Dr. Koray Erdogan, Asmed - 3200 grafts in hairline and midscalp, december 2014

[Astaldo]

Dear members of the forum,

 

 

in this thread I will present my 3200 grafts FUE procedure with Asmed clinic. I was in Istanbul from 16th to 20th december 2014, and my surgery took place between 18th and 19th of december (during two days).

 

 

INTRODUCTION

 

 

I'm 28 years old, and this was not my first HT. I had FUE surgery of approximately 2500 grafts (my previous surgeon didn't inform me of my graft count or provided direct post-op pictures) when I was 26, in december 2012. Needless to say, I wasn't very satisfied with the outcome of my first surgery. Although I did some research, I rushed into it. I was using 5% minoxidile several years prior to the first surgery, and it seemed to me that it lost its effect in my case because I noticed my hairloss got worse during 2012. In that time, I was avoiding finasteride, fearing the possibility of getting side effects described by some of its users.

Also, I was unrealistic and did not properly evaluated the grade of my hairloss (thought in that time that I was solid NW 3V, in reality I was going toward NW 4, with a bit of thinning over frontal forelock and middle scalp), and although my surgeon (not recommended in HRN) noticed that I have lot of thinned hair, she did not specified that I would surely need follow-up surgery. My first surgery was partial success. Grafts were implanted from hairline to vertex all over the scalp, and did not provide much coverage and density. Moreover, regrowth was slow and not completely succesful, especially in the temples and frontal third, leaving me with very thin and see-through hairline. I must say that they at least did a good job in my donor area, and did not depleted or scarred it much. I was also dissapointed with the lack of communication and replies from my former clinic, so I decided to try to finish the procedure somewhere else. I started to read various hairloss forums, of which Hair Restoration Network was among the most informative, and was slowly making decision about choosing a new surgeon.

 

 

I was considering several recommended clinics in Europe and Turkey. Since I have tight scalp and like to cut my hair short in the back and sides, FUT was not an option for my repair. Dr. Erdogan and Asmed clinic seemed to have great ratio of price and reviews, and nicely documented cases. Moreover, I managed to contact several people who had their HTs with Asmed and were very satisfied with their results. So in november 2013 I contacted Denny, Asmed representative in this forum, and sent him pictures for dr. Erdogan to evaluate my case. I was informed that my hairloss does not look stable and that I should try finasteride for several months before deciding whether am I a good candidate. So I put my fear aside and tried Proscar (1.25 mg daily), and after several months and no side effects at all it seemed to me that it made some benefits to improve my condition. My crown and mid scalp hairs thickened a bit, and I even saw some weak hairs in the hairline where previously there were none. I would not say that finasteride caused some significant regrowth or completely stopped hairloss, but it certainly stabilised and improved condition of my hair. So, I contacted Asmed in July with new pictures and this time dr. Erdogan evaluated my condition as suitable for a HT, and suggested me two options. First was a bigger, 4000+ grafts session to cover up all thinning areas of the scalp, and other was to undergo a 3200 grafts surgery for fixing the hairline, frontal third and part of midscalp. Since my previous surgery I was a bit sceptic toward HT-s, so I decided to go for a more cautious 3200 grafts surgery, and maybe a follow up for the crown when I see the result of the first surgery (if satisfying), after a year or so. After that I had a long correspodence with Gianluca from Asmed, during which he was answering my techical questions, and was helping me to book my surgery. Needless to say, he was very professional and supportive and answered my emails as fast as he could, usually between several hours to one day of delay at most. I wired my 1000 Euro deposit to Asmed bank account as a confirmation for booking. My surgery was booked for 18th and 19th december 2014.

 

 

 

 

CONSULTATION AND PRE-SURGERY PROCESS

 

 

I arrived in Istanbul on december 16th, in 23:50 PM. I was picked by the clinic's driver at the Ataturk airport and brought to the Radisson Blu Asia hotel in Atasehir, some five minutes walk from the Asmed clinic. I wont't describe hotel into details, it is enough to say that I had no complaints whatsoever and felt really good during my four nights stay. Tomorrow, december 17th, at 8 AM I was informed that driver will pick me up at 9:30 for my live consultation with dr. Erdogan. So I had breakfast in the hotel and went to the clinic. Assigned translator welcomed me in the clinic's lobby. Before I entered, I had to cover lower part of my footware with plastic cover (they have specialised automated device for it). After brief and kind introduction I was brought to the photo studio where they made photo documentation of my hair pre-op condition. They made pictures with dry and wet hair from several different angles. Following that, I went for a electrocardiogram and blood test. We came back to the lobby and had a short break while waiting for dr. Erdogan, during which I was reading patient brochure and detailed informations about surgery and post-surgical period.

