LordBaldwin

Month 1 I experienced significantly heavier shedding since my last update, and it only let up around yesterday; my hair's quite a bit thinner now in the recipient area.

Alright, so based on a conversation I had with the clinic where I had my procedure, plus a bunch of internet research, it seems that a newly transplanted hair pushing out of the head about 4 mm and then shedding is not necessarily indicative of graft survival, as the follicle might not go into anagen again (and this is true for up to 10% of the grafts, even with perfect extraction and implantation). I've noticed that my transplanted hair, which has mostly shed, is all about 4-7 mm long, which seems to corroborate the idea that this isn't new growing hair, but rather the part of the hair that was beneath the scalp pushing upward as the follicles go into the catagen and telogen stages.

This is already a really good result...so you're most likely on your way to a great one.

Thank you! Yeah, I'm pretty happy with the hairline so far. Yours looks pretty great, too. Hmm, well, I was at the clinic in the morning on the 18th for my first wash, though I didn't come back for one of their dinners until the 19th. Not sure if we saw each other there. Yeah, I've seen your thread and your results look great! I'm sure you'll get a great result this time too. On my end, I'll be updating regularly.

Thanks. Yeah, the shedding's been slow so far, but continuous, so I expect the hair to thin out a bit over the next couple of weeks. Hopefully you're right, though, that I'm a fast grower.

I did read your post, and that statement is logically meaningless. From a certain perspective (like if we looked at every patient's head with a microscope), 100% could be considered "failures." Again, with every procedure and every surgeon, there is a distribution curve. Some people have poor results, some people have great results, and the majority of people lie somewhere in the middle (in this case, somewhere between "good" and "great"). Do you think any surgeon would come online and say "yeah, my practice sometimes has poor results, too?" Of course not. That would be bad for business. But then again, they'd be right about *usual* (i.e., common) causes of poor results. Usual causes...not the only causes. Yes, the patient has a responsibility to tell the doctor what he/she wants. If a woman went for a breast augmentation surgery, told the doctor to do whatever, and then got mad because he gave her DDs and they were too big, she shares some responsibility for not telling him what she wanted. I'm done responding on this thread. It's clear that you're not able to be objective or reasonable about this. I've given my 2 cents.

Do you seriously think any surgeon has 100% great results? This is delusional and clearly not the case. No surgeon on earth has a 100% success rate, no matter how skilled they are. Also, a mediocre result isn't a "failure," nor is it a success. It's partial progress on a hair restoration journey. Is it the desirable outcome? Of course not, but you keep throwing around the word "failure" like you had Sanjar41's result. Some people don't assimilate their grafts properly. It's a medical fact. That being said, my point was only that you were drawing conclusions without any supporting evidence. You don't know that it was because of the technicians; it could have been one or several of any number of factors, including your own physiological response. To compare this, flippantly, to elves stealing your grafts is ridiculous. Regarding the hairline, it is your hair on your head. Therefore, you always have a say. It isn't about "overruling a decision;" it's about working with the doctor to produce a shape that you like, since you're ultimately the one who needs to be happy with it. Also, where are you getting 25% failure from? You just made that number up.

