Turkish Transplants

[kwacluver]

Morning  guys,

I started this topic last week simply in the hope of learning a little about the transplant scene in Turkey and possibly surgeons that I should consider. Thank you to the few people who offered constructive help. I may try reposting again in the hope that the thread doesn't get hijacked as it has in this case. I'm all up for helpful conversation but am left  uncomfortable with some of the tone and language used. For that reason I hope the moderator will allow me to start a fresh thread and leave this one to go where ever it eventually leads.

 

 

 

 First off, many thanks Jean. Just spent a pleasant hour studying your  write ups on here.You write informatively and obviously from your age you are not a typical transplant guy. For myself I should have explained that  I am probably a NW5  hairloss. Two surgeons in Uk suggested 3200 ish grafts but both tried to push me gently in the direction of FUT but probably to help my budget. I am very much looking forward to a response from Dr Erdogan when he has studied my pictures.

John, a big thanks  for your response...I appreciate that much of the work is done by technicians and I guess I need to satisfy myself that they are well trained and motivated. Heres a couple of pics of my starting point.

[Payam]

On 8/10/2018 at 7:08 PM, ASMEDMANUALFUE said:

Hello everyone,

 

I generally prefer to leave HTN Forum discussions to forum users and patients, but this topic needs an explanation.

 As you all know, I am partial to applying mathematics to hair restoration and I like to share the results in an objective way.

 Hair restoration requires full concentration, skill and accuracy during each step of the procedure for a minimum of 6 hours in order to maintain quality.

 To confront this issue, since 2004, ASMED has adopted a system using surgical teams rather than individuals for graft extractions, incisions and placing. Each team member is trained using the K-Head (a life-like training model) placing and extracting a minimum of 10,000 grafts before placing or extracting any graft on a live patient. 

 

Once this training is completed, teams begin on live patients with only 50 grafts per day. This number is increased gradually according to their performance. All surgical rooms consist of 5 nurses and 1 translator, all under the supervision and responsibility of the surgeon and an anesthesiologist. (Per legislation by the Turkish Health Ministry, all surgical assistants/nurses may perform extractions and may place grafts under the supervision of a licensed physician). Collaborative teamwork is necessary as each person is responsible for different parts of the procedure. All grafts are extracted, counted 3 times and the results are then reflected on a screen in front of the patient so that they can follow the entire process at the same time. Statistics are followed and all data is recorded on ASMED Surgical Software. All vital signs are constantly monitored both in the anesthesia theatre and by smartphone applications.

 

The ASMED clinic has a database of 10,000 patients from all around the world with different ethnic origins, hair types and hair caliber. Each extraction team is selected according to their hair per graft average and their expertise with the patient’s characteristics, thereby creating an ideal match. I respect all surgeons that perform all phases of their surgeries by themselves. At ASMED, our aim is to improve and refine the system that we found to have the best results on a daily basis.

 

Respectfully,

 

Koray Erdogan, MD

Answer this: you are doing 4 surgeries in parallel. It is a scientific fact that graft survival decreases the longer they are out of your body. All 4 patients have their extractions at the same time. That means some of them will have to wait a long time for their incisions while you are working on the other patients. All the while their grafts are outside of their body. Doesn't this decrease graft survival rate? 

Edited August 12, 2018 by Payam

[Gasthoerer]

Payam,

Obviously I am not in the position to defend ASMED, as I never have been there myself. But are you sure, that all surgeries start at the same time and on top all surgeries last equally long?

Typically, hairline and pre-op consultation is with the dr. This alone will create a time delay. Also, there are small and big cases. When extractions are finsihes for one case, they will continou in  another case (even when started at the same time). The clinics also typically plan smaller and bigger surgeries in a way that there is no delay and waiting during teh day. Example: My own (very small surgery) was in the early morning. Next patient (mid sized case) arrived later and his surgery started when implantation was ongoing for me.

Why do I tell this? You are still waiting for your result (and everyone is nervous in that case) and you will have to interact with your clinic in future. Especially when it is a result below your expactations. If you give wrong inform (I am not saying you do!) in here, this will make future "cooperation" difficult. Sorry, for the lack of better words.

[Mick50]

5 hours ago, Payam said:

Answer this: you are doing 4 surgeries in parallel. It is a scientific fact that graft survival decreases the longer they are out of your body. All 4 patients have their extractions at the same time. That means some of them will have to wait a long time for their incisions while you are working on the other patients. All the while their grafts are outside of their body. Doesn't this decrease graft survival rate? 

