My HT at Transmed Istanbul

[Jeremiah]

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.

Edited June 7, 2011 by Jeremiah

[TakingThePlunge]

Jeremiah,

 

Thank you for taking the time to share your experience and post your insightful observations. I'm sorry to hear about the minor customer service issues but I'm confident that Dr. Kulahci and her experienced team practice the finest hair transplant techniques available.

 

I hope you will continue to update us on your progress and I wish you the best of luck!

 

Happy growing!

[Jeremiah]

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.

[TakingThePlunge]

Jeremiah,

 

It's always been my understanding that grafts were placed flush with the scalp. I believe this is more to avoid pitting or cobblestoning than blood supply issues. However, I'm inclined to trust Dr. Kulahci's skill and judgement.

 

As with any hair transplant, it's a wait and see game at this point. Please continue to update us on your progress.

 

Good luck!

[Jeremiah]

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!

[Dutch]

Hearing that they rushed you is alarming & no surgeon should ever have the audacity to think or she is too big for criticism & always correct & they don't need to explain. This patronising tone is unacceptable.

I really hope you end up with a good result & it's a success. Looking forward to seeing your pics

[Albion71]

Hi Jeremiah.

 

I hope your HT with Transmed proves more successful than mine.

 

Since establishing that my operation has been a failure, I've been re-assessing my patient experience at the clinic. What you say about the operation seeming rushed chimes with what I remember.

 

Similarly, Dr Kulahci was not present for much of my operation, which is worrying.

 

How common is it for surgeons to use helpers to insert the grafts? This is surely the most crucial part of the operation, and if it is rushed and not supervised by the person with the right expertise, that is very worrying.

[Jeremiah]

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.

[Albion71]

Hi Jeremiah.

 

I've been on finasteride for 12 years, tried minoxidil for a year about four years ago but it had limited impact and I didn't like the side effects.

 

Good luck with your regrowth.

[MRA13]

As part of my research I was advised by one clinic (coalition member) to start taking propecia immediately (this was back in May 2011) and then have surgery in 6 months once hairloss has hopefully stabilised. Am 3 months in to regaine extra strength foam use and seems to be going ok although still early to say.

 

Having just read Albion71s blog and also Jeremiah's experience I am swaying away from considering my quote from Transmed and focusing on other clinics for my potential surgery later in the year. Good luck Jeremiah with your outcome and will keep a look out for your updates if you decide to post any.

[Albion71]

MRA13 - not sure your situation, but some people do respond very well to finasteride, and after a year on the drug, they have sufficient regrowth to be happy. You might want to wait longer than six months if you see promising early signs.

[MRA13]

MRA13 - not sure your situation, but some people do respond very well to finasteride, and after a year on the drug, they have sufficient regrowth to be happy. You might want to wait longer than six months if you see promising early signs.

 

Thanks Albion71, its an excellent point you raise and only yesterday Mick from Farjo actually advised I wait a year based on my pictures and should I see significant improvement that that might reduce the amount of or even proclude the need for surgery. This follows on from Dr Wong who initially said to review after 6 months propecia use (he advised I start taking it via David their UK consultant). I am happy to stick tight for now and less anxious about having a HT immediately. Good luck and safe journey to Transmed.