After some 10 minutes dr. Erdogan came and introduced himself. One of the patients who had his surgery day before was leaving for the airport and dr. wished him farewell. I followed dr. Erdogan and translator to his office, where we discussed my operation in details. His english is very good so I had no problems understanding him, so I easily followed his explanations. He inspected and measured my donor area, and cut some hairs for diameter measuring. He already had pictures of my hair that were taken half hour prior to consultation, and a whole computer folder with files dedicated to my case. I was informed that I have great donor, with hair diameter of 60 microns, and some 8000 grafts left for future procedures. This was a surprise for me. Since I already had HT of app. 2500 grafts, I thought that I wouldn't have more than 5000 grafts left at most. It seems that I am one of those lucky guys with almost 10000 grafts for FUE only. After I told my aims and dr. explained what to expect from a procedure we agreed that I will receive 3200 grafts, of which most will be implanted in hairline, following frontal third and weaker part of midscalp. We decided to leave the crown for now, because it would need at least 1500-2000 more grafts to drastically improve it, and because it is not looking that bad and can be easily covered with Toppik or Nanogen. Dr. had displays in his office which he is using to check undergoing surgeries while he is not present in the surgery rooms.

We also discussed PRP treatment. Dr. explained to me that it has no effect whatsoever to boost the hair growth or improve hair density or diameter of the original hair, etc., but is mainly used to accelerate recovery time of the skin and that it could possibly reduce intensity of redness or itching sensation. I was curious to see would it have some effect in my case since I could compare my recovery with one from the previous surgery, and decided to go for it. The whole consultation and surgery planning with dr. Erdogan took app. 45-50 minutes.

Afterwards, I went to their financial office and payed the surgery (1000 Eur deposit + 7000 Euros at the clinic), mandatory medications (240 Euros), driver pick-ups (120 Euros), PRP treatment (300 Euros) and the hotel (320 Euros).

After that, I went to the hair saloon where they cut my hair and cleaned the scalp. Dr. then took some more pictures with a shaven hair, and designed my new hairline, very similar to my hairline from the first surgery, which I liked. It is half a centimeter higher than my original hairline, but since my forehead is not too tall, it is still looking good. It would serve me no purpose to have a lower hairline and a depleted donor area without chance to fix vertex, since my hairloss was and would be going toward higher Norwood if I did not undergone HT-s and did not use finasteride.

 

 

First pictures are taken in the clinic. Dry&wet pre-surgery

[Astaldo]

SURGERY: DAY 1 (december 18th)

 

 

I had breakfast in the hotel at 7 AM, and driver picked me and three more guys, who had their surgery, at 7:20 AM. I was advised to eat a solid breakfast, but not to drink alcohol, coffe or turkish tea prior to the surgery. Upon arrival, I had to change my clothes for the sterilised ones they gave me. Afterwards, they led me to the lower floor, to the waiting room. They are careful with hygiene standards, so I had to change my footwear again before entering the sterilised area. There I met and had a chat with other patients. Also, the anesthesiologist was there, to explain the functioning of the drugs he intended to give to me, and to calm me a bit, since I started to feel a little bit nervous. Afer app. 15 minutes my assistant led me to the surgery room. There I sat on the operation table, in an upward stance for the graft extraction. Team assigned for my surgery consisted of two highly experienced tehnicians (during the consultation I was informed that every tehnician working for Asmed has more than six years of experience), a nurse and one assistant/translator. Before surgery, I was given a pill to calm me down, and had pressure check, which was, to my surprise normal. They also gave me a blanket to cover myself, since the temperature in the surgery room needs to be kept at low, because of the extracted grafts. Dr. Erdogan came by to check if everything was ok before the surgery.

 

 

Then the real fun started. Anesthesia was applied via injections, as you already know. First few were uncomfortable, I could say even painful a bit. But after that anesthesia numbed my donor and I didn't feel anything during the rest of extraction process. The worst part of the exraction process, I would say, is discomfort, especially if you have problems with back as I have. So, one thing you really need is patience.

According to operation planning, first day they were extracting grafts with lower number of hairs from sides of my head, which were meant to be implanted into hairline. Extraction of 1800 grafts took about 4,5 hours to perform in my case. During the whole process they were checking my pressure, asked me about discomfort, or if I had any pain and needed to drink something. At the halfway, dr. Erdogan came, and did part of the extractions himself (he was extracting for about 20 minutes). During the extractions he was informing me about process, the quality of my grafts (which were, according to him very good and healthy), the statistics, etc. They even developed some kind of a software which enables easier graft counting and management.

