Photographs: Getty Images; Collage: Gabe Conte
I’m lying on a table in Istanbul and a doctor I’ve never met is about to cut 4,250 holes in my head. He might be a doctor. I think he’s a doctor? The procedure will take six hours. I have no friends or family within 5,000 miles.
But in other ways I’m not alone. Thousands have joined me. We’re from the U.S. and the U.K. and the rest of Europe and we’ve flown to Turkey, which is now the hair transplant capital of the world. Surgeries that cost $20,000 in New York can be found for $2,000 on the shores of the Bosporus. We come here with sad hairlines and skimpy crowns. We leave with our heads shaved and raw, red, and scabby—and with hope of newfound youth. At the Istanbul airport, a woman who works at the ticket counter tells me that every day she sees men who are clearly hair transplant patients, sometimes still in bandages, and sometimes with blood leaking from their scalps. She says that this is so ubiquitous, “We call it Turkish Hairlines.”
Until a few months ago I had never considered a hair transplant. They conjured images of hair plugs, toupees, or clumps that looked as if they were taken from your back or your butt. And I never gave much thought to my own receding hairline. At 45 it wasn’t as full as 25, but isn’t that just the grim arc of life?
Then a few things changed. One day, standing in a check-out line, I looked up at the security camera TV and saw a bald guy standing at the cash register. Then I realized that the bald guy was me. I had never seen the top of my head from that bird’s eye perspective; my self-image aged a decade.
Compounding this anxiety, a year earlier, I had surgery on the top of my scalp to remove some basal cell skin cancer. The important thing is that they nipped the cancer in the bud and I’m perfectly healthy. But it left a scar where hair refuses to grow. This, coupled with my new insecurity, inflamed my desire to get my old hair back—a drive for revenge against time.
But the most important thing that’s changed is the tech itself. After seeing that bald guy on closed-circuit TV, I looked around online and learned about the wonders of FUE, or Follicular Unit Excision, which takes individual follicles from the sides and back of your head—where even bald guys still have density—and then, one by one, relocates them to the barren areas of your scalp. The results look real, and they last for life. It’s why celebrities don’t really seem to go bald any more—LeBron James, Ben Affleck, Bradley Cooper, and dozens of other stars are rumored to have had hair transplants.
FUE, of course, does have one whopping catch: It’s not cheap. In most clinics in the United States, hair transplants can cost well over $10,000, even $20,000. I don’t have $20,000 lying around.
But I did have a passport, a high tolerance for risk, and plenty of time to dick around on Reddit.
I tumbled down the rabbit hole of the Hair Transplants subreddit, fascinated by the endless stream of Before and After pics. Here, hundreds of bros proudly share their transformations from Baldie to Hottie; it’s a surprisingly friendly brotherhood that often divulges where they went and what they paid. One destination kept popping up: Turkey. Clinics with names like Hair of Istanbul, Hair Transplant Turkey, World Plast Hair Istanbul, Hairpol Istanbul, Hair Health Istanbul, Hair Time Istanbul.
Why is Turkey such a hair-restoration hotbed? The first reason is obvious. “Turkey is a developing country,” Ali Caglayan, founder of tourist guide IstanBeautiful, told me. “The wages are very low here. The cost of renting an office is very low compared to the U.S.”
Of course, this is also true in places like Mexico and Thailand and the Caribbean, where there are plenty of hair clinics. But, at least according to the Turkish clinics, they’ve set themselves apart with the quality of their doctors. “In the beginning the reason was money, that it was cheaper than other countries in Europe,” says Mehmet Fatih Akdemir, founder of Hair of Istanbul. “For this reason the Turkish doctors became more experienced. They just got better.” It was, he claims, a virtuous cycle: the rise in hair tourism led to better doctors, which led to more tourism, which led to even better doctors.
Turkey’s Ministry of Health saw this growing industry as an opportunity to help boost medical tourism, says Cagalyan, so they offered tax breaks and reimbursements for things like medical equipment, digital marketing, and even the patients’ comped hotel rooms. The plan worked: Caglayan estimates that Turkey now sees between 1.5 million to 2 million medical tourists per year, mostly for hair transplants, plastic surgery, dental work, and weight loss treatments.
Many of these Turkish hair clinics have a mixed and even polarizing reputation, and are dismissed by both online critics and U.S. surgeons as “hair mills” that use assistants and technicians—not doctors—to crank out as many surgeries as possible. They warn that, sure, maybe a medical professional draws the hairline and gives a quick consultation, but a team of assistants actually does the work of punching the holes and implanting the grafts. Hence the bargain prices.
