HT #1: IdealOfMed June 2023 | HT #2: Dr. Resul Yaman May 2024

[Ephemeron]

Given the scarcity of case studies focusing on Asians, I've opted to share my personal journey as a means of giving back to the forum that has supported me in my decision-making process thus far.

I'm a 40-year-old individual of Chinese ethic from Southeast Asia. Struggling with hair loss since my early twenties, I've resorted to wearing a toupee to conceal my NW7 hair loss pattern over the past 18 years.

Opting for a hair transplant was a significant decision for me, especially as it marked a transition away from relying on a toupee. However, the results have been mixed thus far. The psychological impact was profound, as I couldn't fathom wearing a hairpiece for the rest of my life. Hence, I took the leap and underwent the hair transplant procedure.

To date, I've undergone two hair transplant procedures, both conducted in Istanbul, Turkey.

I was primarily drawn to Istanbul due to its competitive pricing and the convenience of my frequent trips to Europe. My first procedure was with IdealOfMed. Their professionalism during the initial consultation via WhatsApp stood out among the clinics I had shortlisted, ultimately influencing my decision to choose them. This initial procedure took place in June 2023.

I will breakdown the various sections for easy reference, documenting from initial contact to post-op care & result (where available).
The ratings provided are based on my personal experiences, so your mileage may vary. By going through these two different processes, I was able to compare them and offer data points for others in this forum. I'll break this down across a few posts and provide updates with specific details.

As a starts, here are the pre-HT pictures, which is a clear NW6-7.

[Ephemeron]

Executive Summary:

 

	IdealOfMed (2023 June)	Dr. Resul Yaman (2024 May)
Pre-consultation	via WhatsApp Detail level 6/10	WhatsApp Detail level 7/10
In Charge	Fatih	Ihsan
Transport	10/10 MPV	5/10 Fiat Sedan (Low Head Room Problem)
Grafts Measurement	None, only visual	With equipment & explaination
My initial expectation communicated	Full coverage with max. donor extraction possible.	Complete crown coverage Temple touch up
Clinic communicated priority in Clinic	Donor preservation, suggested splitting into 2 sessions with frontal image as priority. Grafts from 1 session are not able to offer full coverage on NW6-7 or risk over extraction.	Donor preservation, estimate 2500 – 3000 grafts but this would be only sufficient for crown @ 25grafts cm/2
Target Density	40 grafts cm/2 (frontal)	25 grafts cm/2
Actual Visual Observation (Post Ops)	Similar	Appears to be less.
Donor Estimation	3,500 – 4000	2,500 – 3000
Donor Extracted	4,500	2,300
Target Area	Hairline, Temple, Midscalp	Midscap, Crown, Temple Touch up
Anesthesia Process	3 Star / Administrated by technician Pain level 8/10, but the technicians were gentle and try to make it bearable.	4 Star / Administrated by technician & Dr. Resul Yaman. Pain level 6/10  but subsided quickly. Handling from technician was rough despite request to be a little gentle upon expressing my discomfort.
# of Technician	3	1 – 2
Extraction process	4.0 Hrs	2.5 Hrs
Post Extraction Discussion	Yes - Maintained suggestion to cover only frontal part.	Yes -
Incision process	Technician Mechanical process as per planned.	Dr. Resul Yaman Was quick, yet gentle and with proper communication on what he is doing with slight iteration on initial plan basing on actual grafts extracted.
Implantation Process	2 x Technician	1 x Technician
Communication	Technical understood simple English, Translator followed around which is a plus. I don’t experience any communication issues with IoM	The team doesn’t speak English except for Ihsan and Dr. Yaman. Technical doesn’t understand simple English expression on pain/discomfort.
Handling process	Overall gentle and well communicated on each steps performing/ to be performed.	Technician team was on a rougher side, and offered impression on trying to get things done quickly. Despite under anesthetics, I can feel the saline water/blood seep throughout my face/ears during the surgery which is turning me off.
Incl. Hair wash at Clinic	X 3	X 1
Mesotheraphy	X 2	None
Hyperbaric Oxygen (HBOT)	X 2	None
PRP	X 3 Post Op.	Before extraction.
Multivatamins Shampoo Supplements	12 months Supply	1 Bottle Foam & Shampoo Each. Antiseptic cream
Total Cost	Packages start from €2,950 but I have opted for a premium package which cost extras.  (Incl 5N Hotels)	USD 2,950 (Excl. 3N Hotels)

Edited May 16 by Ephemeron
Information Update

[Ephemeron]

Post Update #2

[Ephemeron]

Post Update #3

[Ephemeron]

Hair Transplant 1 Update.

