A doctor examines a hair transplant patient at a licensed clinic in Istanbul. Turkey’s cosmetic surgery sector is being undermined by illegal operators. Murad Sezer / Reuters
A doctor examines a hair transplant patient at a licensed clinic in Istanbul. Turkey’s cosmetic surgery sector is being undermined by illegal operators. Murad Sezer / Reuters

Turkey’s medical tourism sector can be a hair-raising experience



ISTANBUL // Tourists take a glance at package tour promotions hanging on the door of a travel agency on Istanbul’s Taksim Square as a young man enters the small office with a folder in his hand.

Ismail is in a hurry and takes a document out of his folder with a list of potential customers and hands it to the owner of the travel agency, sitting in her chair.

“I think we can transfer some five or six people this week,” he nods with a smile.

This everyday ritual reveals how the local black market manages its network of unlicensed hair-transplant businesses spread across Istanbul and in other major Turkish cities.

This expanding network of clinics profits from an ever-growing number of visitors from abroad, mainly from Arab countries, the vast majority of whom do not realise they are being treated by illegal and often dangerous operators.

According to data from the Turkish Healthcare Travel Council (THTC), 746,000 foreign visitors landed in Turkey for medical treatment in 2015. As many as 100,000 arrived for hair implant surgeries and nearly two-thirds of them were from the UAE. Turkey earned US$5.8 billion from legal medical tourism in 2015, or nearly $10,000 per visitor. Medical treatment in Turkey costs as little as half the price in countries such as Germany and the United States, the THTC says.

It is perhaps little wonder the illegal clinics are growing. Everyday scores of clients’ documents and lists of customers are delivered by middlemen such as Ismail to and from dozens of tourism agencies in central Istanbul.

Then the agencies introduce the patients to a clinic, which in return pays the tour agency a certain amount of commission per visitor. Once those seeking hair-replacement therapy have decided on a 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.

Turkey’s booming health tourism industry has been driven by increased investment in health facilities and treatment technology over the past decade. Cosmetic surgery options such as hair implants, as well as eyebrow and facial hair implants, have led this boom. More than 200 hair transplants are carried out in Turkey per day, the country’s health ministry says.

Most foreign patients come from the Arabian Gulf region looking to reverse hereditary hair loss or treatment to make repairs after botched operations at illegal clinics.

One such is Sayeed, 32, from Saudi Arabia. As he leaves a new clinic he found recently for post-surgery treatment with a large bandage around his head discoloured by dried blood, he readily admits he initially did little research into his first treatment. With his blood-soaked, bandaged head, he does look unsettling.

Sayeed was in Istanbul a year ago, hoping to get an attractive new look from a local implant clinic he signed up with in advance. He did not know it was unlicensed. “It could have been easy to spot these illegal places but I made very little research on that,” he says.

The treatment was not a success and so he was forced to return to Istanbul to repair the damage done.

Many patients are lured by bargain prices and geographical proximity. Most recently a sub-industry has emerged – moustache transplants – attracting male patients inspired by Turkish soap opera actors or Hollywood celebrities, the general manager at the licensed Natural Hair Turkey, Ersin Murtezaoglu, tells The National. Most patients bring a picture of their favourite movie star or singer whom they want to look like, he says.

“The fake clinics offer a 100 per cent guarantee that the patient will look like his dreams, which of course, ends in frustration,” he adds.

After years of hard-work, many Turkish surgeons and dermatologists have built good reputations for hair implant surgeries but now the mushrooming illegal clinics threaten to undermine Turkey’s regional place in the sector while also damaging tourism.

Istanbul used to have only a handful of hair transplant clinics, all with a valid health ministry licences, a decade ago, today as many as six out of every 10 clinics operate illegally. Observers say the local authorities have long turned a blind eye to this problem and a lack of monitoring and auditing have contributed to the growth of such places to a great extent. When contacted by The National for comment, Istanbul City Health Council, which represents the health ministry locally, says only that “it is the health ministry’s duty to audit the clinics” and it “cannot further comment”.

Professional clinics are primarily concerned that their unlicensed rivals are putting the patients’ lives at risk, while also stealing potential customers.

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 due to illegal clinics in Turkey.

In what is called 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 often opt for surgeries such as eyebrow implants. It takes three days to finalise the implant process and another six to eight months before transplants settle and hair grows normally. 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.

