--:-- Sean Rameswaram: Welcome to Today Explained. I'm Sean Rameswaram.
--:-- Alex Abad Santos: I'm Alex Abad Santos, and I wrote a piece for Vox.com about a trend I've seen on social media lately. Men traveling to Turkey for hair transplants.
--:-- Sean Rameswaram: Have you seen people on social media talking about going to Turkey? I'm going to Turkey, baby. Thoughts on people going to Turkey for these hair implants? Very, very good. Okay, we like it.
--:-- Alex Abad Santos: Turkey is really, you know, I'm not a big fan of medical tourism. I was on Nightline talking about medical tourism, the dangers of medical tourism. But Turkey and hair transplants, they aren't.
--:-- Sean Rameswaram: There are five reasons why I chose Turkey for my hair transplant. Reason number one is of course price. Turkey is one of the cheapest places you can go to to get your hair transplant done.
--:-- Alex Abad Santos: Every single I know has gone to Turkey to get the transplant. Oh yeah. Like RuPaul has a euphemism for dying say you know so and so has left for Paris and I say well she gone to Turkey.
--:-- Sean Rameswaram: Men are going to Turkey and they're not going to see the Hagia Sophia. We're going to look into what's going on in Istanbul. Istanbul. Istanbul on Today Explained. Support for Today Explained comes from the FIFA World Cup, of all things. The FIFA World Cup 26 is coming to North America next summer.
--:-- Alex Abad Santos: It is the ultimate celebration of sports and culture. You can get closer to the beautiful game with a hospitality package, closer to the action, the best seats, the best suites, closer to match day and that world-class food and that world-class entertainment, closer to the experience of a lifetime.
--:-- Sean Rameswaram: Book a hospitality package at fifaworldcup.com slash hospitality. Use code VOX20 for 20% off. Must be 21 and over. This product may cause intoxication. This product has not been evaluated or approved by the FDA. This product may contain up to 0.3% THC.
--:-- Alex Abad Santos: Turkey! Explay! Alex Abad Santos, you wrote a piece for Vox.com about a trend I've seen on social media lately. Men traveling to Turkey for hair transplants. You see people going, oh, he went to Turkey or Turkey did him a solid. Wow, Turkey really ate with that hair.
--:-- Sean Rameswaram: Why is everyone saying this all of a sudden? Is it all of a sudden or have been people saying this forever? I mean, Turkey really ate with that hair. It's pretty good.
--:-- Alex Abad Santos: I like the idea that the entire country of Turkey just decided to make this man's hair really great. I think there's a lot of male beauty that's obviously popped up, a lot of style.
--:-- Sean Rameswaram: And I think one of the things that kept popping up for my algorithm was, I just got a hair transplant in Turkey. Here's what it is. And then it eventually became like this meme. And it's like ironic joke of like guys in Turkey who have all like bleeding skulls.
--:-- Alex Abad Santos: So I think it's becoming like this pop culture thing that like turkey is a place for hair transplants, whether it's like social media or celebrity gossip or celebrity gossip and social media together.
--:-- Sean Rameswaram: There's a lot of turkey. You're just flooded with turkey. Okay, because regular people are going to turkey for hair transplants, but celebrities are doing it too? I mean, do we want to talk about the celebrities we think we had it allegedly?
--:-- Alex Abad Santos: I don't want to lost you. We don't want to blow up people's spots, right? Right, right. Let's punch up.
--:-- Sean Rameswaram: Tom Brady definitely had a hair transplant situation, right? I think he might have had some. I think one of the people that he's getting brought up into this conversation, and God bless. And I think this is a compliment. It's Andrew Garfield.
--:-- Alex Abad Santos: All of a sudden, Andrew Garfield is like, maybe he got a new hairstylist. Maybe it's Propecia. Maybe it's some kind of thing. But everyone's like, wow, this man's hair has gotten a lot better in the last five years. Maybe it's Maybelline. Or maybe it's turkey.
--:-- Sean Rameswaram: Let's leave him alone. Let's talk less about Andrew Garfield and more about turkey, because you wrote a great explainer for Vox.com about the whole turkey phenomenon. Why turkey? So yeah, that's basically the question I wanted to know.