I've tried to hold my tongue on this thread, as it seems to have devolved into a hysterical, hand-wringing, anti-Erdogan frenzy that I didn't want to indulge. However, the claims on here that no one has gotten good results out of ASMED recently are flat out dishonest. While I didn't originally want to name names, I felt I needed to do so in order to make a credible point to those who are lurking here (including newbies) who may be influenced by what's been said, about the clear distortions that have been made on this thread. For great results from ASMED in this forum from surgeries that were performed since the end of 2016 (i.e., no touchup was necessary, whether or not the individual decided to take another pass anyway), look at Alexmczane26575, DEB1982, JeanLDD, Jammerz, Vchorro, Sk78, Artofeden, HG1, Vainism, and Ediee. For good results since the end of 2016 (i.e., there was a major cosmedic improvement the first time around but a minor touchup was needed to achieve a perfect result), see Jonyny (who says he is happy now), Pancake, Shuriken, Nathd911, HairDew (who specifically says he is very happy with his hair), Bloodshoteyes, Handski, Ponchik, Scotty9107, Hamburger, and JustJax. Only five people -- you, Webhandler, Planetstephen, Boulderbalder, and Rwethereyet, showed results that could be considered "mediocre" (i.e., they need another procedure of comparable magnitude to the first to achieve the optimal result, by their own account). I did not include HT0416 because his surgery was over two years ago (in other words, outside the timeframe in contention). That means, in this forum alone, and at the time I did my analysis in the beginning of December, there were 10 great results since the end of 2016, 11 good results, and 5 that were "mediocre." So let's do the math here....21/26 = 81% good or great and 5/26 = 19% that were mediocre. None were poor (poor being defined as the hair looking the same or worse than it did before surgery). For a good example of what "poor" looks like, see Sanjar41 and Sufferer12, who went to a clinic in Colorado and had truly awful results, by their own account. When combining results from the French and Italian forums with those of this forum, the results were essentially the same -- 48% great, 33% good, 19% mediocre, and 0% poor (so, doing the math, 81% good to great) -- but with a much larger and more statistically significant sample size. In this forum, it also looks like grantleebuffalo and cali101 will soon be in one of the top two tiers (although I had initially rated them as inconclusive, as their procedures were 5 months ago or less when I did my analysis); we can also add Panos1982 to the ranks of "great" as well. I hadn't included Panos in my initial analysis since his post was put up afterwards. I understand you're upset, as the numbers above would be of no solace to someone who is in the unfortunate minority. However, you clearly are in a very vocal minority of dissatisfied patients. Furthermore, there is plenty of evidence that the clinic reached out to those that were dissatisfied to try to help those patients. Planetstephen is going back for a touch-up this month. HT0416 was offered a repair but declined. You have openly stated you won't go back there, and you're not even at 10 months post-op (when everyone repeatedly told you you need to wait 12-18 months), so what exactly do you expect from them? The clinic says they offer a 90% regrowth guarantee, which means you wouldn't pay a cent if you got a yield lower than that. As far as the technicians are concerned, you make a lot of assumptions about their level of experience and the idea that it was their involvement that led to your mediocre results. You have no idea what caused your results. Your fever on the first night may have been your body rejecting your grafts, for all you know, but you chose to assume that it was the technicians' fault. You have no evidence of this. You make several claims that you were misled about the surgeon's degree of participation in the surgery. Nowhere on the ASMED website, or anywhere else, does Dr. Erdogan claim to carry out the entire procedure himself. Once again, you made an assumption which could have been easily clarified with simple research or questions posed to your coordinator. I asked my coordinator these questions prior to my surgery and she explained every aspect of the process to me, in detail. You weren't mislead....you just didn't ask questions and made unsafe assumptions about what the experience would be like. Finally, with respect to HT0416's hairline shape....buddy, you really need to take some responsibility for this. Why didn't you ask Dr. Erdogan to change the hairline before surgery began if you didn't like it? I asked the doctor like 3 different times to modify my hairline before I gave them the go-ahead to proceed, and he was happy to make the adjustments for me each time. You are responsible for taking an active role in your own hairline design. Don't just leave it up to the doctor to make that determination and then whine about it later, when you had ample opportunity to make a change.

Day 21: There's been some gradual, moderate shedding since day 16, but, thus far, there hasn't been a single intense shed.

Do you recall if there was any hair transplanted in those gaps originally? Do you have pics from the immediate post-op period showing whether or not there were hairs placed there?

At 16 days, and with a bunch of hair suddenly shedding, I can safely say I've begun my descent into the Ugly Duckling Phase. 😬

Ok, so let's say, hypothetically, that a graft did not survive after it was transplanted. Are we saying, then, that it would go through the same catogen/telogen phases of pushing the hair upward that it would if it survived?