Officially, hair transplant surgeries can only be performed in a hospital by a doctor, dermatologist or plastic surgeon. The hospital must clearly state the procedures of hair implant surgery treatment in its records, it must be equipped with an emergency unit and at least one surgery room as defined by the health ministry. It also has to be properly registered with the national healthcare system according to Turkish laws. But illegal clinics are mostly operating in residential buildings, offices or sometimes at very small-scale hospitals.

Many patients are risking their health by not thoroughly researching the clinics they choose to visit, licensed surgeons tell The National.

“In all unlicensed clinics surgeons leave the work to technicians, inexperienced medical students and sometimes even to drivers or cleaners,” says Gülten Ünveren, the general manager of the licensed Istanbul-based hair implant centre Mega HairTrans.

“These people are playing with the health of hundreds of tourists.” Apart from post-surgery infections or disappointing results, the patients’ lives are at stake, Ms Ünveren says, adding that a hair implant is not simple surgery as promoted by clinics in the black market.

In some cases, if the patient has a heart disease for instance, there is a very real danger of serious injury or even death, she adds.

Ms Ünveren points to an example of how easy it is for black market clinics to set up. Earlier this year, she says, a driver who worked for a hair implant clinic in Istanbul told her that he had opened his own clinic in a central district and that now he earns as much as 30,000 Turkish lira (Dh37,023) per month, more than 20 times Turkey’s minimum wage. “I knew this guy before; apparently he was allowed to join surgeries and learnt how to make incisions and harvesting grafts,” she says.

“After six months, he opens his own place. This is ridiculous since the whole sector and local authorities are aware of this but nobody is taking action.”

It is all to easy for a patient to be attracted by what appears to be a bargain, but anyone considering such cosmetic surgery must be careful she says.

“The customers ask if they can get this treatment for below $1,000. Well, you have to be suspicious with any price offered below the $1,500 mark; imagine that they do this job for $15,000 in the US.”

She says that alone should be warning enough for those considering surgery and is surprised so few seem to get suspicious. “How can customers be fooled by such people if the price is so low – and the treatment so dangerous?”

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The specs: 2019 Mercedes-Benz C200 Coupe


Price, base: Dh201,153
Engine: 2.0-litre turbocharged four-cylinder
Transmission: Nine-speed automatic
Power: 204hp @ 5,800rpm
Torque: 300Nm @ 1,600rpm
Fuel economy, combined: 6.7L / 100km

Section 375

Cast: Akshaye Khanna, Richa Chadha, Meera Chopra & Rahul Bhat

Director: Ajay Bahl

Producers: Kumar Mangat Pathak, Abhishek Pathak & SCIPL

Rating: 3.5/5

RESULT

Shabab Al Ahli Dubai 0 Al Ain 6
Al Ain: Caio (5', 73'), El Shahat (10'), Berg (65'), Khalil (83'), Al Ahbabi (90' 2)

DUBAI WORLD CUP RACE CARD

6.30pm Meydan Classic Trial US$100,000 (Turf) 1,400m

7.05pm Handicap $135,000 (T) 1,400m

7.40pm UAE 2000 Guineas Group Three $250,000 (Dirt) 1,600m

8.15pm Dubai Sprint Listed Handicap $175,000 (T) 1,200m

8.50pm Al Maktoum Challenge Round-2 Group Two $450,000 (D) 1,900m

9.25pm Handicap $135,000 (T) 1,800m

10pm Handicap $135,000 (T) 1,400m

 

The National selections

6.30pm Well Of Wisdom

7.05pm Summrghand

7.40pm Laser Show

8.15pm Angel Alexander

8.50pm Benbatl

9.25pm Art Du Val

10pm: Beyond Reason

Countries offering golden visas

UK
Innovator Founder Visa is aimed at those who can demonstrate relevant experience in business and sufficient investment funds to set up and scale up a new business in the UK. It offers permanent residence after three years.

Germany
Investing or establishing a business in Germany offers you a residence permit, which eventually leads to citizenship. The investment must meet an economic need and you have to have lived in Germany for five years to become a citizen.

Italy
The scheme is designed for foreign investors committed to making a significant contribution to the economy. Requires a minimum investment of €250,000 which can rise to €2 million.

Switzerland
Residence Programme offers residence to applicants and their families through economic contributions. The applicant must agree to pay an annual lump sum in tax.

Canada
Start-Up Visa Programme allows foreign entrepreneurs the opportunity to create a business in Canada and apply for permanent residence. 

