Transplanted to Turkey

As my hairline receded past the point of denial and other medical treatments failed me I decided to get a hair transplant. The most common cosmetic surgery for men, over 1 million hair transplants were performed worldwide in 2023. Turkey has become a Mecca for cosmetic surgery, largely due to competitive pricing. People hope to get 90% of the quality for 10% of the cost.

The procedure isn’t the most technical and requires only local anesthesia, so there is little fear of waking up missing a kidney. For clarification purposes hair transplants move your own hair from the back and sides of your head to the crown and other balding areas. This is not like an organ transplant where the tissue is taken from someone else. They can also take chest chair and hair from other places if you are completely bald on your head.

I originally got a quote from a US doctor: $9,500 dollars for 1200 grafts. I knew I needed roughly 4,000 grafts so getting this done in the US was going to be like buying a new car. After countless hours of reading conflicting reviews online for Turkish clinics I decided to ask my friend from Istanbul for a recommendation. Her dad is a practicing neurosurgeon in Istanbul and she asked him if he could recommend anyone for me. He put me in touch with someone who he has known for 25 years and highly respected. After a FaceTime consult with this doctor I ascertained the cost would be $2,800 and they had openings two weeks from then. I booked my flight and said my prayers.

The cost included 4 nights in a 5 star hotel, drivers for your entire trip, and the procedure itself. My flight was $1,000 and I ended up staying a few extra nights, bought nice dinners, and spent too much at the grand bazaar so my all in cost was roughly $5,000.

My journey consisted of three flights: New Orleans > New York > Paris > Istanbul. It was 21 hours of travel time with two 1.5 hour layovers. The first morning I woke up early with the goal of seeing as many of the items on my list as I could. I knew I likely would not feel like doing much in the days after the surgery. I woke up at 6 and hailed a cab to the historic district.

I saw the Blue Mosque, the Topkat Palace and that Hagia Sophia. I also spent a good bit of time walking around the grand bazaar and admiring the ancient architecture and being fascinated by the people. Most of the noteworthy historical buildings were constructed by the Ottomans.

The Ottomans were the greatest civilization on earth in the 1500–1600s. Istanbul, formerly Constantinople, was the capital of the Eastern Roman Empire, also known as the Byzantine empire. It survived 700 years longer than its western counterpart after Rome fell to the barbarians. The Turks overthrew the Byzantines in 1453 and then ruled the eastern Mediterranean with an iron fist for 500 years. They were basically as large and dominant as the original Roman Empire was but they don’t get nearly as much credit in the west. I suppose due to their political leanings.

Their architecture is as awe inspiring as the more well known places in Western Europe. The Blue Mosque rivals St. Peter’s Basilica in its pristine Beauty. Topkat palace outdoes Buckingham in grandeur but not in refinement. It was built 300 years earlier after all. The Hagia Sophia, built by the Byzantines, is gorgeous and contained the world’s largest architectural dome for over 1000 years until St. Peter’s Basilica in Rome was built.

The grand bazaar is an interesting place but very hectic. You are constantly accosted by merchants hawking their wares. It’s where foreigners go to get ripped off but it’s part of the experience. You get special treatment if you are a foreigner. You get extra special treatment if you are a foreigner with obvious surgical bandaging. A hair transplant at $2,500 is half the average annual income of $5,000 in Turkey. Crazy enough it is about the same in the US: 30k for roughly 4,000 grafts would be half the average US income of 60k. This is largely explained due to it not being a complex procedure but a very labor intensive one.

I went to a little restaurant near the grand bazaar that was busy but had an open table or two. Capacity is the simplest heuristic to know at a glance if a restaurant if worth eating at or not.

There are few obese people in Turkey. This is partly because it is very young population. The average age in turkey is a decade younger than the US and 15 years younger than Europe. The old people in turkey truly look old. Maybe it’s the circles I run in but old people in the US look pretty good. I suppose due to surgeries and skin care. I recently read that 85% of women in the US who are over 65 dye their hair. 50 years ago it was 4%. As far as I can tell in Turkey it is near zero.

The lack of obesity could also be attributed to the fact that everyone smokes. I am a sucker for the aesthetics of smoking. There is nothing better than watching two friends engage in lively conversation while waving their cigarettes around while sipping espressos.

If you think smoking makes your life just 12% better you can easily argue it is worth the on average 10 years reduction in lifespan. If it keeps you thin you could even argue that it’s a net positive for your life. I smoked a few cigarettes in Turkey when they were offered to me and I must say it really gives you a sharp increase in oratorical skills.

