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Deciding between Dr. Espinosa Custodio and Dr. Felipe Pittella

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Hi all,

I finally decided to get a transplant and I'm deciding between Dr. Espinosa Custodio and Dr. Felipe Pittella. I'd appreciate any recs from this community. Here are the pros/cons as I understand them. I'm really torn between going to Espinosa sooner, who is much closer to me, keeping it conservative, and reevaluating after a year and waiting to go to Pittella who is one of the best, but is really far away and also might be more aggressive than I need. Let me know if you have any advice.

Dr Custodio:


  • Dr. does all the work
  • More conservative. Recommended 3,500 to start and the possibility of a second treatment one year later depending on how it goes and the donor area.
  • Less travel: he's in Mexico City every summer, so it would be a few hour flight as opposed to a very long flight with layovers to Brazil.
  • Availability THIS year. By next year I could be deciding if I want a second transplant based on this year's results.


  • Not a lot of patient reviews. The best source is google maps for his Madrid clinic, but there aren't any pics with those reviews.
  • He recommends meds, which I had a bad reaction to.
  • His initial consult was a pretty unnatural hairline trying to cover my entire, very large, forehead. I'm okay with keeping the widow's peak and would rather make it look natural with more density right in the middle.

Dr. Pittella:


  • Tons of great reviews - seems like he is one of the best in the world.


  • Waitlist until late 2025
  • Maybe overly aggressive: recommended 5,500 and 6k grafts in two separate recs that were sent to me within a day. A full covered head would be amazing, but I worry that might be asking too much and not look natural.
  • Significant travel: the closest airport requires at least one layover from the US and it would be more than double the time to get there and back.
  • I could probably only afford his cheapest option which has Jr. docs doing most of the work. I haven't seen many reviews on how much of an impact that might have at his clinic.




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  • Regular Member

I think you need around 6000 grafts in total. 3500 grafts for front part and another 2500 for the crown. What prices per graft did these propose you?

Edited by BaldGuy
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  • Administrators

What are your goals?

I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

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10 hours ago, BaldGuy said:

I think you need around 6000 grafts in total. 3500 grafts for front part and another 2500 for the crown. What prices per graft did these propose you?

Thanks. Pittella is 4 dollars per graft to do it himself, 3 dollars to do some, and 2 dollars if most of the work is done by other staff. Custodio is 3 dollars and he does it all himself. 


The other big difference is that Pittella does 5500-6k grafts in one day while Custodio does 3500 over two days.

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43 minutes ago, Melvin- Admin said:

What are your goals?

Good question. I think I'm leaning more conservatively/not trying to get back to a full head of hair. My first priority is to add density to the front. I'd actually like to keep it mostly in the middle and don't mind the receding on the sides. I think that's my natural look and also think it would be hard to cover my whole front because I have a big head. If possible, I'd add to the crown after that. 

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  • Valued Contributor

Your decision should be based on your objectives.

A prolonged waiting period can be seen as indicative of his good work.

Moreover, a longer wait might suit you better, considering you mentioned being unable to afford Dr. Pittela's higher package. If the surgery is scheduled for a year or two from now, you can save up and choose the higher package.

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