The waiting room of Cosmeticium at the Reyap Hospital in Istanbul resembles that of any other private medical clinic. Magazines are on the table, a vase of fake flowers stands by the velvet sofas and 24-hour news plays on the television.
But the conversation I am having with Dr Batuhan Kurtoğlu is not so familiar. He is trying to persuade me to have a hair transplant, an eight or nine-hour operation, within minutes of meeting me.
‘Don’t worry about it,’ he says. ‘Totally, 99 per cent of every operation is a success.’
Really? I reply.
‘It will make you look younger,’ he promises.
Harry Wallop travelled to Istanbul where he met hair surgeon Dr Batuhan Kurtoglu who said the transplant operation offered a 99 per cent chance of success – following eight or nine hours under the knife Harry visited the Cosmeticium clinic at the Reyap Hospital in Istanbul, pictured Cosmeticium claims: ¿You get completely natural, growing hair that is permanent and has an aesthetic, youthful look¿
When I finally decide not to go ahead, the hospital insists I speak on the phone to Sinan Yildirim, my ‘patient co-ordinator’.
He gives me the hard sell: ‘You come to Turkey for your hair transplantation, we have arranged everything. We are ready. You can be nervous for the operation, but don’t worry. Everything will be perfect and you will be happy.’
Welcome to Istanbul’s cut-throat hair-transplant industry: one that has grown substantially in recent years, promising thousands of men — including many Britons — that they can regain their lost hair.
Cosmeticium claims: ‘You get completely natural, growing hair that is permanent and has an aesthetic, youthful look.’
Like most clinics in Istanbul, it offers hair transplants as part of a package, with taxis to and from the airport and hotel accommodation included in its ‘best price guaranteed’ deal.
British doctors, however, are increasingly concerned about the promises made to lure patients: that the operation will be painless, that cutting-edge ‘sapphire’ or ‘gold’ techniques will be used, that men will be left with no scarring and that the procedure will be a guaranteed success.
Like most clinics in Istanbul, it offers hair transplants as part of a package, with taxis to and from the airport and hotel accommodation included in its ¿best price guaranteed¿ deal
Leading UK surgeons say this is all empty marketing at best, recklessly and dangerously misleading at worst.
Many Turkish clinics also make ambitious promises about how much hair they can transplant.
On inspecting me, the heavily tattooed Dr Kurtoğlu, who also wears chunky earrings, said he could move between 4,000 and 4,500 ‘grafts’ of hair from the back of my head to the top.
Yet this would be ‘clinically dangerous for you and any other patient’, according to Dr Roshan Vara, managing director of The Treatment Rooms in London and medical member of the British Association of Hair Restoration Surgery.
It was at this point that I decided to make my excuses and back out of the operation.
I am balding and, like many men with the same problem, would prefer to have the thick thatch I enjoyed in my 20s. I had not come to Istanbul to have a hair transplant, though, but to investigate the industry.
If I’d had any thoughts of going under the knife on the cheap, they have now been removed.
Hundreds of Turkish clinics advertise to potential British customers online and via Instagram and Facebook. Google ‘hair transplant’ and chances are your first result will be a treatment package offered from Istanbul.
Most clinics ask you to contact them via the text-messaging service WhatsApp to receive a quote. Typically they ask to see a photograph of your head; they then estimate how much hair they can transfer and tell you the price of the package, nearly always including airport transfers and two nights in a hotel.
I flew to Istanbul after hearing from two men about their bad experiences of Turkish hair transplants, which left them feeling anxious and depressed. I travelled with a Daily Mail photographer, who took pictures on his phone ¿ something the doctors seemed surprisingly relaxed about
I flew to Istanbul after hearing from two men about their bad experiences of Turkish hair transplants, which left them feeling anxious and depressed. I travelled with a Daily Mail photographer, who took pictures on his phone — something the doctors seemed surprisingly relaxed about.
Oliver, 33, an accountant from Oxfordshire, claims he was ‘treated like a hunk of meat’, while Jay, 26, an engineer from London, says his treatment caused him to go into therapy and wear a hat in public for two years.
‘I was anxious about socialising. There’s not one day I don’t regret going to Istanbul to have a hair transplant,’ he tells me.
Terrorism and political instability have deterred many holidaymakers from visiting Turkey. But the country is enjoying a boom in one area: medical tourism.
