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Dr. Bruno Ferreira - 3611 grafts - 28th & 29th of January 2020

R

Rolandas

member
Hello dear balding friends!
A lot of you guys asked for it so here you go! My "quick" report :D

I had a 2 day surgery done in Espinho, Porto, Portugal with Dr. Bruno Ferreira on 28th & 29th of January 2020.
Currently resting in my hotel and since I have all the time in the world I decided to write this up - "for whom it may concern" :D Grab a cup of coffee/tea/whatever you are into these days and enjoy reading!
A little bit about me
28 year old Caucasian male, Androgenic Alopecia, NW5a. Older Brother - NW 6/7, Father - NW 7-teen.
To set up a base line, here's a photo of me before any hair loss (age 18). Never had extremely straight hairline (just a fact!).


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I've been loosing hair for the last 7-8 years, obviously not extremely excited about this fact, so when I reached NW3a I became worried. I started my research for "natural cure" and tried Detumescence Therapy (vigorous scalp massages - mechanical stimulation) for 20 minutes morning and evening 6 months straight (according to researcher after doing this type me massage you can expect to START seeing some results from 6 months onwards),and then just gave up as I had big lifestyle changes all at once, so couldn't manage it. I don't want to go into detail of how it works, so google for yourself, but I strongly believe it halt my hair loss progression a bit.
Years went by and I slowly started loosing more and more hair until eventually in December 2018 (that's when I began my research 24/7),when I was full blown NW5a I decided to do something about it. Did minoxidil + dermarolling for a year & Finasteride for 6 months.


Here is my picture showing the extent of my hair loss before surgery.

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While I was doing some treatments, I was also heavily researching (when I say heavily, I mean - on the way to work, at work, at lunch break, on the toilet after lunch, on the way back home, the rest of the evening, almost all weekend) Hair Transplant surgeons until end of November 2019 when I made my decision. More on that below.

https://www.hairlossexperiences.com...uno-ferreira-january-28-2020.8698/#post-68521

In this post, I didn't want to go into too much detail (nobody would really read it for 3 hours straight!),so I kept it nice and short with my main candidates.

Day 0
27.01.20 - Trip to Portugal. Quick flight from London to Porto about 2 hours. Afterwards got an Uber from the airport and in 25 minutes already in my hotel 1 minute away from the clinic! Booked via Booking, quite cheap. Plenty of options. Easy task.

Day 1

28.01.20 - Quick breakfast and 07:30 am @ the clinic. First impression - Super early! The whole clinic looks like it was closed except Dr. Ferreira's part. In the building, a company Rejuvie are offering things like Aesthetic/Antiaging/Dental and many other treatments. However, don't be fooled! Dr. Bruno has his own part on the ground floor where he designed everything himself from consultation room to OR. There's no other things going on in there but Hair Restoration done by Dr. Ferreira. I met his lovely team consisting of 3 nurses and Dr. Bruno himself and been directed to patients room, which is dedicated only for patients himself. They gave me a key of the door, so I wasn't worried about my belongings being there while having my operation.
One of the nurses Ricardo (btw, this guys is absolutely amazing! He will take care of you every second you spent there and you will feel like you are a super star!) gave me a surgical "uniform" to change right away and shortly after Dr. Bruno came to see me to discuss procedure. Obviously while waiting I managed to snap a quick photo :D

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We discussed bits and pieces, signed needed paperwork and headed to the other room for a photo shoot. Dr. Bruno took quite a few pictures and we started planning hairline design. It took a good 15 minutes or so to finalise it. I was actually quite amazed of his attention to detail! Not a typical hairline done in 2 seconds like you see in many videos from Turkey hahaha. After he showed me his final proposal I didn't even want to change a thing. It looked perfect! Now when I'm thinking it's probably because I didn't see any hairline for years :D, but his final design after careful examination of my facial structures was looking amazing.
Afterwards we buzzed my hair completely, made some more pictures, Dr. Bruno took measurements of recipient and donor areas and we headed to the other room "on the table under the knife". As I'm writing this post I don't have any pictures made by Dr. Ferreira, so once I've got them I will update this thread.