Mina Cup winners

Under 12 – Minerva Academy

Under 14 – Unam Pumas

Under 16 – Fursan Hispania

Under 18 – Madenat

The Travel Diaries of Albert Einstein The Far East, Palestine, and Spain, 1922 – 1923
Editor Ze’ev Rosenkranz
​​​​​​​Princeton

UAE%20v%20West%20Indies
%3Cp%3EFirst%20ODI%20-%20Sunday%2C%20June%204%20%0D%3Cbr%3ESecond%20ODI%20-%20Tuesday%2C%20June%206%20%0D%3Cbr%3EThird%20ODI%20-%20Friday%2C%20June%209%26nbsp%3B%3C%2Fp%3E%0A%3Cp%3EMatches%20at%20Sharjah%20Cricket%20Stadium.%20All%20games%20start%20at%204.30pm%0D%3Cbr%3E%0D%3Cbr%3E%3Cstrong%3EUAE%20squad%3C%2Fstrong%3E%0D%3Cbr%3EMuhammad%20Waseem%20(captain)%2C%20Aayan%20Khan%2C%20Adithya%20Shetty%2C%20Ali%20Naseer%2C%20Ansh%20Tandon%2C%20Aryansh%20Sharma%2C%20Asif%20Khan%2C%20Basil%20Hameed%2C%20Ethan%20D%E2%80%99Souza%2C%20Fahad%20Nawaz%2C%20Jonathan%20Figy%2C%20Junaid%20Siddique%2C%20Karthik%20Meiyappan%2C%20Lovepreet%20Singh%2C%20Matiullah%2C%20Mohammed%20Faraazuddin%2C%20Muhammad%20Jawadullah%2C%20Rameez%20Shahzad%2C%20Rohan%20Mustafa%2C%20Sanchit%20Sharma%2C%20Vriitya%20Aravind%2C%20Zahoor%20Khan%0D%3C%2Fp%3E%0A
The National's picks

4.35pm: Tilal Al Khalediah
5.10pm: Continous
5.45pm: Raging Torrent
6.20pm: West Acre
7pm: Flood Zone
7.40pm: Straight No Chaser
8.15pm: Romantic Warrior
8.50pm: Calandogan
9.30pm: Forever Young

How has net migration to UK changed?

The figure was broadly flat immediately before the Covid-19 pandemic, standing at 216,000 in the year to June 2018 and 224,000 in the year to June 2019.

It then dropped to an estimated 111,000 in the year to June 2020 when restrictions introduced during the pandemic limited travel and movement.

The total rose to 254,000 in the year to June 2021, followed by steep jumps to 634,000 in the year to June 2022 and 906,000 in the year to June 2023.

The latest available figure of 728,000 for the 12 months to June 2024 suggests levels are starting to decrease.

Mobile phone packages comparison
Ziina users can donate to relief efforts in Beirut

Ziina users will be able to use the app to help relief efforts in Beirut, which has been left reeling after an August blast caused an estimated $15 billion in damage and left thousands homeless. Ziina has partnered with the United Nations High Commissioner for Refugees to raise money for the Lebanese capital, co-founder Faisal Toukan says. “As of October 1, the UNHCR has the first certified badge on Ziina and is automatically part of user's top friends' list during this campaign. Users can now donate any amount to the Beirut relief with two clicks. The money raised will go towards rebuilding houses for the families that were impacted by the explosion.”

COMPANY PROFILE
Name: Kumulus Water
 
Started: 2021
 
Founders: Iheb Triki and Mohamed Ali Abid
 
Based: Tunisia 
 
Sector: Water technology 
 
Number of staff: 22 
 
Investment raised: $4 million 

Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

ICC Women's T20 World Cup Asia Qualifier 2025, Thailand

UAE fixtures
May 9, v Malaysia
May 10, v Qatar
May 13, v Malaysia
May 15, v Qatar
May 18 and 19, semi-finals
May 20, final

