45 Years Old, 3500 Graft - FUE - Transest Clinic, Istanbul

First off, I owe a great deal of thanks to the...

First off, I owe a great deal of thanks to the RealSelf community. Without your guidance and inspiration, the review I am about to type would not have been possible. In an effort to ‘pay it forward’ to others, I have documented my personal hair transplant experience with Transest Hair Transplant & Aesthetic clinic in Istanbul, Turkey. Since this will be a lengthy review, I will summarize some items in this post and provide procedure details in other posts.

My Background:
I am a 45 year old male who has been thinning since my 20’s. On the Norwood scale, I would be considered NW 6/7, which is Norwood 6 with thinning donor. Back in 2004, I had a FUT strip procedure for 1,400 grafts. I’m convinced that any remaining hair in the front of my head is from the original transplant procedure. Otherwise, it’s thin throughout with very few hairs to the crown. Over the years, I have used many products to slow down the progression of hair loss. These include: Rogaine foam (2x/day), Nixoral shampoo (3x/week), Pura d’or (Argon oil shampoo)

The Decision:
I stumbled upon RealSelf while researching an entirely different topic. I’ve invested dozens of hours reading posts, Q&A’s, and performing general research on different forums over the last several months. I am sceptical by nature, and never did I think I would be one to travel to Turkey for a medical procedure. However, after reading countless reviews from guys like CaliD3, dereklucan, Mahiry, Gmang85, jusbu83 and countless others, I began to consider Istanbul as a real possibility. These guys were the trailblazers, and it was great to follow their experiences and see pictures of smiling faces with new heads of hair. So, my internal questions of “what if” became “why not?”. Besides, medical tourism is a booming industry and this seemed like a good opportunity to sneak in a cultural vacation.

In considering clinics, I looked at many factors including pricing, location and of course positive and negative reviews. Two clinics that really stood out in my mind were Maral and Transest. I'm sure I would be happy with either one. Because the reviews for each were equally positive, I chose to go with Transest because the location was closer to the airport and cost was a few hundred dollars cheaper. Extra spending money to justify the decision to go..

Websites/Resources:
RealSelf - WhatClinic - Facebook
Google flights - Google maps
Baldtruthtalk - Hairrestorationnetwork
Tripadvisor - Turkeytravelplanner
WhatsApp - Currency converter (iphone app)

My expenses:
$ 875 - Airfare from Philadelphia to Istanbul (connect in Frankfort, Germany)
$1,900 - Hair transplant procedure (1,690 Euro)
$ 50 - One extra night hotel that I booked (Premist hotel)
$ 350 - Spending money (sightseeing, taxis, food, souvenirs)

Other supplies (Amazon.com):
$15 - Travel neck pillow (NeckSnug)
$15 - Money belt (AlphaKeeper)
$6 - European Schuko (plug adaptor)

You should also bring these:
Valid passport
e-Visa (evisa.gov.tr) ($20)
Two button down shirts
Noise cancel headphones (for plane)

See related sections for additional details regarding my procedure.

More info: The Flight, Clinic, Staff, Pricing and Hotels

Since a trip to Turkey involves a lot of planning outside of just the hair transplant procedure, I wanted to provide some useful tips and observations to hopefully help and guide others in their decision making progress.

Other options/My anxiety:
One of the harder decisions to make was regarding which clinic to use. To make an informed decision, I provided pictures and solicited advice from 8 HT clinics. The number of estimated grafts was all over the place. Using FUE, Transest, Maral Klinic and Tayfun Oguzoglu estimated they could find 3,000 grafts. Cosmedica estimated 4,000 grafts, AEK estimated 1,500 grafts, FUE Hairline said 1,000, the U.S. clinic said 700 grafts. One well regarded doctor (Hakan Doganay) said I was not a candidate for FUE at all, and one doctor said I was not a candidate for FUT. This was concerning because I am NW 6 with a prior 1,400 FUT and limited donor. What is a person to do? I want to be considered a candidate, but not at the cost of my donor being completely stripped and thinned. Anxiety!

I also found that different clinics have different business models. Some clinics employ a doctor to serve just one patient per day. The doctor clinics in Turkey normally change between 1-2.5 euro per graft. Some doctor clinics provide 2 or 3 nights hotel with transfers, and some do not. The ‘Tech clinics’ that I contacted all seem to provide maximum number of available grafts (whatever can be safely harvested from your donor), hotel, transfers, medications, and sometimes PRP for one set price. In my case, the price was 1,690 euro which equalled $1,900.