Procedure
The Plan - extract and implant around 3500 grafts over 2 days
Tools used - Lion Implanters, Motorised 0.85mm punch, Manual 0.85mm punch (and probably smaller, not sure, Sorry! :D) (more information coming soon)
Implantation approach - pre-made incisions + Implanters for the hairline and the rest using Lion Implanters alone (picture attached)
Area to cover - 75 cm2
Future hair transplant area to cover (crown & mid scalp) - 75 cm2, approximately 1500-2000 grafts (more information coming soon)
Donor area - around 10,000 extractable grafts, lots of multiple units (more information coming soon)
Hair shaft diameter - 51 micron

Picture below shows all extractions updated live by nurses on the screen next to the operation table.


day 1.jpg



Now, it might look like a lot of grafts for such small area, but because my hair shaft is quite thin (~51 microns),I would need more hairs/cm2 to have great coverage.

Everything started from Anaesthesia which to my surprise was almost pain-less! Dr. Bruno was using his fingers to gently massage the area while slowly inserting the needle and to my surprise that was incredibly pain-less. I asked him how is that everyone is talking about how the most painful part is anaesthesia and I almost didn't feel a thing, he replied "I'm just being very gentle". That's when I realised the difference between caring surgeon and money-making-minded surgeon. Anyways... Back of my head numb in few moments and we jumped right into extractions. The feeling of that.. Like a very quiet clippers. I kind of liked the way it feels hahaha (i guess I'm weird :D). No pain.

Dr. Ferreira used 0.85 mm motorised punch only because after examining my donor turned out a lot of grafts are placed almost in a straight line (e.g. 4 hair graft is not in a bunch but in a line),thus covering bigger area, thus larger punch is needed.
After all the extractions had been done we still had a little time before our food arrives, so Dr. Bruno decided to do some incisions for the hairline.


20200128_130853.jpg



BTW selection of food was solid! Fish, Meat, Veg, Soup, Drinks, Dessert... I asked if it's possible to get Freshly Squeezed Orange Juice and turns out it was not a part of the deal, but to my surprise they got it for me!

While extractions went like a knife through butter, Implantation part was quite difficult and it took much longer than expected. I had a lot of popping due to my elastic skin (damn you Detumescence therapy I guess! ) and excessive bleeding. Dr. Ferreira used "every trick in the book" (that's what he said haha) to manage the situation and by the end of the day everything looked promising.


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Post-op instruction and back to hotel... Had a great night sleep, 0 pain. Woke up just 2 times, so I used that opportunity to spray saline solution as per Dr.'s instructions.

Day 2
29.01.20 - Arrival to clinic at the same time 07:30 am. Quick check up, donor wash and right into the action. Dr. Ferreira decided to change his approach to make implantations much smoother and avoid complications.

The Plan - extract ~500 grafts and implant them immediately.


day 2.jpg


Total extracted grafts - 3611
Total extracted hairs - 9861
Total ratio - 2,73

Pardon me, I didn't make a picture of "Total" page! Hopefully will receive this information soon from Dr. Ferreira and will update this thread.
Overall day 2 was sooooo much smoother! The new approach Dr. Bruno decided to take this day worked like wonders! Almost no popping and no excessive bleeding.

Conclusion
I was extremely impressed by Dr.'s adaptability to situations. Taking different approaches "on the go" to control the process. I didn't even realised at first that he was using manual punch until one moment I was like "waaaaaaaaait a second.. Something is different!". No sound, just pure manual rotating movement. I asked Dr. Bruno - "Are you using a manual punch?" to what he replied - "yes, in some places it's easier to get into with manual punch".
The right tool for right situation. How about that?
Anyways, here's some post-op pictures.