Afterwards I went into a local shop to buy some baklava. Everyone you run into is very friendly, wants to know where you are from, has questions about America, and says they love your accent. Basically how we treat europeans in our country. I was told by a couple of people I look like prince Harry. This is always welcome for me to hear. There are few good looking male redheads on this planet but he is certainly one of them.

In this shop I ran into a couple of brits who had bandaging on their heads from hair transplants they had the day before. I could barely understand them. Something about a thick low class British accent is incomprehensible to me. I had no problem understanding the Turks and their broken English. As far as I could find out I didn’t need to be worried about the surgery. It was mostly just boring. Laying flat on your stomach for 3 hours and then 5 hours on your back, depending how many grafts you needed.

I was supposed to meet with my doctor for an initial consult at 3pm so I decided to head back to the hotel. I hailed a cab and we got to talking, google translate helped a lot. He said his brother lived in America and that he was Kurdish. I said I was a fan of Saladin and that he was a great warrior. He liked this answer and asked what else I planned to do in Turkey. I told him the places I visited that day and said I was going to see the WW1 battlefields in Gallipoli. He told me he did his mandatory military service in Gallipoli. We discussed Ataturk and the British defeats in WW1. I guess I was sounding pretty positive about the Turks so he asks me with a straight face: are you muslim? I laugh and say no I’m just a fan of history. We got to talking about his family, he had a wife and a 6 month old boy.

He pulled out a pack of cigarettes and asked if I minded if he smoked. I said no of course. He offered me one and I took one. I hadn’t smoked a cigarette in probably 10 years but when in Turkey. It was a very pleasant conversation. When we got back to my hotel I gave him a $100 bill and said to keep the change. His jaw dropped and he shook my hand and was very thankful. I said it’s no problem and to go buy something nice for his wife and stepped out of the cab. He then got out of the taxi and gave me a hug and said thank you very much he wouldn’t forget this.

I found online later that the average hourly income for a tax driver in Turkey after expenses is around $2. So this was like a 5% annual bonus for him. He seemed like a nice guy and was interesting to talk to. It’s lovely how quickly you can take a liking to a stranger.

I went to Dr. Nuri’s office and he gave me an exam and asked me some medical questions. He said my donor area looked good and he should have no problem getting the 4–4.5k grafts I would need.

That night I went to dinner with my friends father. He took me to a very authentic Turkish restaurant. I was the only white guy in the place so I knew it would be good.

When we arrived it was like Tony Soprano walking into Vesuvio’s. Everyone seemed to know my friend’s dad the great neurosurgeon and they were all glad to see him. They all did the kiss on the cheek thing that the Italians do.

We sat outside at a great table and drank Raki, the iconic foul-tasting Turkish liquor, and smoked Turkish cigarettes for 4 hours as course after course of delicious food was brought out.

He told me the most amazing stories. The time he delivered a baby on an airplane over the Atlantic. The time he assisted someone having a seizure also on a flight. The time he saved the life of a high ranking political official of an eastern European country under clandestine circumstances. I hope I get to live a life half as exciting as this man.

I looked it up and only 74 infants have been born on commercial flights in history, 71 of which survived. Quite an exclusive club.

People at nearby tables would strike up conversations with us. There seemed to be a brotherliness in Istanbul between strangers that we no longer have in America. The best way for me to describe it is how Italian Americans are featured in the Sopranos.

There is a huge population of stray cats and dogs in the city and they are loved by the inhabitants. More than once I fed a cat who came up to me while I was eating who was then my loyal companion until I moved on to my next stop.

From my observations around 50% of women wore Hijab’s, 10% wore Burkas, and 40% wore nothing: meaning standard western clothes. All the brands and clothing were the same as the west except there was a noticeable lack of sweatpants to my great dismay.

It is strange to say but I think I have grown more fond of the Hijab after this trip. For many women it makes them far more beautiful. There is something about the mystery of what’s hidden. It leaves something to the imagination.

I think I have an analogy that westerners can appreciate. During covid there would be girls I knew for months that I only ever met with their mask on and my brain constructed what I thought their face looked like. The imagined image was almost always more attractive than reality.

It was funny to see women in hijab’s with perfectly done makeup and with obvious lip filler. I assume they do as much as they can to maximize their facial attractiveness as it’s all they get to showcase to the world. I felt eerily at home watching a group of 4 girls in a posh restaurant touch up their make up and then take pics for instagram. Posing with duck lips while wearing hijabs.

All of the music is top 40 music from the US. Every time I was in a cab or van it was top 40 US music. When I try to speak to my driver “sorry no english.” But there he is listening to American music for 40 hours a week.