The flight:
Unfortunately, no direct flights are available from Philadelphia, PA to Istanbul, Turkey but luckily there are plenty of connecting flights at good prices. (Thank you google/flights!). My flight from Philly to Frankfort, Germany took 8 hrs - then 1-2 hrs layover - then another 3 hrs flying from Frankfurt to Istanbul. It was a long flight each way (about 12 hrs), but I watched two movies each way and read and took naps. Honestly, since I was travelling alone with no kids, the flight was relaxing and the time passed rather quickly.

Fun fact: For anyone flying international to Frankfort, Germany, I will tell you that this airport is huge. In fact, I nearly missed my connecting flight because the plane from Philly took off late and there was only 1 hour to transfer to the connecting flight in Frankfort. I literally ran at least 1/4 mile through Frankfort Airport, took the required train car, ran another 1/4 mile to the gate, went down a flight of stairs, then took the shuttle bus to the plane on the runway. Had I walked, I’m not sure I would have made the flight. It was quite the experience. I will add, however, that Lufthansa is a top notch airline. The flight crew speaks mostly German but they also know English and other languages. The Lufthansa crew provided terrific service on a long flight.

Transest Clinic and Staff:
Established in 2007, I found that Transest Hair Transplant & Aesthetic is one of the oldest HT clinics in Istanbul. The clinic is located within a few miles of Araturk Airport which makes it convenient for HT patients who simply want to fly in, have the procedure, and fly home without any sightseeing. If sightseeing is desired, then a 25 minute taxi ride will get you to the historic district of Sultanahmet.

There are actually two sides to Transest clinic. Dr Ayse Ozturk handles the plastic surgery (Aesthetic) side, while Dr Ahmed Altan, newer to the practice, handles the Hair Transplant side. I also learned that Dr Ayse Ozturk’s husband - Dr Erdogen Ozturk - had previously worked HT’s at Transest but he now works out of another hospital. Also, Aytac Karadut, the former International Coordinator, is no longer with the company.

The doctor informed me that Transest has performed more than 7,300 HT procedures since 2007. My procedure was performed by a team which included the doctor and surgical nurses/techs. The techs performed all of the prep work and extractions (which I describe in a later post), Dr Altan opened all of the new channels, and the techs implanted the grafts. I asked, and was told, that the doctor and techs have the following experience:

Doctor: Ahmed Altan - 4 yrs HT
Surgical nurse: Sumeyye - 7 yrs HT
Surgical nurse: Kezban - 4 yrs HT
General Director: Erkan Vural - 8 yrs HT

?The Price:
The price I paid was 1,690 euro, which converted to $1,900 U.S. dollars on my procedure date of March 18, 2016. This price was all-inclusive and covered the HT procedure for maximum available grafts, PRP injection, transfers to/from airport, transfers to/from hospital and clinic, lunch on operation date, 2 nights hotel w/hot breakfast each morning, medicines and post-surgery shampoo. There were absolutely no surprise or extra costs, and at no time did the doctor or any representative of the clinic attempt to upgrade or sell anything additional. The cost of $1,900 cash is the only money that changed hands with the clinic.

By comparison, a typical FUE rate in the U.S. would cost at least $7/graft. A procedure of 3,500 grafts - if a U.S. clinic would attempt to perform in my case - would mean that 3,500 grafts x $7 per graft = $24,500. Obviously, paying less than $2,000 U.S. dollars feels like the bargain of the century if the procedure actually works!

Money:
Local currency is the Turkish Lira. Most places will accept Lira and Euro, and I found a few shops that also took U.S. dollars. With the recent turmoil in Europe, tourism is down and shopkeepers are desperate for business. When asked if they accept U.S. dollars, more than one vendor remaked that “money is money”. I converted $350 U.S. dollars to Turkish Lira at Philadelphia airport, just to have it handy. I kept the $2,000 cash, $350 TL, passport and boarding passes safely stored in my money belt at all times. As a general rule, $1.00 = 3 TL = .90 euro. Looked at another way, 1 euro = 3.2 TL = $1.10. I used a Currency App to keep everything straight.

The Hotel:
Since I planned to stay an extra day for sightseeing, I arranged my trip as follows: My total trip consisted of four nights, with my first night spent on the flight from U.S. to Europe.

Premist Hotel - My first night in Istanbul was spent at a little boutique hotel called Premist Hotel. This little B&B style hotel is located in the heart of the historic district of Sultanahmet. This is a perfect location, literally a few minutes walk to Topkapi Palace, Sultan’s Tombs, Hagia Sophia, Basilica Cistern, Blue Mosque, and then Grand Bazarre. Price was about $50 per night which included a delicious breakfast. The hotel receptionist, Derya, was pleasant and helpful, and I spent time having tea in the cozy lobby. I simply can’t recommend this hotel enough.