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I will keep updating this thread until the final result. Also, once I've got good quality pictures from Dr. Ferreira I will update that here.
Please feel free to give me your opinions! I'm super excited to finally get it done (especially the fact that I can see my hairline hahaha :D)
 
Johnjo569

Johnjo569

member
Hey Rolandas congratulations!! it’s looking fantastic so far! Great to hear you so positive and sounds like it was a really good experience for you. Great write up too, can’t wait for the next instalment!!
 
R

Rolandas

member
Thanks John! I really appreciate that!
Cant wait to see what this will bring I will update with day 1, 2 and 3 after surgery some time soon too.
 
janna

janna

Invaluable Member
Hi Rolandas,
Thanks for posting about your procedure. I've met Dr. Ferreira many times at HT conferences and it'll be good to see his work/result documented here. Best wishes for a fantastic result.
 
R

Rolandas

member
Hi Rolandas,
Thanks for posting about your procedure. I've met Dr. Ferreira many times at HT conferences and it'll be good to see his work/result documented here. Best wishes for a fantastic result.
Thank you Janna!
 
R

Rolandas

member
Day 1 post-op
Overall feeling like I had a SPA treatment
Full of energy, no pain, no itchiness, absolutely nothing extraordinary except scalp felt "weird/not normal". I was waking up though around 10 times during the night. Obviously worried if I didn't touch or scratch recipient area.

Prior to my flight I bought a memory foam travel pillow, which is quite wide, thus covering/supporting bigger area of the neck/head. Also Dr. Ferreira gave me a pillow protectors, or what I call "nappies" which I put on my travel pillow before going to sleep. Primary function is obviously to keep the donor area as sanitary clean as possible. Secondary function is to keep you in hotel without extra charges for ruined pillows



Dr. Bruno Ferreira hair transplant review.jpg




Dr. Bruno Ferreira FUE Hair Transplant.jpg




Dr. Bruno instructed me to spray saline solution more often, every 30 min or so as was developing a bit of extra fibrin (yellowish liquid around the grafts). He explained it's just the way my body heals, nothing paranormal
So I was spraying saline on my recipient area every time I was waking up.
Got my breakfast @ hotel, got ready and 11:30 am in the clinic for my donor wash.

Dr. Ferreira had another patient "under the punch" while one of his nurses Ricardo left the OR and came to wash my head. He straight away noticed that my occipital donor area looks quite good for just 1 day post extractions.
While my head been washed, he took some pictures and shortly after Dr. Bruno joined us for a quick check up. He noticed that fibrin was keep building up, so he decided to wash it off with a ton of saline solution and here was the result.


Dr. Bruno Ferreira - 3611 grafts - 28th & 29th of January 2020.jpg


Nice and clean!

Everything else was looking normal so I went back to my hotel where I spend the rest of my day under "lock down". Thanks god I decided to buy a lot of fruits and snacks the day before my surgery, so I don't need to see outside world and focus on recovery (mainly watching some Netflix haha). Also room service food was quite handy! Continued spraying saline every 30 min and following other post-op instructions.
 
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Bigmac

Bigmac

Administrator
Staff member
Hi Rolandas.
Thanks for the detailed write up and the quality pictures. It all sounds like everything went smoothly and you were treated very well. The work looks very nice, the 3500 grafts should produce a nice result. It`s good to hear you are following all the post op instructions. It looks likes everything is healing and looks very clean.
I`m looking forward to following your progress.
All the best.
Bm.
 
R

Risingforehead

member
What did you use to do the Detumescence therapy?

Cheers for putting your experience up I found it fascinating :)
 
R

Rolandas

member
Thanks Risingforehead!
I used just hands!
Todd - vigorous scalp massage for 20 min every morning and evening. Pinching, pressing and stretching in equal parts of time. If doing correctly scalp will feel on fire and hands will be extremely sore
 
Pete from Farjo

Pete from Farjo

Valued member
Great write-up. The work looks really good. Best of luck with it.
 
