2nd procedure 900 grafts with ASMED Dr Koray Erdogan - Tuesday 7th February 2023

[JustJax]

So it’s been years since I’ve regularly posted (posted one update in 2020 and then one in 2021), but I’m back in Istanbul and about to have a 2nd procedure at ASMED with Dr Koray and the team.

History

If you’ve searched old threads for info on ASMED, you may have seen my thread I started in October 2016. Back then I had 2700 grafts at ASMED and you can find the full thread here. I was very happy procedure and biggest regret was not doing it a few years earlier. With that said, while I was generally very happy with my results, there were a few weak spots. Admittedly they weren't overly visible, but it was more noticeable when I clipped my hair very short (buzz cut) in 2020. While my density was pretty good, in a certain light it bothered me a little and it would be nice to have a little more. So after thinking about it, in late 2019 I booked myself in for a small 2nd procedure for 31 March 2020. However we all know what happened in March 2020, a little thing called Covid, so that was cancelled. After the whole covid situation I was in two minds whether to bother, but finally rebooked last autumn and I’m back in Istanbul ready for my 2nd procedure tomorrow. 

2nd Procedure

So I arrived last night and I’m staying at the clinic for 3 nights before moving across the road to the Radisson Blu. Still haven’t seen the whole clinic yet, but I have to say the new clinic (it’s a few years old now) is amazing.  Anyway, I had my pictures and consultation with Dr Koray this afternoon (I will upload the clinic pictures which I assume I’ll get tomorrow or Wednesday) and and we have agreed to approx 900 grafts.  In my mind I was thinking 700-1000, so I’m happy with 900.  Focus will be on addressing the little weak spot, strengthening the left temple, plus adding in a little more density.  BTW, I have to mention the KEBot scan. This wasn’t something they had back in 2016 and it was fascinating to the computer/camera tracking my head and counting up how much of each graft (singles, doubles, triples etc) I had. 

I’ve been told the Procedure is tomorrow morning around 8am.  I had a terrible night sleep last night, combination of an exhausting day travelling (4hrs delay due to bad weather) so I’m really hoping for a good sleep tonight. Have to say I’ve been a bit anxious about it all these past 5-6 days and yesterday was stressful travelling, but thankfully I’m feeling calmer this evening. I’m sure I’ll be nervous tomorrow morning.  For those thinking “you’ve been through it all before, why are you worrying”? I guess it was partly not having had the luxury of a face to face consultant with the Dr before coming over, where as in 2016 I managed to see the Dr in London so I felt confident I knew what we were doing. The other big factor is knowing exactly what’s about to happen. Last time i didn’t have anything to compare it too, where as this time I know some of the short term cons/challenges, i.e numbing bit will be painful (for 2 mins), having to wear the darn neck cushion and sleeping upright for several days and then just that first few weeks of having to wash it very gently and the mild discomfort/itching as the scalp heals over the first few weeks, etc. Anyway, it will be worth it and no turning back now. 😀

Lastly I just realised I didn’t take any good pics this month before flying over and getting my head shaved. These are a few after a fresh cut from Sept 2022.  I’ll wait post the Asmed pics from today once I have them. 

 

Edited February 9, 2023 by JustJax
Typos

[Fueway]

Good luck 🤞 ASMED gets a battering here, but i really hope this will work out for you ! 

[Belve]

Good luck. I wish you all the best 😀

So this procedure is a touch up to add Density on the front part ? Your first one was pretty good as I saw from your first thread. 

[JustJax]

Sorry all, I’ve been a bit tired these past few days, as well as needing to switch between the clinic and hotel.
 

Surgery on Tuesday 7th went well. I don’t recall the exact time we started but I think it was around 8am. Unlike in 2016, they now include some sedation, not just local anaesthetic, to help with the pain (you are awake, you just feel a little more relaxed, perhaps a little woozy when it first kicks in, but still very much awake). Feels like they also used a different tool to inject the local anaesthetic, kinda felt like lots of little micro needles and less painful and faster. Dr Koray suggested 900 grafts and they extracted and implanted 913 grafts in total.  I was done by late lunchtime, I think by about 1:30 - 2pm maybe? Hard to recall so far back but I think this time around with sedation I felt a bit more drained and slightly fuzzy once I was back in my room.

By around 4pm I think the anaesthetic was starting to wear off in some areas and I had a little discomfort and stinging sensation. It was at this point I did have a brief moment questioning myself why I was putting myself through all this again when I already had a pretty good result, but they gave me a painkiller (not sure what one, but apparently quite strong) and that helped and to be honest, I asked for another for later that evening, but didn’t need to take it.  Despite the surgery and having to sleep a bit more upright, I think Tuesday night was oddly my best night sleeping as I managed to get in a good position. 

