hair transplant Hair Transplant - I've narrowed it down to Dr. Espinosa Custodio, Dr. Muresanu, Dr. Bisanga, & Dr. Pittella. Looking to get a second opinion on who I should go with.

[Joey9]

After spending a lot of time researching and contacting many surgeons and looking at availability, I've narrowed it down to the following surgeons: Dr. Espinosa Custodio, Dr. Muresanu, Dr. Bisanga, & Dr. Pittella.

All 4 of them seem fairly legit and I wouldn't mind going with either one, so was curious to hear what members of the community here think.

I will admit I have a slight preference for Dr. Espinosa Custodio just because he has a location in Mexico, which would make my travel logistics much easier (I live in the US), though I also don't want to ignore the others if their quality results justify the longer travel. I've seen pictures from each of their work and, at least to me at first glance, they all seem fairly good, but again I'm not an expert who knows all the fine details of what to look for when judging hair transplant results. I'm not expecting perfection, though I do want fairly good quality results that look natural.

Any experts on here like to chime in on what you'd recommend?

[Berba11]

They're all excellent and distinguished names, but the critical piece of information you've left out is... you! Can you share some photos? And can you tell us what each of these surgeons/clinics have said about your case and their plan to get you where you want to be?

[Joey9]

Thanks for the reply! I attached the same photos I provided to each of the surgeons.

Overall, they each said roughly the same thing. They rate me at around a Norwood 5 who will likely need 2 FUE sessions (expecting 4,000-5,000+ grafts total) to fully cover the area. They all (including me) seem to come to the consensus that we can prioritize the frontal area (which they expect enough availability in the donor hair area) and then they can use the remaining donor hair to fill into the crown area as much as they reasonably can (there's no guarantee on how much they can cover here since it all depends on how much they can reasonably grab from my donor area, but it will at least look much better and I'm fine with that since it's the front I want to prioritize).

One thing they did mention (especially Dr. Espinosa Custodio and Dr. Muresanu during the online consultation) is to think long-term in that my balding will likely continue as I age (currently 30 years old) and I'll have to be on medication (going to try Minoxidil again after stopping for a while) and/or may need another transplant in the future depending on how my hair looks in the next decade or so.

Dr. Espinosa Custodio also did recommend doing a hormonal study beforehand. I was going to look into it since that was the first time I ever heard of such a thing. If anyone has any experience or useful info on this, please feel free to let me know.

In the end, they all seem to be roughly on the same page. I had online consultations with Dr. Espinosa Custodio and Dr. Muresanu so far. I've talked with Dr. Bisanga and Dr. Pittella over email, but still need to schedule an online consultation with them. Dr. Muresanu did mention he'll be visiting my area in the US next month in October for a conference and recommended to meet up in person to get a better look at my case. I said I'd be more than happy to.

 

 

 

 

 

 

Edited September 8 by Joey9
Had to re-upload photos because they were showing upside down for some odd reason

[4chanhrn]

That crown is dipping low and you have retrograde? Hard to see from that pic. I say you are diffuse 6. Have you considered FUT? From those options, I would go with Muresanu. Pittella is good too and would be my first choice, but his wait list was 2 years away last time I checked.

[laverita]

As said, crown dipping and retrograde. You should also be on meds if and see if you tolerate them and what benefits you get as you have a lot of hair albeit miniaturised and be on a good six months prior to any surgery as it may change things. If you take it and have sides then you know that meds are not part of the package and then it will mean planning differently knowing you will lose what you have etc. Hairloss is progressive even past 50s so keep that in mind and have personal consultation not online because it simply doesn't give you the data you may want to have. 

[Berba11]

7 hours ago, Joey9 said:

Thanks for the reply! I attached the same photos I provided to each of the surgeons.

Overall, they each said roughly the same thing. They rate me at around a Norwood 5 who will likely need 2 FUE sessions (expecting 4,000-5,000+ grafts total) to fully cover the area. They all (including me) seem to come to the consensus that we can prioritize the frontal area (which they expect enough availability in the donor hair area) and then they can use the remaining donor hair to fill into the crown area as much as they reasonably can (there's no guarantee on how much they can cover here since it all depends on how much they can reasonably grab from my donor area, but it will at least look much better and I'm fine with that since it's the front I want to prioritize).