--:-- Alex Abad Santos: What I found out is that it's a little bit of like a chicken and the egg. You sure it's not a turkey and an egg? A turkey and an egg, I guess.
--:-- Sean Rameswaram: Basically what had happened was turkey had always kind of like this influx of good health care, And that translates into a lot of doctors that are practicing and a lot of good infrastructure.
--:-- Alex Abad Santos: And what happened was those doctors started doing hair transplants. And as it got more popular, all of this word of mouth kind of grows and grows. And people start going there and start making Turkey a destination.
--:-- Sean Rameswaram: And basically Turkey's hair transplants in Istanbul have become synonymous with each other. And it's just like a brand now.
--:-- Alex Abad Santos: I think one of the things that's kind of fascinating is that this is the one procedure that men have. And it's like, okay, well, the men have this one thing. They have this hair transplant, and they're all going to Turkey.
--:-- Sean Rameswaram: And I think also one of the weirdest things is that it's now being treated kind of like a bachelor party. All these places are very luxury. They serve brunch. They drive you around in Mercedes-Benz's, and it's a luxury experience, which feels more like Vegas than a hair transplant.
--:-- Adam Hurley: I am Adam Hurley. I've been a grooming journalist for about 13 years. I cover the men's beauty industry. I write about all things that might be cosmetics. They could be procedures, topicals, things like hair transplant.
--:-- Sean Rameswaram: The cost of a hair transplant is extremely expensive. Your insurance is not going to cover this. And if you go to a place like Istanbul, it has the reputation of being a hair mill.
--:-- Adam Hurley: But that's to its benefit too. Exactly how large Istanbul's hair clinic industry is, is impossible to pin down. Actually, now Istanbul is seeing the capital of the hair transplants.
--:-- Sean Rameswaram: There are hundreds of clinics across Turkey that offer hair transplants, bringing in hundreds of thousands of mainly men from around the world each year.
--:-- Adam Hurley: If you go to the place where they're just pumping out hair transplants over and over and over and the technology has gotten so good, your hair transplant doesn't need to cost as much.
--:-- Sean Rameswaram: Let's say you're going to do the average hair transplant. That in Istanbul might cost you somewhere between $3,000 and $5,000. But in the US, depending on the zip code, could cost you anywhere between $20,000 and $50,000 or upwards of that.
--:-- Adam Hurley: And to be honest I just have a really hard time recommending anyone spend that much money on something when there is a much more affordable option in a city that has so many world doctors.
--:-- Sean Rameswaram: Okay, so you're looking to drop $3,000 or $5,000 on a trip to Turkey to get new hair. I'm guessing that's without airfare, of course. What do you get for that when you show up?
--:-- Adam Hurley: You would have them picking you up at the airport. They would be shuttling you to and from your hotel to the clinic, you would have a really clear itinerary. You should feel like you are in great hands all the way through being looked after.
--:-- Sean Rameswaram: And typically that will include hotel. And so you're looking at the hospitality, the transportation, and the care, as well as the procedure itself.
--:-- Adam Hurley: Which clinic did you choose? What was it called? My clinic is Dr. Serkin Aigen. Come to Turkey, find your way To Dr. Serkin Eigen with Expert Stay.
--:-- Sean Rameswaram: Okay, so when you get to Dr. Serkin Eigen, what does he do? How does this process work exactly?
--:-- Adam Hurley: Okay, so you don't necessarily have to buzz your hair. If you're fine buzzing your hair and you're not being secretive about your hair transplant, I would encourage you to do so. It makes it a lot more rewarding, I think, to see the entire process go through.
--:-- Sean Rameswaram: So they will, let's say they're buzzing you down. And then what they're going to do is they're going to anesthetize you. And you can choose different versions of that, but they're really not going to fully put you under so that you can sort of come to if need be.
--:-- Adam Hurley: And what they're going to do is they're going to extract follicles uniformly from the back of your head, whereas they typically used to take a strip of skin from the back and that would leave a scar. Now they're taking it more uniformly. It's going to heal up.
--:-- Sean Rameswaram: And they've got little pens that make clean incisions. They can plant it at the optimal angle. And then each graft can grow naturally as it would a normal hair. And about 90% of these will survive, assuming you do all the proper protocol in the month following as the scalp is recovering.
