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  5. I got a hair transplant in Istanbul, a sanctuary for balding men. It pulled me out of a dark place.

I got a hair transplant in Istanbul, a sanctuary for balding men. It pulled me out of a dark place.

Spencer Macnaughton   

I got a hair transplant in Istanbul, a sanctuary for balding men. It pulled me out of a dark place.

It was a scorching August day in 2022 and I was lounging at the pool of the Mercedes Club, my fitness center in midtown Manhattan. I had invited one of my best friends Bennett to spend the day with me.

When he walked onto the pool deck and took off his hat, I nearly passed out. A year ago, he was essentially a bald headed man. But today — about eight months after he took a trip to Turkey — he had a fully restored hairline.

Happiness. Jealousy. Shock. Intrigue. Fear. I was flooded with emotions. Bennett, who's three years older than me and was a bit further along in the balding process, had been my hair loss mentor.

I started combing over my hair. When I talked to my mom about it, I would often end up crying.

But now, he was one of the growing number of men who traveled 5,000 miles to Istanbul, the global capital for hair transplant surgery. According to the Turkish Health Tourism Association, about one million people traveled to Turkey for a hair transplant in 2022, spending about $2 billion.

Balding has become huge global business in the past two decades. It's projected to be worth over $11 billion by the end of 2024.

So far, no matter how many new, promising pills and treatments hit the market, none have made the transplant redundant. If anything, it's booming, and Turkey has built a reputation as the go-to destination.

Looking at Bennett's luscious hair poolside was the first moment I seriously considered joining the ranks of the millions of men who have traveled to what's become known as "Hairstanbul."

The deep pain of hair loss

My hair loss started in 2015, at 24 years old, when I noticed a bald spot the size of a penny on my head in a Snapchat video my friend posted.

Over the next eight years, my balding progressed and, like many men, my self-esteem deteriorated.

I felt less attractive, less masculine, like I was less likely to find a partner, and as though I was aging way too fast. Like a Real Housewife once said, in my mind I only had "five good summers left."

I tried the two leading FDA-approved drugs for hair loss: topical minoxidil (Rogaine) and oral finasteride (Propecia). I also tried the oral version of minoxidil, a blood pressure drug that dermatologists have been using off-label to curb hair loss. While these drugs helped a bit, I wasn't consistent in using them. Over time, my hair loss significantly progressed.

I started combing over my hair. When I talked to my mom about it, I would often end up crying. I avoided looking at security cameras or in mirrors that might expose the bald patch at the back of my head. At my lowest point, I'd intentionally walk out of rooms backwards. I eventually started on an antidepressant to manage my intrusive thoughts about my receding hairline.

I spent the majority of 2023 asking myself if I'd follow in Bennett's footsteps.

I was filled with anxiety about the 10-hour flight, about the prospect of getting surgery in a foreign country, about the operation itself, and — most intensely — if the transplant would leave me scabby and botched. My head spun. Do I fly 5,000 miles to Turkey or do I shave my head and rock a naked dome?

I put my journalist hat on and dug into the research. Aside from some negative online reviews, Bennett's doctor, Dr. Serkan Aygin, seemed reputable. He was cited in prestigious publications as a trusted expert, he'd won an award for innovations in hair transplant surgery, and he is a member of the International Society of Dermatology, an organization that includes members from respected universities and medical centers in the US.

Plus, I knew at least four other New Yorkers within walking distance from my apartment in Manhattan who had gone to Aygin, including my Turkish barber, a guy from my gym who runs a hookah shop down the street, and two other friends who live in Hell's Kitchen. They all reported a great experience and had good results to show for it.

I decided to take the plunge.

Turkey's pursuit to become the hair-transplant capital of the world

As I boarded my Turkish Airlines (or, as I called it, "Hairlines") flight in December, I was shocked to discover the 21-year-old from New Jersey to my left and his older cousin to my right were also headed for hair transplants. I texted my friend, filmmaker Kenny Wassus, who was coming along to capture my experience, and was sitting a row over: "You can't make this shit up!"