Raphael84

Raphael84

Valued member
Great write up.
Impressive average hair per FU.
I look forward to following your progress and wish you the very best!
 
R

Rolandas

member
Day 10
Feeling great! After came back home I completely recovered and by day 7 been feeling like a million bucks!

Few things to note though. Since day 6-8 I started feeling some pain in my donor after rubbing/touching it. Even if I just rest my head on the leather sofa it starts to feel sensitive. Dr. Bruno said donor is healing well and pain is possibly coming from nerves. They are not happy for some reason. I've been instructed to massage area behind my ears few times a day and take ibuprofen every 12h if pain persists. So far, seems like massage is helping. Anyways the pain is not unbearable, so I don't take any painkillers.

Until day 9 I still had quite a lot of scabs, so today I scrubbed my recipient area much longer and slightly harder and quite a lot of scabs fell out!
I had quite a lot of multiple grafts (especially 3s and 4s),so if you zoom in, you can see them on the picture. Looks amazing to me!

P.S. Vertex looks much worse than it actually is. Picture doesn't really reflect finer hair correctly. For some reason in few places on my scalp (donor and vertex) hair looks like it didn't grow at all! It's so much shorter than any other surrounding hairs. Weird!
 

Attachments

R

Rolandas

member
For those of you who want to learn more about my journey in video format, you can watch me on




Some people have been asking me to make some videos and whatnot, so here you go!

P.S. I spend quite a few days editing this video, I`ve put my personality in it, so please, grab a drink or snack and enjoy!


Travelling Video Thumbnail.jpg
 
R

Rolandas

member
How you doing guys? Hope you are well, because I am!

Day 14 post hair transplant.

All scabs are gone and it looks freaking amazing! I guess that's the time when we can see "best case scenario" end result with short hair.

Look how well it frames my face! I'm extremely excited for the next 12 months hoping that everything will grow as it is right now...

Native hair starts to grow in in the mid scalp/crown.

P.s. I forgot to take my cap while being on the sun... For how long would you say you can safely be under the sun? 5 minutes?

Currently I'm worried of such dramatic difference In hair colour! I didn't realise my hair in the back is so dark.. What's your experience with this, will it get lighter, or the way it looks now it's pretty much end result in terms of colour?

Thanks gents!

P.s. is there a way to upload pictures facing correct direction?
 

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Bigmac

Bigmac

Administrator
Staff member
Hi Rolandas.
Everything looks right on track.
Thanks for uploading the video. It is nice to see the techs using the microscopes.
As for the Sun, as long as your head was not exposed too long and did not suffer any sunburn you will be fine.
If you're posting pictures that look normal on your computer, phone or tablet, but when you upload them to Koiphen they seem
to randomly post upside down or sideways, here are some tips.

When taking pictures with your mobile device, which many of us do, most software programs can tell which way you
had it positioned when you took the picture so it knows which way is "up". Koiphen can't do that. It is assuming you have
the device position in "landscape" mode, meaning you have it positioned horizontally and the "top" of the device is on the side.
You need to be in portrait mode.
I`ll edit your images so they are the correct way.
 
R

Rolandas

member
Hey Bigmac,
Thank you for your reply!
Techs are amazing there. They even gave me a chance to see through microscope how my follicles look like in between brakes!

Unfortunately my phone Samsung S8 doesn't have portrait mode... But as I see if I take picture in "landscape" position it works, so I will try to use this
 
Bigmac

Bigmac

Administrator
Staff member
Hi Rolandas.
I often chat with Dr Ferreira at the various hair loss conferences around the world, he is very passionate about what he does and about the quality of work he provides. His techs will have the same attitude.
Don`t worry about the images. If they are sideways, I`ll amend them.
 
baldasabadger10

baldasabadger10

Valued member
Looks like you got a good job done. Couldn't get over the difference when i viewed your before picture compared with the one you posted outside. When things look so good straight after surgery i bet it feels a real bummer when the shedding happens to patients. Good luck with the growth :)
 
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