Jeremiah

Hi, I had a FUT at Transmed in May 2011. I have an old thread about it which I haven't updated. I didn't take decent photos, so I can only describe the results. Firstly, I have to say I was not too happy with the way I was treated. I found Dr. Melike a little offhand, possibly distracted - she seemed very busy. I found the female agent to be a bit nasty. When I pointed out that the grafts were protruding 1-2mms the day after the transplant, they fobbed me off as if I were a bit of an idiot. Well a lot of those grafts didn't take, the hairs withered and died rather than fall out with a bulbous root end. The nurses at the operation seemed to be having trouble getting the grafts to stay in. They were tutting and going over the same area, and even got a hairdryer out to blow on it to cool it. My take on it is that although they told me to lay off some things, vitamin C and E, I think, as it thins the blood, they didn't mention fish oil or garlic, both of which I am heavily into taking. I believe these caused the blood not to clot and hence the grafts wouldn't seat properly. I knew at the time I wouldn't get an great result and I was right, so I feel annoyed that I wasn't taken seriously - they must have known the outcome would be sub-optimal. But that's not to say it isn't an improvement on what I had before, just that it could have been 30-40% better in my estimation. I think they have it in their hands to produce great results at Transmed, but whether they can do so consistently depends on their ability to give full attention to each patient, IMHO.

I just saw your 8-day pics. Yes, they could have used a little more imagination in the placing but I think as time goes on it will be less of an issue. A) The transplanted hair will probably grow back thinner to begin with after shedding, so less noticeably situated. B) Not all the transplants may survive, thus breaking up any 'lines' to some extent. C) Hopefully any topical remedies or internal supplements will cause your native hair to rejuvenate and the whole effect should thicken and blend in OK. Hope it pans out well for you!

I did wonder if some of the lack of communication, friction or misunderstanding with Transmed was simply down to language and cultural differences. I noticed in Istanbul that for a sprawling modern city, the de facto capital of Turkey, surprisingly few people spoke any English. To enroll personnel with the right organisational, customer empathy and technical abilities as well as good language skills must be pretty difficult for them (though the nurses clearly understood the word 'chocolates'!) So, for now I will give them the benefit of the doubt as regards showing some failings in several aspects - but only as long as my HT looks like being a reasonable success! Thanks again Sparky.

Yes, that looks somewhat similar, though my own graft protrusions were maybe twice as long. So these are perfectly normal then, and they dry up and fall off after 7-10 days as mine did? Panic over, thanks for helping dispel the anxiety. Though I do wish the doctor would have had a more careful look and explained things a bit better rather than me having to collar her in the corridor to express my alarm over this. To my mind they did seem a bit over-relaxed about a few things, to the point of being a little off-hand, let's hope it is just well-placed arrogance in their own abilities! I guess because there have been a few negative posts/threads about Transmed lately that it's making me a little jittery about things. I'm sure others will find this subject helpful as well. Thanks again.

Thanks for your input Mattj and Sparky. I have to say the scalp looks pretty normal, just a little bare in the affected areas. The portion of the grafts that stuck out obviously had no blood supply, so they dried and detached as little gritty lumps but left no sign of bumps/scarring/pitting. I think probably around 15%-20% of the grafts were affected. It really does seem like this is a fairly unusual occurence after HTs, otherwise it would be immediately recognised by others. So, this tends to reinforce my opinion that things may not turn out quite so well. It may well turn out that the follicle roots of these grafts may survive, but just regrow at a slower rate or not as vigorously as they might, we'll see. At any rate, it's good to get feedback from you guys to help me know roughly what is considered normal and how much my experience deviates from that. I don't expect things to turn out disasterously, maybe just a reduced yield (say 50% instead of an acceptable 70%) meaning more trouble and expense at a later date to reach a reasonable outcome. Nothing for it but to wait patiently to see what transpires. Thanks again for your input.

