Upcoming surgery at Transmed with Dr Melike Kulahci

[lisco]

in preparing for a surgery at Transmed, I'd like to invite your comments and advice to make it if possible, a successful effort on my part.

I went to Transmed for an informal introduction in May and experienced a highly professional check up by a staff member called Taner who told me that I should get 2900 grafts using FUE. Also, I was acquainted with all the steps of the surgery, including a visit to the surgery room which made me feel comfortable and confident in Transmed (perhaps naively) and I shortly decided to do my surgery there. The only negative answer I was given related to availability of Dr Kulahci to attend the check-up and surgery due to a packed schedule, and will only be available at times during the surgery as a supervisor.

Having read the posts on the forum, primarily by Woody and Albion, I'd be keen to learn whether there is a way to secure the adequate punch size and would appreciate any other input or suggestions that may be of assistance. Likewise, do you think it's possible to extract 2900grafts in only one day and do it successfully, as Transmed claims to be routinely done in their daily practice.

many thanks!

P.S.

I'll post my pre and post-op.photos when I get home on Aug 18. Wish me luck!

[jessie1]

Lisco,

 

Whilst I am most certainly a well wisher, I must say that you are asking questions here that are typically asked during the research phase.

 

Are you having doubts about Transmed?

 

Dr Kulahci is recommended on this site, however it would be fair to say that there has been some blips of late within Transmed which can not necessarily be attributed to her.

 

In addition to the cases you have mentioned, see the thread by SalemSalem which effectively highlights two issues: the success of his HT and aftercare problems specifically with communication.

 

Salem may be a good source of information on a private basis. Salem was very keen to point out that his experience on the day was excellent, but for me personally its the resut and the aftercare that are the most important factors.

 

Lisco, from the uneasy tone of your post I'm really not sure what to make of it.

 

Its not uncommon to have second thoughts about going through with a HT on the build up to the big day, but you are raising some very important issues about punch size, aftercare concerns , accessibility to the Doc and sustainability of large graft extract sessions. These are issues that will no doubt attract a whole array of different opinions but I'm not sure how this advice will be put into practice given that the surgery is booked and you seem commited to going through.

 

In any event, please don't misconstrue my comments. I wish you all the very best. I'm just confused about your queries, which are all very valid.

 

I hope you receive the reassurance that you are after and have a fantastic experience,

 

Good luck,

 

Jessie

[Albion71]

I can only second Jessie's comments - the questions you are asking should really be asked well before you book surgery. Most people who have had successful HTs will have spent years undertaking painstaking research before taking the plunge.

 

As you've noted, my experience with Dr Kulahci was not a good one.

 

However, based on the research done by Bill and the panel, I think she is the only Transmed surgeon who has coalition membership. Be careful before going ahead with any other surgeon.

[lisco]

thanks you guys for the honesty and support - I guess I am just going through the usual hesitation prior to surgery asking myself whether I;ve done everything to prepare this well.

I failed to say I've gone through extensive research over the past years and having studied many websites, forums and experiences, and came to the point where I need to take action in order to make my daily functioning easier. I am confident that Transmed is the best choice for me at this point and remain hopeful that the surgery will be successful. The thing I'd greatly appreciate is a piece of advice on the questions I should ask immediately before surgery and thus ensure better results.

flying in the morning, talk to you soon

[Bill - Seemiller]

Lisco,

 

Thanks for sharing the details of your upcoming procedure with Dr. Kulahci. I agree that your concerns should be addressed prior to undergoing surgery. Thus, I recommend discusisng all of your questions and concerns with Dr. Kulahci prior to moving forward.

 

In my opinion, Dr. Kulahci performs state of the art ultra refined hair transplant surgery. The reality is, all surgeons have cases of less than optimal results. But Dr. Kulahci has a long history of standing behind her patients, even in the rarer event that things don't go as planned.

 

That said, I feel strongly that patients should discuss all their concerns, including the possible risks involved in hair transplant surgery and how problems are handled before they undergo surgery. That way, patients can feel more confident that they're in good hands.

 

I look forward to hearing more about your experience and viewing your photos.