Wednesday 8th, I was up about 8am. This was the day of my first wash. That process was a little tender, but fine.  Does seem they do quite a few things a little differently to 2016. For example, after the donor area being sort of bandaged up the first night, the donor area is left open to heal after the first wash where as I swear they smeared it in some sort of cream last time. Anyway, Wednesday afternoon was also the day I was moving over to the Radisson Blu for the remainder of my stay. The hotel had kindly upgraded me to a superior room and I swear it might have been the one I had in 2016.  Anyway, things started off well, but then room was too hot and I couldn’t seem to cool it sufficiently, then after going to sleep I could hear a dog barking and turns out it was outside and I could hear it even 10 floors up. Then a few hours later I heard some weird noises in the bathroom and I turn the taps on and the water is brown and turns out there is a pump issue that they are working on (this is at 3am) anyway, basically totally crap nights sleep due to the dog, water issues, my mind working overtime and just not finding a comfortable positioned in the bed. 

Yesterday (Thursday 9th) I woke at 7am and despite being exhausted, I figured I’d just get up and have breakfast and see about changing rooms to avoid a repeat of the barking issue. Reception were fine and moved me to a room at the back of the hotel.  I’d agreed with Sevinc (my patient coordinator) to come over for my hair wash around 10:30. I was ready early so walked over about 10:10am. For those unaware, the Asmed clinic is literally a one minute walk away from the Radisson Blu.  Didn’t see Sevinc as she was busy with someone else in surgery, but at the clinic I got chatting to one of the few male staff while he was putting some cream on the recipient area before they do the wash and he asked if I was about day 6-7? I said no, actually only my 2nd wash.  He suggested my donor area was healing fast. I’m guessing that’s probably down to it only being 913 grafts. I didn’t quiz him on his thoughts, I guess he possibly also thought the recipient area wasn’t looking too bad either, again probably due to less grafts/less trauma to the area.  With that said, I should mention I definitely have some swelling moving down my forehead due to the local anaesthetic. I’ve been trying to ice my forehead regularly as instructed and it wasn’t too bad and I wasn’t looking to much like an alien. 

Anyway after the wash I just headed back to the hotel and relaxed. I was originally going to pop over to the mall which is 5 mins away but couldn’t be bothered and just sat watching Netflix.  I was super tired late afternoon and kept nodding off, but didn’t want to sleep in case it messed up my sleeping overnight .. oh the irony, as it would turn out to be another poor night sleep. I did asked for more pillows last night so I could try and create a wedge of pillows so I couldn’t roll to my side and that helped, but last night it was more about my mind thinking about work tasks back at the office and I wasn’t overly feeling tired. So that’s now 4 out of 5 nights of rubbish sleep. 

Today is Friday 10th, its my last full day in Istanbul.  Little up date on the swelling, unless I’m delusional from lack of sleep, I think the swelling has subsided so perhaps I’m over the worst of it. That reminds me, for past 2 days I am getting the odd tingle of discomfort and itching which is what I had last time as it all starts to heal. Nothing too bothersome, but a bit annoying. Anyway, I’m planning to get my hair washed again around about 10-10:30.  After my hair wash, I’m determined to get out of the hotel and do something today. With that said, while I don’t really care how it looks, I’m a little anxious about my head being exposed to the elements. 

Lastly ..  some official Asmed pics from before and after my surgery. 

[JustJax]

Two pictures from yesterday, donor area before the wash. 2nd one is after hair washed. Think my donor area is looking pretty good. 😀

Edited February 10, 2023 by JustJax

[A_4_Archan]

Works look clean and u will soon gonna get a dense front scalp...😊

[JustJax]

6 hours ago, Archan said:

Works look clean and u will soon gonna get a dense front scalp...😊

Thanks, fingers crossed. 🤞

[JustJax]

Got them to take some pics for me after it was washed this morning. Have to say I’m amazed how quick the back is healing. Obviously you can see it more on the sides but still happy the back is healing so quick. I guess it’s perhaps to be expected as it’s only 913 Grafts  

[A_4_Archan]

Oh yeh the donor looks nice and soon it wud get healed ...

[Belve]

Happy growing. It looks clean work !

[JustJax]

So today (Saturday 11th) was my last day in Istanbul. Had my hair washed around 9:30 and then the driver picked me up at 11 am for my ride to the airport. It was quite funny at the airport, I saw several  people with transplants walking past me and on my actual flight back to London, there were 7 of us in total with hair transplants. 😂 

Flight home wasn’t too bad although I swear Turkish Airlines have their planes so hot. I finally got home about an hour ago and looking forward to my own bed again. Tomorrow will be my first wash at home.  Definitely glad that I stayed an extra few days in Istanbul to get my hair washed daily (last wash this morning was my 4th wash).  Off to shortly, but here are a few pictures again just after the wash this morning.  