Hair transplants are cheaper in Turkey — for a few reasons. The cost of living is cheaper and wages are lower. Crucially, the Turkish health ministry, keen to draw in medical tourists and ambitious doctors, offers tax breaks and subsidies to clinics. It's working: Since 2019, health tourism has ballooned more than 50%.

In the United States, hair transplants range from $10,000 to $20,000. Aygin charges about $3,500, to be paid up front. This includes a consultation, the operation itself, some aftercare, three nights in a four-star hotel, and transport from the airport, the hotel, and the clinic. Flights from New York set you back another $2,000. It's still about a third the price of getting the operation done on US soil.

Aygin told me he had been obsessed with men's hair since he was a child. "We are the hunters of beauty," he said.

It's not just Americans flocking over. In the sleek lounge area of Aygin's clinic, I found dozens of balding men from around the world, sitting nervously on sofas.

Aygin is ready for the influx. He told me his clinic — 20 doctors, 80 technicians, and eight anesthesiologists — performs between 20 and 22 transplants a day.

The tightly-run operation starts with tests and scans. On the first day, a nurse drew my blood to test me for HIV and hepatitis B and C. After the results came back negative, I was put in a spaceship-like booth for 3D imaging to assess my hair loss. They showed me which hair strands were healthy (pictured in green) and which were dead (pictured in red). The doctor would use this information to determine his approach for my transplant.

The next day was the consultation with Aygin himself. Walking in the room, he exuded Central Casting for a celebrity doctor in a yet-to-be-produced reality show about balding men. He was charming, charismatic, assertive, and eccentric. He told me he had been obsessed with men's hair since he was a child. "We are the hunters of beauty," he said.

The consultation was quick — about 15 minutes — and I had to make a rapid decision about my new hairline. I was prepared for this. The only critique my references had of Aygin was that he can be "pushy" with his vision for their hairlines, and that he "didn't attentively listen" to their requests. He's been practicing hair transplants for over 25 years, and is confident in his opinion. So, it's important to go into this meeting with a clear sense of what you want.

I didn't have a firm vision for my new hairline. All I said was I wanted something "age appropriate." Aygin took a makeup crayon and drew my new hairline, writing numbers around my head of how many grafts, or follicular units, would be transplanted in each area. When he finished his drawing, he put a mirror up to my face, and told me I was "going to love it."

He proposed that they transplant 4,000 grafts (within their typical range of between 3,500 and 4,400), pulling from my "donor areas," or the regions of my body where I was still growing hair. In this case, 3,400 of the grafts would be pulled from the back of my head and the remaining 600 would be pulled from my beard. Each graft equals two or three new strands of hair. In other words, I am expected to grow 8,300 new strands of hair when the results appear – between six months and a year from the operation.

I was happy enough with what he drew, so I said: "Let's do this."

A nurse escorted me to a cafeteria for a grilled cheese sandwich followed by a low dose of Xanax to quell my nerves. I was surrounded by about 10 other men — some nervously waiting to go in for their operation and others, bandaged and bloodied, who had just finished. Once I'd swallowed my medication, I was escorted upstairs to the operating room.

Inside the operation

One of the main concerns from critics of the Turkish hair transplant wave is that doctors, incentivized by tax breaks, set up clinics to cash in and then leave the work to technicians that the patients have never met. But this isn't always the case, and wasn't the case for me.

While Aygin only came into the room for a quick check in, six folks greeted me in scrubs and were with me through the entire operation. One anesthesiologist (who came in and out of the room), one doctor, and four technicians. I confirmed with Bennett and my other friends that they'd had the same lineup of professionals working with them.

The beginning was the scariest part. I was connected to an IV, given a low dose of fentanyl for pain relief and sedation, then flipped onto my chest. My head looked through a massage table-like hole as they spent 30 minutes injecting needles into the back of my head to anesthetize me. My mouth was so dry from the fentanyl that I couldn't swallow.

The next couple of hours were dedicated to extracting healthy follicles. From there, a few of the technicians worked feverishly on a table to the side as they inserted my hair into a Choi Implanter pen to prepare them for insertion into the "recipient area" of my head (i.e., the bald part).

