Ten days isn't long enough to cover Istanbul plus another country. Istanbul is huge, and getting from place to place takes time. This is my Day 6, and I have so far stuck to walking around the old town, but preliminary checking of public transit routes turned up several situations where connections involved walking a few blocks (not an issue) and locating the second bus stop or Metro station (could be time-consuming). Upon arrival I ended up taking a long bus trip into the city and then a taxi (something I never do), because starting the trip by Metro (which now serves the newer airport) looked like it would require Metro-Metro-Metro-tram, and neither of the Metro connections seemed to be easy.
You shouldn't drink the tap water or use it to brush your teeth, which means sourcing large bottles of water every couple of days. It's sold everywhere, and cheaply, but it's just one more little thing that makes travel less than efficient.
Basically, a list of Istanbul sightseeing goals that looks like it could be accomplished in 4 days/5 nights will take at least a day longer. I'd want to stick to Turkey or at most add a single non-Turkish city--and I think it would be a shame to see only Athens in Greece or only Sofia in Bulgaria. In choosing another Turkish city to include, consider how long it will take to get back out to the airport (traffic can be horrible, at least to IST) and whether you can fly between the US and the other destination rather than having to deal with IST 4 times in 10 days (eek).
I really have no guidance to offer on other parts of Turkey beyond this: I've heard Izmit and Bursa are nice, and they do not require flights. I'm sure a place like Konya or Cappadoccia would contribute to a more varied trip, however.
Honestly, I don't think 10 days in Istanbul would be too long. You could spend a day doing the Bosphorus, hopping off at each stop to walk around, and another day on the Princes' Islands. There are also sights on both sides of the Golden Horn
On a short trip, I think it's worth considering the ease or difficulty of transportation between the airport(s) and the location of your hotel in Istanbul. An area reachable via one simple Metro connection would be great. Staying in the area I'm in, near Sirkeci Station, would be a culture shock, though very convenient for walking to Hagia Sophia, the Blue Mosque, Topkapi Palace and the Archaeological Museum.