 

Best wishes,

 

Bill

[SkinUpPinUp]

I'll agree that 2,900 FUE extractions in a single sitting is...ambitious.

 

I can only base this on - in my opinion - some of the best FUE surgeons in the world, namely Christian Bisanga and Ron and Paul Shapiro. For larger FUE numbers (around >1,600 grafts for Bisanga, possibly less for the Shapiro Medical Group), they will split it over two days to prevent any excess trauma to individual follicular units which may affect yield results.

 

That said, despite this, I trust Kaluhci to do a good job of it and prove me wrong. Only time will tell and I wish you the best of luck. Please keep us updated with your progress.

[Jeremiah]

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.

[hairthere]

Having viewd the OPs post pictures I;m highly suspect of the work done.The way the FUs are grouped just does not look natural. It appears to be stadium rows....

[TomCruise]

The photos concerned me too. I'm pulling for you Lisco but I'm worried about the placement and the size of the grafts.

[Jeremiah]

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!)

[Bill - Seemiller]

Lisco,

 

Thanks for creating albums on your social profile to share your pre-op and post-op photos. I do happen to share some of the same concerns as some of the above posters about the placement and size of the grafts. Dr. Kulahci's work typically looks more refined as you can see on the forum topic "Details of Surgery".

 

I will go ahead and contact TransMed and ask them to share their strategic plan regarding placement and graft size with the community.

 

Ultimately, what matters most of all is the results when they grow in. Thus, as we learn more about TransMed's plan for you by discussing it further, I encourage you not to lose heart and wait for the results to grow in before drawing any conclusions.

 

Best wishes,

 

Bill

[SkinUpPinUp]

Bill, please can you ensure that this is followed up by Transmed? Is this a genuine case from one of their patients or is this an elaborate hoax or attempt to besmirch the clinic - and surgeon's - name.

 

The two main questions here is whether this was genuinely done by Dr Kaluhci and, worse, whether we're actually looking at FUE at all here. This, to me, looks like micro-grafts and not follicular units that have been transplanted. I've not seen something like this in a long time, and was certainly not something I was expecting to see on the forum.

 

Lisco, you've been silent since putting these pictures up, we would like your side of the story on this as well. Please clarify on some of the questions and concerns that have been made so far. I don't mean to come across as accusatory, but your input would be appreciated.

Edited August 19, 2011 by SkinUpPinUp
Bad grammar

[Bill - Seemiller]

Guys,

 

I just sent an email to TransMed with a heads up regarding this topic and our concerns about the photos presented on Lisco's profile. In my opinion, these photos aren't indicative of the kind of ultra refined work I'm used to seeing from Dr. Kulahci and her experienced staff. Thus, I've asked her and/or one of her clinic representatives to post a reply on this topic and address the concerns.

 

According to Lisco's first post (before the procedure), Dr. Kulahci was not the surgeon performing the surgery. However, Lisco did claim that she was going to supervise. I've asked Dr. Kulahci and/or TransMed to view this topic and photos and post a public reply to this thread. But I also ask Lisco to provide us with more information about the procedure now that he's actually undergone surgery. Who performed the surgery? Are the incisions really that large or did Lisco bleed and scab a lot?

 

At the end of the day, it's the results that matter most. However, I am concerned that the post-op photos aren't the usual type of ultra refined work we're used to seeing from Dr. Kulahci and other members of the Coalition.

 

We're now going into the weekend, so I'm not sure if TransMed will get a chance to respond before then. However, I trust they'll respond as soon as they can. I'll certainly keep everyone updated with anything I find out in the meantime.

 

Best wishes,

 

Bill

[HARIRI]

Thats the problem when a clinic with a recommended Doc uses other standby doctors who arent recommended to do the job. When Dr. Kulahci is recommended in the forum, tit doesnt mean that her clinic is recommended overall.

 

So anybody going to Transmed make sure that Dr. Kulahci is the one who is going to perform and other standby Doc. Unless the other Doc is recommended as well such as H&W, TRUE & Dorin, Rom & Paul Shapiro...

[lisco]

Hey guys,

I was back on the forum only a few days after the op, after I came home and was quite taken aback with your reactions to post op pics as it doesn't seem to be very promising. Let me share my impressions abt the surgery with you and potentially get additional feedback and advice from you all.