After the extractions were over, they cleaned and bandaged my donor area. I had lunch break for app. 1 hour, during which I was given another pill by the anesthesiologist.

When the break ended, I was again led to the surgery room where staff repeated whole pre-op process. Dr. Erdogan came and made all of the incisions in the recepient area himself, which took around 30–40 minutes. After that, the implantation process begun. Two tehnicians were implanting all of the grafts and were giving me injections with anesthesia when I felt pain. This was maybe the most uncomfortable part of the surgery, since I was already tired and felt the pain in the recepient area more often, so I needed more anesthesia in certain areas. Dr. Erdogan came few times to check me.

The whole process ended around 17:00 PM, and they took photos of my head, bandaged my donor area and cleaned recipient area from the blood. I had some more drink and snack in the waiting room, after which I put back my clothes. I was led to the hair saloon where I had 5-minutes low level laser therapy for blood circulation, and was given ATP spray, antibiotics, pills against the pain (just in case for the night), sleeping pillow, medical gel to put it on my forehead against the swelling, a cap with Asmed, and post op instructions. I was then brought back to the hotel. I had no problems with sleeping or pain, and could finally relax for the rest of the day (and night), but I rigorously followed post-op instructions.

 

 

SURGERY: DAY 2 (december 19th)

 

 

Day two was pretty much identical to the day one, with one or two exceptions. I had breakfast and was picked by the driver at the same time with two other guys. Second day, they extracted the grafts from the back of my head. After the extraction of 1405 grafts, they took a small portion of my blood, which would be used in PRP treatment. I had lunch break, was given pill, and went back for the surgery. Dr. Erdogan again did all of the incisions, this time in the midscalp, and tehnicians implanted all of the grafts. The second day surgery was a lot faster, and implanting was not so uncomfortable as during the first day. After implantation, they inserted PRP gel in designated areas of the scalp, and cleaned my donor and recipient area. I was again led to the hair saloon, where I received more cleaning and low level laser therapy. Than they took the post-op photos and bandaged my donor area. I had last words with dr. Erdogan, who informed me that everything is ok.

I was brought back to the hotel, and spent rest of the day spraying ATP solution every hour and following post-op instructions, as well as informing my family and friends that everything went well.

[Astaldo]

AFTER THE SURGERY (december 20th, ...)

 

 

I had brekfast in hotel and driver brought me to the clinic at 9:30 AM. I was led to the hair saloon where they performed post surgery washing of my head, and explained me in detail what I need to do during the next 10 or more days. Also, I received summary of my surgery on paper, confirmation for medication use for airport staff, as well as DVD with my pictures and video with instructions how to wash my head in post surgery period. After that, I wished all the Asmed staff farewell, and was brought back to hotel. I packed my luggage, checked out, and was picked by driver at 12:00, and brought to Ataturk airport. At the airport I did not wear any cap because I was afraid that it will scratch my head and cause some damage to the recipient area. I also saw several people who also had HT-s in Istanbul. At the airport, nobody was interested to look upon my head. My flight home went without problems, I picked the seat near the window to avoid someone to accidentally hit me in the head.

 

 

The only issue after the surgery was low intensity pain in donor area, that started around day four and lasted till day thirteen. I was washing my hair every day, as instructed, and scabs started to fall off during the fifth day after the surgery. With them, few hundreds of the transplanted hair fell off. There were no problems or any bleeding. On the day 7, my scalp was almost free of scabs, but the redness was, and is still evident. After day 11, transplanted hairs started to shed more often during the washings and massaging, and I am noticing quite a number of them at the bottom of my sink. Donor area is still a bit itchy, and I also had some pimples there, but nothing to worry about.

 

 

So, shedding is in the process, I would like to avoid it as everyone, but I guess there's no help with that. I really like my new/old hairline and density in the frontal part of my head. I will update this thread with new pictures after 1 month or so, when I enter ugly duckling phase.

 

 

The summary of my 2nd HT is as following:

 

 

TOTAL GRAFTS: 3205 (hairline and midscalp)

 

 

Single grafts: 283

 

 

Double grafts: 1582

 

 

Triple grafts: 1226

 

 

Multiple grafts: 116

 

 

AVERAGE HAIR PER GRAFT: 2.36

 

 

Last pictures presented are 12 days post surgery

 

If you have any questions, you can PM me.

