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Dr. Raymond Konior

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Dr. Raymond Konior last won the day on February 10

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About Dr. Raymond Konior

  • Rank
    Recommended Physician

Basic Information

  • Gender
    Male

Hair Transplant Clinic Information

  • Hair Transplant Surgeon
    Dr. Raymond Konior
  • Hair Transplant Network Recommendation Profile
  • Hair Transplant Clinic Name
    Raymond Konior, MD.
  • Primary Clinic Address
    1s280 Summit Avenue, Suite C-4
  • Country
    United States
  • State
    IL
  • City
    Oakbrook Terrace
  • Zip Code
    60181
  • Phone Number
    (630) 932-9690
  • Website
    http://www.premierehairdoc.com
  • Email Address
    drkonior@sbcglobal.net
  • Provides
    Follicular Unit Hair Transplantation (FUT)
    Follicular Unit Extraction (FUE)
    Eyebrow Transplantation
    Prescriptions for Propecia
    Free In-depth Consults

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  1. Dr. Raymond Konior

    Manual punch vs Micromoter FUE

    What is my opinion on clinics that utilize technicians for extracting grafts? Hmm… Answer these three questions: 1) Would you allow a tech to remove a brain aneurysm on your mother? 2) Would you allow a tech to perform coronary artery bypass on your father? 3) Would you allow a tech to remove a testicular cancer on you? If the answer is “yes” to any of these questions, you should do nicely in a tech-driven hair restoration facility. If, on the other hand, you answered “no” to all questions, then ask yourself why you would allow a technician to perform a surgical procedure on your scalp. Also, if you answered “no” to all questions, and you decide to use a facility that uses technicians for graft extraction – without direct supervision by the operating doctor – ask your doctor why he or she is not performing the procedure, but rather uses the service of a technician to perform what I deem to be a surgical procedure. Questions I would direct to the physician if he or she uses technicians for graft extraction without direct doctor supervision: 1) Do you use a technician because you have poor eyesight? 2) Do you use a technician because you have a tremor? 3) Do you use a technician because you will be in another room maximizing your profit for the day? 4) Do you use a technician because you don’t believe patient care and supervision is important? 5) Do you use a technician because you are lazy and prefer to surf the web or check your stock portfolio? 6) Do you use a technician because you lack surgical skills and believe the technician is capable of delivering a better quality graft than you would be capable of delivering? 7) Do you believe harvesting grafts is a “simple” component of the surgical procedure or that harvesting grafts is “no big deal” such that it can readily be delegated to a technician? The bottom line is that I believe hair restoration is a surgical procedure that should be performed by a doctor. It is not a mundane and simplistic task that is capable of being delegated to the technician level. Face it, most technicians have little to no formal education, i.e. they receive “on the job” training. Who is training them and who is supervising them? We in this practice respect the doctor-patient relationship and feel that the patient is entitled to the doctor’s presence in the operating room from beginning to end.
  2. Dr. Raymond Konior