I wouldn't worry, dude. According to the timeline the clinic provides (as well as other sources), growth doesn't even usually *start* until around month 3. As far as the negative reviews are concerned, it's a very small percentage of cases...two guys, in particular, have been very loud on here, but they don't even come close to representing the majority.

Thanks. So far, I agree. I'm kind of dreading the "great shed," but if I get a final yield that looks anything like this, I think I'll be in pretty good shape.

Day 14

Hmmm...is it known how much they "move up" during the catagen phase (like 4mm, 6mm, etc.)? From what I've found, the base of the follicles are about 4 mm beneath the surface of the scalp, on average...so I'm assuming they could move upward that amount.

Ah, whoops. I'm 30.

Thanks! I plan to update fairly regularly.

I just had my FUE transplant 12 days ago and was curious about graft survival. Is there a way to know if your grafts survived before the regrowth that starts around month 3? For example, if the hairs that were transplanted grow well for the first few weeks following the transplant, is it relatively safe to assume they'll grow back again after they shed, or is there no correlation between early growth and regrowth later on?

Alright....looks like it's my turn at the plate. Since I'd used this forum quite a bit when making decisions concerning my hair restoration surgery, I thought I'd share my experience with the community to help others make their decisions as well. My FUE procedure with ASMED was performed 11 days ago (December 17, 2018) and I had 3051 grafts transplanted. My progress and thoughts are described below. Online Quote I submitted my request for a quote on ASMED's website. This was a pretty simple process involving the submission of 12 photos (6 wet, 6 dry) from various angles and the submission of answers, on the website, to certain questions related to my hair loss, hair restoration goals, and medical history. Within a day, I received an email assigning me my patient coordinator. The following, day, I received an estimate for the total graft count I'd likely need, as well as the expected duration (in days) of the surgery and the amount of time I'd need to spend in Istanbul. A rough sketch of the surgical plan was provided, as well as a brief synopsis of what the surgery would entail, as well as the price per graft (2.5 euros) and information about the regrowth warranty. For those who have not done this yet, I'd recommend using a flash when you take your pictures. I didn't use a flash with mine (I used indirect natural light) and ended up getting under-quoted, as the extent of my hair loss at the vertex wasn't completely apparent in the images I had provided. Why I Chose ASMED I did a lot of research prior to making my decision. Out of all the reputable doctors I found (ones who were endorsed by the IAHRS, American Hair Loss Association, and this forum), Dr. Koray had the most patient results posted online, both by the clinic and by the patients, themselves. I had done an analysis of these results on one of the other threads by scanning through three of the online forums, including this one, and found that there was at least an 81% chance of having a good to great result, which was sufficient for me. There weren't really enough reviews of the other doctors to analyze them in a similar way with statistical significance. When combined with the cost of the procedure (which was relatively low compared to other top-tier clinics), dates of availability that aligned with my own, the 90% regrowth guarantee, ASMED's generally good reputation, etc., this clinic seemed like the best match for me. Coordination Prior to Trip While I waited for a few months between the submission of my deposit and my travel date, I peppered my coordinator (Muge) with questions about the process and procedure. For example, I asked her about: Methods of payment (including exchange rates, whether I could bring USD for the cash portion of my payment, etc.). You make an initial deposit in euros (maximum of 3500 euros) and then the remainder of the balance is paid in cash upon arrival at the clinic, on the consultation day. I was allowed to bring USD. To be honest, I wasn't very happy about having to carry thousands of dollars of cash with me (since I was kind of paranoid about losing it or being robbed), but, thankfully, I didn't end up having any issues. Information about my personal safety and the drivers. ASMED provides a photograph of their drivers, who pick you up at the airport, drive you to the hotel/clinic. All transportation to/from the airport and to/from the clinic is handled by ASMED. Information about accommodations. You're given the choice to stay at the Radisson Blu Istanbul Asia or at the clinic itself. I opted for the former, as the rooms at the clinic, as nice as they were, looked/felt a bit too much like hospital rooms. Also, I liked the 24 hour room service available at the hotel and the option to eat in solitude, if I so chose. If you choose to stay at the clinic, however, they provide you free meals throughout the day (you only get breakfast included if you stay at the hotel). Details about who would be performing the various aspects of the surgery, which was a point of contention on these forums. Dr. Koray performs the consultation, draws the hairline, and does the incisions