About 765,000 patients from 144 countries reportedly visited in 2017, contributing £5.6 billion to the economy.
And one of the main procedures on offer is clearly visible in the streets. In some areas of Istanbul, it is hard to miss seeing young men wearing the headbands given to patients after their operation to reduce swelling, often branded with the name of the clinic. The lobbies of both hotels I stayed in were full of men wearing bandages and discussing their transplants.
I received quotes from as low as £1,499 from MedAway, a medical tourism broker that uses Cosmeticium. This would include a hair transplant, two nights in a five-star hotel with breakfast, ¿VIP transfers¿, follow-up wash and aftercare in Turkey
I received quotes from as low as £1,499 from MedAway, a medical tourism broker that uses Cosmeticium. This would include a hair transplant, two nights in a five-star hotel with breakfast, ‘VIP transfers’, follow-up wash and aftercare in Turkey.
The price was quoted before I was asked any questions and even before the company had ascertained that I was a suitable candidate for a transplant.
Other clinics were offering similar packages for £1,250; one said it would give me a ‘promo price’ of £1,100 if I booked before the end of the week. In nearly all cases, the money was to be paid in cash on arrival at the hospital.
These prices compare with the £8,000 to £9,000 I was quoted by British clinics.
Spencer Stevenson, 44, had a very bad hair-transplant experience in America and now runs a website and consultancy called Spex Hair, which advises people of the risks. He describes the wave of clinics in Istanbul offering cheap but poor-quality procedures as an epidemic.
‘I’ve dealt with really clever, successful people who have seen nothing more than an Instagram advert for a clinic in Turkey,’ he says. ‘And because they do a hotel package all-inclusive, and because it’s £1,000, they are jumping on the next flight to get it done.’
Transplants cannot make hair regrow. Instead, they move hair from the back of the head to the top or front. This is possible because hair at the back of men’s heads is resistant to a form of testosterone that causes follicles to shrink and eventually fall out.
There are two methods of moving this healthy hair. The first involves cutting a substantial strip of hair from the back, sealing up the cut (leaving a scar) and moving these follicles to the front.
These prices compare with the £8,000 to £9,000 I was quoted by British clinics
What nearly all the Istanbul clinics specialise in is the second method, because it is less complex. Here, individual grafts containing one to four hairs are taken from the back of the head using a tool that looks like a pen, then placed one by one into the top or front of the head.
It is a medical version of robbing Peter to pay Paul, but done skilfully it can give a man the appearance of having a full head of hair. Done badly, however, it can leave the donor area looking very thin and patchy.
This is exactly what happened to Jay when he visited an Istanbul clinic in 2016, he claims.
He had started to lose his hair a few years before, in his early 20s, and had read an article about how James Nesbitt, the Cold Feet actor, had won more roles after his transplant. After friends recommended Turkey, Jay emailed a clinic in Istanbul.
‘They said: “We can achieve maximum density and maximum coverage.” I remember them using those words; they sounded good.’
His procedure cost £1,400.
Cosmeticium initially told me it could move 5,500 grafts on my head. After seeing my photos, it revised this to 4,300; it was one of several clinics that offered to harvest more than 4,000 grafts
He was surprised at how quick the initial consultation at the hospital was: ‘I saw the doctor, he took a few pictures. Then they shaved my hair down to a number one cut — he literally got a pen, drew a line. This took five minutes. No more.’
Nonetheless, Jay was confident he was in good hands.
But a few weeks after the operation, he says it became apparent that the clinic had taken too many grafts from the back of his head.
‘Straight away, when my hair started to grow back, you could see they had over-harvested. They’ve left an obvious patch where I used to have nice, thick hair. It looks like I’m thinning and it’s all uneven and patchy. They have left me with a bigger problem than I had before.’
That was not the only issue. ‘I was promised maximum density and maximum growth,’ says Jay. ‘It wasn’t there. I sent pictures to the doctor but he barely replied. And when he did, he didn’t seem bothered.’
Jay says the operation damaged him psychologically. ‘I wish I could go back in time to that moment when he was drawing the hairline on me, and just walk away.’
Greg Williams is president of the British Association of Hair Restoration Surgery (BAHRS) and one of the UK’s most senior hair-transplant surgeons. He says many patients come to him after poor transplants carried out overseas.