Helpful tip: If you stay at Premist Hotel, be sure to check out the shops and restaurants within walking distance of the hotel. From the hotel, instead of walking straight up the cobblestone hill to the main attractions, just prior to the Art Store, make a left through the neighborhood and you will stumble upon outdoor cafes, fish markets, and vendor shops with fairly priced souvenirs. Walking down the cobblestone road (instead of up) will take you to the Bosphorus Straight where you can see the continent of Asia. (I took a selfie!)

MidMar Deluxe Hotel - My last two nights in Istanbul were spent at MidMar Deluxe Hotel, which were included in the HT package. MidMar is located in a working class part of town, very close to the airport. Honestly, it’s a bit of a sketchy area but the hotel was clean and service was good. The breakfast, although robust, was not as good as Premist Hotel.
?Helpful tip: If you stay at MidMar Deluxe, be sure to take a 5 minute taxi ride (12 Lira, ~$4.00) to StarCity Outlet Center. This is an American style mall which contains a very large grocery store (food, beer, cookies), clothing stores, jewelry and appliances under one roof. A chocolate fountain with various fruits is on the 1st floor, and a pub style food court with tv’s can be found on the 3rd floor. I had a grilled cheese sandwich with bottle of water for 10 TL (about $3.00). My sandwich was better and cheaper than any food I had back at the hotel.

My next posting will get into the actual HT procedure.

Photos- Before, D-day, Day 1, Day 2

Transportation and Hospital

My first impression upon arriving at Araturk Airport was that I had made it, but my luggage did not. Apparently my suitcase did not make the connecting flight. No worries, said the nice girl behind the Lufthansa counter. The suitcase will make the next flight and they will have it delivered to my hotel by 8:00 PM. Airport transfers were included in my package; however, I had previously informed the clinic that I would like to spend my first night in the historic district of Sultanahmet. So my next order of business was finding my way to my hotel. The girl behind the counter said the subway would be a good way to get there, and so I made my way to the subway. The subway is actually more of a trolley car that travels on the streets above ground. The Sultanahmet stop is literally right in the heart of the historic district, and a 5 minute walk to Premist Hotel.

Helpful hint: The subway from Araturk Airport to Sultanahmet requires two tokens, one at each turnstile, due to a connecting rail. Purchase 2 tokens @ 4 TL each = $3.00. If you choose to take the subway from the airport, take to Stop 6. Get off on the right, go down stairs, cross over the tracks (locals walked me through an open passing train car which served as a bridge to cross over the tracks), then take that train all the way to Sultanahmet.

Fun story: As I rode in the train, an older Turkish man was waving and speaking frantically at me. Mind you, I speak no Turkish and had literally been in the country for less than one hour. I finally realized that he was concerned for my safety as I leaned against the train door, and he was afraid I might fall out at the first stop. I moved away, and everyone on the train had a good laugh. By the way, I was probably the only person in Turkey wearing a rust orange jacket and white sneakers. I guess I’m an easy mark as a tourist!

I’ve already mentioned how much I enjoyed the location and atmosphere of Premist Hotel, so I won’t go further. I will say that spending my first day and night in the historic district was huge for my confidence. With just three days in Istanbul, my free time was going to be limited and I wanted to take advantage of being able to sightsee as much as possible. When I returned to Sultanahmet two days later, I was already familar with the town and I knew my way around a bit. If you do get a chance, be sure to check out Arasta Bazaar located behind the Blue Mosque. Lots of outdoor vendors, reasonably priced, and almost a flea market atmosphere. Be sure to stop by vendor No. 8 which is run by a Moroccan woman and her husband. She is very friendly and helpful, and she gave me some great deals on turkish made pillow cases and silver jewelry. Business has been down significantly since the recent terrorist bombings and these vendors are very appreciative of any business they can get. I chuckled out loud when she used the ‘F-word’ to describe ISIS.