To keep things concise, I plan to document my entire Hair Transplant 1 journey and provide updates over the first few posts. Afterward, I'll share my experience with the second procedure.

As it was my first hair transplant procedure, I wasn't fully prepared to document the entire journey with photos, but I did manage to capture a few essential ones.

Initially, the estimated number of grafts from my donor area was approximately 3,500. However, the clinic was able to extract 4,500 grafts while preserving the donor area, which was great news. Unfortunately, 4,500 grafts were not enough to achieve full head coverage with adequate density.

The clinic suggested splitting the process into two sessions: the first focusing on the frontal area and the second on the crown. Initially, I was reluctant because this meant undergoing the procedure twice.

The clinic patiently explained the importance of donor preservation and that scattering leftover grafts from the frontal area wouldn’t be effective. They estimated that I would need at least an additional 3,000 grafts to cover the crown area to my satisfaction. Since my grafts had already been extracted, I took a leap of faith and followed their suggestion....

Here are some pictures on the extracted grafts and also the growth journey through month 1.

 

Extracted Grafts - Does it look like 4,500 grafts?

 

Immediate post ops Hairline

 

Post Ops Day 5

 

Post Ops Day 10 (Prior Scabs Removal)

 

After Scabs Removal

 

 

1 Month Update - Start of Shedding Phase...

 

Edited May 16 by Ephemeron

[Ephemeron]

HT #1 Updates from Month 2 onwards.

Wispy hair along with ongoing shedding.

 

Month 3 - More hair started sprouting..

 

Donor area recovering well, but still early to see results

 

Month 4 Update - Donor area recovering well, and more growth started on frontal side.

 

Month 5 Update - Initial hairline forming...but disappointed with some empty patches and the hairline look relative high, especially at temple area.

 

 

 

Month 6 - Started maturing....

 

 

 

 

 

 

 

[Ephemeron]

Month 7 Updates

[Ephemeron]

I was unable to find a pic for month 8, so updating for month 9.

 

This is where we find thickened growth, yet appear a little sparse on the frontal side under harsh lighting.

 

 

[Ephemeron]

Update for month 10, under normal lighting.

This is where I noticed my frontal growth seems to slowed down and having some deviation to expectation...

On the other hand, donor is recovering well and thickening.

 

 

[Ephemeron]

This is my month 11 update, and I've eagerly planned my second hair transplant procedure to address the empty crown. My goal is to touch up the temples and achieve full crown coverage using my remaining donor hair.

However, during regular updates with my first hair transplant clinic, they expressed doubts about achieving full coverage. They suggested I might still have some empty patches and recommended using long hair to cover them.

Seeking better options, I decided to get second opinions from various clinics. This led me to Yaman Resul, who offered the confidence I needed to proceed with the fix.

[Melvin- Admin]

Great case presentation. How many grafts does Dr. Yaman propose?

[Ephemeron]

41 minutes ago, Melvin- Admin said:

Great case presentation. How many grafts does Dr. Yaman propose?

From the initial assessment based on photos, it was estimated that I would need between 2,500 and 3,000 grafts before deciding to fly to Istanbul. However, only 2,300 grafts were ultimately harvested from my donor area.

I had hoped to extract more grafts to cover both the crown and touch up the temples, but unfortunately, that wasn't possible.

Psychologically, this was disappointing and didn't meet my expectations. Nevertheless, being halfway through the process, I still have to make the best of the situation and move forward with the best recommendation.

However, after the post-op grafting, I began to feel uncomfortable and uncertain about whether this reaction was normal.

I'll let the pictures speak for themselves...

[Ephemeron]

HT #2: Dr Yaman - 8 May 2024 

The journey began at Istanbul Airport, where I followed the clinic's instructions for pickup. Unfortunately, it wasn't as well organized as I had hoped, especially compared to my first hair transplant experience with IoM.

I waited nearly an hour for the driver, who seemed unsure of our destination until I corrected him. The car, a Fiat sedan, was in poor condition and reeked of cigarette smoke. Given my height (over 6 feet), the limited headroom was concerning, especially since my first hair transplant included an MPV with ample space.

I don't mean to complain, but considering the nature of the procedure, ensuring adequate headroom to avoid accidental bumps should be a priority for the clinic.

Nonetheless, i try to be as understanding as possible as I am here on a specific purpose and not a vacation. At least the driver was polite.

 

The "fanciful" MPV that i was picked up in my first HT with IOM.