Company%20profile
%3Cp%3E%3Cstrong%3ECompany%20name%3A%3C%2Fstrong%3E%20Fasset%0D%3Cbr%3E%3Cstrong%3EStarted%3A%20%3C%2Fstrong%3E2019%0D%3Cbr%3E%3Cstrong%3EFounders%3A%3C%2Fstrong%3E%20Mohammad%20Raafi%20Hossain%2C%20Daniel%20Ahmed%0D%3Cbr%3E%3Cstrong%3EBased%3A%3C%2Fstrong%3E%20Dubai%0D%3Cbr%3E%3Cstrong%3ESector%3A%20%3C%2Fstrong%3EFinTech%0D%3Cbr%3E%3Cstrong%3EInitial%20investment%3A%3C%2Fstrong%3E%20%242.45%20million%0D%3Cbr%3E%3Cstrong%3ECurrent%20number%20of%20staff%3A%3C%2Fstrong%3E%2086%0D%3Cbr%3E%3Cstrong%3EInvestment%20stage%3A%3C%2Fstrong%3E%20Pre-series%20B%0D%3Cbr%3E%3Cstrong%3EInvestors%3A%3C%2Fstrong%3E%20Investcorp%2C%20Liberty%20City%20Ventures%2C%20Fatima%20Gobi%20Ventures%2C%20Primal%20Capital%2C%20Wealthwell%20Ventures%2C%20FHS%20Capital%2C%20VN2%20Capital%2C%20local%20family%20offices%3C%2Fp%3E%0A
Conservative MPs who have publicly revealed sending letters of no confidence
  1. Steve Baker
  2. Peter Bone
  3. Ben Bradley
  4. Andrew Bridgen
  5. Maria Caulfield​​​​​​​
  6. Simon Clarke 
  7. Philip Davies
  8. Nadine Dorries​​​​​​​
  9. James Duddridge​​​​​​​
  10. Mark Francois 
  11. Chris Green
  12. Adam Holloway
  13. Andrea Jenkyns
  14. Anne-Marie Morris
  15. Sheryll Murray
  16. Jacob Rees-Mogg
  17. Laurence Robertson
  18. Lee Rowley
  19. Henry Smith
  20. Martin Vickers 
  21. John Whittingdale
What is Folia?

Prince Khaled bin Alwaleed bin Talal's new plant-based menu will launch at Four Seasons hotels in Dubai this November. A desire to cater to people looking for clean, healthy meals beyond green salad is what inspired Prince Khaled and American celebrity chef Matthew Kenney to create Folia. The word means "from the leaves" in Latin, and the exclusive menu offers fine plant-based cuisine across Four Seasons properties in Los Angeles, Bahrain and, soon, Dubai.

Kenney specialises in vegan cuisine and is the founder of Plant Food Wine and 20 other restaurants worldwide. "I’ve always appreciated Matthew’s work," says the Saudi royal. "He has a singular culinary talent and his approach to plant-based dining is prescient and unrivalled. I was a fan of his long before we established our professional relationship."

Folia first launched at The Four Seasons Hotel Los Angeles at Beverly Hills in July 2018. It is available at the poolside Cabana Restaurant and for in-room dining across the property, as well as in its private event space. The food is vibrant and colourful, full of fresh dishes such as the hearts of palm ceviche with California fruit, vegetables and edible flowers; green hearb tacos filled with roasted squash and king oyster barbacoa; and a savoury coconut cream pie with macadamia crust.

In March 2019, the Folia menu reached Gulf shores, as it was introduced at the Four Seasons Hotel Bahrain Bay, where it is served at the Bay View Lounge. Next, on Tuesday, November 1 – also known as World Vegan Day – it will come to the UAE, to the Four Seasons Resort Dubai at Jumeirah Beach and the Four Seasons DIFC, both properties Prince Khaled has spent "considerable time at and love". 

There are also plans to take Folia to several more locations throughout the Middle East and Europe.

While health-conscious diners will be attracted to the concept, Prince Khaled is careful to stress Folia is "not meant for a specific subset of customers. It is meant for everyone who wants a culinary experience without the negative impact that eating out so often comes with."

RESULTS

5pm: Maiden (PA) Dh80,000 1,200m
Winner: Ferdous, Szczepan Mazur (jockey), Ibrahim Al Hadhrami (trainer)
5.30pm: Arabian Triple Crown Round-3 Group 3 (PA) Dh300,000 2,400m
Winner: Basmah, Fabrice Veron, Eric Lemartinel
6pm: UAE Arabian Derby Prestige (PA) Dh150,000 2,200m
Winner: Ihtesham, Szczepan Mazur, Ibrahim Al Hadhrami
6.30pm: Emirates Championship Group 1 (PA) Dh1,000,000 2,200m
Winner: Somoud, Patrick Cosgrave, Ahmed Al Mehairbi
7pm: Abu Dhabi Championship Group 3 (TB) Dh380,000 2,200m
Winner: GM Hopkins, Patrick Cosgrave, Jaber Ramadhan
7.30pm: Wathba Stallions Cup Conditions (PA) Dh70,000 1,600m
Winner: AF Al Bairaq, Tadhg O’Shea, Ernst Oertel

Meatless Days
Sara Suleri, with an introduction by Kamila Shamsie
​​​​​​​Penguin