To close out this chapter, I was thankful that my luggage arrived at the hotel around 7:00 PM. No use unpacking since I would be transferring to a new hotel after my procedure the very next day. I had planned on taking a taxi to the hospital for my procedure, but Dr Altan had called my hotel and also sent an email to inform me that he would be sending a driver to pick me up the next morning and deliver me to the hospital for my procedure. I was happy about this since it was one less thing I would have to arrange on my own. The driver is a small, happy man named Mustafa. His English is very limited so plan to use a lot of hand gestures to communicate. About 30 minutes later, we arrived at the hospital. The name of the hospital is ‘Ozel Erdem Hastahanesi - Gunesli. (I only know this because I snapped a picture on my way out). You can find a picture of the hospital if you Google ‘Erdem Hastahanesi’. It looks like the hospital receives 4.4 / 5 stars on Facebook, which is promising. It looks like the hospital accomodates everything from hair transplants, plastic surgery, and baby delivery.

That’s enough background for now. My next section will get into the actual procedure. Promise.

The Procedure

My hair transplant procedure took about 8.5 hours. I won’t lie, this was a long day. Since I was staying in the historic district the first night, I had planned to take a taxi to my procedure on Friday morning. However, I received an email and phone call from Dr Altan saying that he would send Mustafa, the Transest driver, to pick me up between 10-10:30am. This was nice of them since it saved me from having to hire a taxi to the hospital. Thanks to a traffic jam in each direction, I arrived at the hospital around 11:30am. The clinic typically likes to get started by around 9:00am.

I met Dr Altan for about 15 minutes, signed papers, and handed over $1,900 U.S. dollars. (The cost for the procedure is actually 1,690 euros which converted to $1,904.60). I handed over $1,905 but the doctor returned the $5.00 bill and said that $1,900 was enough. I thought this was nice and fair of them. A few weeks earlier the price would have been $1,850 but the euro had gotten stronger against the dollar. It was nice being able to pay in U.S. dollars which actually saved me some money since I did not have to pay a bank to convert to euros. The clinic did not charge any conversion rate. The doctor snapped a few “before” pics of my head, then we moved to the procedure room which was the room next door. Since I would be checking into MidMar Hotel following my procedure, I had my suitcase and carry bag with me. The driver carried these to my procedure room so that all of my belongings would be close to me all day. This made me feel comfortable and secure.

The procedure consisted of several steps: Following Prep work, the 3 major steps are: 1) Extract grafts from back of head; 2) Make new channels on top of head; 3) Insert grafts into new channels. In terms of timing and procedure, I had the following experience.

3 stages:
Prep = Performed by surgical nurse (15 mins)
1 - Extraction = Performed by surgical nurses/technicians (3 hrs)
Lunch = (10 mins)
Prep = (5 mins)
2 - Channels = Performed by Dr Altan (1 hr)
3 - Implant grafts = Performed by surgical nurses (4 hrs)

Prep work: I sat down in a chair, and the young nurse shaved my head. In my 45 years, I have never had a fully shaved head, so it was interesting to see how I looked in the mirror. It was strange, but not too frightening. The nurse then took a vial of blood to screen for disease and also to use for PRP (Platelet-Rich Plasma) injections. I then lay down on a table for anesthesia shots. I like to think I have a fairly high pain threshold, but the shots were painful, probably a 5/10. The top of my head started to become numb. The nurse would poke with a needle and ask “pain?” If I said no, she moved to another area. If I said yes, then it was another shot to the head. In all, I counted a total of 70 anesthesia shots in this step. This is no typo.. I counted 70 needle shots to the head.

Extraction: The Extraction step was performed face down on my stomach. In all, this step took about 3 hours. Members of the team took turns using a micro motor (which is basically a Dremel tool) to cut around each graft. The tech would drill around approximately 10 follicles, then rub over them before using a tweezer to pull out each drilled plug. This process was followed until all 3,500 grafts were removed. The grafts were soaked in petri dishes filled with a solution (possibly blood) and sprayed with saline to keep them moist while the second nurse sorted the grafts by 1, 2, and 3 hair. Dr Altan later informed me that 50-60% of my grafts were 1 hair, 40-50% were 2 hair, and 1-2% were 3 hair. In total, my donor yielded: ~1,900 (1 hair), 1,550 (2 hair), and 50 (3 hair), for a total of 3,500 grafts and 5,150 hairs transplanted. Tis is a relatively small yield, especially considering that my hair is on the thin side. However, the fact that they were able to actually harvest 3,500 grafts from my donor was more than I could have imagined when the procedure began, and this makes me very happy.

As for the work rotation, the two nurses (Sumeyye and Kezban) started with the extractions, followed by the nurse with head scarf, followed by Erkan Vural. (Note on Mr Erkan: He was interchangeably called Dr Erkan and Mr Erkan, so I’m not sure if he has a PHD or something else, but I suspect he is not an MD. However, I believe he was listed as General Director on a website, and I was told that he has 8 years experience in HT). I would be thankful if somebody could learn his true credentials for the record.