There was a beautiful waterfront park in front of my hotel which I walked extensively. It’s a waterway the feeds into the Bosphorus. To the back of my hotel was a very poor area with many buildings in disrepair. Housewives hang laundry on clotheslines outside their window. Men carry vegetables in hand-drawn carts down streets lined with dirt and broken glass. Kids play soccer in the street and cars honk aggressively as they come barreling around the corner interrupting their game. The drivers in turkey are insane, it would make a New York cabbie uncomfortable.

I explored the area around my hotel for bit and found a real hole in wall place to eat. The owners were a nice family who spoke no english. The restaurant only had locals in it so I knew this was the place for me. It was a bit dirty and there was a number of flies but it was home like.

With the help of google translate I had one of the best meals of my life for around $3 USD. This was a full meal with dessert and multiple glasses of tea. I gave them a 200% tip which the owner was thankful for. I really enjoy these small acts of philanthropy. I don’t know if it’s a desire to represent America well around the world or if I just get a kick out of seeing people’s reactions.

I then walked for many miles up and down thousands of stairs, Istanbul is a very hilly city. People would just be hanging on their porch drinking tea and smoking cigarettes. taking life slow and enjoying it.

Finally the next day I had my actual surgery. I did not sleep a wink the night before. Possibly due to anxiety about the surgery, the fact that I slept in so much that day, or jet lag. But I got out of bed had a good breakfast and waited to be picked up and brought to the clinic. The surgery went well and wasn’t too painful. It took roughly 8 hours to do 4000 grafts. 2 hours for extraction, 1 hour to poke 4k holes for insertion, then 5 hours to place the grafts in the holes. This was pretty rough to endure. Your neck gets very stiff and sore sitting in one position as they work on you. It’s a marathon of boredom and minor discomfort. You can play on your phone once you flip to your back but you don’t really feel mentally up for even mindless scrolling.

The most painful part of the whole ordeal are the anesthesia shots. These take maybe 5 minutes and are really just sharply painful for the first few seconds as the anesthesia is injected. Then your whole head goes numb and you don’t feel a thing. They only give you local anesthesia for this procedure and do not knock you out.

Both my translator and surgeon spoke good english but the team of 3 technicians did most of the work. Actually the doctor did nothing at all except assist in drawing out my hairline. Because I was a friend of a friend of this doctor I hoped I would be getting his A team of technicians. Later in the procedure I discovered the younger two techs had 8 years of experience each and the lead guy had 15 plus years. They were extremely professional and worked quickly.

During the procedure you just lay there and listen to the techs converse in Turkish. They laugh frequently and you hope they are not laughing at you. The facility wasn’t quite up to what you would expect of a US hospital but it’s passable. Things look a little dated but these things don’t matter so much for a minimally invasive procedure. I would much rather have a very skilled technician above a hypersterile environment as they give you prophylactic antibiotics.

Near the end you are quite ready to have it over with. Sitting still for 8 hours with low or no stimulation is quite tough. They had a TV in the room tuned to Turkish political speeches, which was incomprehensible to me but I took the time to ask the technicians about Turkish politics and culture with the help of the translator.

I survived the procedure and think my grafts look excellent. They made it very dense in the front and filled me in a good bit on my crown. As a kid I never had a good hairline. I always had a widows peak. Now I will have the ability to rock whatever hip euro soccer player haircut is currently in style.

The worst part of this ordeal is that you have to sleep upright with a travel pillow around your neck for the first few nights. This is to lower the chance of disrupting the grafts as they anchor themselves in place. Sleeping upright is hell but I did manage to sleep maybe 2 hours on and off. This was made easier because I slept zero hours the night before so I was truly exhausted. Some places I read said you only need to do this one night while other said a week. I kept it up for 3 nights to hedge my bets. The first night sleeping on your back again is heaven.

I have spoken with countless guys from the US/UK/Canada/Italy who are here for transplants. At the breakfast buffet in the morning at my hotel 80% of guys have bandages or other obvious signs of transplant. on the streets around 1/5 white guys clearly recently had a transplant. People in Istanbul don’t even stare at foreigners with the scabby head anymore, it is such a common sight for them now. I had far more people staring at me at the airport in New York or back in New Orleans.

Excuse me while I discourse on medical tourism for a moment and its implications. On a theoretical level I love the concept of medical tourism. It is a great way for consumers of medicine to exit their system and seek better outcomes elsewhere. Often the most effective way to change a poorly functioning system is by simple refusing to participate.

Think of immigrants fleeing a corrupt regime for a better life in America. They could stay and try to affect change within the system by campaigning for office or starting a revolution but these are highly uncertain endeavors.

If enough people flee the corrupt regime will eventually die. Criminals stay in power by exploiting others so if there is no one left to exploit the regime will fall. Reform is costly, time consuming, and uncertain. If you abandon the old system and move to a better one you benefit yourself immediately and perhaps inspire others to follow you.