I was thinking about this whether  they stagger the patients in relation to how long the grafts left out of the body  so you are saying they all begin at the same time ?   The clinic I went to in Turkey the Doc saw me before first ...so the other patient didn't start his til maybe a good 45 mins after me there were only 2 of us .

  As I said before anyone who has spent anytime on this forum knows that the techs do the extractions and I have always been impressed by the results the clinic produces  ,my only concern is if someone doesn't understand  this before the day of the surgery ,it will naturally be a shock to find out the techs are doing the extractions  and not Doctor Erdogan if they haven't been properly informed how the clinic operates.   I think all clinics who are heavily tech reliant have a duty to make it clear [ Full disclosure ]    exactly what part of the operation the Doc performs , it shouldn't be left for patients to read between the lines or work out what exactly does "the Doctor and his surgical team mean "in relation to specific parts of the surgery  to be carried out

Edited August 12, 2018 by Mick50

[Payam]

3 hours ago, Mick50 said:

I was thinking about this whether  they stagger the patients in relation to how long the grafts left out of the body  so you are saying they all begin at the same time ?   The clinic I went to in Turkey the Doc saw me before first ...so the other patient didn't start his til maybe a good 45 mins after me there were only 2 of us .

  As I said before anyone who has spent anytime on this forum knows that the techs do the extractions and I have always been impressed by the results the clinic produces  ,my only concern is if someone doesn't understand  this before the day of the surgery ,it will naturally be a shock to find out the techs are doing the extractions  and not Doctor Erdogan if they haven't been properly informed how the clinic operates.   I think all clinics who are heavily tech reliant have a duty to make it clear [ Full disclosure ]    exactly what part of the operation the Doc performs , it shouldn't be left for patients to read between the lines or work out what exactly does "the Doctor and his surgical team mean "in relation to specific parts of the surgery  to be carried out

This would make sense, I really hope they do stagger the patients. I think the greatest shock was how many surgeries were being done that day. I read somone say they do disclose it in the emails, but this is a lie, at least in my case.

Edited August 12, 2018 by Payam

[Mick50]

On 8/10/2018 at 6:08 PM, ASMEDMANUALFUE said:

Hello everyone,

 

I generally prefer to leave HTN Forum discussions to forum users and patients, but this topic needs an explanation.

 As you all know, I am partial to applying mathematics to hair restoration and I like to share the results in an objective way.

 Hair restoration requires full concentration, skill and accuracy during each step of the procedure for a minimum of 6 hours in order to maintain quality.

 To confront this issue, since 2004, ASMED has adopted a system using surgical teams rather than individuals for graft extractions, incisions and placing. Each team member is trained using the K-Head (a life-like training model) placing and extracting a minimum of 10,000 grafts before placing or extracting any graft on a live patient. 

 

Once this training is completed, teams begin on live patients with only 50 grafts per day. This number is increased gradually according to their performance. All surgical rooms consist of 5 nurses and 1 translator, all under the supervision and responsibility of the surgeon and an anesthesiologist. (Per legislation by the Turkish Health Ministry, all surgical assistants/nurses may perform extractions and may place grafts under the supervision of a licensed physician). Collaborative teamwork is necessary as each person is responsible for different parts of the procedure. All grafts are extracted, counted 3 times and the results are then reflected on a screen in front of the patient so that they can follow the entire process at the same time. Statistics are followed and all data is recorded on ASMED Surgical Software. All vital signs are constantly monitored both in the anesthesia theatre and by smartphone applications.

 

The ASMED clinic has a database of 10,000 patients from all around the world with different ethnic origins, hair types and hair caliber. Each extraction team is selected according to their hair per graft average and their expertise with the patient’s characteristics, thereby creating an ideal match. I respect all surgeons that perform all phases of their surgeries by themselves. At ASMED, our aim is to improve and refine the system that we found to have the best results on a daily basis.

 

Respectfully,

 

Koray Erdogan, MD

Hi Dr Erdogan, I'm not sure if you have understood the main concern recent threads have  highlighted with your clinic . There seem to be 2 main issues, the first one is the matter of  full disclosure regarding , are patients aware that you will not be doing the extractions  .