--:-- Adam Hurley: What does your head look like when you walk out of this procedure? It is bloody. It has been bandaged up because they've got a big diaper type thing over the back and sides of your head where they took all the grafts from.
--:-- Sean Rameswaram: And then you are really bloody up top. And then you're going to scab over. Mine almost turned into this uniform scab helmet over the next few days.
--:-- Adam Hurley: Wow, uniform scab helmet. Yeah, and it takes about 10 to 15 days to slowly loosen itself.
--:-- Sean Rameswaram: Are there a lot of dudes walking around Turkey with uniform scab helmets? Yeah, but it takes a few days for the scab helmet to form.
--:-- Adam Hurley: I mean, the pictures you see on social media, the Turkish hairline strokes, that's accurate.
--:-- Sean Rameswaram: When you realize that not everybody went to Turkey for vacation, Turkish Airlines, Turkish hairlines.
--:-- Adam Hurley: And one thing I have to say is that's a really encouraging thing to see if you are going there because you're not going to feel weird. No one's going to look at you weird in the airport on your flight home.
--:-- Sean Rameswaram: And you see guys with fresh hair transplants, like just, you know, staring at the Galata Tower in Istanbul and just out having dinner.
--:-- Adam Hurley: Personally, I would just order dinner and stay in the hotel room to each their own. But it is a very surreal and weird thing.
--:-- Sean Rameswaram: But it's reassuring when you're in such a vulnerable state to see so many other people doing it.
--:-- Adam Hurley: And even the hotels, a lot of times they have partnerships with these clinics. So it's this weird, sad, but also shared feeling when you look around the hotel brunch and it's all people who either had a transplant the previous day or who are about to go have a hair transplant in an hour.
--:-- Sean Rameswaram: There's this really nice camaraderie that's there of all these people from all different countries around the world.
--:-- Adam Hurley: Because like what? Because balding is something we're made to feel ashamed of. And here you're seeing people who are embracing their, their desire to have hair again.
--:-- Sean Rameswaram: I don't think it's that balding is something we should be ashamed of. I don't think we should be ashamed of it, but I think it's something that maybe we are made to feel ashamed of.
--:-- Adam Hurley: Yeah, I agree with you there. I think it's a sign of like virility or vitality or something, youthfulness, sure.
--:-- Sean Rameswaram: I also just think if you have the option of having hair, you can always shave it off and rock a bald look. But if you are bald, that's a period. There's punctuation on the amount of things you can have.
--:-- Adam Hurley: And that was a big reason I wanted a hair transplant in the first place is I'm a grooming editor. I have to have a canvas to try products. I've grown my hair to my shoulders twice since my hair transplant, just so I can try blow dryers and hair creams and all these different things.
--:-- Sean Rameswaram: And if I lost that, I do lose my virility as a grooming editor, you know?
--:-- Adam Hurley: Totally.
--:-- Sean Rameswaram: Adam's kind of locked into his procedure for life. He told us he'll be taking hair growth meds to keep his new hair, even with his old hair, until he dies, his new transplanted hair, even with his natural hair.
--:-- Adam Hurley: That's a big commitment.
--:-- Sean Rameswaram: I assume you haven't had this procedure, Alex?
--:-- Adam Hurley: I have not had a hair transplant.
--:-- Sean Rameswaram: So as a reporter who's written about this procedure but hasn't done it himself, can you just tell us, you know, from your objective vantage, does the transplant look good? I mean, compared to transplants from back in the day, from like all the research I've done for this story, yes, they look pretty good.
--:-- Adam Hurley: It's like they're very unclockable. Everyone I spoke to says the only person who can tell is my barber. And I think that is possibly the biggest compliment that you can get for a hair transplant.
--:-- Sean Rameswaram: No one can tell, only my barber can tell.
--:-- Adam Hurley: Especially when you compare it to, like, the 80s. And, like, there were lots and lots of advertisements for hair plans and there was a lot of, like, hair restoration stuff that did not look good.
--:-- Sean Rameswaram: But what, I guess, like, the biggest difference is they figured out, or doctors have figured out better ways to extract hair follicles and put them in places.
--:-- Adam Hurley: Back in the 80s, they were taking clusters of hair and transplanting them to a new spot, and they didn't really know the hair was growing or the patterns of the hair, and so it would kind of look like doll hair, and that is a term that you want to avoid.