No, I mean up to half the graft itself including the skin surrounding the grafted follicle was sticking out from the scalp. The top half of hundreds of grafts were not level with the surrounding scalp, particularly in the crucial front central area. Normally I would have expected just a hair poking out from the site of the graft with the transplanted skin surrounding the transplanted follicle fairly unnoticeable, being level with the skin of the recipient area. This was not the case for many of my grafts. The protruding grafted skin dried (these were nothing like scabs) slid along the hair follicle and fell off within 10 days, soon followed by the follicle thinning at the base and just breaking off rather than detaching with the root bulb in tact. To me this suggests atrophy of the follicle, perhaps due to lack of blood supply to the root area, rather than shock-loss with the follicle detaching normally from the root. I personally can see no way these grafts would be seated at their optimum level for regrowth, but I will be very happy should it prove otherwise. As I said, the doctor seemed very sure it would turn out OK. I don't know if that was just bravado (there was a rep and an ex-patient present) or if she really believes it would turn out OK, we'll see. All I wanted to know was if anybody else had this happen to them and how did it turn out? As of now, it seems clearly not and this is something of a rare occurrence probably suggesting a less than favourable outcome.

Hi, As mentioned in my earlier thread of my experiences of my FUT procedure at Transmed, after the op, I was alarmed to find that hundreds of the transplanted grafts weren't seated flush with the scalp and were protruding 1mm-2mm. Has anyone else had the same thing and how did it turn out? I can't believe I am the only one to have experienced this, is it something to be overly concerned about? Sadly, I didn't take a detailed photo of it at the time, so I can't show what I mean, but I'm sure anyone who had the same thing knows what I mean. I did notice there was a little concern during the transplanting of the grafts as the nurses sprayed saline solution on the area and blew a hairdryer over it a couple of times, and kept going over the same area pushing the grafts in again and again. I knew this because it was later in the op and the LA had started to wear off and it was becoming painful. Probably there had been an issue with swelling kicking in early and unseating the grafts. I only noticed the protruding grafts the second day and queried Dr. Kulahci about it (she hadn't bothered to closely look at my scalp after the procedure) She was quite laid back about it, said it wasn't necessarily the case that deeply seated grafts produced a better result. So I was a little less troubled about it afterwards. But then a week after I got back home I noticed the protruding skin dried and fell off, leaving the grafted follicle in place for a few days. After that, I found a lot of follicles weakening and falling over before falling out, that too without the usual root bulb on the end. So even from that time I suspected the end results would not be favourable. I am now approaching the 3 month mark and notice some stirrings of growth, but not so much in those areas where the grafts protruded which were largely in the crucial front central area which I'd hoped to have good coverage in. A couple of the mods suggested it may only affect the cosmetic appearance of the scalp but not the viability of the regrowth itself. To my mind, a graft not seated in the optimal depth to receive adequate blood supply as well as adhere to the correct type of skin cell would probably struggle to regrow satisfactorily, so I'm not expecting great results. I would appreciate anyone else's views on this.

Congratulations on going through with the op. Was it performed by one of Dr. Kulahci's colleagues as per my previous post? I don't know if I agree with the previous 2 posters. I think the result may be OK depending on good graft survival and the thickness of your follicles, but I'm no expert. Best wishes for your regrowth (and also my own!)

Just to help clarify, having had a FUT with Dr. Kulahci at Transmed in May this year. I spoke with the rep after my own op about the merits of the various doctors there. The rep informed me that Dr. Kulahci tended to specialise (and excel) in the FUT procedures, whereas Dr. Ali Kan (who made a good job of removing a small cyst under my eye) and another Dr. whose name I don't remember, tended to specialise in the FUE procedures.

Hi Albion71, I meant to reply to your last post on my own Transmed thread but have been sidetracked lately (planting a mango orchard of all things!) Yes your latest set of pics on your blog give a better indication of the level of improvement, though again, more detailed shots would have been preferable. Is this the best detail they could provide? If so, it would seem to suggest further obfuscation on their part. To my own eye, the improvement looks to be only 50%-60% at best. Not a disaster by any means, but a little disappointing for sure. If I were in your position, I would hold out for something like a 40%+ refund and use the dosh towards getting maybe 1000+ FUE grafts done in the frontal areas, maybe by one of the Belgian docs. As you know, I already have my doubts about Transmed, and didn't particularly like the way I was treated at times (but of course this will pale into irrelevance should my own HT eventually prove a success!) If I could go back in time, I would perhaps opt to go with a small-scale doc that specialises in HT only, rather than a full-spectrum cosmetic clinic with international aspirations, that might sometimes be paying more attention to brand promotion and protection, cash-flow and business planning etc. than to customer satisfaction. To pick up on one aspect of your post-op experience, how did the many zits you encountered end up? I ask this because I've had maybe ten in the last few weeks (now 2 months post-op) One grew quite big, so I went and squeezed it, only to find the whole graft came out as well, the hair in it was bent double as if it had been growing and was trying to emerge, but couldn't. So did you take care not to lose grafts in that way? Do you think the number of zits was in any way relevant to the number of failed grafts? Anyway, I'm sure things will turn out well for you in the end, it'll just take a little longer getting there than expected, and it's good we have the support of the guys here on the way. Chin up M8.