“The biggest risk is falling into the wrong hands and not doing your proper research,” says Dr. Ricardo Mejia, who sits on the Board of Governors of the International Society of Hair Restoration Surgery (İSHRS), a non-profit medical association (which also includes Turkish doctors). He strongly recommends ensuring that the doctor is registered with the İSHRS, and points me to an ISHRS page that outlines the horror stories from “black market pirate clinics”: scarring, infections, poor hair growth, and unnatural hair lines. “Who’s going to be doing your surgery?” he asked me. “Is it a doctor or technician? Is it the taxi driver that they trained last week?”
This all strikes me as good and wise and important advice. And if I had a spare $15k, I’d probably just stay local and go to a practitioner in New York—a highly-compensated plastic surgeon who has never once driven a taxi.
But here we are. So I trawled the Reddit forums, read reviews, and watched YouTube videos with titles like “FUE Hair Transplant in Turkey. ALL YOU NEED TO KNOW ABOUT THE WHOLE PROCESS OF HAIR IMPLANTS *blood*”. Then somehow, without any specific inflection point, I shifted from “this is crazy but I’m curious” to “I am doing this and now I need to find the least-crazy option.”
I would like to say that I conducted a rigorous review of every clinic in Turkey, but the reality is that I was instantly blown away by the before-and-after pics of a Redditor who went to Hair of Istanbul. They don’t just show a transformed hairline; they reveal a transformed man. Even his eyes look brighter. “My confidence is back,” he gushed.
HOI has its critics, but that seems true of most Turkish clinics. Their results look good. Stunningly good. I canvassed Reddit to find patients who went to Hair of Istanbul, and stalked their old Reddit posts to ensure they’re not HOI bots. I sent several of these bros DMs to ask about the experience; they gave a collective thumbs up.
Increasingly Transplant-Curious, I reached out to Hair of Istanbul via WhatsApp. In a surprisingly speedy back and forth, given the 7-hour time zone difference, I sent photos of my hair and answered a few basic questions about my medical history. They sent detailed information about the procedure, a video showing FUE in action, and a price tag of $6,000, to be paid in cash. They promised three nights at what they told me was a glitzy hotel, transportation to and from the airport, and translators on call to guide me through the whole deal. When you add another $1,000 for flights, the total is both far more expensive than many ultra-cheap Turkey clinics (you hear tales of operations for under $2k) and a bargain compared to the United States. This was starting to feel like a reasonable middle path, a prudent compromise.
Only a month after I had even heard of FUE, I texted back Hair of Istanbul: “Let’s do this!”
I arrived at the Istanbul airport with the entire fee in cash—far more than I had ever held in my life—and was met by my driver, Zikrullah, who whisked me to the hotel. HOI had promised 5-star lodging, and I was almost surprised to see that’s exactly what it is. Stunning views of the Sea of Marmara. Sauna, steam room, massage tables, a music video-ready pool. It was also clear that it was a 5-star hair transplant recovery location. Every morning at breakfast—a never-ending buffet that sprawled over at least 20 tables—there were several lonely-looking guys sitting by themselves, their heads newly shaved, at various stages of post-operation rawness.
On the day before the operation, I doubled-up on Turkey’s medical tourism industry and got my teeth whitened for $250. Rookie mistake. I hadn’t considered that you’re supposed to go on a “white food diet” after teeth bleaching, which meant that I had to avoid all bold and colorful food—Turkish food. (This is the big drawback of medical tourism: The demands of the medicine can prevent the enjoyment of the tourism.)
Surgery morning, I have an egg-white omelet and anxiety about two big open questions: The location of the hair line and the health of the “donor area.” A buddy of mine got a hair transplant over a decade ago, before FUE became mainstream. “The hairline is the entire game,” he told me. The doctor can draw your new hairline wherever you want. But that’s almost too much freedom. If you draw it too low or too straight, then it could look fake, even cartoonish, for your age. (And as you get older it will look even sillier—the new transplanted hairs are there for life.) And if you draw it too high, well, that feels like leaving money on the table, right?
The all-important question of the hairline’s location is one of the most concrete benefits of going with a qualified local clinic. Normally, your doctor would examine your hair and assess the risk of future loss, ask about your family hair history, discuss your goals, and then draw a potential hairline. Then you can go home and show that hairline to your friends or spouse or partner. You can sleep on it. You could even check out how it looks in the harsh light of a check-out line security camera. Here in Turkey, with no pre-consultation, I knew I’d have to make a snap decision. Then there’s the concern about potential cultural differences. As Mejia put it, “If they do a traditional kind of Middle-Eastern hairline on you, because that’s what they do for everybody…” he tailed off ominously.