‘There have been some horrendous results, particularly over-harvesting from donor areas,’ he says. ‘These men are ruined. Absolutely ruined. And they can’t be rescued.’
Cosmeticium initially told me it could move 5,500 grafts on my head. After seeing my photos, it revised this to 4,300; it was one of several clinics that offered to harvest more than 4,000 grafts.
Britain’s Dr Vara is alarmed. ‘While some patients may require 4,000 grafts to give them a desirable result, this should not be performed in one sitting.
‘There is a high risk of failure, as the grafts that are taken out are unlikely to survive such a lengthy procedure.’
He points out that last year a man in India died after a hair transplant where he had asked for 9,000 grafts.
‘While there hasn’t yet been an identifiable cause,’ Dr Vara says, ‘poor surgical planning and the size of the procedure potentially caused his death.’
During my consultation at Cosmeticium, Dr Kurtoğlu insisted that moving more than 4,000 grafts would be no problem. ‘If you want, you can get 6,000 grafts, maybe 7,000 . . . but we can extract 4,500 without any damage.’
Cosmeticium, like many Turkish clinics, promises ‘100% Painless Needle-Free Anaesthesia’.
This is a common marketing promise in Istanbul clinics. Highly pressurised air or liquid is used to penetrate the scalp. In most cases, after this has been administered, a needle then injects local anaesthetic. (Elithairtransplant also boasted of its ‘patented needle-free anaesthesia’.)
Only later, when I met Dr Kurtoğlu, did he concede: ‘The numbness blocks you feeling the needles. After that we will use needles to inject anaesthetic.’
I shared a taxi to the consultation with an Australian who’d had the procedure the day before with Dr Kurtoğlu. He was going for a check-up and to have his bandages removed before flying home.
By chance, he worked as an anaesthetist. He said of the ‘needle-free’ anaesthetic: ‘It didn’t work. It should sting but it shouldn’t be painful. But it was quite painful, I had to ask for it to be topped up.’
He added: ‘It’s such a competitive market [in Istanbul], they tell tall tales. Like it’s not painful, there will be two doctors there and stuff like that. It’s just not true. There were two doctors there but I didn’t see them do anything.’
Did that worry him? ‘Yeah, it did a bit. The technicians were obviously skilled and trained but in my opinion, coming from a place where that would be unacceptable, you feel like you are being misled.’ Then he added: ‘I suppose if the results are good I don’t mind.’
Cosmeticium — again, like most Turkish hair clinics — also claims that, thanks to the ‘surgeon’s success and skill… no trace or scar is left in the area of removal’. Greg Williams, of BAHRS, says this is impossible. ‘All surgery leaves a scar. If you make 1,000 holes, you get 1,000 little scars.’
The final claim made by Cosmeticium is that the transplant is guaranteed. This was confirmed by Dr Kurtoğlu in my consultation. He pointed to the back of his head: ‘This part, the hair’s roots, are not affected by testosterone, which causes hair loss. We take hair from here and put here [he pointed to the front]. It is guaranteed it will not fall out.’
Greg Williams says: ‘This is surgery. How can you possibly give any form of guarantee? It’s just not ethical.’
Cosmeticium is by no means the only Istanbul clinic to offer a guarantee. Elithairtransplant, for instance, offers a 30-year guarantee. For me, this would mean that my transplant was guaranteed until I was 75.
Was this possible? Yes, according to Dr Abdulaziz Balwi, who runs Elithairtransplant and who had been Jay’s doctor four years ago.
‘The guarantee we give to you after the operation. We guarantee that 700 of the 1,000 grafts will grow up [sic]. In fact, we give you more than 900. But we give guarantee for 700.’
He explained that if more than 30 per cent of my transplanted hair fell out, I could come back to Turkey — at my own expense — and he would perform another operation free of charge.
His clinic was certainly slick, with a steady stream of patients. I had a blood test, was asked quite detailed questions about my medical history and was handed a goody bag containing a branded neck cushion (so I didn’t rub my head on my pillow after the operation).
Jay claimed he had received a poor hair transplant, despite Dr Balwi receiving almost universally glowing reviews on various websites.