Before and during the operation, all Transmed staff was most kind and professional, on top of the assistance for transfer to and from the airport, hotel arrangments etc. What also may be of interest is the announcement by the Transmed manager (I'll fwd the email exchange to Bill) that the planning and supervision during the surgery will be done by Dr Kulahci, however she was not present in the planning at all but only came in twice during the surgery for about 5 minutes each time, while the surgery was done by Dr Apayidin Ilker, second most experienced surgeon in Transmed. Dr Kulahci came after the surgery was over and told me that the results will be excellent.

Anyhow, Dr Ilker was fully professional and committeed during the surgery and explained. As noted in my first post on the forum, I asked him a few questions prior to surgery (what is survival rate for grafts in mega sessions, what will be the punch size, is medical tratment/regime needed after surgery to improve and boost results and of course, if it would look natural once it's grown). I was told that punch size would be 0.8mm, that the donor area is exellent and that Dr Ilker will take out ca. 3.000 grafts. Also, the expected results are going to be 100% nautral as Transmed applies state of the art techniques and that it would be helpful if after the operation I would take Propecia and Rogaine foam, especially if I am concerned about any side effects. Frankly, I was quite satisfied and reassured after the operation that all went well and that effects will be as desired, until I saw your comments and concerns which I greatly appreciate but find really upseting and would invite your advice on anything that can be done to make this endeavor worthwhile.

To go back to the surgery - after I was given answers to the initial questions, we started the surgery with a very dedicated team that paid attention to me feeling comfortable and going through the extraction process in a releaxed atmoshpere. Three hours later, I was told that they extracted 3.200grafts, most of them (2.250) with three and four hairs, 650grafts with two hairs and 300grafts with one hair. Following the extraction came the planning phase although Dr Kulahciwas not present but I had trust in Dr Ilker and remained confident that the surgery will go well even without her present in the planning. It was explained to me that 2.300grafts will be placed in the frontal area and 900grafts in vertex and should I wish for better results in the vertex, I am welcome to be back in a year for evaluation and adding grafts to the vertex area. According to this distribution, Dr Ilker made channels asking me kindly not to pose questions during cahnnel-making as he has to do the counting. Technicians who performed graft selection were most pleasant and told me that graft quality is excellent which only added to my confidence in final reuslts. In the afternoon 3-5 technicians were engaged in placing grafts into channels (technicians were changing every half an hour). My personal impression is that this segment of the surgery was done very carefully, whereby at the end of that stage Dr Kulahci came to supervise and seeing my situation, claimed that results will be outstanding and Dr Ilker fully agreed with her statement.

After the surgery was done, I had a short conversation with Transmed Manager Taner and Dr Ilker who provided me with a list of medications to use five days following the surgery and while in the pharmacy I also bought propecia supplies for the next six months. I left the clinic feeling most positive about the surgery and hopeful of its outcome. I don't know if I beld and scabbed alot although I didn't feel I did. However, since they used punch size 0.8 I'd expect that there was some bleeding as it would be the only explanation for graft size you saw on the post op pics.

After I came to the hotel, I posted the pics on my profile and when I saw them, it appeared to me that in the frontal area grafts are placed like in a stadium row (as you noted) but bearing in mind that I have some of "my own hair" in the frontal line, I still believe that the applied placement method might be appropriate. At the same time, vertex distribution was a bit of a surprise to me although I was told that I would need to refill the area in one-year's time and after seeing the results of the surgery aided by taking propecia. Still I was very happy because I passed the surgery and made the significant step from my perspective (Toppik is an amazing aid, but not good for gym and sports as you may know).

I really read alot over the past years and tried to bring myself up to date with modern trends in hair transplant techniques, but now it seems to me that I remained ignorant in spite of all my efforts to prepare well and make the right choice of the clinic/surgeons, should any such thing exist in transplant terms. Please don't get me wrong, but I have to admit that my enthusiasm about the surgery, clinic and positive outcomes was deeply shaken by the comments to my post op pics on the forum - while I'd like to maintain my belief that the results will be as expected, I look fwd to your continuing comments and constructive input to make my prospects better if possible.