 

 

Best regards

[BUSA]

shud be happy with them results. wish I had as much hair as u do before surgery lol.

 

with that much donor hair I'm sure all the haters won't be able to whine about why u had so many grafts at such a young age cause ull lose so much more hair as u ago.... blablabla.

[1966kph]

Haters Busa ?

Does dr Erdoğan have any haters ?

Very nice looking work as one would expect from asmed.

I hope you get the results you desire.

Excellent detailed account of your experience by the way.Thank you.

Have a good day

[BUSA]

Haters Busa ?

Does dr Erdoğan have any haters ?

Very nice looking work as one would expect from asmed.

I hope you get the results you desire.

Excellent detailed account of your experience by the way.Thank you.

Have a good day

well, wen ignorant ppl make comments like "Turkey just inst what it use to me" are made id say yea there are quite a bit of haters out there.

[stinger99]

If find it hard to believe he has 8000 fue even after 2500 have already been taken. I'm sure in the next 5 years we will see more patients doing more fue grafts over multiple surgeries and we will be able to see how a donor looks like after 10000 fue have been extracted.

[Bahrain]

I also had live consultation with Dr Erdogan on Dec 23rd and he auggested I take propecia for 6 months post which he will decide how many grafts are required.

 

Top-notch clinic with exceptional hygiene levels.

 

Wish you a happy growing and please do keep this thread updated as others have tended to disappear amd continue with their lives

[Astaldo]

BUSA,

I will probably lose more hair in the future, without doubt. But for now, Proscar has completely slowed down the thinning, and if I manage to keep my hair in current state (+ density from last HT in the frontal part that I should hopefully achieve in the next 12-15 months) for the next 10-15 or 20 years I would probably be very happy. Later in life, it is a lot more acceptable to have thinned hair over your scalp, and more or less balding crown. As long as meds are doing their part I think it will be ok. If they lose their efficiency, I will try to deal with it when the time comes. Nothing is certain when one's physiology comes in mind, but I accepted the risk of the HT route and will have to deal with it during my whole life.

 

1966kph,

thank you for your wishes

 

stinger99,

I was also skeptical toward the estimated number of available donor grafts, and asked dr. Erdogan several times if those numbers are overestimated. But his replies were without hesitation or doubt. I presume he knows what he says. I knew that I had pretty good donor area with good quality hair, but was expecting lower number of available donor because of my previous surgery.

 

Bahrain,

hope that propecia will work for you without side effects. I forgot to mention that during consultation dr. mentioned that he is also using finasteride for last 8 or so years (his hair is looking good, with only minor recession in the temples and hairline), and that it is vital for the patients with agressive hairloss if they want for HT to benefit them in the long turn. This issue was brought when dr. mentioned how a number of patients refuse to try finasteride, and after few years they are not happy since they lose more and more of their original hair.

I will try to update this thread regularly, probably every month and a half. Next pictures will show me in a lot worse condition I think, lol.

[wibbles180]

Happy growing ! Hope you keep us all updated

[Yaz89]

Loving the hair line! Wish you well and happy growing!

[CAMPBELL]

Outstanding write up & report! Good Luck in your HT journey.

[Astaldo]

Wibbles 180, Yaz89, CAMPBELL,

 

thanks guys for your comments!

 

Now, new set of pictures. I took these today, 49 days after the HT.

As you can see, I'm deep in ugly duckling phase, I think 99% of transplanted hair has shed, and I also presume that I had some minor shock loss in recipient area.

For now I am successfully masking my hair with Nanogen fibres.

 

Eagerly waiting for regrowth in few months. I am planning to post new set of photos after 3 months mark.

 

Wish you guys all the best

[ready4Hair]

After viewing literally 100s of Dr. Erdogan results (I am scheduled with him in April) you look like the type that is going to have stellar results.

[wibbles180]

Looking good , I will follow this thread with interest please keep a regular update

[wibbles180]

Also what was your opinion on the prp treatment ? I notice you still suffered with redness for some time ?

[Astaldo]

ready4hair,

 

thanks bro, I hope you're right

 

wibbles180,

 

don't worry, I intend to regularly update this thread, at least to the 12th month after surgery.

Also, you asked about PRP. Honestly, it is not easy to give a proper evaluation of its effect. Comparing recovery from my first and second surgery, I think that after second scabs fell off faster and more easily.

Also, there was less pain in the donor area. But those effects could possibly be the result of better post op instructions and products, or better performed surgery from Asmed clinic. I personally think that it helped a bit with faster recovery and enabled me to go out in the public after 9 days without hat.