Lunch: Once the extractions were completed, we broke for a 10 minute lunch which consisted of eggplant in beef, noodles, roll, and apple. I believe the lunch break would normally be longer, but I suppose we were making up time for a late start. Besides, I was so hungry by this point that I finished everything in 5 minutes. Then it was time for more anesthesia shots to the head.

Prep: After sitting on the table, the younger nurse administered a new round of anesthesia shots to the forehead. This is the area that would be receiving the grafts. Even though the number of shots was less (only 7 shots) and took just 5 minutes, I can tell you that the pain level was very much higher than it was in the initial round. Apparently the forehead contains many more nerve endings than other parts of the head. I believe it, since this round of shots registered an 8 out of 10 on the pain scale. Yes, it hurt that much. I have a fairly high tolerance for pain, but actually yelled out loud a few times. Good thing is, the shots were done fairly quickly and we were on to the channel insertion.

Channels: The channel part of the procedure was performed while sitting in a chair. This took about 1 hour. Dr Altan informed me ahead of time that the channels were the most critical part of the procedure, and that he does all of the channels himself. This held true in my case. Mr Erkan held me still while Dr Altan made the channels in my head. It was hard to see, and I had to remain perfectly still, but the doctor essentially used a tool to poke 3,500 holes from my forehead back to the crown. This part of the procedure was painless but I could hear a crunching noise with each hole that was made. I took advantage of watching the Turkish Top 20 music channel while this part of the procedure was performed. Many of the acts were American, like Katy Perry. Not sure if the Turks enjoy the American music videos or if they were catering to their audience, but it may be a combination. After all channels were cut, I believe the doctor administered the PRP injections, then it was time for the nurses to place the grafts.

Graft implant: The third and final phase of the procedure took the longest at approximately 4 hours. The two surgical nurses used tweezers to place each of the 3,500 grafts into a channel, one at a time. At times one nurse placed grafts, sometimes they switched places, and sometimes they both placed grafts with one nurse standing on each side of my head. They talked and giggled in Turkish while working, which I really didn’t mind, since they seemed to enjoy their work and this task obviously required a great deal of manual dexterity and coordination. Occasionally when a cell phone would ring, they would check it and then get back to work. Not sure if these were personal texts or work messages, but it didn’t bother me so much because the job was tedious and these little disruptions were probably healthy. By this time, I was mostly exhausted. At one point, I asked how many grafts remained to be implanted, and they said 2,000 with an ETA of 2 hrs. Ugh. This was entirely painless but it was difficult to remain still for so long, and my neck was cramping. I was thankful when they repositioned my head from time to time. I actually caught myself dozing off a few times. On one occasion, I caught myself and jolted awake which startled the nurses. We all had a laugh. Once all grafts were placed (again, about a 4 hour process), I met Dr Altan in the office room next door for post-surgery instruction.

Post Surgery: Along with post-surgery instruction, Dr Altan provided Cipro (antibiotic), Prednol (anti-inflammatory), and Majezik (pain pill). He also provided Haarex shampoo specially formulated for HT and to be used to completion. All products were free of charge and at no time did the doctor or anybody else at the clinic offer or attempt to sell me anything in addition to what I had already paid.

Funny story: So following the procedure and post-op instructions, the doctor said that Mustafa would return me to the hotel. The car was a fairly small vehicle, similar to a Mazda compact minivan. We waited a few minutes outside in the car, then the doctor appeared. I guess we were providing him a ride home, I thought. Then the two nurses who had just worked on me for 8 hours appeared. It turns out this was a carpool and we were giving everyone a ride home. How interesting. So, Mustafa drove me to the hotel with the doctor and two nurses crammed into this little 5-speed car, zipping through side streets and over bumpy roads, 8:30pm after 8.5 hours surgery. This is certainly not something you would experience in America. The young nurse shared cookies and skittles as we drove. After about 10 minutes, we made it safely to my hotel and I was free to relax and prepare for the next day.