 

I do appreciate all your comments and input and would be thankful for advice on anything I can do at this point to improve the effects and results. Also, you may rest assured that I am a real patient and that my case is truthful as my only motive for joining the forum and spending time to read and post is exactly to share my experience and concerns with all of you and learn from your experiences which I find helpful and informative.

 

Today is my fourth day after the surgery (a new ear has begun and I am taking the new count) and I will post fresh pics during the day today

 

Many thanks again!

Lisco

[SkinUpPinUp]

Lisco,

 

Firstly, I wouldn't panic just yet. Until you see the final results in 12-18 months time, it would be wrong to assume that it was a failure. So, for now, just remain positive, try to keep your stress levels down, look after the recipient and follow the post-op procedures to ensure the best yield possible. The advice they gave you regarding Propecia and Rogaine was certainly good advice, so following that is important. Particularly the former.

 

That said, if you could take picture closer up of the individual FUs, it might be able to give us a better idea of what is going on. To my eyes, they look like micrografts, not follicular units of 1-4 hairs. Everything they said (0.8mm punch, 1-4 hair FUs) sounds like a standard FUE procedure, but the appearance seems to indicate that something else is going on. I'm judging this by how dark the transplanted units are and the spacing between them. This looks particularly evident on the transplants on the crown.

 

Anyway, as I said, try to remain positive, follow post-op instructions, and keep us updated with photos and further developments. Hopefully Bill can get the clinic's side of things early next week.

[Albion71]

How common is this approach by some surgeons, whereby they have a 'supervising role' during the HT?

 

When I had my surgery at Transmed, Dr Kulahci removed the hair from my donor area, but only came in 2-3 times after that, with her assistants inserting the grafts into the recipient area. She just seemed to check what they were doing.

 

How common is this approach? From consultations I've had with all HT surgeons, I was always given the impression that the surgeon would do EVERYTHING. It was only when surgery started at Transmed, that I realised Dr Kulahci would not be doing the graft insertions.

 

It didn't strike me as an issue at the time. I assumed it was normal. But I ask the question wow because I'm still trying to establish what went wrong in my own HT, and wonder whether this could have been a factor.

 

It may also be an issue for Lisco by the sound of it.

[SkinUpPinUp]

How common is this approach? From consultations I've had with all HT surgeons, I was always given the impression that the surgeon would do EVERYTHING. It was only when surgery started at Transmed, that I realised Dr Kulahci would not be doing the graft insertions.

 

 

Don't worry, this is commonplace. The surgeon will generally punch the donor or cut a strip and make incisions in the recipient. The technicians will separate out the individual follicular units and place them into the incisions made by the surgeon.

 

If the surgeon did EVERYTHING, surgery would take a lot longer, cost more and not necessarily yield a better result, possibly even worse as FUs would have to spend more time out of the head and thus face greater trauma.

 

That said, every surgeon should communicate this very clearly to all prospective patients before surgery to avoid confusion or distress.

[Bill - Seemiller]

Lisco,

 

Thanks for providing us with a detailed account of your experience. I'm sorry if the above comments shook your confidence in the procedure and results yet to come. However, I agree with others that there's no reason to panic at this early stage. At the end of the day, the results are what matter most. But I would like to garner TransMed's input on this topic given the size of the grafts appear somewhat larger and there's been some question about placement. It's quite possible however, that graft size and placement given your natural hair pattern is normal and that what appears to be larger grafts, could simply be larger scabs. Larger and/or excessive scabbing can occur in patients who bleed more during the procedure.

 

I hope you'll continue to post updated photos showing your progress, especially photos of the grafts before they shed but after some of the scabbing has dissipated. This will give us a better idea of the size and placement of the grafts.

 

Best wishes in getting the results you want and deserve,

 

Bill

[hairthere]

Lisco, Generally speaking, I try to be an optimist on this forum. That being said, I also try to be as honest as possible. I have seen plenty of post-op work and I can say that the work done on you does not appear to be proper, ultra-refined HT work. I also am not sure I get why it swoops the way it does. Was this intentional as part of a styling plan for you? Then there is the question of the graft size. They appear quite large, and even if they are scabs, large scabs can sometimes indicate large grafts. They are also spaced quite far apart and you did not have that much native hair to account for filling in-between the gaps.