Hi Albion71 and Dutch. Thanks for the replies. I really must clarify though as you both seem to have the impression that the whole procedure was rushed, which I don't think it was. The nurses were working away at a steady pace, chatting and gossiping contentedly until about an hour before the end when something must have occurred and a raised level of activity set in, with the spraying and air blowing. I felt something was not quite going right at the time, but they seemed to end up satisfied with their work and as I said, Dr. Kulahci gave no indication that there'd been any problem. If I had to guess, I'd say that swelling in the recipient area may have kicked in early and the pressure was causing problems in forcing some grafts to re-emerge. However, it is far too early to criticise and I really wouldn't like to be too negative at the moment and say anything which may unnecessarily negate the clinic's reputation. Albion71, I just read through your own blogs and see you are less than happy with results. It is a little difficult to gauge as the 'before' photos are not so clear and the hair was unkempt. I think the last set of photos show some improvement, but not as much as I think should have occurred. I think 2900 grafts of what appears to be fairly coarse hair should have been more than enough for the area, and you should have had better results. Have you been on any meds or supplements over the year? If not, maybe a further 6 months with some of the pills and potions suggested on this site will improve things. If not, perhaps you should try and negotiate with Transmed for some free remedial FUE grafts to try and thicken things up at the front, or else a partial refund and get the work done elsewhere.

Thanks for the reply TTP. Yes, I also would have thought grafts should naturally be flush with the scalp, which is why I was so alarmed to see otherwise. As I mentioned, there did seem to be a flurry of activity towards the end of the transplantation procedure as the nurses hurredly sprayed what I think was saline solution onto the recipient area a couple of times, and seemed to be dabbing and going over the same area a lot. There seemed to be a bit of tutting going on as well which suggests something less than satisfactory was occurring. The doctor herself wasn't present at that time and seemed fairly blase about it all afterwards. She didn't even closely examine the scalp afterwards, and seemed confident of the eventual outcome when I saw her the next day. So I will bow to her reputation and expertise and await results - it's just that it's not the way I thought things would have been handled. I must say the scalp doesn't seem to have suffered any unnatural scarring as a result, but a lot of hairs seem to be laying flat prior to falling out, rather than standing vertical. As people say, every case is different and I will obviously be in the dark until final regrowth is established. I am hoping that prospects of an optimal outcome have not already been compromised. On a more philosophical note : How fragile we are that minor changes to our physical appearance should count for so much, and mean the difference between joy and misery - and at 54 years old, perhaps I should know better than most not to put too much emphasis on such things!

Thanks for the welcome Taking the Plunge. Do you have any views on whether my problem with 'protruding plugs' may be less than ideal for a final result? My own guess would be that the transplanted root needs to be at an optimum depth to be able to connect to an adequate blood/oxygen supply as well as the correct type of surrounding cell in order to regrow efficiently. Has anyone else encountered this at the time of the op and/or the transplanted hairs in the same general area afterwards laying flat before breaking off with a bend at the end? To my mind these little observations are already beginning to bode ill for a successful outcome, but I live in hope that I may be proved wrong.