One thing they did mention (especially Dr. Espinosa Custodio and Dr. Muresanu during the online consultation) is to think long-term in that my balding will likely continue as I age (currently 30 years old) and I'll have to be on medication (going to try Minoxidil again after stopping for a while) and/or may need another transplant in the future depending on how my hair looks in the next decade or so.

Dr. Espinosa Custodio also did recommend doing a hormonal study beforehand. I was going to look into it since that was the first time I ever heard of such a thing. If anyone has any experience or useful info on this, please feel free to let me know.

In the end, they all seem to be roughly on the same page. I had online consultations with Dr. Espinosa Custodio and Dr. Muresanu so far. I've talked with Dr. Bisanga and Dr. Pittella over email, but still need to schedule an online consultation with them. Dr. Muresanu did mention he'll be visiting my area in the US next month in October for a conference and recommended to meet up in person to get a better look at my case. I said I'd be more than happy to.

 

 

 

 

 

 

All of these plans sound very sensible. Given that you're in communication with one of the premier FUT surgeons and that you're higher a NW, I'd certainly be thinking about FUT here. If I could rewind the clock three years, I'd do FUT rather than FUE myself. Your donor above what could be a little retrograde does look quite thick and full, which again would be absolutely prime for a strip and would avoid having to take grafts via FUE close to an area that might thin out more in the future.

[Hair4Days]

What did these surgeons say about your donor quality? Did they mention how many grafts they believe you’d be able to harvest from there? Looks like you’d have atleast 6k to work with. The previous mentions about  the dip in your crown isn’t really relevant because when surgeons are doing fue, they tend to extract under & around the lower crown anyway. Even in patients that don’t have signs of loss there yet. You just have to take into account that extended area of the crown and include it with the size of the recipient zone

Edited September 8 by Hair4Days

[Al - Moderator]

All of the Drs you chose are very good. Once you've narrowed your choices down to where you feel comfortable going with any of them, there's nothing wrong with choosing by location at that point. If it's easiest and most convenient to go with Custodio then that may be the best choice for you. There's no reason to get yourself more stressed out with long trips if you would feel just as good with a Dr closer to you.

I'm not trying to make the decision for you. I'm saying this because you may have read on here or elsewhere that you shouldn't make location a factor. While that's true in the researching stage, if you truly feel good about going to a Dr who happens to be closer than some others, then you can certainly decide by location if all else is equal.

 

 

 

 

[Joey9]

14 hours ago, 4chanhrn said:

That crown is dipping low and you have retrograde? Hard to see from that pic. I say you are diffuse 6. Have you considered FUT? From those options, I would go with Muresanu. Pittella is good too and would be my first choice, but his wait list was 2 years away last time I checked.

Dr. Muresanu did discuss the options of FUT and FUE with me. Also, excuse my ignorance as I'm still learning a lot about the science behind balding here, what exactly is diffuse balding, like how is it different than regular balding (MPB)? Is the treatment for it different?

[4chanhrn]

3 minutes ago, Joey9 said:

Dr. Muresanu did discuss the options of FUT and FUE with me. Also, excuse my ignorance as I'm still learning a lot about the science behind balding here, what exactly is diffuse balding, like how is it different than regular balding (MPB)? Is the treatment for it different?

Diffuse=you have some native hairs that can be saved via medication. Important to not transect them while placing grafts if they can be saved via medication. Transplanting around native hairs is a skill and something which lot of docs fail at.

[mr_peanutbutter]

if you want to get full coveragr in one sitting, id go with hattingen and fut (even though they also do excellent fue jobs)

[Raphael84]

Diffuse hair loss refers to hair thinning that occurs more evenly across a larger surface area or the entirety of the scalp, rather than only in more specific, concentrated areas such as the crown or hairline for example.

Depending on the specifics of each patient, diffuse loss may well represent the potential propensity for further and more extensive loss and hence why medication can be an important consideration.