The hair transplant is becoming an increasingly popular cosmetic surgery procedure. In follicular unit extraction, hair implantation is simply removing hair from the back of the patient’s head and replanting it on the balding parts. It is predominantly male patients who seek this treatment, while female visitors tend to opt for eyebrow implants. It takes three days to finalise the implant process and another six to eight months before transplants settle and hair grows normally.
Turkey is the leader in hair transplant tourism. Official figures suggest that the country had over 100,000 hair transplant tourists in 2015, which is over 200 a day. Most foreign patients are looking to reverse hereditary hair loss. The official price of hair implant surgery by a licensed clinic starts from $1,500 but this can drop to as low as $800 among the illegal black market operators amid cut throat competition to lure patients.
Turkish surgeons and dermatologists have built good reputations for hair implant surgery but the illegal clinics are undermining Turkey’s position in the sector, whilst also damaging tourism. Many patients are lured by bargain prices and geographical proximity. However, the surge of illegal new clinics is threatening to destroy the genuine industry.
An expanding network of unlicensed clinics is opening across Istanbul and in other major Turkish cities. These clinics are profiting from visitors from abroad, mainly from Arab countries. More worryingly, it appears that the vast majority of people undergoing this procedure do not realise they are being treated by illegal and often dangerous surgeons.
Hair transplant surgery can only be legally performed in a hospital by a doctor, dermatologist or cosmetic surgeon. The hospital must clearly state the procedure of hair implant surgery treatment in its records; it must be equipped with an emergency unit and at least one surgery room. It also has to be properly registered with the national healthcare system according to Turkish laws. However, unlicensed clinics operate illegally in residential buildings, offices or even at small hospitals.
The local black market is linked to a network of travel agencies, which are desperate to stay in business following a decrease in tourism figures over recent years. Every day lists of customers are being delivered by middlemen to and from dozens of tourism agencies in central Istanbul. The agencies introduce the patients to a clinic, which in return pays the agency commission, per visitor. Once those seeking hair-replacement therapy have decided on treatment, they usually arrive on an all-inclusive package covering a welcome at the airport, transport in luxury cars, a hotel reservation in a central location and transfer back after the treatment is finished.
Istanbul used to have only a handful of hair transplant clinics, all with valid health ministry licences, but figures show that as many as six out of every ten clinics operate illegally. It is believed that local authorities have long turned a blind eye to this problem. A lack of monitoring and auditing has contributed to the growth of illegal clinics. Istanbul City Health Council looks to avoid responsibility by claiming that it is the health ministry’s duty to audit the clinics.
Professional clinics are primarily concerned that their unlicensed rivals are putting patients’ lives at risk, while also reducing their level of customers. In many unlicensed clinics, the surgeons leave the work to technicians, sometimes inexperienced medical students, and surgery may end up being carried out by people with no or only limited medical training.
Aside from post-surgery infections or disappointing results, patients’ lives are at stake, as hair implantation is not the simple procedure black market clinics would promote it to be. If the patient has heart disease, there is a very real danger of serious injury or even death.
Hannah Hope, paralegal in the cosmetic surgery team at Penningtons Manches LLP, warns: “So far, no politicians, police, health authorities, tourism or medical tourism bodies are doing anything to stop the problem getting worse. Inaction means that sooner or later we will see headlines about hair transplant tourists dying - and by then it will be too late to explain the difference between legal and illegal clinics.”
The Turkish Society of Plastic Reconstructive and Aesthetic Surgeons and the International Society of Hair Restoration Surgery have both issued warnings for patients to be aware of potential health risks posed by illegal clinics in Turkey.