Dr Gokhan Gur, Istanbul - 3163 grafts - FUE - NW III

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Age 37

Norwood III/IV

Grafts: 3,163

Average graft size: 2.3

Cost per graft: EUR 1.25

Total cost: EUR 3,955

VIP package where Dr Gokhan Gur does the extractions and channel openings

Hair loss history

There is a history of hair loss in my dad’s side of the family.

I started noticing hair loss in my crown back in 2013 aged 27 and started using 0.5mg daily finasteride. I used this until 2015 and it did a great job in growing back my crown. I was happy but then I noticed I was having sexual side effects. I have no idea when it started but this was around the time I was getting married which is when I noticed it. Was it fin or the newly married / ‘nocebo’ nerves – who knows? There was a lack of morning wood which was a big clue. So in order to preserve my fertility I immediately dropped fin at the end of 2015. The libido went back to normal.

In the following months there was some gradual hair loss so I started using minoxidil foam in mid 2016. This did a good job in slowing down the hair loss. However, coming to 2022 the receding hair line and crown loss were starting to become apparent.

I also have children now so was considering what my options were. I thought it’s a good time to get a transplant as I could hide it from people due to me still being in the early stages of hair loss. Now that I have kids, I have also thought about resuming fin post loss either in pill or a topical format (as I had read some of the 0.005% topical formulations may be less likely to cause side effects).

 

 

Why did I choose Dr Gur

I needed to have the procedure in November 2022. My preference was Dr Bicer due to her being the one Turkish doctor recommended by Spex but she was booked out till August 2023.

I decided to contact many of the well known doctors in Turkey by starting with those listed on IAHRS and ISHRS and sent them my photos. I effectively whittled down doctors who:

-          could be available in November

-          personally perform the procedure

-          for whom I could find good detailed reviews on forums with people commenting on good hairlines and the use of single grafts for the hairlines. (I ignore Google reviews).

-          The preference was to have IAHRS/ISHRS doctors.

In the online consultations nearly all of the doctors said I was a NW III going on IV and recommended around 3,000 grafts for an FUE with the focus on the hairline and use some for the crown.

Dr Pekiner in Ankara was an exception who said I ignore the crown due to further future hair loss and just focus on the hairline. I didn’t like Dr Pekiner’s approach as I did want crown work done although he seems like one of the best in Turkey based on what is posted about him on forums (he would take a whole week as he seemed to do everything himself).

Dr Erdogan’s team suggested something more aggressive and going in with 5k+ grafts. Dr Erdogan’s approach would use up most of my donor supply now and there had been some of the recent reviews on the forums which were lately showing some unsuccessful procedures (also his team was a bit too slow to respond).

Dr Kayihan Sahinoglu was personally responding on emails but I couldn’t find too many reviews of his work. I don’t really trust Google reviews and the forums didn’t have much other than a couple on some of the German ones so I decided not to use him for this reason.

There were a few other doctors for whom I found good and bad reviews so eliminated them.

When I asked for Dr Turan’s availability (listed on IAHRS), I was told that he wasn’t available in November but Dr Gur could fit me in (this was mentioned by Fuecapilar who represent both doctors).

Dr Gur isn’t listed on IAHRS or ISHRS (I understand he was a member previously) but there have been some good posts of his work in recent times on these forums. In addition, there is a good private Facebook group called Hair Loss Conquerors where people have posted good reviews of him. His price and availability in November on the dates I wanted, his personal involvement in the procedure and the results in the reviews made it seem like an acceptable choice for me.

He suggested 2,500-3k grafts. About 2,000-2,250 for the hairlines and the rest for the crown. In the package I chose he would be involved in the graft extraction and opening of all channels prior to inserting the hair.

I booked the procedure, secured it with a EUR 500 online card payment and booked my flight to Istanbul. I decided to book the hotel and accommodation package just to make it easy both before and after eventhough I have visited Istanbul many times before.

Arrival

A few days before the procedure I was provided with all of the detailed instructions about what to do on arrival, how to dress, the operation plan etc.

I was given clear instructions prior to arrival and followed these to go to the meeting gate at Istanbul Airport from where I was taken to the driver who took me to the hotel.

Procedure

I can have a sensitive digestive system if I eat the wrong things and I wanted to make sure toilet trips or flatulence was kept to a minimum so I ate a light breakfast.

I was met at the hotel lobby by Ahmet from Fuecapilar around 9.30. We walked to the clinic which was only 3 minutes away. After filling in some paperwork we went into the consultation room and I had my first encounter with Dr Gur. He inspected my hair and showed the different regions to me on the screen using the trichoscope. He said my donor region looked ok and had over 5,000 grafts available. The mid region of my scalp was showing signs of thinning and would thin in the future over time. He recommended fin for post op maintenance. His consultation backed up what I had been told before with the focus of 2,200 grafts for the hairline and about 800 for the crown.