    Manual punch vs Micromoter FUE

    The mostly useless topic of manual versus motorized should be relegated to the trash heap. It may have held relevance at some point in time, but it means little today. Patients should also be leery of dogmatic statements made about how an individual conducts his or her practice as the only person who can provide definitive detail as to what is done and how it’s done is the surgeon himself. The fact is that I use multiple devices for extracting grafts, with the device of choice depending on the situation at hand. There are days when a motorized technique is best and days when a manual technique is best. There are days when a straight-wall trephine is best and days when a flared-wall trephine is best. There are days when a straight-edge trephine is best and days when a serrated-edge trephine is best. This argument reminds me of guys arguing which is better, a straight-edge screwdriver or a Phillips screwdriver. Of course the answer is that it depends on the situation at hand. Also remember, there are some talented surgeons who can use every technology effectively and some who, despite having the best of the best instruments, can’t extract quality grafts on a consistent basis. When it’s all said and done, it’s not the instrument that matters as much as the surgeon choosing the instrument to use for the situation at hand. If you place the world’s finest and most expensive Steinway piano in front of most people, very few would be able to generate a beautiful song. On the other hand, place one of the world’s top five pianists in front of a Walmart special keyboard and you will probably hear some darn good tunes.
  3. My experience shows 300 grafts to be an average amount needed for average strip scars in need of camouflage. There are definitely cases needing fewer and some needing more, but this is a good estimate for most. It is interesting and encouraging that most patients burdened with visible scars can eventually opt for fairly short hair styles if enough grafts are used. I find two staged sessions are needed for most larger scars when one wants to go with the shorter hair styles.
  4. This 34 year old patient presented with a history of three prior hair restoration procedures that were performed by three different surgeons. He was unhappy with the lack of density and patchy appearance in the prior transplant zones. The patient also expressed concern about the visibility of his strip harvest scar. His examination revealed very low frontal and midscalp density which was of concern in light of him having undergone three prior procedures. Restoration of the density deficient frontal and midscalp regions, as well as the donor strip scar, was performed using a total of 1940 grafts that were obtained using an FUE harvest. The scar was treated with 300 grafts and the frontal/midscalp regions were managed with 1640 grafts. Presented here are preop and postop pics which demonstrate the final frontal/midscalp density and donor scar camouflage that was accomplished. Preop Front Preop Right Donor Preop Center Donor Preop Left Donor Postop Front Postop Top View 1 Postop Top View 2 Postop Top View 3 Postop Top View 4 Postop Right View 1 Postop Left View 1 Postop Right View 2 Postop Left View 2 Postop Right View 3 Postop Left View 3 Postop Center Donor Postop Right Donor Postop Left Donor Graft Placement Zone - 5 Days Postop Donor Scar Graft Placement - 5 Days Postop
  5. The circle was a reminder to remove a small skin tag that was a cosmetic nuisance for the patient. Thanks for the upbeat comments.
  6. This 39 year old male requested frontal hairline restoration. His exam revealed an isolated frontal hairline recession with excellent hair characteristics elsewhere. An FUE harvest was recommended to accommodate his desire to sport different hairstyles which included short hair. A total of 945 grafts were used to enhance density and shape at the frontal hairline. Presented here are one year postop pics. Immediate graft placement pics, one-day and one-week postop pics and density inspection views of the graft zone are included. Preop Front: Preop Tilted View: Preop Right Preop Left Postop Front 1 Postop Front 2 Postop Front 3 Postop Front Comb-back Postop Left 1 Postop Left 2 Postop Left Comb-back Postop Right Postop Right Close-up Intraop Planned Graft Zone Immediate Intraop Graft Placement One Day Postop Graft Zone One Week Postop Graft Zone Donor Site Day of Surgery Donor Site One Day Postop Donor Site One Week Postop Density Inspection Center Density Inspection Left
  7. This 29 year old patient requested reinforcement of his frontal hairline. A total of 2204 grafts were transplanted using a non-shave, stick-and-place approach. Presented here is his eighteen month postop result.
  8. This 48 year old patient presented eight year earlier hoping to boost density throughout his thinning frontal and midscalp regions. His history was significant for progressive thinning over the previous decade. He began using oral finasteride and experienced decent stabilization, but wanted to strengthen density in the remaining weak zones. A total of 2550 grafts were transplanted throughout the frontal and midscalp zones with distribution being prioritized based on the relative degree of thinning in the various zones. Presented are eight year follow-up photos, including part views, which show the density gains achieved. The value of ongoing finasteride treatment for maintaining density in the preexisting, genetically-susceptible follicle population is implied from the long term density gain that has been realized.