Having read Albion71's and other's accounts of their HT results at Transmed, I thought I ought to relate my own experience of a FUT procedure I had there two weeks back. I am 54 and have been losing hair since my 20's. I chose Transmed after reading this site for a month or two. I thought the logistical problems of getting to Istanbul etc. would be worth it as the costs would still be favourable. Having heard some negative reports of other doctors at Transmed, I insisted that I should be in the hands of Dr. Kulahci who was also recommended here, which they agreed to. They also kindly agreed to remove two small cysts for me at no extra cost. I must say I concur that the clinic itself looks very clean and modern, and that transport was always there to ferry me to and from the airport/hotel/clinic when necessary, though pick-up timings often had to change due to traffic and other problems. I briefly met Taner (?) who was affable but wasn't dealing with my particular case. My dealings were mostly with another rep, Ayla, who is obviously very busy juggling many patient/doctor schedules at any one time. However, maybe it was just me, but I felt my interactions with her were sometimes a little 'edgy' and I was not always happy when what I considered were legitimate doubts or concerns were met with what appeared to be impatience and tetchiness. Maybe it's a cultural thing but it wasn't what I am used to by way of customer care, and I didn't find it very reassuring at all. Anyway, about the op itself. I was not very nervous about the procedure until the morning of the op itself, but I soon relaxed once I was in the chair. A few pricks of the LA needle at the back were probably the worst of the pain, with some discomfort later as the LA wore off in the recipient area. The whole op took about 6 hours and I only found the last hour or so to be bothersome. I've never had one, but I think having a tattoo would probably hurt more. With Transmed being busy offering all kinds of cosmetic treatments, and with other sister clinics around the globe, I think Dr. Kulahci necessarily has to spread herself a little thinly. She always seemed to be very busy and though she was present at the beginning of the op to take the donor strip, staple the area and create the recipient incisions, I don't remember her being present for the final two hours of follicle transplantation, which she mainly left to the team of nurses. And there did seem to be some concern from them later on as they were hurredly spraying my scalp with saline (?) solution and following it up with blasts with a hair dryer. The next morning I noticed that dozens of the transplanted plugs, particularly in the central frontal area, were not seated flush with the scalp and were protruding 1mm-2mm. I raised this with Ayla and the doctor soon after the wash procedure later that day, but was made to feel a little foolish for doubting their expertise. Sort of 'We've done 16,000 of these so I think we know a little more than you!' I now wonder if this is normal and perhaps the thickness of the scalp at the donor area exceeds that of some areas of the recipient site, so a part of the graft will necesssarily protrude - any comments about that? The doctor herself did put me at ease a little by saying that a deeper transplant doesn't necessarily mean a more successful one and that I'll be much happier in a year's time when the full results are visible. She also pointed out two patients at the clinic who'd had transplants with Transmed, and they both seemed happy enough with their results, which looked fine to me. Perhaps my living 15 years in India has over-sensitised my phoney-detector instincts to the point where I unnecessarily distrust people! I will be more than happy to call myself an over-suspicious ignoramus if Transmed's confidence is well-founded and I eventually find myself with a reasonable head of hair. Anyway, I found that the tops of the protruding plugs dried and detached from the scalp and were washed away during the first week, leaving the underlying transplanted hair in place. Though I have been concerned to notice that quite a few of the transplanted hairs (possibly those from the protruding plugs?) have now begun to lie flat instead of vertical and have started to break off. They also don't seem to be detatching with a slightly bulbous base as a normal hair would, but just with a bend at the end. Hmmm, don't know what to make of that? All in all, I will have to reserve judgement until a year has passed, try and ignore my current leaning toward pessimism and hope and pray that the results will be reasonable. I have begun taking MSM powder and Biotin, have ordered whey protein and have already been taking Saw Palmetto, multivitamins, vitamins C, E and omega 3 oils for a long time. I will also rub olive oil (with garlic) into my scalp occasionally overnight and will use Nizoral shampoo twice weekly as well as restarting daily 2% (may up it to 5%) minoxidil after a few weeks. If that lot doesn't help - nothing will! I also had a cyst removal op at Transmed with Dr. Ali Kan, who performed the procedure with humility and finesse. The cyst was under my eye and he cleverly left the (very minor) scar following the course of an existing wrinkle, so it will eventually be almost undetectable (not that I'm particularly bothered - I wouldn't have minded having a scar to give myself a bit of 'street-cred' !) I believe he also does (FUE) HT procedures and, having had the cyst op with him, I feel I would have also been happy to undergo a HT with him. After I mentioned to Dr. Kulahci that not all the reports of doctors at Transmed were favourable, she did say she had trouble with a particular Dr. a few years back and had to sack him, and that she had full confidence in her current team. I have to say I have seen nothing to dispel that impression either, and I even wonder if I should have been happy to opt for one of the other docs who would presumably have been less time-stressed.