 

[Ephemeron]

After a 45-minute drive from IST Airport, I arrived at Yaman Clinic. The driver dropped me off outside, leaving me to find my way to the clinic on the third floor. This transition could have been smoother.

Fifteen minutes later, I was sitting in front of Dr. Yaman for a consultation that lasted about 20 minutes. He conducted a physical evaluation of my donor area and made an initial estimation of 2,500-3,000 grafts.

I inquired about the possibility of extracting slightly more than 3,000 grafts to accommodate some touch-ups on the temple area. Although Dr. Yaman didn't give a definite yes, he suggested it might be possible depending on the actual extractions. 

Nonetheless, I clearly communicated my expectations, and we worked out a plan to prioritize the grafts. We agreed to use around 300 grafts for touch-ups on the temple area instead of the initially hoped-for 500, understanding the need to preserve more grafts for the crown. This compromise was acceptable to me, given the importance of achieving adequate coverage in the crown area. 

Here are some pictures from the planning phrase.

 

Microscopic view on my grafts, measured ~5.5um, which Dr. Yaman suggested it is of med-thick diameter.

 

 

Calculation on the area and density planning. 

From below, we can learn that 4,000 is the most ideal grafts in order to have the best coverage but again Dr. Yaman assured that we still can have a good coverage basing on what was available.. 

[Ephemeron]

9th May 2024

After a light breakfast at the hotel, I was promptly picked up at 8 a.m. and headed to the clinic. The formalities, including administration, a blood test, and a pre-op PRP session, were completed quickly.

Then it was time to shave my head and get ready for the procedure.

 

[Ephemeron]

The anesthetic administration for extraction was performed by a technician. I have a moderate pain tolerance, and this part hurt the most until my entire head was numb.

One issue was the technician's rough handling. She was quite harsh, and when I expressed discomfort, she ignored me and continued forcefully.
Even though the process was not long but i feel this could be a more delicate process, as least comparing to my first HT experience. 

The operating room was naturally ventilated, which was fine given the cool weather. However, I was concerned about the potential risk of infection in an uncontrolled environment. Additionally, construction work next door resulted in drilling noises coming through the open windows, which I had to endure throughout the procedure. This was far from ideal.

Interestingly, the room was equipped with a large TV with Netflix. Despite lying face up, I wasn’t offered any entertainment. Instead, the technicians played Turkish music on the TV for their own enjoyment. This wasn't the best experience, in my opinion.

During the extraction process, two technicians worked on me.

 

Here are some pictures on the post extractions:

 

 

Fridge with oxygen supply to preserve the grafts after extractions. 

t

 

Visually I can see only two Petri dish which i was told each contained 1000?
I cant help but to feel slightly doubtful about this as compared to images taken on my first HT.

This is on top of some scattered grafts on another petri dish which i was verbally told there are around 300s.

 

 

 

[Ephemeron]

Next: The incision steps and implantation after a short lunch break.

Dr. Yaman personally performed the incisions, which was a relatively short process before handing it back over to the technicians. The anesthetic administration and procedure by Dr. Yaman were more bearable than the morning session.

However, I continued to struggle with the technicians' handling. The implantation process seemed rushed, and the lack of patient care was concerning. On several occasions, blood and saline water seeped around my face and ears, causing discomfort and requiring me to remind them.

The technicians didn't speak any English, which made communication difficult.

It might just be me, but I expected a more professional approach that considered the overall patient experience.

Here are some pictures after the implantation process on the crown:

Observation: This seems to be less than desirable as the grafts were spread out relatively wide. 

 

 

As the technician was wrapping up the session with bandages, they were playing with their phone. This raised concerns for me regarding hygiene practices.

This eventually leave me with a weird looking bandages as below for the night, until i return for my first wash the next day. 

 

 

 

[Ephemeron]

Post Op Day 2: 

I returned to the clinic the following day for my first wash.

It was an expected process having going through the procedure once.

After unwrapping the ugly bandages, here are some better pictures to illustrate both the transplanted and donor area. 

Top View

 

Side View on Donor

 

 

Close up

 

Density is obvioously lacking, and this is probably not within what i was expecting. However i hope it turns out well. 

 

Side view

Donor

[Ephemeron]

A side by side comparison on before and after.

I would appreciate comments from the forum on what should i be expecting (realistically)? 

[Berba11]

3 hours ago, Ephemeron said:

A side by side comparison on before and after.

I would appreciate comments from the forum on what should i be expecting (realistically)? 

Hard to say for sure, but I imagine the coverage will be quite light. At the end of the day, 2300 grafts to cover the crown and midscalp on a NW7 won’t be enough to get full coverage. I think the placement of the grafts could have been planned differently. Will it be a visible improvement from where you started? Yes, quite probably and now it’s just a waiting game. 
 