Sleeping and Post Checkup: Night one, I had some general discomfort and a slight pressure headache, but nothing that necessitated taking the blue pain pills. My foam neck pillow came in handy as this kept the donor (back of head) off the nice hotel pillows. I would estimate sleeping about 4-5 hours total. The next morning, I woke, shaved, and had a nice breakfast in the MidMar Hotel basement where Mustafa met me at 9:30. Mustafa drove us to the Transest clinic (different from the hospital) where I met Dr Altan who addressed any questions or concerns. The assistant removed my bandage and replaced it with a black headband. I actually felt pretty good considering I was poked and prodded over 7,000 times just the night prior. My forehead was a bit swollen but nothing major. The office assistant then washed my hair while discussing proper technique. I asked about wearing a hat in public. His preference was that I not wear a hat, however, he said it would be okay if I was absolutely careful to not allow the hat to touch any of the implanted grafts. Finally, he asked that I forward an email with pictures in 10 days so he could monitor progress and concerns. I was happy to hear that he was interested in ongoing follow-up. After the 20 minute office visit, Mustafa returned me to MidMar hotel, and I was free to tour the city.

Pictures: Days 3-13

The following pictures show a progression of hair growth from days 3-13.

More thoughts

The best part of my trip (other than the hair) is being able to share my experiences and hopefully inspire others to make the journey if it feels right for them. The worst part my trip was learning that there was a suicide bombing in Taksim Square. This occurred one day after my procedure. I learned of the bombing while I was walking and shopping in the historic district of Sutanahmet. Although I was in Istanbul just miles from the attack, I saw and heard nothing suspicious. Admittedly, the event did put me on edge a bit, but despite the seriousness of the day I still felt very safe walking the city. I'm a numbers guy, and statistics would show that you have a much higher probable chance getting hit and killed by a car than getting caught up in a terrorist attack. The threat was certainly in the back of my mind, however My suggestion is to take normal tourist precautions if you go. Remain vigilant, and stay apart from large tour groups. I don't say this to dissuade anyone from going, in fact, from a personal standpoint I felt safer walking streets in Istanbul than cities in America.
Some other tips: definitely check out the coveted bazaar with almost 4,000 shops, but don't buy anything there. Much better deals can be had in the local family owned street shops without the haggling.
Tea is popular in Turkey. It's not uncommon for shopkeepers to invite you into their store for a cup of tea. This is part of their culture, but mostly they would like to sell you a carpet (Turkish rug). Their carpets are hand made of silk and wool, and stunningly beautiful. Each carpet can take 8-12 months or more to weave. I have pictures of a woman weaving carpets in a small corner store. The larger ones can still go for between $1,500 to several thousand dollars, but this is still a 75% savings vs if you were to buy domestically. Regardless, I did not purchase a rug in Turkey. After all, that money can go towards a second hair transplant.

Week 3 pictures

Things have been progressing well. I still shampoo using the special Haarex shampoo provided by the clinic. In addition, I resumed using Rogaine foam (2x/day) and started Finasteride (1.25 mg on M, W, F). I also take a daily multi-vitamin and daily biotin supplement (5000 mcg). I also try to eat fairly healthy and drink lots of water to give my new grafts the best possible chance to grow. I haven't experienced any shedding (that I've noticed) other than just 1-2 little hairs that fell out while shampooing. Not sure if this is a sign of more shedding to come, but I am not looking forward to it. The final few pictures are from today.

Week 3 pictures (End of week, cont'd)

Here are a few more pictures from end of week 3. I would say that everything is fully healed with no soreness anywhere. Numbness on top of head (recipient area) has subsided.
I'm surprised I still haven't experienced shedding. Not sure if the shedding will come later, it may vary by person.
Anyway, I'm very happy with the way things look at just 3 weeks post-op. My co-workers have been very supportive and quite a few men with thinning hair have been watching closely. (They may make the trip if it works for me.. Lol!). I try to take all pictures under direct light to really capture the details, so I think the hair really looks better to the naked eye than on camera. Let me know your thoughts!

Week 4 pictures

Not sure how many people read the posts, but I will continue to post pictures to track my progress. For my daily routine, I still use the special Haarex shampoo provided by the clinic. That bottle will last a long time. Once it finishes, I will alternate with an Argon-oil shampoo and Nizoral shampoo.

I also use a small amount of Rogaine foam 2x per day, and take 1.25mg Finasteride every M, W, F. Besides that, I take a multi-vitamin and biotin supplement.

The donor and recipient sites continue to grow with no apparent shedding. I keep wondering if/when the shedding will happen. Not sure if the PRP procedure, my daily routine, or just chance is keeping the shedding at bay, but I guess we will never know.

Week 5 pictures

Things continue to progress as week 5 draws to a close. Still no shedding which is positive. At this stage of the game, I'm thinking it won't happen. The donor and recipient areas both continue to grow. The donor is obviously a bit thicker at this stage, so I'm thinking a haircut might be needed in the next few weeks to keep things even.

