Turkey is the number one destination in the world for having a hair transplant. It is estimated that there are over 1000 hair transplants performed in Turkey each day. The reasons why most people in the world choose Turkey for a hair transplant are;
However, these don’t mean that all hair transplant clinics in Turkey offer a high quality service and and that there is no need to do an in-depth research. We recommend that you read this overview explaining the world hair transplant market, hair transplant in Turkey, the different types of companies and how they operate, hair transplant prices, signs that are an indication of low and high quality and how to choose the best hair transplant clinic for you.
Having a hair transplant is a serious decision that involves a permanent change in ones physical appearance. Once a hair transplant is done it is impossible to undo it and in case a hair transplant is performed unprofessionally, this can lead to an unnatural appearance, extensive scarring, loss of valuable donor hairs that can not be recovered later which could lead to the loss of any opportunity to do any further hair restoration. Don’t forget that the single most important hair transplant surgery is the first one and that the result of the first procedure mostly determines the long term prospects of hair restoration.
The most important two determinants of hair transplant price are location and quality. We call this ‘the location-quality-price triangle’. From the three parameters, location and price are obviously clear, however, we need to determine quality, which is one of the most difficult parts of the decision-making process. We categorize hair transplant quality into low, medium and high quality. We are going to explain how you can determine the quality of a hair transplant later, but let’s give a couple of examples why you need to fix one of the three parameters in order to compare the other two.
Lets say you are comparing a clinic in London which gave you a quote for an FUE hair transplant for 4000 British Pounds and a clinic in Turkey that is 3000 Pounds. Now, if you look at only price, you may think it is not worth buying a flight ticket and traveling all the way to Turkey, however, if you know that hair transplant prices in the UK that are below 5000 Pounds are low quality and that you could get high quality in Turkey for the same price you may decide that it is a no-brainer to fly to Turkey. So if you fix the quality to medium/high, then you would be able to make a healthy comparison. Let’s use the same example, say for some reason you are okay with low quality and you believe that this will give you a sufficient result – obviously we don’t recommend that approach – now instead of choosing the 4000 Pound UK clinic, you could look for a 1000 Pound low quality clinic in Turkey and save the remaining 3000. As you can see from this example, if you do not analyse and fix one of the parameters you may end up making the worst decision.
|Location||Low Quality||Medium Quality||High Quality|
|UK, USA, Europe||3.000 – 5.000 Euro||5.000 – 10.000 Euro||10.000 – 20.000 Euro|
|Turkey||1.000 – 2.000 Euro||2.000 – 3.000 Euro||3.000 – 10.000 Euro|
Now let us look at hair transplant prices in relation with location and quality.
Table 1 is a very rough categorization of hair transplant prices. Of course, there can be examples that do not fit in with this table, but it gives a good idea. There are three main conclusions to make from this table;
Website-clinics / Hair transplant brokers: This is usually a digital marketing expert(s) that consists of a website, a sales person, a desk and a computer. The company name may sound like a clinic, the website may contain pictures of a luxury hospital which do not belong to this company. A doctors name will usually not be found on the website. Google ads are used to generate customer leads. The sales person closes the deal. The surgical treatment is outsourced to a no-name medical company or a surgical team. These companies may do up to 100 hair transplants per day. You can not expect any quality by going through these companies.
Hospital-wall clinics: The difference between this one and a website clinic is that there is a physical hospital and the hospital may be very luxurious and famous. The marketing team belongs to the hospital company. The surgical team may be full-time or may be outsourced to rotating freelance technicians. There is no hair restoration surgeon employed by the hospital. One of the employed doctors will be used to sign surgical reports in order to fulfill legal formalities. It may not be possible to identify a hair restoration surgeon mentioned on the hospital website, or a signature-doctor will be assigned. If you check this doctors training and background you will usually not find any evidence that this doctor is experienced in hair surgery. Surgeries are performed in a small room that is not equipped for hair surgery. Surgical theater’s in hospitals are never used for hair transplants, because the hourly cost of a surgical theater would be too much. You will never see a surgical microscope in these hospital rooms. There may be up to 100 hair transplant procedures done every day. You can not expect any quality from these companies.
Signature-doctor clinics: There is a hospital/clinic and there is a doctors name mentioned. However, this doctor has little to no experience in performing hair surgery. He basically is the boss and the leading brand. The doctor has very little to no involvement in the surgeries. The surgeries will be performed by technicians only. Up to 100 surgeries may be performed per day. Other doctors will almost never be employed, because the costs would go up and advertising other doctors do not fit in with the marketing strategy of these companies. This type of clinic is very difficult to distinguish from doctor-clinics. It requires an in-depth research about the doctors credentials and the way the clinic operates to realize that this is only a signature-doctor and that he has no quality control over the surgical team. You can not expect any quality from these clinics.