during the surgery. Techs to the extraction and implantations. I discussed this at length with my coordinator and had a thorough understanding of how this would work long before I traveled; by the time I made the trip, I was comfortable with this arrangement. From what I was told, all technicians are required to meet specific, rigorous requirements (certain number of years practicing with the clinic, quality certification, etc.) before they are allowed to take part in the surgery. My coordinator was responsive, quick, and went out of her way to allay any of the concerns I had. She responded to me by email, phone (on the rare occasion when texting wouldn't be sufficient), and WhatsApp texting. Flights, Transportation, and Hotel I'm not going to go into detail about the flights, as that whole process is pretty straightforward and not really relevant to the clinic itself. Given that I'm from the US, I did need to get a travel visa to enter Turkey (you can do this online in advance and it costs about 20 USD). As expected, my driver was waiting for me in the airport arrivals area. He was holding a tablet with my name on it. The ride from the airport to the hotel was about 45 minutes (you cross from the European side of Istanbul to the Asian side) and I was the only passenger. The driver was friendly and responsive to my requests; he even described some parts of the city to me, as if he were giving a tour, during the drive. Additionally, water bottles and snacks were available inside the car. I opted to stay in the hotel for the reasons previously described. The room is comfortable and clean and there's a nice view of Istanbul if you're on one of the higher floors. Moreover, the hotel has 24 hour room service and a reasonably diverse menu -- this was a big selling point for me, as I was a bit self conscious about leaving the room with my head all marked up before the surgery and bandaged up after surgery. The employees at the front desk speak English, though the room service bellhops sometimes don't (IMO, they didn't really need to). The hotel has a spa and other pretty cool amenities, though I'll admit I didn't take advantage of many of them. In-Person Consultation On consultation day (the Friday before the procedure), I was driven to the clinic in the early afternoon. I was promptly greeted in the lobby by my coordinator, as well as a host who asked if I needed a drink or a snack (she did this repeatedly throughout the day). Two girls in the lobby serenaded the waiting patients with piano and violin. The atmosphere was light and relaxing. There were several other patients in the lobby at the same time, taking a break from various stages of the consultation. My coordinator sat down with me and gave me an overview of what I should be expecting that day, as well as on surgery day. After we discussed certain questions I had, she led me to various rooms for different stages of the pre-operative process, including a blood test and EKG, photographs, head shaving, etc. These activities were generally smooth and quick, though I had one small criticism -- specifically, that I had to wait for a while in the lobby for Dr. Koray to finish surgery before my in-person consultation. I was really jetlagged and tired at the time and it would've been better if I didn't have to wait nearly as long between the tests and the consultation with the doctor (like if they had timed me to come later in the afternoon). Other than this, everything was pleasant. When I met with Dr. Koray in his office, he greeted me warmly and introduced me to some of the other senior staff members. He came across as affable, jovial, and welcoming. As I introduced myself, he cracked a joke about the trend line from my analysis on this forum; at first, I was a bit taken aback that he knew I was the author, since I never actually identified myself (but I guess there weren't many American patients coming at the same time as I was). I sat down and Dr. Koray showed me the photographs taken earlier that day on his monitor. I showed him my own printed photos of what I wanted to look like (images of me from about 5 years ago), as well as pictures of my bald grandfather as an illustration of family history. Dy. Koray explained that we could meet my goal, but that I was, unfortunately, on my way to a NW6 (I'm currently NW3). He went on to explain that the degree of surgical intervention required would likely be higher than originally expected. As mentioned above, the photos taken at the clinic revealed noticeable thinning at the crown/vertex that wasn't nearly as apparent in the images that I had taken at home. The doctor recommended that I take finasteride in order to avoid having to come back to have the vertex worked in the near future (I was only quoted for a one day surgery on the frontal part of my head) and I explained to him the negative experience (i.e., side effects) that I'd experienced with finasteride years ago. He said he understood and that he respected my position, given that I'd tried it already in the past. I ultimately decided that I prefer to avoid finasteride (given what happened the first time I used it) and might come back to Turkey for a second round later, if necessary. I'll deal with the vertex when the time comes; this way, I'll have a chance to see how the results on the front part of my head turn out before I make any more decisions. At