--:-- Sean Rameswaram: You never want your hair to look like doll hair. I think people would rather be bald than have doll hair.
--:-- Adam Hurley: Alex Abad Santos from Vox.com, Adam Hurley from blue-print.co.
--:-- Sean Rameswaram: Adam also writes for GQ. Traveling for your cosmetic needs or even your medical needs is nothing new but it certainly is more popular than ever. We gonna find out just how popular it is next on Today Explained.
--:-- David V. Quist: I'm David V. Quist. I'm the director of the Center for Medical Tourism Research at the University of the Incarnate Word in San Antonio, Texas.
--:-- Sean Rameswaram: David, you study medical tourism. Does that include the more cosmetic stuff we talked about earlier in the show?
--:-- David V. Quist: Absolutely, yeah. We look at a variety of, if you will, kind of patient consumerism that's occurring throughout the world, not only traveling for cosmetic surgery, but traveling for fertility treatments, traveling for surrogacy.
--:-- Sean Rameswaram: Speaking of that, been in the news here recently, which is birth tourism, which is people going to other countries, for example, people from Latin America coming into the United States to have children in the U.S., so they have dual citizenship.
--:-- David V. Quist: Also, the idea of pharmacy tourism, which we see, for example, Americans purchasing pharmaceuticals in Canada. Also, deaf tourism, people traveling to either in the United States, certain states that allow doctor-assisted suicide, or people that go internationally to places like Switzerland.
--:-- Sean Rameswaram: Also, including gender change or gender reassignment surgery. Some of the best surgeons in the world are located in the country of Iran.
--:-- David V. Quist: Now I just think we should stop talking about everything we're talking about and just talk about how that happened. It's a really interesting and controversial topic.
--:-- Sean Rameswaram: So it's illegal to be gay in Iran, and it's sometimes punishable by death. However, if you were to undergo gender reassignment surgery, it is legal to be trans.
--:-- David V. Quist: And so many of the surgeons in Iran actually ended up helping people with these transitions. And they became some of the most successful and competent surgeons on this surgery in the world.
--:-- Sean Rameswaram: So because of that, because of this expertise that grew within the country, again, because people felt this pressure to get these gender reassignment surgeries in the country, people from around the world traveled to Iran, a religious theocracy, to be able to get these surgeries.
--:-- David V. Quist: And it's just a very fascinating story.
--:-- Sean Rameswaram: It sounds like from what you're saying, from that brief tour you gave us of all the medical tourism, cosmetic tourism, health tourism, whatever you want to call it going on around the world.
--:-- David V. Quist: If we just took like a look at a world map and had sort of flight trackers for all of the flights that were taken for these kinds of purposes, we would see like a fully colored in world map of people going from this continent to that and the other for various procedures.
--:-- Sean Rameswaram: That's correct. People are wanting the value equation in health care, which means they want the health care they want at the price that they want, at the time that they want, where they want.
--:-- David V. Quist: It tends to be that both affluent people that have disposable income, the wealthy, tend to travel more for medical tourism. And also we see the less economically well-off people, people that don't have as much disposable income. They also travel more often.
--:-- Sean Rameswaram: So you're saying this is something that rich people do, certainly, but it's also something that poor people do.
--:-- David V. Quist: Yes. Yeah, it's really fascinating.
--:-- Sean Rameswaram: So where I at here in South Texas we very familiar with the trend because in the Rio Grande Valley which is on the southern border of Texas with the northern border of Mexico we have some of the poorest counties in all of Texas and we also have a shortage of particularly primary care physicians in those regions.
--:-- David V. Quist: And so these are some of the poorest and less economically well-off people in all of the United States. And they travel frequently into Mexico for access to pharmaceuticals at the pharmacia, for dental and also for medical care.
--:-- Sean Rameswaram: And it's very common. So that tends to, if you will, show this consumerism that's going on. Again, you can understand it with the wealthy because they're looking for perhaps some of the best care on the planet.
--:-- David V. Quist: But when you look at people that are essentially impoverished or in poverty situations, that they're traveling as well.
--:-- Sean Rameswaram: Is there a dark side to this for those who are less wealthy? I mean, if you're rich and you go to Iran for gender reassignment surgery and something goes wrong, maybe you can just easily buy your way out of that situation.
