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LordBaldwin

3051 Grafts FUE - 17 Dec 2018 - ASMED Dr. Koray Erdogan

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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:

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Surgical Plan:

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Immediate Post-Operative (Day 0):

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Day 2 Post-Op: 

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Day 3 (swelling is mostly gone):

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Day 5 (scabs and some minor cracking visible):

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Day 7 (vast majority of the scabs have come off):

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Day 10: 

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Edited by LordBaldwin

 

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13 hours ago, hairlossPA said:

great write up. can’t wait to see this result 

Thanks!  I plan to update fairly regularly.


 

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Great review, nice work!

The only thing you left out is your age.. :)

Will be following your progress, happy growing!

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52 minutes ago, VicTNYC said:

Great review, nice work!

The only thing you left out is your age.. :)

Will be following your progress, happy growing!

Ah, whoops.  I'm 30.


 

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13 minutes ago, LordBaldwin said:

Ah, whoops.  I'm 30.

The numbers and stats guys misses the most important number...haha 🙂

👍

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4 minutes ago, Gorgio said:

Looks really clean and natural

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.


 

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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. 😬

144455106_AndHereWeGo.gif.7d5d9563d8031577fdd75a431f931f7b.gif


 

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Day 21:

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

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Wow you're retaining on to the transplanted hair fairly well. Unfortunately, it's bound to shed sooner or later. But the good thing is that you may be a fast grower. Thanks for keeping us updated on your progress.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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33 minutes ago, Melvin-Moderator said:

Wow you're retaining on to the transplanted hair fairly well. Unfortunately, it's bound to shed sooner or later. But the good thing is that you may be a fast grower. Thanks for keeping us updated on your progress.

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.  


 

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Your hairline looks brilliant and the work looks very dense. I had my second surgery the day after you on the 18th. Not sure if you saw me at the clinic on the 17th or 18th. I do remember being told on my day about someone there who had done a thorough analysis though. 

I’ve just hit 3 weeks today and have started to shed a few hairs. Keep updating as I think you’ll have a knock out result here. 


First Transplant: 5000 FUE grafts with Dr Koray Erdogan ASMED, December 2016

 

First Hair Transplant link: http://www.hairrestorationnetwork.com/eve/185564-5000-grafts-fue-13th-14th-december-asmed-dr-erdogan.html

 

 

Hair loss regime

 

Propecia 1mg daily

Saw Palmetto 450mg daily

Biotin 1000ug daily

MSM 1500mg daily

Pumpkin Seed Oil 1000mg daily

1% Nizoral shampoo weekly

Lasercomb x 3 weekly

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10 hours ago, DEB1982 said:

Your hairline looks brilliant and the work looks very dense. I had my second surgery the day after you on the 18th. Not sure if you saw me at the clinic on the 17th or 18th. I do remember being told on my day about someone there who had done a thorough analysis though. 

I’ve just hit 3 weeks today and have started to shed a few hairs. Keep updating as I think you’ll have a knock out result here. 

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.


 

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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.

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Day 41 (a month and 10 days):

When I look at these pictures zoomed in, I can actually see new hairs starting to pop up in some areas.

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Wow early growth already that's awesome happy for you man.  Please keep us updated on your progress.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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53 minutes ago, Melvin-Moderator said:

Wow early growth already that's awesome happy for you man.  Please keep us updated on your progress.

Thanks.  Yeah, I'm feeling relatively optimistic about this so far.  I'll be updating at least once a month.


 

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Wow that’s a lot of growth for only 2 months! Amazing! 


First Transplant: 5000 FUE grafts with Dr Koray Erdogan ASMED, December 2016

 

First Hair Transplant link: http://www.hairrestorationnetwork.com/eve/185564-5000-grafts-fue-13th-14th-december-asmed-dr-erdogan.html

 

 

Hair loss regime

 

Propecia 1mg daily

Saw Palmetto 450mg daily

Biotin 1000ug daily

MSM 1500mg daily

Pumpkin Seed Oil 1000mg daily

1% Nizoral shampoo weekly

Lasercomb x 3 weekly

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1 hour ago, LordBaldwin said:

Thanks.  Yeah, I'm feeling relatively optimistic about this so far.  I'll be updating at least once a month.

Your results are looking good already mate. I’m particular interested to follow your journey and look forward to seeing updated photos.

I’m hopefully going to book with Asmed this week. Thanks for the initial detailed post.

I’m 31, from the UK and have been quoted 2500-3000 grafts for my hairline and frontal scalp.

Would you recommend staying at either the hotel or clinic a few extra days after surgery to help with the shampoo? I was going to arrive a day earlier then I needed to but fly back the next afternoon/evening after surgery. 

Thanks,

Craig 

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4 hours ago, Craig2412 said:

Your results are looking good already mate. I’m particular interested to follow your journey and look forward to seeing updated photos.

I’m hopefully going to book with Asmed this week. Thanks for the initial detailed post.

I’m 31, from the UK and have been quoted 2500-3000 grafts for my hairline and frontal scalp.

Would you recommend staying at either the hotel or clinic a few extra days after surgery to help with the shampoo? I was going to arrive a day earlier then I needed to but fly back the next afternoon/evening after surgery. 

Thanks,

Craig 

Hey Craig,

As far as timing for leaving Istanbul is concerned, there are different schools of thought.  Some people advise leaving the day after the surgery (i.e., as soon as possible) given that a lot of folks swell up pretty badly for days following the surgery.  In my case, I opted to stay a couple of extra days in the hotel because:

- I didn't want to go through the airport and a long flight when the grafts were still vulnerable; I felt that traveling increased the risk of accidentally hitting my head and damaging grafts (after the first few days, the risk of damage drops considerably).

- I wanted the pain to ease up a bit before my 14 hour flight to LA.

- I wanted to be close to the clinic for a few days in case there were any complications.

- I wanted to give my donor area the opportunity to heal before I pressed my head up against the headrest in the airplane (which so many other things and people touch).  The last thing I needed was to travel home and then get an infection.

- I wanted my redness and swelling to go down a bit before I traveled so it wouldn't look as bad.

- The clinic will do your wash in the morning every day you're there -- I trusted them to do this more than I trusted myself for the first few days.  It's very important that the washes be done correctly and that the crusts be removed in a timely manner.

I was fortunate in that the worst of my swelling was gone on the third day, right in time for me to leave.  I think I made the right decision with respect to timing, and think it would probably not be a bad idea if you did the same (though, again, it's possible that your swelling may last a bit longer than mine did, as I seem to have deviated from the norm a bit in terms of recovery time).

I'll also note that you do have to pay for any extra time you spend in the hotel (the first couple of nights are covered in the package), but it's really not that expensive (about 80 USD / 62 GBP per night) and the hotel is pretty nice.  You have the option to stay in the clinic instead, which some people prefer.  I opted to stay in the hotel for the 24 hour room service and because I thought the clinic rooms looked and felt a bit too much like hospital rooms.

Let me know if you have any other questions and I'll be happy to share my thoughts/experience.


 

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13 hours ago, LordBaldwin said:

Thanks.  Yeah, I'm feeling relatively optimistic about this so far.  I'll be updating at least once a month.

Thanks for the advice. You’ve raised some good points and I haven’t even thought about touching the headrest on the flight back home. I’m going to stay at either the clinic/hotel for an extra night I think and also arrive the day before my consultation. 

My flight home would be 4 hours so not a long flight. 

How is your donor area now? Do you think you could get away with having your back and sides shaved down to a number 1 or even have a skin fade without the tiny scars/redness being noticeable to most people? 

Thanks mate 

 

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