this point, the doctor took measurements of my hair and explained the calculation he uses to determine coverage. He then drew a hairline and asked for my thoughts. I was a bit picky with the hairline and requested several tweaks (including one small modification on the morning of the surgery) so that the line would match the natural one I used to have as closely as possible/reasonable. The doctor was patient with me and made the changes I asked for. After we were finished, and as I was getting up to leave his office, Dr. Koray turned to me and said something to the effect of "LordBaldwin, I can tell you care a lot about details, and so do I. I won't disappoint you." He went out of his way to reassure me; it seemed like he cares a great deal about making his patients happy. Surgery On surgery day, I was driven to the clinic early in the morning. I was taken to a small locker room to change into a surgical gown and was then led to the surgical room. The entire surgical area was very clean and organized (as an example, my coordinator had me change into a different set of shoes that they provided me as I entered into the "clean area"). In the surgical room, the team gave me a blanket and checked that I was comfortable. The anaesthesiologist asked me if I was nervous and I told him that my heart rate (which was showing on one of the monitors as around 90 bpm) is usually around 70 bpm. He nodded and injected me with a benzodiazepene and a sedative. I almost immediately relaxed. I sat upright with a head support wedged between my chin and my lap as the technicians injected my scalp with local anaesthetic and began the extraction phase. As they proceeded, they were very professional and repeatedly asked me if I felt any pain (if I did, they'd give me some more local anaesthetic). As grafts were removed from the donor area of my scalp, one of the technicians observed them under a microscope and counted, in real time, how many singles, doubles, triples, etc. had been extracted. These numbers were displayed on a screen in front of me. My coordinator handed me a tablet in case I wanted to surf the web or watch a movie. If I recall correctly, extractions took about 3 hours. We took a break for lunch, which the clinic provided. Upon returning to the operating room, I was told I could lie down for the remainder of the surgery. I was hooked back into the IV and Dr. Koray came in to do the incisions. I don't remember exactly how long the incision phase took since I was sedated and kept drifting in and out of sleep, but I do remember Dr. Koray working on me for some time, then shaking my hand at the end and mentioning that my circulation was very good and I'll be very happy with how things turn out. I slept through most of the implantation phase as well, up until the last hour or so. The technicians were methodical and quiet, and my coordinator, who sat across from me, assured me that everything was going well and repeatedly asked how I was doing. In total, the procedure took about 9 hours. After it was over, I was led back down to the photography room for post-operative photos to be taken. I was given instructions on how to do the post-op washes, sat under a laser/light follicular stimulation pod for a little while, and then was invited to dinner at the clinic (invitations for dinner at the clinic were extended to me every night I was in Istanbul, except for the weekend). Although I was only required to stay until the next day for the first wash, I opted to stay for an additional two days to recover a bit before I traveled back to the US. In the morning on each of the additional two days, I was driven back to the clinic for my morning wash (and some tea). Overall Impression Overall, I'm very happy with my experience at ASMED and would recommend it to other prospective patients (provided that they've done their due diligence and understand how surgeries are performed there). Since I had prepared extensively for my trip, I knew pretty much exactly what I was going to experience and there were no surprises. All of the employees were very accommodating, friendly, and attentive, and I felt well taken care of. The clinic itself was large, clean, and modern (ASMED had clearly spared no expense). A couple of other little pluses I noted: - On one occasion, I asked if the clinic had Turkish coffee (I wanted to try this since I didn't really get the chance to explore Istanbul while I was there). They didn't have it at that moment, but they actually went out and got it for me the following day! This was a relatively minor thing, but it impressed me. - On the last day I was there (when I came to the clinic for my third wash), Dr. Koray came into the room and asked me about my experience, making sure that it was positive. I told him I had enjoyed my time there, which he was happy to hear. The fact that he cared so much about my experience struck me very positively. Progress First, some hair characteristics... Hair thickness: 55 microns Hair per graft: ~2.44 Donor capacity prior to surgery: 8400 grafts Number of grafts transplanted: 3051 over 60 cm^2 Transplanted graft density: ~50 grafts/cm^2 And now, some pictures. Pre-Operative: Surgical Plan: Immediate Post-Operative (Day 0): Day 2 Post-Op: Day 3 (swelling is mostly gone): Day 5 (scabs and some minor cracking visible): Day 7 (vast majority of the scabs have come off): Day 10:

I'd be interested to hear where you heard this.

I think you chance it anytime you have a surgery with any surgeon. Have you been to this clinic yourself? Also, doesn't hair direction gradually change as a result of how it's styled over time? Can't really comment on the first part of this, as I've never heard it before. As far as the pricing is concerned...um...would you say the same about Konior, who charges like 8 USD per graft?

I appreciate the well wishes.

First of all, I don't think that's what my post showed. If you're referring to the scatter plot and trend line I included... it only covers the last two years (as did the entire post). Second, if you look at where the line actually goes (and assume it continues over the long term), the expected result is still between good and great where the data stops on the X-axis (around April/May 2018), albeit closer to "good" and further from "great" than it was 2 years ago. Third, I think it's possible that there was an X-factor sometime in the second half of 2017 that may have caused some of the negative results that influenced the trend line; I don't presume to know what it was, nor do I assume that it still exists today. This clinic has a very long track record and one iffy 6-month period isn't necessarily indicative of a long term worsening of quality.

Understood, but I think prospective patients should probably do their homework before they go in for a surgery. There aren't many of them. Also, those who are complaining tend to get emotional about their situation and exaggerate (saying that they were "botched" or a "failure" instead of acknowledging that there's been at least some improvement and that they're disappointed because reality didn't meet their expectations). Additionally, as far as the shape of the hairline is concerned....from what I've read, patients are asked if they approve of the proposed hairline and have the option to request a change. When I go, I'll be bringing pictures of what I used to look like so that the doctor and I can use them as reference for what a natural hairline on my head looks like. According to whom? Aren't hairs supposed to grow vertically? From what I've seen, this isn't what's happening. The mods seem to jump in when a patient starts complaining about their own results on someone else's thread (the moderators didn't shut down these individuals' original progress threads). For example: Person A creates a thread and says they're not currently happy with their growth. Person B then comes on Person A's thread and says "Yeah, your result sucks! So does mine! A lot of people are saying theirs suck too! This must be because of clinic negligence!" There are a lot of things wrong with this kind of post -- first, it draws attention away from Person A's result and experience. Second, Person B is judging Person A's result with a bias caused by his own bad result. Third, it draws overgeneralized conclusions about the clinic without providing evidence and leads to a bandwagon effect for the minority of dissatisfied patients. This gives the impression that there are more unhappy patients than there actually are. As far as the "agenda" is concerned, here's an explanation. The patient does not have an agenda when they first go to the clinic. However, once they decide that they've had an unsatisfactory result, they get very upset about it and choose to channel their anger toward the clinic by attacking its reputation on other threads.