ASMED - Dr. Erdogan - 5020 Grafts

[Tiger1985]

This forum has been very helpful, here is my review so that it may help/guide others.

Background

I am in my mid thirties based in North America with hair loss starting since I was 25, but it really accelerated in the past 6 months. I also suffer from seborrheic dermatitis which I have had trouble controlling with shampoos. As I lost hair, the dermatitis has become more apparent and that is what got me looking into hair transplant more seriously. I had never really thought about it much before that.

My family has a Norwood 6 history and that is where I was heading. So, it was crucial I found someone that would both address the current hair loss and have a plan for future hair loss. Therefore, I needed to understand my donor capacity, total recipient area and a realistic understanding of what to expect from a hair transplant present and future if I choose.

I started researching limiting myself to North America as I wanted to be close for post-care treatment. And due to price, not fully understanding fue and not having to shave my head, I limited myself to FUT only at the start. After further research, I realized how advanced FUE has become and I refocused my attention to only looking at FUE. It was a big bonus not to have a scar and have the option to wear my hair short in the future. Due to the price of FUE in North America, I started to consider Europe and Turkey as well.

I quickly realized how advanced Turkey was in FUE. I got a total of 18 consultations/proposals, around the world,  3 of which were directly in person with the Doctor. All the responses suggested 3000-4000 grafts with pricing ranging from 2,000$-18,000$ and one was even 30,000$.  My issue with every one of these proposals is when I asked about donor capacity, required grafts/cm2 for good coverage, manual vs motorized extraction, max number of grafts per session and many more, I got many conflicting non-scientific answers. It started to feel like an art and not a science which doesn’t sit well with me. I resorted to my own research on a lot of it and got some of the answers but not all. I will not get into any of that here.

Then I found Dr. Erdogan. I had read about him on the forums but did not like that he was a technician clinic. But after I researched him, his method and his work, I was impressed. I watched his presentation on coverage value as a function of density, caliber and number of hairs per graft. I was sold. Finally someone with a scientific approach and a coverage value based on research and evidence. I watched all Dr Erdogan’s videos, devoured his website and before/after results on Baldtruthtalk, Hairrestorationnetwork and other forums.

My decision was made before the online consultation. I filled the consultation form, received an answer back fairly quickly within a week saying that they recommend 5000 grafts. I was expecting that as I realized from the forums that they are of the mentality if you are above 3000 and you have both donor capacity and current/future hair loss area. And I agree. The maximum you can do per session is typically 2500 grafts. So for two days in a row, it would be 5000 grafts. I booked for December. I asked questions periodically from then on and received answers in a timely fashion.

My main concern with the 5000 grafts was to make sure I had enough donor capacity to allow some for future in case. They assured me that an assessment of donor capacity will be done at the in-person consultation with Dr Erdogan and the number of grafts could potentially be reduced accordingly.

They recommended I start on finasteride, and I started taking it in September.

The Arrival

My patient coordinator was Artun York and he was great answering questions and making suggestions for things to do during my stay. I arrived on a Sunday and Artun coordinated with me through WhatsApp for the driver to meet me at the airport and take me to the hotel. Smooth.

The in-person Consultation

The in-person consultation was on Monday and I was asked to be ready in the hotel lobby at 1230 where a driver met me and took me to the clinic lobby. Artun met me there and went over some paperwork procedures, what to expect etc. And of course, I drained him with my questions, but he was very patient and very helpful.

If you get Artun as your coordinator, you are in good hands.

Then we went to a room where I was asked to take my shirt off so they can take an ECG and bloodwork. Then before pictures. Then some paperwork.

It took a while to meet Dr. Erdogan and they should probably time patients visit to wait less at the clinic. Nonetheless, it was a very nicely designed clinic with two girls playing violin and piano in the lobby with a snack/juice bar. Everyone was very friendly and welcoming. I can see that being draining on a consistent basis for the employees, so I commend them on such a hospitable consistent attitude.

When I met Dr. Erdogan, he was very humble and professional. He was happy with the progress using finasteride.

After some small talk, he measured my hair caliber (55 microns), my hair density (between 70-80 grafts/cm2) and estimated the average number of hairs per graft (1.95). Based on that, he came up with a donor capacity of 8500 grafts, which was great. He also explained that I will get more density up front where I lost more hair and then it will reduce as he moves back. The max density he would go based on experience is 52 grafts/cm2, which would give a coverage value in my case above the 5.4 threshold.

Just to side track for a minute, I had an in-person consultation with one of the most reputable hair transplant surgeons in North America and he measure my hair caliber at 40 microns. He did not measure any densities or anything else and then determined I had a donor capacity of 5000 grafts. When I asked him how he came up with that number he looked at my donor area and said, “I can tell by look at it.” That was insulting to me. When I mentioned this to Dr. Erdogan, he told me that he measured the caliber in numerous locations, so he was certain.

Dr Erdogan then began to draw the hair line. When I looked in the mirror, I noticed it was aggressive and slightly pointy at the front. He asked me what I thought, I said he was the expert and I liked his work so I didn’t change anything. I asked everyone in the room and they liked it as well.

Then we went to the finance office where I paid the remaining amount owed.

We then went to get my head shaved. That was cool- never done it before. Then I went back to the photo room where Dr. Erdogan met me again and checked the hairline and adjusted it slightly based on my shaved head. He was always very friendly.

Then I went to the K bot that scanned my head to take more data.

