget hair problems during next couple of months and that would be ideal but if not I'm not going to be devastated if touch-up ends up being probable.

 

 

 

[StayThick36]

Based on your current state, big growth days are still ahead. The next 2 months will be huge for you and thinking about your hair constantly will be something you can put behind you. 
 

Consider yourself blessed. My hairloss is more advanced than yours, so I already have a 2nd procedure lined up with Freitas for crown work and any additional areas that require more density or touch up. Freitas can’t determine that until around 9 months post op from my 1st procedure with him, but I have enough grafts still available for full coverage which is great news.
 

I wish I was one and done because of the process we are both experiencing at the moment. It can be mentally taxing, but I’m personally focused on the end result.

Looking forward to watching your progress and the mop of hair that’s to come your way. It’s coming. Happy growing my friend.   

Edited April 17 by StayThick36

[TheGreatPretender]

7 hours ago, StayThick36 said:

Based on your current state, big growth days are still ahead. The next 2 months will be huge for you and thinking about your hair constantly will be something you can put behind you. 
 

Consider yourself blessed. My hairloss is more advanced than yours, so I already have a 2nd procedure lined up with Freitas for crown work and any additional areas that require more density or touch up. Freitas can’t determine that until around 9 months post op from my 1st procedure with him, but I have enough grafts still available for full coverage which is great news.
 

I wish I was one and done because of the process we are both experiencing at the moment. It can be mentally taxing, but I’m personally focused on the end result.

Looking forward to watching your progress and the mop of hair that’s to come your way. It’s coming. Happy growing my friend.   

Same boat.

[Gatsby]

@Kraki77 everyone is different in terms of their rate of growth. Slow and steady wins the race!👊

[unleashedshah]

@Kraki77 I wish you all the best mate. I have also booked my appointment with Dr. De Freitas. But still communicating on a lot of stuff with his staff.

[Kraki77]

Just wanted to let you know that doctor informed me yesterday that I have folliculitis based upon pictures that he has seen. He immediately prescribed Clobisdin as treatment. 

Can you share your experiences and share few tips how to battle against it? How worried should I be about it? Problem is that I'm sweating quite intensely and that probably does not help.

I just wanted to say that I'm again humbled by overwhelming support on this forum with so many words of support. They are basically essential for peace of mind and without them I would have much more question marks above my head.

 

Edited April 19 by Kraki77

[Stilgar]

Someone is about to hit the Boom stage. Praying for a speedy and a dense sprouting for your brother.

i do however have one note/question. I have done a similar surgery to yours (although i confess that your pre op temples were way better than mine), i had about 2.5k grafts last Feb with Dr. Pekiner (yet another great Dr.)
Similarly though, I haven’t touched my mid scalp as well. But i am experiencing a lot of shock loss to that native area as well (granted that like you, i have a weaker mid scalp compared to my crown/rest of my scalp). I was wondering if you can show us the recovery in your untouched mid scalp since it seems that after month 3, it looks as strong as the rest of your scalp.

p.s you can view my operation summary in my profile.

[Kraki77]

1 hour ago, Stilgar said:

Someone is about to hit the Boom stage. Praying for a speedy and a dense sprouting for your brother.

i do however have one note/question. I have done a similar surgery to yours (although i confess that your pre op temples were way better than mine), i had about 2.5k grafts last Feb with Dr. Pekiner (yet another great Dr.)
Similarly though, I haven’t touched my mid scalp as well. But i am experiencing a lot of shock loss to that native area as well (granted that like you, i have a weaker mid scalp compared to my crown/rest of my scalp). I was wondering if you can show us the recovery in your untouched mid scalp since it seems that after month 3, it looks as strong as the rest of your scalp.

p.s you can view my operation summary in my profile.

I would not say that my temples look better than yours. My temples are quite destroyed for some reason, with good temples this intermediate diffuse hairloss would be much more bearable for me. My midscalp is also weaker in comparison with crown, however it was not affected additionally with surgery. The only reason lies in the fact that we didn't interfere too much with native hair. It would be too risky to do any kind of procedure on area that is still looking decent, to some degree.

I'll upload few more pictures of the rest of my scalp for you, including donor. I had a haircut recently and maybe some different pictures offer different perspective and better insight.

[StayThick36]

21 hours ago, Kraki77 said:

Just wanted to let you know that doctor informed me yesterday that I have folliculitis based upon pictures that he has seen. He immediately prescribed Clobisdin as treatment. 

Can you share your experiences and share few tips how to battle against it? How worried should I be about it? Problem is that I'm sweating quite intensely and that probably does not help.

I just wanted to say that I'm again humbled by overwhelming support on this forum with so many words of support. They are basically essential for peace of mind and without them I would have much more question marks above my head.

 

I’ve been using Clobisdin as prescribed by Dr. Freitas because I to suffered from folliculitis, which he identified when my head was shaved. I’ve been applying this as prescribed, 20 days on and 20 days off and it’s helped with the issue, prevented bumps, and has reduced my redness. 

The medication will definitely help! Take it as he prescribes. 

Edited April 20 by StayThick36