  9. This 42 year old patient had a prior frontal hair restoration using FUE harvesting. He was dissatisfied with his final density and complained of some pit formation in the frontal graft zone. His main donor area showed evidence of moderate density reduction resulting from his initial procedure. His main desire was to boost density in the immediate frontal hairline so that his hair could be styled back. A small preliminary procedure was used to remove several of the deeper pitted grafts in the frontal region. A secondary session of 1580 grafts was performed at a later date using FUE harvesting and graft insertion with a stick and place technique. Graft harvesting was focused more to the side donor areas in order to minimize the risk of over-depleting his previously harvested donor areas. His eleven month postop photos are presented here along with immediate graft placement photos and two week postop photos.
  10. Gasthoerer quotes: "Nape hair might be one solution (at least I think so). That is why I am so interested why Konior promotes the useage of it...," and "...cherry picking with FUE for fine singles doesn't exist." The comment that “cherry picking with FUE for fine singles doesn’t exist” is incorrect and would be something expected from someone who has no actual intraoperative experience using FUE or someone who lacks ownership of high-power magnifying loupes. Variations in hair caliber - which exist throughout the donor region - will be clearly apparent with loupe magnification, the variations more and more apparent with higher powers. Be clear that I do not promote nape hair for every case, but this is a great tool for those patients who will benefit when the need calls. Most patients with average hair, skin and healing characteristics do well with centrally harvested hair. However, it is not uncommon to see an occasional less-than-ideal hairline that results when higher caliber hair - which was not anticipated to be a factor in the predicted end result - demonstrates itself to be a bit less natural and a bit more detectable. In these cases, a secondary finessing procedure can be performed with lower caliber nape hairs. For the occasional patient where stalky hair can be anticipated ahead of time, lower caliber hair from the nape can be preemptively placed at the hairline. Included is a pic which show caliber variations in the nape region and a pic which shows caliber variations between the nape and higher donor area. These variations stand out quite clearly under high power magnification. A final pic shows the glaring contrast in size between upper level donor area follicles and follicles selectively harvested from the nape. I don’t have to point out which is which, and one should be able to appreciate how the finer hair would “soften” a “heavy” hairline. Finally, there is a very short video clip that shows the selective incising of very small caliber nape hairs with FUE. Here I am scanning the entire harvest zone to select the lowest caliber hairs. In summary, cherry picking specific follicles to select for certain characteristics is possible. Short Nape Harvest Video
  11. This patient presented with a request to strengthen a receding frontal hairline. His exam was unremarkable except for isolated frontotemporal recession. A session of 1328 grafts was performed to boost density within the weak recessions. Presented are four year postop views. Included are part views through the graft zones to demonstrate the density that was achieved and immediate postop graft placement views.
  12. This 30 year old patient presented with a prior history of having undergone what was described as an unsuccessful FUE hair restoration. He was concerned that few grafts grew, leaving him with unacceptably low density in the transplanted frontal area. He was also bothered by unacceptable thinning in the donor harvest area that followed his procedure. His examination revealed miniaturization confined primarily to the frontal half of the male pattern region. This was associated with punctate scarring absent of hair growth that presumably arose following his original procedure. He underwent a secondary procedure in my office at which time 2090 grafts were obtained using FUE harvesting and planted into the outlined frontal recipient area. The graft harvest was strategic in attempting to avoid the previously depleted “sweet spot” of the occipital donor area so as to prevent any additional apparent thinning. The graft harvest focused primarily in the temple and lower occipital regions, which were untouched at the time of his first procedure. Presented are one year postop photos and immediate graft placement photos. Also shown is the depleted occipital donor harvest site with a #2 short-clip and a zero-guard hair length. Finally, an immediate postop photo of the temple donor harvest area contrasts the small punch openings of this session to the large-punch scars that are located toward the back of the current harvest zone.