I met Dr. Umat too (the anesthesiologist) throughout this process who was a cool guy with an interesting sense of humor and very sharp as well.

The seborrheic dermatitis at the time was mostly under control but there were still some red spots that they put some cream on to take care of.

Have dinner at Develi, they have a shuttle to and from the hotel. Or Beluga if you like fish. Both great restaurants and decently priced. Don’t worry about the lines drawn on your head, people are used to that in Turkey, or at least I assumed they were. Who cares, you don’t know anyone anyways.

Surgery Day

I had breakfast at 630am, then the driver picked me up to go for surgery at 710am. Took the required antibiotic pill which we were to take fore 3 mornings in a row. First, we went to the barber room where my nurse shaved my head again to make sure its all the same required level. Then I headed to the surgery room and met all the nurses. The surgery chair is very comfortable.

The first part is the anesthesiology where they poke needles into the donor area to number it. It stings and they do this numerous time to numb the one side of the donor area for day 1 surgery. Day 2 surgery they numb the other side. They measure your heart rate throughout the procedure and blood pressure at the beginning. An IV is put into your hand for the incision phase/

Then they gave me a chin rest as extractions are done in the sitting position. It was not very comfortable for me but manageable. They have a screen in front of you showing live the number of grafts, number of hairs per graft, speed etc. Loved it, it was like watching an NBA game where it was singles vs doubles vs triples and of course I was routing for the triples. Keep in mind they need a fair number of singles on the first day to cover the front hair line and on the second day you will see a slightly higher hairs/graft. I also kept busy on Netflix on the ipad they provided. Phones are not allowed in the surgery room. I was hoping to have a few conference calls in there for work, didn’t work out. Extractions took about 3.5 hours.

Then we had a break for lunch. Food was decent, but I wasn’t hungry after the big buffet breakfast at the hotel.

Then I went back in and it was incision time. I was injected with IV which made me drowsy. Dr. Erdogan walked in and started to make the incisions. I fell asleep in the middle and woke up finding them already in the middle of implanting the extracted grafts. It was a long day that ended around 6pm. Then they bandage you up and Dr. Erdogan checks to make sure it all looks good.

They give you a neck pillow to sleep on, which I don’t recommend you use. Bring your own memory foam neck pillow, wish I did.

The next day, same routine. They washed our hair in the morning and shaved the head again to make sure it’s all the same level. The procedure was the same drill.

I had dinner at the hotel that night.

Post-op

Day 1-

The night wasn’t bad, uncomfortable of course as it’s hard to sleep in your back with the neck pillow.

The next morning the driver picked me (and others) up after breakfast for the wash. At this point they teach us how to wash and do it for us the first time. I was there for 2 more days and they were kind enough to let me come in in the mornings to get my hair washed.

They found some oozing in my graft area which was explained as some residual anesthetic oozing out of my skin. To be on the safe side they gave me more antibiotics.

I was fairly comfortable from pain perspective that day.

Day 2-

I woke up in the morning and found due to the neck pillow, the fluids in the back of my head moved up and formed a big ball at the back of my head. When I stood up it all settled down. Weird feeling.

I started to get some pain in the donor area on this day, but assumed it was normal with the number of holes I had in my head (10,000- 5000/5000 recipient/donor). I took painkillers, that helped only a bit.

Day 3-

I was very uncomfortable in the donor area and asked the clinic about it. They checked the donor area and said it looked normal and gave me a stronger painkiller.

I slept on the flight back but woke up in a lot of pain.

Day 4-

My donor area was swollen, and the pain was not bearable. That night, I had so much pain, I slept like 1.5 hours and was pacing the hallways at night not knowing what it was. The back of my head in the donor area is where it hurt, and it was swollen. Texted Artun asking about it. He asked for pics and talked to the doctor. The doctor reviewed it and said, it looks normal, it will pass in a few days.

I called a doctor friend of mine who came over and looked at it. He also said no sign of infection, but that my nerves are finding their way back. I researched the internet and found that although that happens, it is not that painful. He then examined me further and found my neck, traps and upper back were very tight creating a lot of tension in the donor area. I got it massaged and holy shit, what a relief. The nerve ending sensitivity exacerbated the tension in the donor area significantly. The pain after that massage to loosen the muscles went from an 8 to a 2. It was still tingling and uncomfortable to sleep on, but bearable pain. Hot showers and massage helped. Also, i tried to keep my feet off the ground as those nerve endings triggered pain at the bag of my head donor area.

Post op responses take a bit longer than I would like.

Day 5-

The pain came back, but then I got a massage again and it got better again. Donor area still sensitive.

Day 6-

The pain started to get slightly better. Donor area still sensitive.

Day 7-

The pain started to get a lot better. Donor area still sensitive, which is normal and okay. Sensitive to cold.

Summary:

Mid thirties

Heading to a Norwood 6 based on balding pattern and family history

Donor capacity: 8500 grafts

Caliber 55 microns

Donor density: 70-80 grafts/cm2.

Recipient grafts: 5020

Av number of hairs per grafts: 1.96

Overall experience at the clinic: 9.5/10

 

 

Edited December 21, 2018 by Tiger1985
Grammar

[BjornBorg]

Looking good. Thanks for a long and quality review.

[baldlivesmatter]

You're in good hands with ASMED and glad to read you hopped on Finasteride. 

Looking forward to seeing this in 6-12 months.

[DEB1982]

Love the hairline. Looks good mate. Have a feeling this will be a brilliant result.