Edited February 11, 2023 by JustJax

[SeanT1]

Just wondering, how much did it cost per graft?

[JustJax]

4 hours ago, SeanToman said:

Just wondering, how much did it cost per graft?

It’s €3 per graft.  I understand from one of the other patients there is a lower rate of €1.90 per graft if you opt for the techs do all three stages and I guess Dr Koray just does the initial hair design. 

[CharlesBarkley]

Looking very good. And you have great hair already so the result would be perfect for sure. 
So in ASMED you have packages? The one you got is $3/graft and Dr Koray does all the work? 

[IMM1979]

On 2/15/2023 at 8:01 AM, CharlesBarkley said:

Looking very good. And you have great hair already so the result would be perfect for sure. 
So in ASMED you have packages? The one you got is $3/graft and Dr Koray does all the work? 

had my procedure done at Asmed in April 2022. I paid the premium for Koray, but according to my understanding, he just handles the incisions so technicians understand how/where to place the grafts. the rest of the work is still done by others. Given how many botched cases Asmed has had since 2018, I am guessing it is because he was not involved in those procedures at all (unless I am missing something). 

[JustJax]

4 hours ago, IMM1979 said:

had my procedure done at Asmed in April 2022. I paid the premium for Koray, but according to my understanding, he just handles the incisions so technicians understand how/where to place the grafts. the rest of the work is still done by others. Given how many botched cases Asmed has had since 2018, I am guessing it is because he was not involved in those procedures at all (unless I am missing something). 

No idea. I didn’t realise until this time around that there was an option to have it cheaper by just having his team do it all. I can’t only speak for my experience and I was pretty happy with my first procedure, obviously to early for me to say what my outcome from this procedure will be.  At least you seem to have had a good result? 

[JustJax]

Quote

 

Okay so it’s day 10 or 9 days post surgery if that makes sense.  Struggling a bit today, recipient area feels quite dry and tight and almost feels a little sunburnt so having a little discomfort.  Probably a 2 on the pain scale, so not really enough for any pain killers. Feel like I want to apply some moisturiser to soothe it.  Also keep obsessively taking pics and then looking and worrying if it’s getting infected and that I think that’s being triggered by the tightness and mild discomfort.. did I have similar tightness and discomfort at this stage before? Can’t really remember.  I’m probably being silly but I’m quite an anxious person when it comes to health things so that doesn’t help. 🥴

As you can see below, I’m still reasonably scabby. I know by day 10 it should be almost scab free. But like during my first HT, I was again very anxious washing it myself so probably should have been firmer over the past few days.  As you can see the donor area is now pretty much clear and I have to say I’m shocked how good it looks. Donor area was pretty itchy and some occasional pain but that seems to have dissipated today.  Although it’s difficult to compare to first HT because i’m in different location/lightning, but I do feel like recipient area is less red this time. But maybe I’m deluding myself. 🤷‍♂️
 

 

[IMM1979]

4 hours ago, JustJax said:

No idea. I didn’t realise until this time around that there was an option to have it cheaper by just having his team do it all. I can’t only speak for my experience and I was pretty happy with my first procedure, obviously to early for me to say what my outcome from this procedure will be.  At least you seem to have had a good result? 

Yep got a good result so no complaints. Though was a bit concerned after reading all the negativity about this clinic on here.. 

[JustJax]

So it’s day 11 or 10 days post surgery.  I wasn’t planning to go into the office at all this week, but something came up so I had to go in for a meeting today. I was a bit annoyed as I am still a bit scabby and ideally wanted to be scab free before I was seeing people again, but I had to suck it up and at least it’s Friday so I knew the office would be quieter.  Anyway, upside is I got one of my team to take some side and rear pics which are difficult shots for me to do living on my own.  Also took a shot of the front myself but with office lighting. 

I appreciate I only had 913 grafts so it’s probably not a surprise to most, but I really wasn’t expecting the donor area to heal this fast. One of my biggest concerns about a 2 nd procedure was what the donor area would look like, so buzzing it looks so good.  As mentioned above and you can see, recipient area is still reasonably scabby, but now I’m day 10-11, so I’m going to shampoo it a little firmer tomorrow in the hopes that I get quite a few scabs off. Really want to be completely scab free by Monday as I’m travelling for work on Monday and seeing quite a few people Mon-Thu. 

 

[JustJax]

Well it’s day 13 or day 12 post surgery and after a gentle, but thorough shampooing this morning, I’m almost scab free 🙌. I think after tomorrow’s wash it should be clear.  

