Transmed has sent me some 'before' and 'after' comparison photos, which I've posted below. The before photos were taken in June 2010, just before the HT, the after photos were taken last week, on my follow up visit to the clinic.

 

Firstly, I should say that they present a more positive picture, and actually I feel a bit better for seeing them. 

But - I don't think they tell the full story because: 

1. My head is tilting forward further in the after pictures.  

2. My hair is longer in the after pictures.

3. My hair was carefully combed forward by the photographer. 

Underneath the Transmed photos, I've posted one of my own recent (one month ago) photos with the Transmed before photo - the angle is slightly different, but I feel it gives a closer representation of the actual outcome.

What particularly bothers me is the lack of density in the front, which is why I find it hard to understand Dr Kulahci's assertion that 90% of grafts have survived.

 

So, just over a year on from my HT, I returned to Transmed for a follow up consultation. As before, the patient experience was excellent; my flights and accommodation paid for, a car to and from the airport, and to and from the hotel and Transmed, and excellent service when I was in the clinic.

However, when I had the consultation with Dr Kulahci, her view - somewhat to my surprise - was that I'd had a good result.

I had my photos taken, but there was apparently a problem downloading them, so we couldn't compare my before photo from last year with my new after photo, side by side on screen. Instead we had to compare last year's before photo with how I looked in the mirror, which wasn't as easy a comparison to make.

(The next day, I got a call from the clinic to say there was still a problem with the photos, and could I come back in again to have another set taken. On this occasion, the photographer carefully combed my hair before some of the shots, presumably to present a better impression.)

Dr Kulahci's view was that 90% of the grafts had been successful, maybe only 80% on the left side of the hairline. But generally she thought there was a big improvement on last year. Her view was that it was much better in actuality than in photos.

I asked what caused some grafts not to work, and her general view was 'it happens'; it was nothing particularly to do with my skin type or anything else to do with me. The pimples, which I mentioned I'd had a lot of, were also not an issue in affecting regrowth, she thought. I got to see the scalp up close under the microscope. I could see the clear difference between transplanted grafts and native hair. This was a relief of sorts; at least some of the grafts appear to have survived, which gives me hope for future surgery.

But I would still say that my personal estimate of how many grafts have survived still is no more than 30%-40% - and that's in the good areas like the right temple – while the bad areas like the left temple can only be 10%-20%.

I did express my surprise at Dr Kulahci's view that so many grafts had survived, and brushed by hair back to show the (in my opinion) thin hairline. But she stuck with her view that 90% had survived. 

So where did we leave it? Dr Kulahci was fully prepared to do a second operation there and then, either FUT or FUE. I expressed my preference for FUT. She said this was possible, and estimated around 1,500 to 2,000 grafts could be obtained from the back of my head still. Which is good news I guess. For this, I would pay for the first 1,000, and the remainder would be 'on Transmed'.

One interesting point Dr Kulahci made was that subsequent operations are always more successful – this is because there is more blood supply in a recipient area that has already received grafts, than one that hasn't. I don't know how true that is based on other patients' experiences.

Anyway, I declined to have the operation on the spot, and said I would think it over.

As to the option of a refund - well, the detail of this is to be confirmed, but because Dr Kulahci estimates that only 10% of transplanted grafts failed – itself within the margin of error – than I would be entitled to that much of my fee refunded, about £500.

So now I have to decide which option to go for...