I was also worried about my donor area. That thick hair that even bald guys have on the sides and back of their heads is your “budget” for how many grafts you can relocate. When you pluck a donor graft it will never regrow. You could have more money than Elon Musk (who, by the way, almost certainly had a hair transplant), but once you rip through your budget of donor hair, you’re done. And there’s an art to determining how much hair to transplant. The more hairs you pluck from the donor area, the greater your odds of improving the front and the crown, but this could leave the sides looking thin or patchy. And when you “over-harvest,” you risk scars, patches, blank spots.
So my mission as I arrived at the clinic was to ensure that my hairline was not drawn too low, and to avoid any over-harvesting. HOI, incidentally, looked more like the lobby of the Bellagio than a medical facility, with chandeliers hanging from high ceilings and flowers accenting the walls. Two attractive women in black dresses greeted me at the door. They escorted me to meet the doctor who was to draw my hairline, as well as Mehmet Fatih Akdemir, HOI’s founder (it’s not clear if he’s always there for this stage or because they knew I was writing this story).
“I’m 45,” I told them, “So I want to make sure that the hairline is not too low. And I want to make sure that there’s no over-harvesting.”
Akdemir assured me that they do not over-harvest, and that the doctor would draw an age-appropriate hairline. In fact, the doctor inspected my hair, looked at it from all angles, inspected it more, and eventually he drew two potential hairlines—one just a bit lower than the other. They said that both of these hairlines would be appropriate for my age.
Now I had to choose. I punted and again told them that I wanted a natural and age-appropriate hairline, and they politely told me they understood, and again asked me to choose. They shaved my head with clippers and the doctor then drew a new hairline between the original two. He asked me again: Do you like it?
I’m the kind of person who has a hard time buying a blender without reading hundreds of customer reviews. I was desperate to text my friends and seek input, but given the time zone and the pace of things at HOI, this clearly wasn’t an option. I stared at myself in the mirror. Is it straight? Or is maybe the left side too high? I felt a stab of panic. I studied the hairline the way you might agonize over whether a painting you’re hanging on the wall is level, only this would be a painting that everyone would see on your face for the rest of your life.
“It looks good,” I said. I had no idea if it looked good.
With that, they brought me into the operating room itself. The phrase “hair mills” had led me to imagine some dystopian combination of barbershop and assembly line, with dozens of bros getting their heads ravaged at once, writhing in pain. (In fact, there’s a photo like this on the İSHRS page.)
Instead it was a small private room with a translator, an anesthetic doctor, two assistants, and another doctor who performs part of the procedure. The anesthesiologist asked if I would like a sedative, and at this point my memory gets a little fuzzy. But from some combination of what I can remember, what I learned from my online sleuthing, and my conversation with Dr. Mejia, I can tell you there are three phases: Excision (also called Extraction), where they remove the grafts from my donor area; Channel Opening, where they cut tiny holes in my hairline and crown (like drilling pilot holes when screwing something into a wall); and the actual insertion of the follicles.
One Redditor described the pain of this operation as an “11 out of 10.” That wasn’t my experience. You feel a sharp pinch when they stick in the needle of the local anesthesia, but then your head is comfortably numb. It felt more like they’re gently touching your head with the point of a needle. The most painful part of the operation was being forced to watch looping Adele music videos, Clockwork Orange-style.
I had hoped to talk to the technicians to hear more about their background: Were they driving cabs last week? As he was sticking hairs in my head, the technician told me he’d been doing this for five years, and that this was his first job out of school. I didn’t probe further—in a wave of pharmaceutical wooziness, it suddenly seemed unwise to distract someone currently doing surgery on my skull.
According to Akdemir, Hair of Istanbul has performed over 14,000 transplants since it opened in 2014. “We have technicians here with over 15 years of experience,” he would later tell me. “That’s more than other doctors in some places.”
They said the operation could take up to eight hours, and it took six. In some ways it’s the easiest part of the entire process.
Immediately afterwards, I looked in the mirror and saw a strange head, with bandages on the sides and thousands of red dots on my scalp. You know the end of Return of the Jedi when Vader removes his helmet? It’s like that.
Here’s what they don’t really tell you, and by “they” I mean just about everyone involved with hair transplants: The surgery isn’t painful, but the aftermath is hell. Your new follicles are precarious, having not yet locked into your skin. If they are bumped or scratched or interfered with in any way, you risk torpedoing the entire operation.
courtesy of Alex Hawkins
So: No exercise for a month. No sex for a week. (Granted, this did not materially change my lifestyle.) No alcohol for two weeks. (This did.) No touching or scratching or itching your head for at least the first week. No looking down: To see your phone, you have to raise it up to eye level instead of bending your head downward. An HOI translator demonstrated the correct way to pick something up off the ground by bending his legs with his head pointed straight and forward, like a robot.