I’m fairly happy with how it looks, although grafts on my right (left in the images) seems a bit odd in terms of direction, but if I look closer I think that’s the grafts with multiple hairs so I’m trusting they are just confused 😂 and it’ll be fine.  It’ll be interesting to see what it looks like after the shedding starts and I’m at the usual ugly duckling phase. As I haven’t lowered my hair line further this time and this is just extra density/filling in some weak areas, I’m hoping the hair from the 1st HT will cover up the area and it won’t really be noticeable.

Although I said in a previous post that the itching in the donor area had subsided, I think I spoke too soon. It’s not too bad but it’s happening back and fore and I think it being so short and bristle makes it’s more uncomfortable when you lay down. Also getting some discomfort (mild sort of burning sensation, itching) in the recipient area. I have been stressing the past few days that it’s down to a possible infection, but I think (as per usual) it’s just me overly worrying and funnily enough, looking back in this forum, I posted a thread in 2016 where I had the same sensation at this stage.  Looking at todays pics, I think the scalp looks relatively good considering it’s only 12 post surgery, so I’m putting the discomfort down to just healing/nerves repairing as per the first HT. 

Lastly, looking forward to sleeping this evening without the neck pillow. Asmed guidance suggests the neck pillow and elevated sleeping for 10 days so I’m already past that, but last night I figured I’d sleep with the pillow for one last time as I still has some scabs on the side and didn’t want any potential drag/pull on the hairs if slept a little on the side.  On the pillow, I have to say the new (well new to me) pillow that Asmed give you is brilliant. The one they gave me in the clinic for the first night was the inflatable one that I also got to take home during my first procedure and it’s not really that comfortable, but they now give you a memory foam one in your “care package” and it’s so good. Going to give it a good wash and keep it for travelling etc. 
 

[JustJax]

So I can’t believe it’s already been a month.  I was worried a few weeks back that my skin in the recipient area was perhaps a little bumpy and inflamed, but it seems to have settled down and I saw a dermatologist today (for other reasons) and asked her to look at my recipient area and she said while it’s a little red it otherwise looks fine.

I think it’s looking pretty good 4 weeks in.  I can’t say I’ve overly noticed the shedding this time, but not sure if I’ve just missed it while showering or whether perhaps the hair from the earlier transplant just makes it difficult to tell. Shedding was certainly much more obvious with the first HT as I’d lowered my hairline so was very evident once the shedding really kicked in, which it had by this stage last time.  Anyway obviously it’s nice that doesn’t at least appear to be major shedding as it means it’s less noticeable. I’ve actually had quite a few people tell me the buzz cut sits me. I quite like it too, but I do think that one side is still going to land up with less density based on what it looked like once all the scabs come off. I think I’ll def try the buzz cut again perhaps late summer to get a better sense on coverage once it’s growing in.

I am planning to get my sides and back cut this weekend for the first time post HT, so will post some pics on the weekend. 

Lastly just to note that while it looks quite red in the recipient area, it apparently much more less noticeable in daylight and in the office, at least according to work colleagues.  

Pictures are from Wednesday evening, so 4 weeks post op. 

[stephcurry30]

looking good!

[JustJax]

So got my first haircut post surgery on Friday (which was 31 days post surgery). Only got the back and sides clippered and then had the barber blend the sides with the top, but with scissors only. He didn’t touch the recipient area.  It was starting to get a bit bulbous on the sides so it was great to get it cleaned up.   My friend was visiting so took the opportunity for him to take go decent pics of the donor area too.  Have to say I’m super happy with the donor area. Was a little worried with 2nd procedure as to what the donor area might look like but clearly I needn’t have worried.  

Btw, I did mention above about not much shedding much, but then yesterday I was putting on some aloe vera gel and I noticed after I wiped it on that I had one or two hairs on my hands, so clearly some shedding happening ..  of course it’s expected, so wasn’t concerned. 

[Gatsby]

Wow! for one month your hair grows fast and it looks like you have hardly shed at all! All the best! 👌

[JustJax]

6 hours ago, Gatsby said:

Wow! for one month your hair grows fast and it looks like you have hardly shed at all! All the best! 👌

Thanks, to be honest I think it’s perhaps a little deceiving as it was only a top up procedure so I think a lot of hair I’m seeing in the recipient area is the hair from my original HT, which is giving me coverage that I didn’t have after the first HT, as I lowered my hairline last time. Unlike this time, it became very evident when the shedding happened with the first procedure. If it’s doesn’t get much worse that this then I’ll be very happy. Looking at when I buzzed my hair in March 2020, in about 2 months (early May) I’ll have enough length that it then should unnoticeable. At least I hope so.