 

Redness is a tricky issue in my case, because I periodically suffer from seborrheic dermatitis and would probably have prolonged redness in comparison with other people.

You could see in my pre-op pictures that my scalp, in lower light conditions looks a bit red.

After first outbust of seborrhea, when I was 17, I never managed to go back to completely pale and white scalp. Luckily, I never had seborrhea anywhere else but in the scalp area.

Hope this clears situation a bit.

 

I'll post new pictures at 3 months mark, today is day 67 after my HT, and for now there is no new growth in comparison with my last pics, but it is too early anyway.

 

Best regards

[Astaldo]

New update with pictures.

 

It has been three months (95 days to be correct) since my 3200 FUE with Asmed clinic.

 

Currently, my hair is (aesthetically) in the same condition as it was before surgery. I had some regrowth of original hair from the shock loss.

 

Regrowth of transplanted hairs is just at the beginning (or soon will be, I hope). I can see small number of thicker hairs penetrating through the skin. I also see a number of thin hairs with little or no pigment growing. For these, I am not certain if they represent new, unmatured growth, or old miniaturized hairs.

My hairline was quite messy before the second FUE, with transplanted and old hairs spaced here and there in low density, so it is hard for me to see the difference between new and miniaturized hairs in this stage.

 

I still have some redness, but it is not bothering me much. Hope I'll soon have more regrowth to show.

 

Not the best quality of pictures. Today was the rainy day and the light was awful.

Edited March 25, 2015 by Astaldo

[Wwiizzkkiidd24]

and only at three months.. Thats a great result already. Your going to be one happy man at the final result.

 

Happy growing buddy

[Astaldo]

Thank you Wwiizzkkiidd24.

 

However, I need to point out that because of the low light the day pictures were taken, it looks a bit better than in the reality. My frontal third is still pretty much see through when you come close, especially in the harsh daylight.

But it will continue to get better and better.

 

Best of luck to you buddy!

[Bahrain]

Exceptional results and only at 12 weeks post procedure!! Brother, these pics speak volumes about Dr. Erdogan's consistency in performing successful FUE procedures. Please update your thread on a monthly basis.

 

Are you taking any medications?

 

Looking forward to mine and wish you a happy growing!

[Astaldo]

Thanks Bahrain.

 

I wish you best of luck in your upcoming HT journey.

 

Yes, my hair is definitely improving, although I am experiencing it as a painfully slow process I need to remind myself on a daily basis to have as much patience as I can gather. It is a tough game at time, my friend. In the end, I hope it will be worth waiting.

 

Yes, I am taking 1.25 mg of finasteride (quartered Proscar) on a daily basis, without any sides for a year and 3 months. I will continue to use it for as long as I can, cause I think I had some minor benefits from it, and although I still experience some daily shedding, miniaturization of my original hair is quite reduced, and lot of hairs thickened.

 

I will try to update this thread more regularly, maybe even on a monthly basis.

 

Best regards

[Astaldo]

A quick update, 4 and a half months (day 141) after FUE surgery with Asmed clinic.

 

Things are improving slowly. It is obvious that I had some new growth and a bit of thickening, although it is hard for me to notice stronger, thicker hairs breaking through the skin. Occasionally I see some new weak and thin hairs with very little pigment.

I hope things will continue to improve. I definitely expect more growth and density in the hairline, especially on the right side in the following months.

I had a haircut two weeks ago, and my weak spots are still clearly visible from various angles.

Nevertheless, it is better than previous month. Maybe I have become greedy and impatient.

 

Last two pictures are the current condition of my crown, and the condition of my crown in November 2012. I had 1000 - 1500 grafts during the first surgery (not with Asmed), two years ago. Now I am relying on Proscar to keep it as it is. I can efficiently mask it with fibers, but the problem is, when my hair is longer, my crown lacks in hair volume and appears somewhat flat.

 

If I achieve my goals with the frontal third in the next 8-10 months (that is, good illusion of density and volume), I am not certain what should I do with the crown. To keep it as it is for the next few years and mask it with fibers, until the medications lose their effectiveness, or to put another 1500 - 2000 grafts and to satisfy my vanity? What would you guys do if you were in my place?

Edited May 9, 2015 by Astaldo

[Bahrain]

You are on the right track brother all you need is a few more months to realize the full potential. What other remedies are you using other than Proscar?

 

I am keeping tabs on this thread because Dr. Erdogan continues to demonstrate dexterity and you are another testament to his work.

 

Happy growing!

[ersko72]

Looking good Astaldo, and hoping to read more updates on your growth.