I continue to use the medical shampoo, Rogaine, and Finasteride. I also resumed using Nizoral shampoo (part of the Big 3) 2-3 times per week. If you suffer from MPB hair loss, you will want to make sure Nizoral (Ketakonazol) is in your arsenal.

I'm really hoping to see some quick growth in top, with enough to cover some of the crown area. As a NW grade 6, the 3,500 grafts were enough to cover the front and top, but not enough to cover the crown. Im hoping my donor area is strong enough after one year to provide another 1,000 grafts for the crown. If not, then I may need to resort to BHT. (Turkish clinics will transfer from beard to head!)

Week 6 pictures

Here we are now, 6 weeks post-op. The transplanted hairs continue to grow longer, and the donor area continues to thicken. Still no shedding of hairs, which is a good thing. I would say that things look about as good as possible considering it's only 6 weeks in. I am happy and excited at the prospect of having hair again (who-hoo!). However, the lack of hair in the crown area is very bothersome. I look forward to having the crown taken care of in the future. Take care all!

I continue to use minox (daily), finast (3 days), Haarex shampoo (4 days) and Nizoral shampoo (3 days). This regimen seems to work great for me so I will stick with it.

Week 7 pictures

Week 7 is in the books. No changes in my hair treatment plan or anything else. The hair continues to grow at a slow but steady rate. Hair is getting longer but still sparse, like a porcupine, but I can feel (and see) tiny black hairs growing up between the longer hairs. Looking forward to these little guys continuing to pop to thicken everything up. I will see you in another week, and then probably update monthly. Take care!

Week 8 update

Hello RS community. Today marks the week 8 anniversary of my HT with Transest. I would say things are still progressing. The original fine hairs continue to lengthen, as well as some transplanted hairs. In addition, little black hairs are sprouting. From a distance, these create a "shadow effect" on my forehead. If you've had a HT, you probably know what I'm talking about. It looks a lot like a sunburn in the recipient area. The donor area looks fine, and I may eventually have it cut since I like to keep it on the shorter side. From this point, I will probably update monthly. Feel free to ask questions; otherwise, I will post an update at month 3. Take care!

Month 2.5 update

Hello RS community. I've been following my normal regimen and wanted to report on progress. Little black hairs are growing in, which leads me to believe there was some prior shedding of the transplanted hairs. I may not have seen the actual shedding if the hairs came out with the scabs around day 6-7. Anyway, at 2.5 months, I think I have at least as much hair as I did prior to the procedure.

Today I had my first haircut to even out the sides. I asked the barber to use a #4 guard on the back and sides, and lightly trim the top. I had wanted to keep the top longer to give the illusion of more hair, but Franco went to town and I ended up with something of a crew cut. Haha. Anyway, I'm not too concerned since it's been hot outside and summer is coming. Let me know what you think.

3 month update

Here are updated pics that mark the 3-month milestone. I continue to follow the regimen described in earlier posts. It's difficult to tell from the pics, but the hairs are growing in thicker. Still a lot more time needs to pass, but so far I am happy and excited with results after just 3 months. I will post again next month.

Month 4 update

Hello RS community. My procedure was March 18, so today represents month 4 of my HT. My hair continues to thicken and grow daily, and I'm 100% satisfied with the progress to date.

I'm finally using up the last of the Haarex Premium shampoo that was provided by the clinic. When it's gone, I will resume using my Pura D'or argon shampoo and conditioner. In addition, I continue using Rogaine foam daily, and I take 1.25mg finasteride every M, W, F.

My hair seems to look and feel healthy and appears to be growing at a faster pace, but I'm not sure how much, if any, of the growth can be attributed to minoxidil or finast. I look forward to getting another hair cut soon, only this time I will ask the barber to buzz the sides with a #4 and leave the top to grow out longer.

I know that some of you with upcoming procedures are very concerned with the recent turn of events in Turkey. If you choose to make the trip, I would advise you to maintain a low profile, don't get caught up in large groups or demonstrations, and by all means do not say anything bad about president Erdogan. If you survive the trip, it will be the best $2,000 you ever spent. Good luck!


Month 4 pictures

Before & After (Month 4)

Here is a closeup picture at month 4. Density has improved a great deal.

5 month update

Hello RS community. This marks the "5 month anniversary" of my HT procedure with Transest. Things continue to progress, with added thickness on the front and top. I didn't have enough donor at the time to hit the crown, but started on finast 4 months ago to see if this will help the crown.

