Did anyone elses grafts protrude?

[Jeremiah]

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.

[Sparky]

Is there still proud lump of skin where each folicle was planted or not, if your just talking about the white blobs on each transplanted graft after the ht, that's pretty normal.

[Jeremiah]

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.

[mattj]

It's hard to know at this stage what it'll mean for you in terms of growth. It's always good to remember that it's too early to predict how the final result will turn out from looking at yourself at only 3 months. Things still tend to be very patchy at this point. Although if there is an area where growth is definitely lower and this corresponds to the area that caused your initial concern then it seems unlikely to be coincidental.

 

If the grafts were poorly planted then they could still grow. It's possible that the skin will appear raised in bumps at each graft site. Is there any evidence of this? It will only appear if the grafts weren't dislodged and are growing. (because the skin won't heal into a bump where grafts were lost). Of course if there are no such bumps then that doesn't necessarily mean that no grafts will grow from that region. It's just a possible outcome.

[Jeremiah]

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.

[Sparky]

What you are explaining is normal, there are often little white bits of tissue showing on each graft after surgery, as long as they came off leaving your scalp flat your fine, i've seen hundreds of photos of peoples heads with exactly what your explaining, including my own. All of these from top notch docs too!

 

Example attached, let me know if this is what you mean?

[Jeremiah]

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.

Edited August 23, 2011 by Jeremiah
Clarity and balance

[Sparky]

Yeah they dried up and fell of in about that time period, they mostly came off in the shower.

 

You can find negative threads and posts about most of the doctors really, but I also would be annoyed if they were being off hand on the day and not giving me the care that you deserve and have paid good money for.

[Jeremiah]

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.

Edited August 23, 2011 by Jeremiah

[Sparky]

Yeah, I couldn't care less how I was treated on the day if my hair looked awesome in the end.

 

Don't worry about the grafts protruding though, didn't cause an issue for me or any of the other forum members, it's normal. Sometimes it can cause bumps in the recipient, but you would see those now.