 

I would really like for the clinic to come onto this forum and explain the approach behind your hair restoration. The good news is that if the growth you get is not satisfactory it can always be fixed, so don't despair too much. Many of us, myself included, have had repair work done and it worked out wonderfully. Hopefully this is not necessary for you, though...

Edited August 23, 2011 by hairthere

[bonkerstonker]

Lisco i hate to be so frank but there's been a robbery here for definite! The work looks like a absolute novice job i don't care if god is supervising the work is only as good as the person doing it, i find it very hard to believe it was done with a .8 puch i'd say over 1mm for definite and how the slits were lined up is really bad. On the good side you do have existing hair to hide the doll hair effect if it grows like that which i suspect it will. I'm really sorry pal but i see no sense in blowing smoke up your ass.

[SkinUpPinUp]

Lisco, is there any way you can post some pictures of the donor area? A good look at this area, plus a close look at the follicular 'units' in the crown should give us some idea of what we're dealing with.

 

Again, I suspect that this is mini/micro-grafting which is pretty shocking to see on a forum dedicated to quality HT work in 2011. Even worse that a recommended physician was supervising it.

 

That said, I would still try to remain positive and let the grafts heal and grow. If we can get those pictures from you and Bill can get a response out of Transmed, we will have some solid information to build on.

[jessie1]

Lisco,

 

Plenty of comments here which shows that please are supporting you and trying to work out what's happening.

 

I too have seen your pics and admitedly, I have not seen anything like this before, however as I am always keen to express, there are far more experienced members on here than me , who perhaps have seen similar cases, and will offer you some sensible and encouraging advice.

SkinupPinUp is one of them. I have followed some of his posts and he knows his stuff. There are dozens of others that have clearly done their homework too.

 

OK, I will reiterate what other forum members have touched on: support. The days and weeks following a HT can be difficult, especially if concerns exist about the way in which it has been conducted. This is the number one priority right now and this should not be overlooked. Although people have come forward with genuine concern and explanations, your head must be a complete shed Lisco. Been there.....

 

Open up, talk to people that you trust. I would also be making early contact with Transmed. I have nothing against Transmed, in fact I know very little of them , however it would be fair to say that there have been a few concerning cases of late which have involved communication issues amongst other things. Be mindful of this and record everything.

 

Lisco, let things settle for a few weeks and try not to over speculate: easier said than done I know. If you need to talk, even to release some thoughts, PM me. I have received 3 poor HTs and I know all too well the emotional journey mate. Hey, and remember, plenty of support to help you along the way with Transmed should you need it.

 

Bill has been particularly helpful in resolving some of the recent Transmed cases.

 

All the best,

 

Jess

[HairToday72]

Lisco, i dont completely agree with the slamming your hts got on here.

 

Yes, your immediate post op pics look shocking as all post op pics normally do. Your 4 day post op pics look a lot better to me. The donor looks consistent with a recent fue procedure, nothing unusual there.

 

On the close ups it looks like the grafts have been placed evenly inbetween native hair, and if youve got a good number of 2s,3s and 4s then i dont think you'll have anything to worry about.

 

The pattern of placement on the crown looks like the surgeon has tried to create a swirl pattern, the grafts look widely placed but again close up you can see much of the grafts have been placed inbetween native hair. if you have nice thick hair and a good hair count per graft this may well turn out ok for you - remember its all about the illusion of having hair when it grows in.

 

Keep your chin up mate and think positive, look after your grafts etc. I dont really care if I get slated for saying this to you but dont let anyone tell you your ht hasnt been a success only a few days after surgery.

Best wishes.

Edited August 22, 2011 by HairToday72

[jessie1]

Hairtoday72,

 

I agree. I think a bit of a cooling off period is warranted. If things are causing Lisco some concerns in a couple of weeks after things have settled, sure, lets try and work through it with him.

 

Why should you get slammed for saying that, I feel it's sensible advice.

 

For now the key message should be 'Chin Up'...... Talking to somebody about any probs is srtongly advised as I mentioned above.

 

Jessie