Coworkers who knew about the procedure have remarked how nice the hair is looking. A few people I haven't seen in awhile have also commented on a slight change in appearance, but they have no idea it's the hair. (I've had questions like, 'are you working out'? And 'have you lost weight?.. you look great'. No, it's not the body, it's the hair (Haha!).

As far as routine, I finally used up the last of my HT Shampoo. My routine includes the following:
- Nizoral shampoo (M, W, F)
- Finasteride (M, W, F)
- Rogaine foam (daily)

As you can see, the so-called "Big 3" are incorporated to help combat thinning of the donor hairs. I've used Nizoral and Rogaine for a few years now, but I think think the addition of finasteride is really helping to keep my existing donor in check. It's only been 4 mths, and results can take 6-12 mths, but the donor area obviously looks healthier now than it did pre-op. (I also stopped taking a Creatine supplement which was absolutely killing my hair!).

I use the Rogaine foam in the morning, and sometimes at night. It doesn't take much, and I really like the foam because it serves as a styling gel without having to use another product.

I will post again in another month. Until then, feel free to comment.



6 month update

Hello again RS community. Sept 18 marks the 6 month anniversary of my HT. This timeframe is supposed to be where things really start taking off, so I am excited for the future. Although I've seen consistent growth since day 1, it's been a slow grind and lately I'm feeling impatient as I'm anxious for the finished product.
The front and top continue to grow and thicken, and I hundreds of new growth stubbles can be felt in all areas, including towards the crown. Hair grows at a rate of 1/2 inch per month, so in another month or two the stubbles should be actual hairs. The pictures are taken under direct light, so I believe the actual growth and coverage looks better in person than it does in the pictures.
My regimen incorporates the big 3 (finast, rogaine, nizoral). I started with finast 5 months ago (M, W, F). They say it can take 6-12 months to see effects, so I'm hoping this med will help to recover some growth in the crown area that I wasn't able to hit with grafts in the first HT session.
I've included a few pics from last week and this morning, before and after a hair cut. Overall, I am happy and pleased with results to date, and excited for the future. In a few months I will see where things stand and may send a note to the clinic to see how many more grafts could be grabbed for a crown session. Good luck and happy growing!

7 month update

Today marks the 7 month milestone of my procedure. I believe things are progressing, albeit very slowly. The front looks okay, but still very minimal coverage on the top and crown. I've been feeling impatient lately because at 7 months I should have experienced about 70% growth. I'm starting to wonder how much additional growth is in the cards for me. Will I see another 30%? Only time will tell, I guess.

Regardless, I'm thinking another trip to Istanbul should be in my future. I'm sure the clinic can scrape up another 1,500 grafts to hit the crown. Just need to convince the wife..

7 month update (2 more pics)

I wanted to post two more pics after my recent haircut. The barber used a 3.5 grade on the sides and scissors cut the top. Looks very trim now. Front on, you can see the density which looks great. (1,000% improvement over the 'before' pics). The second pic shows part of the crown and top that still needs growth. They say the top and crown are the last to respond, so I'm hoping the remaining 30% expected growth takes place in this area. Cheers

8 month update

I'm now 8 months into this journey and feeling very good about the progress to date. Looking back over prior pictures, I can definitely see month to month progress being made. At the 8-month mark, I should be about 80% complete, with the remaining 20% growth coming over the next 4 months. Finasteride can take time to work its magic, with benefits coming over two years, so I'm hopeful the medicine extends my hair journey well beyond 12 months.

My regimen consists of Rogaine, Propecia/Finasteride (M, W, F) and Pura D'or (Gold label) Argon shampoo. I left my Nizoral shampoo at the gym, but probably won't bother replacing it at this point since the Pura D'or contains Ketoconazole as an ingredient.

Oh, and I recently colored with JFM light brown, which I swear adds thickness to the hair. Unlock Hairflick, I desperately wanted to stay away from 'Trump (Oompa Loompa) Orange'!

Let me know if you have questions or feedback. Happy hair growing, everyone!
Dr. Ahmed ALTAN

Transest is a well-run company. The hospital and clinic are clean and sterile. Dr. Altan opens the channels to receive the grafts, and he oversees all aspects of the clinic and the procedures performed by surgical nurses/techs. From day 1, the doctor has been kind and considerate, and has responded to my many questions in a timely and thorough manner. The doctor has delivered on all promises. I was very concerned about over-harvesting, so time will tell if the procedure is a complete success. If over-harvesting is an issue, my opinion will change drastically. As for now, I couldn't be happier or more impressed with the work ethic and efficiency of Dr Altan and Transest clinic.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
4 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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