 I have looked at your website and in the in the "What We Do At Asmed" it is ambiguous to say the least as to who performs the extractions  ,as I'm sure you are aware it  points out the 'Doctor wears a magnifier on his head " and directly beneath there is a picture of you I presume, with said magnifier ,OK it doesn't directly say you carry out the extractions  but I'm sure you can see how this might cause confusion. Can you clarify   that this potential confusion is cleared up in following consultations and the patient is fully aware what happens at that stage of the transplant ?

  The second issue/concern is    some patients have posted on here that they feel the techs are not properly supervised as you are doing up to 4 procedures per day and you  do not have the time to properly supervise the work they are doing. Can you clarify that it is possible for you to fully  supervise the techs  ?   

    Regards.

  

 

Edited August 15, 2018 by Mick50

[Martino]

On ‎8‎/‎9‎/‎2018 at 10:27 PM, John Baris said:

 

 

For every kind of doctor in Turkey, if you interested, ask if they have ABHRS, ISHRS membership. This is the best way to see if you are taking a risk, or if you can really trust them.

ABHRS is American Board of Hair Restoration Surgery, there are currently a little over 200 doctors as members there. There are 4 doctors in Turkey having the certificate and members of this board. 

ISHRS is International Society of Hair Restoration Surgery. This is like the special A+ society, or platinum class doctors thing. I know that there are two doctors who are active members there. This board is very hard to get in, you have to pass an exam to get in, have to participate meetings in years, be an active host or the leading doctor, make new researches on hair and write papers which is supported by the society. I know for a fact that only two doctors in Turkey has the fellowship, 130 in the world.

 

 

Cheers

This is very interesting. Someone on another thread said those qualifications meant nothing.

I researched Dr Amonpattana at Maple Hairclinic and her results looked good and she helpful over messages, but I was informed not to use them because this forum said they were not 'recommended by the forum'.

https://www.maplehairclinic.com/copy-of-8

I haven't booked with any surgeon but she is only a 1.5 hour flight from my country so its tempting

 

[Payam]

On 8/13/2018 at 2:16 PM, Mick50 said:

Hi Dr Erdogan, I'm not sure if you have understood the main concern recent threads have  highlighted with your clinic . There seem to be 2 main issues, the first one is the matter of  full disclosure regarding , are patients aware that you will not be doing the extractions  .

 I have looked at your website and in the in the "What We Do At Asmed" it is ambiguous to say the least as to who performs the extractions  ,as I'm sure you are aware it  points out the 'Doctor wears a magnifier on his head " and directly beneath there is a picture of you I presume, with said magnifier ,OK it doesn't directly say you carry out the extractions  but I'm sure you can see how this might cause confusion. Can you clarify   that this potential confusion is cleared up in following consultations and the patient is fully aware what happens at that stage of the transplant ?

  The second issue/concern is    some patients have posted on here that they feel the techs are not properly supervised as you are doing up to 4 procedures per day and you  do not have the time to properly supervise the work they are doing. Can you clarify that it is possible for you to fully  supervise the techs  ?   

    Regards.

  

 

Don't hold your breath waiting for any answers

[ILtrooper]

Folks,

I had a great experience with Dr. Doganay, so my recommendation would be him. Well he is my only experience, so I can’t really talk about anyone else. 

Dr. Doganay did not do the extractions and honestly I wasn’t happy about that. But, I knew that going in, so I guess I can’t complain, but is there any doc out there does his own extractions nowadays? I mean we select certain surgeons for a reason and expect the work to be done by them. Anyways, I trusted his team and it ended up being great, but Noway in hell I would agree someone else doing the implantation as that is pretty much where the true skill is needed. So, Dr. Doganay did all the implantations for me. Upto this point, I am happy with the way things are. I will continue to share my experience with you guys and we will see how things turn out. I hope it just gets better from here.

As for Erdogan, he yields great results from what I see. However, my biggest reason not choosing him was because all he does is the incisions (someone correct me if I am wrong, but that’s what I read online). So the team extracts and implants the hairs. I don’t know about you but I felt uneasy about that. However, results seem good, so they are doing something right. 

It appears pretty much most HT surgeons follow similar exercise. 

Also operating on multiple people a day doesn’t sound so practical to me. I m sure it yields in some nice $$ though. HT is  Such a delicate procedure, I feel like a couple persons a day should be max before calling it for the day. But that wouldn’t make any sense in accounting perspective.  I would hate to be the 4th guy after doctor pretty much blinded and fatigued himself with the other 3. 

[Kiwi Guy]

This is interesting to read as a newly interested HT patient, this stuff gets so confusing at times.