No bumping your head against anything. And finally, the big one: No sleeping normally. Because the top of your head is not allowed to touch a pillow, you are instructed to sleep on your back—never on the side, never on your stomach—propped up on pillows. Then you use a neck pillow (like the kind you see on planes) to keep your head straight and upright at a 45-degree angle. This is not how humans sleep. On the first night I slept for one hour. On the second night I slept for two hours. Fortunately, NBA games were tipping off at 3 a.m. local time.
The next few days felt like three weeks. On the day after the surgery, they brought me to the clinic to remove the bandages and gently wash the wounds. There was no pain—just a gentle massage, really—and it felt comforting to see that everything was on track. On the following day, they washed my new “hair” and taught me how to clean it myself. I was paranoid I’d do it wrong and rub out all the new transplants; it was terrifying.
Each morning I spoke to other HOI patients at the Crowne Plaza’s lavish breakfast buffet about their experiences. A Norwegian dude said he’d felt a little rushed, and he was confused by the offer of a sedative, but he “could tell the doctor knew what he was doing, and he drew the hairline where it’s supposed to be, so I’m fine with it.”
A guy from Switzerland described something similar. During the brief consultation, to convey the ideal hairline that he wanted, he showed the doctor a photo of an Instagram influencer. He was impressed that the doctor counseled him against that choice, saying it wouldn’t look natural for his age and the shape of his head. Overall he was pleased, having found it “rushed, but efficient.” That seemed to be the consensus. No one I spoke with had buyer’s remorse, though the real results wouldn’t be known for some time.
And now, finally, it was time to explore Turkey! For a little more money, I had extended the hotel a couple of extra nights to do some sightseeing. I had wanted to visit Istanbul for years—the historic collision of cultures! The Byzantine architecture! The Grand Bazaar!
What I failed to take into account is that after the operation, your new follicles are so delicate that you are not allowed to get your head wet, and it rained the entire time I was there. “Can I leave the hotel and use an umbrella?” I asked a HOI translator. (There’s almost always one in the lobby of the hotel, given how many men they’re constantly shuttling back and forth to the clinic).
He shook his head. “What if the rain breaks the umbrella and it hits your grafts?” This may seem improbable to you, but it made perfect sense to me. This is simply how you think in the days after your transplant. You are constantly assessing threats to your head, weighing risks, trying to minimize any chance of complications. I never once left the hotel.
When I returned, a friend asked me what I thought of the Hagia Sophia. I just laughed. For the next month, I shuttered myself inside and avoided most social activity. I barely slept for two weeks. It was like being a new parent, but without a kid or the accompanying sympathy.
It’s a weird phase. Your head looks even worse than it did before the surgery; this will last for months. (Unlike fillers or botox, a hair transplant is not a treatment with plausible deniability.) A few weeks after the operation, the relocated hairs go through something called “shock loss,” aka a “shedding” phase, meaning that most of the new hair actually falls from your head. It’s expected but it’s demoralizing; on Reddit it’s known as the Ugly Duckling phase. Under the surface, however, the transplanted follicles are effectively taking root and growing before finally bursting through with a vengeance in months four, five, or six. (Hopefully.) You won’t know the true results for a full year. This is always a leap of faith, but all the more so if your surgeon is all the way back in Turkey.
My contact from Hair of Istanbul—the one whom I first texted months ago—regularly follows up with me (at least so far in the first couple of months post-transplant), texting and asking for photo updates. My barber is impressed with where they drew the hairline (even if the hair hadn’t yet grown in): “Very natural,” he told me. My friends tell me it looks good. (What else are they going to say?) I sent my goriest photos to the buddy who had a hair transplant years ago. “You’re going to want to have so much sex with yourself,” he texted back.
Dr. Mejia is less enthusiastic, though he leads with the good news. “One good thing is that they didn’t bring it too low,” he allows. “It looks like your donor site is pretty well preserved.” But he doesn’t love how the two lines of the hairline (which go up in a wide V, like a widow’s peak) are straight. “We like to create what we call ‘mounds of irregularity.’ Normal hairlines are usually not straight—they’re kind of zig-zagged and irregular.” But he concedes this might not be that noticeable when the hair grows out. In the worst case, I can tweak the hairline in a follow-up operation.
This whole experience would clearly not be for everybody; I have a high tolerance for risk. And I still have anxiety over some big outstanding questions. Did I do something dumb in the after-care that will ruin the results? Will hair grow over my surgery scar? Will I be one of the two percent of hair transplants that HOI says fail? Will it make me look younger? Will it look fake? That’s where things stand now, three months post-op. But based on how this usually goes, I think the gamble worked.
And while I feel a mix of uncertainty and hope, I do know this: Istanbul’s claim to the title of hair transplant capital of the world is well-deserved, even if that’s the only thing I can tell you about the place.
Alex Hawkins is a pseudonym the author is using to one day pass as a guy with a naturally full head of hair.