Hair transplant chains: These clinics are usually found in Europe or North America, not in Turkey. The company has multiple branches. It is impossible for these companies to keep quality control over so many surgical branches and teams. Hair transplant surgery is not a standard technological product that can be designed and produced thousands of times. Hair surgery depends on the individual skills of each surgical team. Therefore, we can not expect any quality from hair transplant chains.
Doctor-clinics: This is the only type of clinic where are real hair restoration surgeon exists. The hospital/clinic will usually be small to medium in size with a daily limit of 1 to 5 surgeries per day, rarely up to 10 if other doctors are trained. The doctors will usually have international memberships such as the ISHRS (International Society Of Hair Restoration Surgery) and credentials such as the ABHRS (American Board Of Hair Restoration Surgery). The doctor will usually be scientifically active with regular attendances to medical meetings and involvement in giving lectures. The doctor will be an expert in performing every step of the surgery and usually train his own staff and make sure that the delegated parts of surgery are performed at the highest quality. The consultation and design is an important part of the service. Obviously, these clinics may be at variable quality, but this is the only category of clinics that stands a chance of providing quality. The quality of the treatments will depend on the talent, surgical skills and the ethics of the doctor.
Who is the hair transplant surgeon? Is this a real surgeon that has experience in performing every part of the surgery? Is he actively involved in surgeries? Or is he just a signature doctor? These may require a bit of online research because these questions can not be asked directly to the clinic. Don’t always expect a fully honest answer if you ask these questions to the sales representative of the clinic. What is the doctors medical background? Does he have training in cosmetic surgery? What are the credentials and memberships of the doctor? Is he a member of the International Society Of Hair Restoration Surgery (ISHRS)? Does he have American Board Of Hair Restoration Surgery (ABHRS) certification, the only international medical board for hair restoration? Is he actively involved in scientific events, any publications and lectures given? Does he have experience in the surgical technique chosen? Some doctors have experience in one technique, but no experience in another one.
This is a very complicated topic and one of the most frequently asked questions. We believe this topic should be broken down into three subtopics:
Laws And Regulations: Obviously, every company and person is expected to respect local laws and regulations. However, there may be a significant difference in regulatory and ethical standards between countries. In some countries, incision-making (making cuts through the skin) should only be done by doctors. In Turkey, hair transplant surgery can be done by technicians under the doctors supervision. In fact, this is one of the reasons why hair transplants are cheaper in Turkey. Technicians’ hourly labour is significantly cheaper than doctors.
The Nature Of Hair Transplant Surgery: Hair transplant surgery is a very labour-intensive procedure and therefore is a team’s work. It is practically impossible for a doctor to do every part of the procedure unless we accept extreme costs and one surgery taking a couple of days to be completed. The training of the technicians becomes very critical in determining the quality of a hair transplant. Therefore, most of the involvement of the doctor needs to be before the surgery, that is to train the technicians. When discussing the doctors involvement, we must realize that there are two parts of the involvement; involvement in training, that happens before you get the service and involvement during the procedure. Since an important part of hair transplant procedures are done by the technicians, the doctors involvement for training becomes even more important than the involvement during the surgery. And for that to happen, the surgeon must be trained and skilled to do all parts of the surgery.
Critical Parts Of A Hair Transplant: Hair transplant planning and design, is the most critical part of the procedure. Since every individual is unique in the nature of hair loss, facial features and architecture, a significant amount of experience and expertise is needed for this step. We recommend that the design and planning is done by the senior doctor in all cases. A hair transplant procedure consists of three parts; donor harvesting (taking grafts), recipient site creation (making the cuts for the grafts) and graft placement. Some of these steps require a higher degree of training and decision-making, while some steps are easier to teach and are merely a repetition of the same maneuver thousands of times, which makes it easier to train technicians. Recipient site incisions are the most critical part of the surgical procedure after design and planning and require a lot of artistic and technical skills. Unless a technician is extremely talented, there is a fair chance that the senior doctor will do a better job, so if we are going to increase the cost of surgery for the doctors physical involvement, these two steps could be preferred. Donor harvesting in FUT (strip surgery) is always done by the doctor. Donor harvesting by the doctor in FUE is a more sophisticated decision. This step does require a lot of surgical skills, but at the same time with rigorous training, technicians should be able to do it perfectly. Graft harvesting in FUE is the most labor-intensive step and if the doctor is asked to do it, the doctors involvement may increase 4-5 times more and therefore the cost of surgery. If the technician is trained very well then it may be more cost-effective to have this part done by the technician (in a country that is legal to do so like Turkey). If the cost is not concept at all then the doctor may do it. Some surgeons think that technicians can do a better job than the doctor in this phase, because of the extreme physical effort needed to do it and the doctor may end up worn out after some years. The graft placement is routinely accepted to be the technicians job. There are some doctors that like to be involved in this part as well, but these are doctors that will typically perform a few cases a month and a price of over five figures.