After that, it was about three hours of artwork. One of the technicians compared the process to crocheting a sweater or making a rug. Feeding hair into new follicles is arduous, and requires dexterity and endurance.

Around the fifth or sixth hour mark, I felt like I was in a drunken stupor. (They avoid general anesthesia because they are flipping your body around, and they want you to get up to eat a sandwich and go to the bathroom.) That's when they started the painful part: pulling from my beard.

This hurts because the skin tissue is so much softer and thinner than the back of the head. Unless you called for a translator who would arrive within 10 minutes, nobody in the room spoke English. I yelped about 15 times to which the woman working on my beard would say, "anesthesia!" and someone would stick another needle into my beard in an effort to numb me out.

Considering I was awake for the eight-hour procedure, it really wasn't so bad, although I was getting impatient as the anesthesia wore off in the last hour. I remember them telling me multiple times that there were "30 minutes left" and I eventually yelled "you've said that five times."

When they finally announced I was finished, it was around 10 p.m. They took me back to the cafeteria to drink some juice and eat a chicken breast. I chatted with a guy from Detroit who had also just left the operating room. I felt zonked, emotional, proud, and accomplished, and he did too. We actually did the damn thing!

My scalp and beard were gooey and bloody and I had to sleep with bandages on my head and neck. But there wasn't much pain after the operation. I took another Xanax when I got to my hotel room and slept like a baby.

I'll probably be on hair-growth drugs for life

A hair transplant isn't the be-all and end-all.

Aygin recommends that I continue taking minoxidil and finasteride because they reduce the production of DHT, the hormone associated with hair loss in men. He says it's important to take these drugs not to maintain the transplanted hair, since these follicles were taken from my donor area where I'm not expected to experience hair loss, but rather to keep the vulnerable hair I had before the transplant.

Taking these two drugs costs upwards of $60 a month and can be sourced by companies like Keeps, Hims, Roman and other businesses that are trying to capitalize off of changing male beauty standards. It's a huge investment. Sitting in Istanbul, having gone all-in on hair retention, I felt compelled to follow his advice. Time will tell if I stick with it.

In Istanbul Airport, literally every fourth man's head was raw from a transplant.

In the short-term, there were some dos and don'ts for the healing process. No sex or alcohol for five days, no cardio for two weeks, no weight lifting for three weeks, and no sauna or steam room for two months. You need to sleep on your back and with an airplane pillow behind your head for the first seven days (this was not fun). You also need to wear a hat outside during daylight at all times for the first two months. And you need to abide by a rigorous shampoo and lotion regimen for the first month. A technician also performed a low-level laser procedure 24 hours after the operation, which they said would speed up my recovery.

Two days after the operation, Kenny and I were driven to the Istanbul Airport, where literally every fourth man's head was raw from a transplant. I spoke to around 15 of them. Business executives, a waiter, a lawyer, and a real estate agent. They were all giddy — proud of themselves and glad they took the leap of faith.

Somehow, a cosmetic treatment lifted me in a way I never expected

It's now been about four months since the operation. The recovery has been a breeze.

It takes about 6-7 months to see serious results and about a year for final results. But over the last month, I've noticed new strands of hair populating my hairline every day. I now want to pose for pictures with my friends and family. I feel more confident in Zoom and in-person work meetings.

Aesthetics aside, knowing I took control of something that at one point was shattering my self esteem has lifted me in a way I didn't think possible. Even if the transplant doesn't continue to work or one day falls out, I'm going to be happy and proud that I gave it a try.

I would do it again, and I just might need to. Aygin told me before I booked my flight that I'd need two operations to get full coverage. This first procedure should fully restore my hairline, but I'll still have a bald spot on the back of my head. My barber and Bennett have already gone back for their second treatments, and are happy with the results.

As for me, I'm elated. And, who knows… maybe this summer it'll be Bennett, my friend who inspired this whole journey, who falls over when he sees my new hairline at the pool.