He drew my proposed hairline on my head and I agreed with his approach of not being too aggressive. The idea was to be conservative and get a nice dense hairline whilst preserving the donor region for any future hair loss in the crown or mid region. He said this way I could have a further couple of procedures in the future if needed. Once agreed we got ready to start. Photos were taken. I had my head shaved and changed into the operation outfit and used the bathroom (highly advisable on every break you have!).

In the room I was to lay flat on my belly for the first part of the procedure. The hardest part are the anesthetic injections in the head as I did my best to ensure I didn’t make a squeak whilst squeezing the stress balls they gave. These are the only painful minutes during the day (once at the start and a second time in the afternoon). There was also some blood taken from me.

Then I laid for perhaps an hour as Dr Gur used his motor tool to do the donor extraction. This seems to be a two step process as Dr Gur worked on it for an hour and said he had done about 1,500. Then other members of his team came in to pull the hairs out as Dr Gur leaves. Lying flat on your belly with the head down and remaining still is tricky (think of little things like how to position yourself so your nether regions are comfortable!) but in the end I learnt that I can move any part of the body as long as the head itself doesn’t move. Dr Gur mentioned that the donor region was very good and he was happy with what he saw.

We had a break where I was given some drinks and snacks and after a toilet trip we resumed. This time I was told to lie sideways which was easier as Dr Gur continued doing the same thing on the sides. Again he used his tool to I guess make the holes and when he had finished his team took over to pull out the hairs.

I wasn’t keeping track of time but the morning took in total around 3 hours.

I was then ready for the lunch break where I was given a Subway tuna sandwich (you choose your lunch at the start of the day) and other things. Another toilet trip and then we resumed around 2pm.

I was laying flat on my back for. Again there was the initial painful part of taking the anesthetic injections for the first few minutes. I felt a bit fidgety as I moved my legs and Dr Gur said this is fine as it’s the adrenaline that they used in the anaesthetic. I think I spent 2 hours there as Dr Gur used his tool to open the channels all over my head into which the grafts would be inserted. I could see on the side his team analysing my grafts one by one and I guess this was them classifying the grafts.

When Dr Gur finished he told me there were still 3 hours left for me as the process to insert the grafts would start. He left and I had a quick break to use the toilet and came back.

I think at times there were 3 members of the team there working on me as they inserted the grafts. I just laid at the table and patiently sat waiting for it all to finish. About half way through I felt as though I would need a quick toilet break but I decided to lie there and let them finish. At one point I started to feel a bit of pain as they poked my head and when I told them it immediately went away as they topped up the anaesthtic in the region. In the final hour or so one member of the team was doing the work and they attached an IVF drip. I was starting to feel cold and shivering at this point so I asked to put my socks on and they gave me a blanket.

Once finished I was bandaged up and it was around 7pm when we finished. Ahmet gave me the instructions for the night which was to sleep in an upright position supported by pillows plus the travel pillow that they gave me. This would ensure that I don’t rub my hair or move side to side. I could shower as long as I didn’t wet my head. I was given some antibiotics which I had to use twice a day (10 tablets) and some pain killers which were optional.

The final graft count was nearly 3,200 so they had used more grafts than expected. I paid using the USD cash that I had. The little extra that was needed I paid using my card.

He walked me back to the hotel. I ordered some room service and then went to sleep around 10pm. It took about 30 minutes to find a way to get comfortable but I then remember waking up at 1am all sweaty so I took my shirt off and went back to sleep. All in all a surprisingly comfortable and well slept night considering how awkward it was to sleep.

Post operation

The following morning I had my breakfast at the hotel and room service lunch at the hotel. I was picked up around 3pm by Ahmet for my first wash. We walked to the clinic. My bandages were taken off and then I laid back as a team member washed my head. Once finished I went for my final post op consultation. I was surprised that Dr Gur wasn’t present as the instructions were given by Ahmet. He was well informed and gave me all of the detail on what to do next but I was disappointed that Dr Gur wasn’t there for a few minutes at least to look at the end result (although I didn’t raise this as an issue).

I was given the post op instructions in writing together with Ahmet’s own verbal explanation in detail of how to wash my head each day.

In brief the next day would be a dry day and then after than I would use the panthenol foam on the transplant region each day for an hour, was it off gently using a low pressure and then use the shampoo that they provided to wash the transplant region. After 5 days I would increase the time for the foam to 2 hours, and also gently massage the transplant region when using the shampoo.

I was given saline spray to use and encouraged to spray it every 30 minutes.

I would have to sleep upright for 10 days.

Various restrictions on hat wearing, keeping out the sun, exercising etc. I was also encouraged to start using finasteride.