For instance why should I waste my time calling my congressman and telling them to reform the US healthcare system. This is a massive system with a huge bureaucracy, what are the odds I can change it in a reasonable amount of time.

If I simply go to another country for medical services I reduce the demand for the old system and force it to make hard decisions. Instead of paying a US doctor 30k for this procedure I paid a Turkish one 3k. If the US doctor counters by lowering his prices to be more competitive I have benefitted all other men in the US who need a hair transplant. I took my demand and went to another market which reduces funding to the US system. It’s small but it adds up if enough people do it.

I know there is a large difference between cosmetic surgery which is largely paid for in cash vs. other medical care which is covered by insurance. It is the latter that has primarily been effected by the government and insurance industry. But cosmetic surgeries use the same resources in terms of manpower and facilities that other medical care uses so their costs have risen in lock step.

I think the US medical system is corrupt and bad. I think the AMA artificially keeps the supply of doctors low, I think the hospitals in concert insurance companies charge more than they need to because the cost is obscured to the consumer and paid by the government. The incentives structures are all broken. Anything I can do to crush this outrageous system is a public good.

My health care premiums are the same as those of an obese person with multiple chronic illnesses even though he is likely to consume multiples of my healthcare expenses. Why do we charge higher healthcare premiums to smokers but don’t charge higher premiums to the obese. They are both at far greater risk of needing expensive medical interventions.

From a more practical and less ideological perspective I don’t think doctors in the US are 10x as good as doctors in turkey or 5x as good as those in the UK but they certainly make that much more. Perhaps the quality of care is 5–10% higher but can that real justify 10x the price? Fight back against the corrupt and outrageously expensive US medical system by seeking medical care elsewhere. It is what your immigrant ancestors would have done.

I spoke to a number of Young Turks about the political situation in Turkey. Most young people in the large cities are very dissatisfied with Erdogan and his policies. They see him as a religious fanatic who has made himself dictator for life.

Erdogan has been the most powerful man in turkey for 21 years now. Originally Turkey had a two term limit for prime ministers but then the constitution was “amended” after a “coup” to remove power from the ministers and place more power in a newly upgraded presidential role.

This restarted his two term limits quota but there is a technicality that allows him to continue to run forever. If snap elections are called before the very end of a term then the term does not count towards your two total. This line of reasoning was challenged by Erdogan’s rivals but the Supreme Court ruled that Erdogan could run for a third presidential term. Which he won the fall of 2023.

My friends in the US love to talk about how likely it is something similar could occur here. We all scoff and say it is impossible. When I spoke to the young turks they said they would have said the same 10 years ago.

Most of the people I spoke to disliked Erdogan but I was in a large city which is not his demographic. He is very conservative and very religious. He tried to ban drinking and started a program whose sole purpose is building what seems to be an infinite number of very beautiful mosques.

He is truly popular among the working class. Some people I spoke with explained his popularity by saying he a is likable and plain spoken man who “tells it like it is.” which is how the working class likes their politicians. He is frequently compared to Putin and Trump for these reasons.

I personally dislike term limits. In principle I think they are an unnecessary overregulation and therefore infantilize the citizenry. Who are we to tell the people they can’t vote a guy in for a third time if 90% of country wants him in office. I’m glad we had FDR for a full third term even though he was a socialist.

The only instance where term limits would help is if you think the elections are tampered with. But if a politician is able to fake election results he very likely can also change the constitution to eliminate the term limits anyway. So the extra regulation seems meaningless.

Before my operation I asked all the guys I ran into how it went for them. Now that I am one day post op guys keeping coming up to me and asking me how bad it was, how much did it hurt, will they be able to sleep? I am now deemed a hair transplant elder and dispensed wisdom freely. I did my best to alleviate the fears of my soon to to be hairy comrades.

Overall my trip went basically how I planned. I am now sitting in the airport waiting to board my plane to Paris. My face is swollen and I look like the alien in Prometheus. This is a normal side effect of the surgery. Overall this trip has been about what I expected and I would recommend it to my balding brethren.

I spoke to another lady on the flight from Istanbul who said she was there for liposuction. For this surgery any bandaging would be covered so it’s hard to know if someone had it done. She stated that she was in the hospital 3 nights and that it was very painful. She said she hated the experience and the lack of ability to communicate with the staff. But she was happy to save 10 grand.

On my flight to Paris I counted 14 men with recently done hair transplants and 5 women with nose job bandaging. Some of them tried to cover this with masks but I knew what to look for. This may not be a representative sample but of the 160 seats available on this Airbus A220 at least 12.5% of the travelers were engaging in some form of medical tourism. The future of medical tourism appears bright.