Elithairtransplant was also one of many clinics to offer ‘Sapphire FUE Hair transplant with the GOLD Method’. Cosmeticium said they too used ‘sapphire blades’ to extract the grafts, which was ‘more kind and gentle’.
Greg Williams says: ‘These are all marketing terms and complete nonsense.’
Perhaps Elithairtransplant’s oddest claim was that Dr Balwi has ‘conducted more than 20,000 hair transplants’. This seemed improbable for a man aged under 40.
George Jimoh, my ‘patient co-ordinator’ at Elithairtransplant, who had booked me in for my £1,850 operation — for a less ambitious 3,500 grafts — had told me Dr Balwi would do the transplant and I would be one of just ‘two or three’ people having the procedure at his clinic that day.
At breakfast in my hotel, however, I spoke to 11 men — mostly from Germany but some from Switzerland, France and Portugal — who all told me they were being operated on by Dr Balwi later that day.
In my consultation, Dr Balwi said there were 17 hair transplants in his clinic that day.
I asked if he would be doing the operation himself. ‘No. I will co-ordinate the operation.’ When I asked which doctor would be extracting my hair and making incisions into my scalp, he said: ‘I don’t know. I can check.’ He did not supply me with a name.
This is a common complaint, not unique to Elithairtransplant: qualified doctors do not operate, leaving it to mostly low- paid technicians.
This would be illegal in the United Kingdom. ‘Under UK law, only a doctor can use a knife or a scalpel to make incisions into anybody,’ says Dr Vara, adding that technicians have a vital role to play, but ‘the surgeon should do about 75 per cent of the hair transplant’.
When I backed out of the operation, Mr Jimoh, who was based in Germany, called me to say: ‘This is the best clinic for you … I am doing all my best to help you. I am just hurt. I just want you to do it.’
He later denied this was putting any pressure on me, saying: ‘I said it to empathise with you for the inconvenience this might have caused you.’
For me, it was easy to say no. But as Oliver, who says he had a terrible experience in Istanbul, points out: ‘It is really hard to walk away when you have flown four hours across Europe to have it done, you’ve booked into a hotel and have taken two weeks off work. You’re already invested in the procedure.’
Oliver says he had serious concerns from the moment he walked into the hospital and was given a consultation lasting just five minutes, at which his questions were only partially answered.
He adds: ‘But you end up listening to the information you want to hear: that it’s affordable, that it’s a simple thing — have it done, come home and everything will be good. But it’s a serious procedure. I wish I’d taken more time to listen to those nagging doubts.’
He believes the end result was awful. ‘I became very obsessed about it, and quite anxious and depressed about what I’d done to myself.’
Challenged on the claim that extracting 4,500 hairs was safe, Cosmeticium’s Dr Kurtoğlu said: ‘These numbers are absolutely not the exact goals.’
He pointed to a Chinese study that suggested men with transplants of between 3,000 and 6,000 grafts in one operation were 81 per cent satisfied with their outcomes.
In a statement, Dr Kurtoğlu said it was ‘unfortunate’ that I felt under pressure at Cosmeticium after expressing a desire to back out of the operation.
He also said Cosmeticium’s website and the quote I was given ‘must have caused misunderstandings’ over promises of ‘needle-free painless anaesthesia’ and any ‘scarless method’.
Dr Kurtoğlu added: ‘There is no question of complete elimination of pain … There will be a mark after extraction … Once the healing process … is completed, the scars will decrease slightly and they will also be hidden after your hair grows.’
Elithairtransplant’s Mr Jimoh denied putting any pressure on me. He insisted it was standard for a doctor only to draw the hairline and not to operate: ‘The procedure takes five to 12 hours. There is no hospital where the doctor will do all of that … all the technicians who have worked in our hospital need to have over 12 years of experience.’
He also pointed to Elithairtransplant’s 2,446 reviews on the Proven Expert website, where it scores 4.71 out of 5 for customer satisfaction. Dr Balwi did not respond to Jay’s allegations.
Every year, thousands of men come to Turkey for hair transplants. Perhaps many, like the Australian I met, don’t mind a few corners being cut if the end result is convincing and the price is a fraction of what they face in their home country.
But hundreds are nonetheless lured in by cheap prices and over-ambitious marketing claims, and end up regretting it for years.
As Dr Vara says: ‘For them, it is devastating. Their life has been torn apart.’
Some names have been changed.