We walked back to the hotel and my driver was waiting to take me back to the airport. I took my flight back home and made it home to my bed around 2am.

I had a lot of swelling for the first 3 days as (my wife called my football head after the Hey Arnold cartoon character!). The swelling worked it’s way down the forehead and down the side of the head with a little on the eye. It is essential to minimize bending forward for this reason!

The hardest part in the following days was the sleeping as I found it very difficult to get comfortable as the travel pillow is not comfortable and also requires a lot of lying on the donor region/neck. In the end I adapted using a different pillow which is cylinder in shape but thicker. I am good at keeping still as I sleep so I adapted by either lying flat with my neck/donor region on the cylinder pillow and sometimes tilting my head to the side with my hand over my ear (easier once the swelling had gone).

From about day 6 I started feeling pretty normal with the only problem being in the evenings my donor region started feeling more sensitive and sharp pains at times so I used the pain killer before I went to sleep which worked like magic.

There was a lot of thick scabbing on my head but otherwise I could go about my business. I had 2 weeks off work and hid myself from friends. However, I did have a family holiday in the second week which involved a couple of long drives. I was in the sun for a bit and as I couldn’t wear a hat I remained in the shade a lot and maximized use of the saline spray.

On day 10 post wash my scabbing was finally in a position in which I could gradually scratch it off.

I have posted my images in the posts below. 

 

 

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Here are my photos following my fifth wash (day 6 if you count the procedure as day 0).

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Here are my photos after my 10^th wash (day 11).

[ray35]

Great detailed review, looking forward to more updates. 

[Gramatik]

Great and detailed review....Dr Gur seems to be an ethical surgeon in Turkey who cares about future hair loss etc... He also does most of the procedure by himself for 1.25 € per graft, so its really great value. Waiting for your future updates.

[Bob88]

good choice

[Chris_the_firefighter]

Awesome review I think I will be going with Dr Gur and I am in a similar situation to you hair loss wise. Please keep us updated and thank you for posting. 

 

[Damonh]

Looking good so far mate! 
 

I went with Fuecapilar also, but with Dr Turan. I think we are both around the same stage 2-3 weeks post transplant. 
 

Both doctors seem to do very nice consistent work it’s good to see 👍 

keep us updated! 

[mrmane85]

I enjoyed reading about your journey. 

I hope you receive a great outcome

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Day 30 update

I have attached my pictures. The difference between the recipient area at the front and the rest of the hair in the looks more dramatic in the pictures than in real life and my family say the same thing. In real life the front hair blends in with the rest and only looks to be growing a little slower. My phone camera also likes to make my forehead look bigger than it appears to me in the mirror.

You may notice one hair at the front towards the centre that looks a bit out of place and ahead of the rest of the hairline. That was an existing hair and is not a transplanted hair. I guess I can shave that one hair in the future if it looks too out of place.

There is still a bit of redness at the recipient area at the front. I also seem to have some dandruff which is expected as it all heals. The donor area sensitivity was there for a quite a while but now seems to have gone mild although is still apparent when pressure is applied.

Dr Gur commented that the process is going as expected. Some transplanted hairs have fallen out and others may continue to fall but all are expected to grow back. My donor area has recovered well and I can trim it to 2-3.

I have been gentle with my hair and wash it only a couple of times a week still using the shampoo they gave me and do it gently and don't rub it to dry. I have been told since day 14 that I am free to wash it as I please.

I have ordered 0.005% topical finasteride and plan to start on it soon as it arrives and hope that that I avoid the sides and maintain what I have. I will also will also probably combine it with minoxidil seeing as I was using it for the past 6 years and so want to retain any benefit that it might have given. I was told by Dr Gur's teams to wait till day 30 before using these topicals.

I am waiting for the full HT report from Dr Gur which I hope to have soon.

Edited December 20, 2022 by tiktok

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Day 32

Just added a few more pictures after my first haircut today. Number 2 machine on the sides and a scissor cut touch up of the top so it looks less of a mess and the hair blends in. 

Donor has recovered other than some of the bottom parts at the back. 

Resumed using kirkland minoxidil foam today.

I received my 0.005% finasteride gel from farmacia Parati (prescription by Dr knap). Just need to make a decision on whether I want to start on it. Went for the low percentage as that was the one in some studies shown to have the lowest impact on blood dht levels. I probably will start soon as I might as well go in with all weapons while the hair is still growing back to deal with any sheds etc. and perhaps aim to get some improvement in density in the crown and centre in the coming months or at least halt any more loss. 

Maybe i'll go minoxidil in the morning and fin gel in the evening. Minoxidil once a day is perhaps enough due to its 21 hr half life. 