The Actual Practice: Let us face it; the main incentive behind using technicians in hair transplant surgery is to reduce the cost. In theory, we could ask 3 hair restoration surgeons to do the whole procedure but we would face an unbelievable cost. So we have to combine using technicians to be able offer affordable procedures, but we must train and supervise these technicians in order the keep the quality high. The fact that delegation to technicians is legal in a country does not mean they should be left untrained and unsupervised when doing surgery. So when looking at the doctors involvement issue, we must prioritize the doctors involvement before the surgery and that is the involvement in training. Patients frequently realize that low quality hair transplants are associated with no doctor involvement, however, they do not understand the concept of involvement in training and that is involvement before the surgery. Some patients naively ask for a hair transplant that is performed only by the doctor and with a budget that is less than a tenth of what would be required for a doctor-only procedure. So the whole topics evolves around cost-effectivity; that is trying to get optimal quality at a reasonable price.
You can gather a lot of information by checking the company website. Is there a doctors name mentioned at the front or does it look like a made up brand? Who is the doctor of this clinic? Is this a real doctors website or a bunch of hair transplant brokers? Is the content properly written, or are there many grammatical mistakes? What are the main marketing arguments? Is it the doctor and his philosophy, or is cheap price marketed? Are techniques marketed as magic and new inventions? If surgical techniques, surgical instruments and fancy names are emphasized, this is a good sign of low quality. Is there a good before and after gallery? Are patient photos properly shown or does it look like there is photoshopping, light and shade tricks, concealers used to make results look better? Do the results look too good to be true? What is the quality of the before and after pictures and videos? Are there enough examples? Are there any educational content including educational videos? Is the website trying to get your contact information as quick as possible or is it trying to provide you with content? Is the hospital building marketed? Companies that market hospital walls are very likely to provide low quality. Does the hospital belong to the company or are they marketing a hospital where day rent rooms daily? Low quality companies frequently take the photos of a luxury hospital that they rent rooms daily and market it. These companies will usually outsource the surgical procedure to freelance teams. Are hospital accreditations marketed such as JCI and TÜV? Hospital accreditations have nothing to do with the quality of surgical service and should be taken as a sign of low quality. Don’t confuse doctors accreditations with hospital accreditations.
The number of patients per day, matters if there is a certain doctor. If a doctor is asked to design and planning, he could do up to 10 patients a day. If a doctor is asked to do the recipient site incisions as well, he could do up to 5 patients a day. If a doctor is asked to do the graft extractions as well, he could do only 1 patient a day, even 1 patient in 2 days. As you can see, the more the doctor is physically involved in the surgery the less patients he can do per day. Now, how about clinics that do 30 or 50 or even 100 patients a day? We could easily call these clinics ‘hair mills’; there is absolutely no chance that there could be any quality control in a clinic where a doctor has to deal with over 10 patients a day. Even at 10 patients, the doctor could dedicate little time and supervision per patient. Imagine 10 patients that day, 10 patients from a day ago coming for a checkup and 10 patients from next day coming in as well. The summary is that over 5 patients a day per doctor, you are unlikely to get much of the doctors attention.
We know that patients would like to get some assurance by reading online reviews. Unfortunately the number of 5-star reviews does not correlate to the quality of a clinic. Most reviews are written right after surgery upon being asked by the company employees. The patients happily write a 5-star review in order to show their appreciation of the service, not having a clue about the quality of the hair transplant procedure and the eventual outcome. Most of those 5-star reviews end up in a poor result and never get turned into 1-star. It takes a year to see a result and patient tend to forget or get used to the situation. On the other hand, most negative reviews are fake reviews written by competitors. Some of the negative reviews are the consequence of a personal conflict between the patient and the clinic. It could be a poor breakfast, an uncomfortable bed, a 10 Euro change that was never received or an impolite driver. None of these are very relevant to the quality of the hair transplant. Most patients just check the number of reviews and look at the average rating and never read the reviews. All these don’t mean that reviews have no value. In fact, if you read carefully, ignoring fake reviews, personal conflicts, reviews that show no proof of the quality of the procedure, you may find a couple of very useful reviews that allow you to sneak into the clinic even before arriving there. Maybe 5% of the reviews are such reviews that really give an insight into the service, but you have to take your time and find those. Online forums are even worse than objective platforms like Google. These forums are biased in that there are some companies sponsoring the forum behind the scenes. There are employees in forums who behave as if objective participants and troll the environment in favor of the sponsoring clinics and against others. Clinics frequently have a hidden agreement with patients sharing results and reviews.
Before and after pictures are the most frequently searched pages in the hair transplant industry. It is understandable that patients want to look at results of previous patients to get an idea about the service they are considering. However, things are not as simple as it may seem;
In conclusion, choosing a hair transplant clinic is an incredibly critical decision in ones life and can not be done carelessly. The selection process is much more sophisticated than most people think. We believe this article gives important hints for patients seeking a hair transplant.