--:-- David V. Quist: But if you're poor, maybe you get stuck. Maybe there's a language barrier. And then what? How ugly can this get for people?
--:-- Sean Rameswaram: So we had a situation a little over a year ago now where a group of people drove into Texas and then drove across the border into Mexico.
--:-- David V. Quist: It happened in the border state of Matamoros, just three miles away from Brownsville. They took a trip across the border last week for a cosmetic surgery, and that's when they were possibly mistaken for a rival cartel.
--:-- Sean Rameswaram: They were chased by gunmen who were opening fire on their white minivan. Now, two people were found dead. The other two survived and are back on U.S. soil, recovering this morning.
--:-- David V. Quist: And so that shows you, if you will, the possible safety and security issues of going into a foreign country.
--:-- Sean Rameswaram: But we find from some data, for example, the CDC looked at data from Americans in 2016, and they found that the overall self-reported bad outcomes that occurred from the actual surgery itself were about 5%, which is actually reasonable depending on the type of procedure.
--:-- David V. Quist: But there are people that travel internationally and in the past have included people of wealth and affluence that could choose any health care they wanted in the United States.
--:-- Sean Rameswaram: Kobe Bryant traveled to Germany. For health care? Yes. Alex Rodriguez, when he was with the New York Janshies, traveled. Recently, Kirk Cousins traveled to the Caribbean.
--:-- David V. Quist: And you see probably a lot of Instagram influencers that have traveled to foreign countries to get access to cosmetic surgery.
--:-- Sean Rameswaram: I think that's what brought us here to you is how much social video has blown up this industry. Can you give us a sense of how big it is at this point?
--:-- David V. Quist: So it's a very large industry. When you look at people traveling domestically, it's very large. And then when you look at the international, when you include health, wellness, dental, cosmetic surgery, all the things that people are traveling for, it's truly hundreds of billions of dollars.
--:-- Sean Rameswaram: It's possibly a $1 trillion industry worldwide.
--:-- David V. Quist: Interestingly, it's also a very ancient trend. So, for example, when I was helping the Egyptian government by training some Egyptian physicians and hospitals on how to receive international patients, I went on a Nile cruise is what they provided as the compensation for doing this training.
--:-- Sean Rameswaram: And on the way back from Ashwan up to Cairo, the tour guide had a stop at an ancient temple. And on the temple wall, there was a formulary for these procedures and these potentially medications that were given by the temple priest to people.
--:-- David V. Quist: And it was well known at that time that throughout the world, people would come to Egypt to get access to some of the best medicine in the world.
--:-- Sean Rameswaram: So not only is it a very ancient trend, but it appears to be a trend that keeps coming back over and over again.
--:-- David V. Quist: Professor David Viquist University of the Incarnate Word Heidi Mawagdi produced our show today.
--:-- Sean Rameswaram: He was edited by Jolie Myers Fact-checked by Laura Scab-Helmet-Bullard And mixed by Andrea Christensdottir And Mr. Rob Byers Who's saying goodbye to Vox today.
--:-- Sean Rameswaram: He's been a friend of Today Explained since the show's inception seven years ago, and we hope he'll continue to be one hereafter.
--:-- Sean Rameswaram: The rest of the team includes N-O-E-L King, executive producer Miranda Kennedy, supervising editor Amina Alsadi, Miles Bryan, Avishai Artsy, Amanda Llewellyn, Peter Balanon, Rosen, Victoria Chamberlain, Travis Larchuk, Patrick Boyd, and welcome Devin Schwartz.
--:-- Sean Rameswaram: Breakmaster Cylinder makes music, and I made a mistake. On Monday's show, I said there's no Silk Road movie, but it turns out there is a Silk Road movie. It's called Silk Road, and seven people saw it when it came out in 2021.
--:-- Sean Rameswaram: Maybe after this correction, it could be eight. I apologize.
--:-- Sean Rameswaram: Today, Explained is distributed by WNYC, and the show is a part of Vox.
--:-- Sean Rameswaram: You can support our journalism by joining our membership program today. Go to vox.com slash members to sign up.
--:-- Sean Rameswaram: Thank you if you do that. And if you don't, you can always leave us a nice review, or you can tell us that we forgot about the Silk Road movie.
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