Part of me things I should space out fin and minox rather than use both topicals at the same time. This is why I didn't opt for a minox and fin combo formula. (Unscientific hunch that applied together at the time could mean some more fin is at risk of going systemic in the blood. You can tell me if I'm wrong! ) 

 

 

 

Edited December 22, 2022 by tiktok

[eladnm]

Hi, can you please update on the results? I plan to go to Dr Gur as well.. 

[Spring15]

Yes please 3 months update if you would be so kind

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Here are a series of posts to provide an update on how things have been going. Firstly I got my photos from the clinic as well as breakdown of grafts.

Single grafts: 350

Double grafts: 1350

Triple and quadruple: 1463

Hair index (average grafts) 2.35

Implantation by region - Hairline: 350; Front: 1,850; Vertex: 800

Pre and post op photos are below

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I already gave an update on day 32 in an earlier post.

I resumed using minoxidil foam at the one month point.

Here are photos from day 60. As you can see a lot of the transplanted hair has fallen out. 

I had a supply of finasteride gel as well as finasteride pills and had been putting off starting. In the end at this point I decided that with the hair growth using the gel would be difficult as the hair got longer and there would be a danger of me overusing it. I needed a strategy to stop any further hair loss as I knew the untransplanted hairs in the crown and centre would continue to fall out. I decided to go back on to finasteride pills (alongside my current use of minoxidil foam).

The strategy I adopted was to go for 0.5mg every other day. This is similar to the approach recommended by Dr Jayaprakash on the Youtube Hair loss show although he says to start with 1mg. The reason I went for 0.5mg was when I used it back between 2013 and 2015 I was on 0.5mg per day and it did a great job in stopping hair loss and increasing density but I stopped due to side effects (As detailed in my first post above). There is a part of me that thinks that was more a nocebo/new marriage nerves.

Even this time as soon as I started the fear was on my 'performance downstairs' and it's I could think about. Does it respond, does it stand up lol. So in order to reduce any pressure and to cancel out any 'nocebo' effect I decided to keep quiet about the use of fin (i.e. the wife doesn't know) and I also try to use a placebo cancelling effect by using some maca powder as a supplement to boost energy and libido.

Studies show that the effect of 0.5mg and 1mg on DHT is almost the same so I stuck with 0.5mg. Last time I did it daily so this time I thought I would go for every other day.

Next post will update on how this strategy went.

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Here are the photos I sent to Dr Gur at day 90. He was happy with the progress as I have hair growth which many patients don't get at this stage and the donor area is in very good shape.

His expectation is that month 4 has 40% of the result normally so definitely a long way to go still. 

I think the 3 month point is when the hair has started to grow quicker by the day as I look in the mirror. I also think it looks far worse in these pictures from the phone camera than it does in real life in terms of density and hairline height.

Regarding my use of finasteride, I think it's been great. From the day I started I think libido has been good and no real performance issues. It's been a month and a half of use and I don't even think about any potential side effects any more. I think the nocebo thing is definitely a big factor as it's the negative thinking which in the 2-3 weeks which I had to get out of my head. Now I don't think about it at all as everything seems to be working normally.

Edited March 3, 2023 by tiktok

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These photos are from today at 3 and a half months. 

One is with the hair down and the other when I stand the hair up. 

I'm due a hair cut which is why there is such a difference in length between the new transplanted hairs and my existing hair. 

Hairline is growing by the day and can feel new hairs waiting to pop out when I rub my hairline. Hope it continues and with the support of fin my crown gets thicker but expect it will take many months to notice the effect. 

 

 

 

[eladnm]

Looks good man. Thanks for sharing. How long approximately it took you to recover from the surgery? 

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1 minute ago, eladnm said:

Looks good man. Thanks for sharing. How long approximately it took you to recover from the surgery? 

Quite quick. My first post discusses this in detail but the worst of it was gone in the first 10 days. 

The tenderness in the donor area lasts longer but is light and doesn't affect life probably all ended at 2 months. 

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Just to add gym also plays a role in my life and try to lift weights 2 to 3 times a week and play football and tennis so trying to everything to keep body in shape, fit and good testosterone levels lol. 

Edited March 3, 2023 by tiktok

[AFinBro]

Hey tiktok, do you have April updates? Been following Dr. Gurs cases pretty closely 

[FarisQari]

any updates bro ?

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5 month post HT. I'm still doing 0.5mg fin every other day and everything feels great.

The hair growth is very good and I'm delighted with progress. People have commented on how good my hairline is suddenly looking and they don't know about the HT. 

The bright light phone pics make it look thinner than it looks in the mirror. There are still new hairs coming and certainly in the crown area I can feel lots of little hairs waiting to grow out. 

 

The first set of pics are in bright light after a shower where the hair is a little damp so looks thinner. 

 

In the next post I will put the pics with dry hair and without excessive bright light

Edited April 21, 2023 by tiktok

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And here are the pics without excessive lighting and fully dry hair

[Spring15]

Nice growth coming along