I do have to say that I think you put yourself in a tough spot by going with the first clinic you went with. NW7 cases are difficult even in the best hands and shouldn’t really be left to lower quality clinics in Turkey. For not that much more money you could have gone to some very good clinics in India & Thailand… But what’s done is done and you’ve achieved reasonable coverage even if there are some issues/issues to come. 
 

Your documentation of these surgeries is probably the best and most thorough I’ve ever seen though. Great job!

[Napoli]

Happy Growing. Dr yaman is an excellent choice for higher Norwood patients when they have enough donor left. However you don’t have much donor left that’s why dr yaman harvested only 2300 grafts. But dr yaman did the best plan possible for your case. So just be patient for the final result. 

[Ephemeron]

Update on day 10 from the second HT.

This is right after scabs removal.
This was much more manageable with some experience from my first procedure and perhaps the lighter density plays a part as well.

 

 

[Chrome Dome]

Some of my experience with Dr. Yaman was like yours and some differed.

Airport travel- IST is a HUGE airport and I did struggle to find my pickup location. I felt that could have ben a little more clear.  I travel a lot for work and I think you could put 3 Atlanta airports inside the IST airport.  Lots of walking.

Van ride from Airport- I was driven in a larger van and not a sedan.  It did slightly smell of smoke but honestly I didn't see any man in Turkey that didn't have a cigarette in their mouth:)

Car/Van ride- They seem to use 2 different drivers. I mostly rode in a van to and from places.  On the hair wash day a car did pick me up.  I was extra careful so I wouldn't hit my head and everyone from the clinic and the driver helped me get in and out.

Operating room- The window was open and I did think about the sterilization process of the room.  I concluded that with all of the antibiotics I was on that it wouldn't really matter.

Technicians- I found them to be very enjoyable.  I had 2 days of surgery and one day, one of them did the lidocaine injections and it was noticeably more painful than when Dr. Yaman or the other techs would give them.  But I had a lot of shots and it was really only one time I felt the tech was being a little forceful.  I did experience the lidocaine and water spray running down my face though and that was a little annoying, but tolerable.

Technicians- They did ask me if I wanted to watch anything on TV.  I asked them to watch what they wanted.  They chose some Turkish pop music channel.  I enjoyed them enjoying their music.  I view that implantation phase as very long and tedious so I wanted them to be comfortable.  One of them even sang a little and honestly it was very calming.

Tech phone usage- I witnessed the same Tech/Nurse as you have pictured on her phone during my process.  I always saw her pull her gloves off and then put new back on when doing any procedure to me.  She seemed like more of what I would call an "Registered Nurse (RN)" in the US.  She did my IV's and monitored my EKG, Etc.

Communication- The techs had some basic English like, "sit up", Roll over", "Face Down" and "Pain?".  They checked my condition often.

Overall, judging your second surgery, It doesn't appear to be many grafts implanted.  They seem sparse. I can't imagine 2300 grafts would get much coverage.  I had 6700+ on my Norwood 6/7.  I'm guessing your donor area just wouldn't accommodate more?  

I am very happy with my results overall.  A few minor things like communication that I would offer their clinic improve upon but when I consider cost and Dr. Yaman's ability, I think I will have a great result.....But I'm just over 3 weeks in.

Best of luck.

 

 

[Al - Moderator]

You had a huge crown to cover so I don't think there was going to be any way to get dense coverage over all of that area especially since you also put some grafts into the frontal corners. It does look like the mid scalp is covered half decently, so at least you'll have good coverage further back than you did after the first procedure.

 

 

[Ephemeron]

On 5/17/2024 at 3:32 AM, Ephemeron said:

Post Op Day 2: 

I returned to the clinic the following day for my first wash.

It was an expected process having going through the procedure once.

After unwrapping the ugly bandages, here are some better pictures to illustrate both the transplanted and donor area. 

Top View

 

Side View on Donor

 

 

Close up

 

Density is obvioously lacking, and this is probably not within what i was expecting. However i hope it turns out well. 

 

Side view

Donor

 

 

I start to get concerned about the actual numbers of grafts that were implanted as ~2000 grafts on crown seems overstated. They are countable visually and from the picture angle covering 4/5 of my crown area, the numbers hardly goes beyond 1,000 grafts.  

From the total 2,300 grafts that were extracted, Dr. Yaman estimated 300 were used to touch up my temple, the coverage should be better than what it is looking like.

Could anybody advise if my concern is valid...?