  13. jbl2093 – Prior to developing a surgical plan, all patients are screened with a thorough scalp examination and review of family history, and provided a patient consultation that includes a discussion of goals, risks, limitations, etc. One has to be selective in the creation of any surgical plan as all patients are unique, i.e. the surgical plan must be customized to the individual. Based on the definition of aggressive previously provided, this type of plan is more of a rarity simply because there are more men who either have or are predisposed to a higher class pattern. I believe that grafts require a minimum of 18 months to fully mature, and sometimes longer for certain hair/skin combinations. Hassler – Life and most of its components are a gamble, especially when looked at over the long term. There is never any certainty about predicting long term hair loss, just as there is no certainty that the next flight you take will land safely. However, the odds of having a safe hair procedure and a safe plane flight are high when all proper precautions are taken. I sense that you believe there is a mass haphazard approach being utilized by surgeons for surgical planning and providing advice to patients. Although this may be true in surgical mills, it would be the exception in the hands of most caring and competent surgeons who presumably use common sense and experience to provide reasonable treatment plans that are based on individual needs. Caution is a good thing and I absolutely agree with your belief that it be emphasized to any patient seeking this type of restoration, but caution should be applied to all patients and all components of the procedure, not only hairline location. Even a 60-year old man with a class 2 recession and no evidence of donor, midscalp or crown miniaturization must be cautioned as to long term consequences. Yes, cautionary advice is provided to one hundred percent of patients as all patients are intrinsically subjected to the risk of age-related, progressive hair loss. However, there are those with low risk profiles who can successfully tolerate such a plan if that be their desire.
  14. This discussion is important as an aggressive approach to the hairline can easily be abused without proper preoperative consultation, presurgical planning and surgical implementation. The definition of “aggressive” is important as this term may mean different things to different individuals. I define aggressive restoration as one that attempts to create something which tends to resemble the original youthful hairline once enjoyed during high school or college days. Prior to initiating this endeavor, the prudent surgeon has to take into consideration many factors, which include: 1) defining the patient goals; 2) predicting the final hair loss pattern; and 3) assessing the lifetime donor stores. For patients with an imbalance between donor supply and recipient demand, i.e. an advanced balding pattern (which is most often associated with limited donor supply), the goal becomes unattainable as the surface area needing coverage is too large to manage given the available donor supply. However, a favorable donor supply/recipient demand ratio in those with a more limited class 1-3 pattern may allow one to accomplish this type of restoration. Unfortunately, having a lower class pattern and a great supply does not fully end the discussion. This statement is based on the unpredictable nature of hair loss progression which can turn a seemingly good idea into a problem should an aggressive restoration be met with the future development of an advanced pattern. This predicament was experienced all too often in the early days of surgical hair restoration when few surgeons factored in aging as they routinely set a hairline along the original adolescent path. Although there is no crystal ball which allows the surgeon to fully predict a final pattern, factoring in details such as family history, patient age, and a careful scalp analysis can help screen for candidacy or non-candidacy. The casual use of aggressive hairline restorations is discouraged, especially in very young men with evidence of widespread miniaturization, as this can lead to a less-than-ideal hair distribution with a low hairline and negligible coverage behind it. However, the selective use of aggressive hairline restoration can provide long term satisfaction to those who truly desire that appearance. With respect to the comments of Mr. Hassler, I question his rational in believing that every man with an early pattern will progress to an advanced pattern as I have many long term patients over a 30 year career who have never progressed beyond a lower graft classification. I question the comment that this patient will eventually look odd as I have many patients with lower classifications who have been restored to a more youthful hairline position while looking quite good for decades. I question the comment regarding donor usage as this becomes a moot point if the pattern does not progress substantially. Finally, I find the assertion of encouraging aggressive hairline restoration in a haphazard fashion to be rather bold in consideration of the detail our practice has historically placed and continues to place on patient assessment and education. With respect to the “forehead reduction” reference, this technique has tremendous potential mostly for female patients with a long forehead and a stable hairline. The technique is not meant for anyone with an unstable hairline, thereby removing most male patients from candidacy. The term is used because many female patients complain not of having a high hairline, but rather of a long forehead. Quite obviously, these are synonymous. The procedure has been well-documented in the hair restoration literature. For those of you with an inquisitive mind, here is a chapter reference from the Facial Plastic Surgery Clinics of North America which I edited along with my colleague Dr. Gabel.“Kabaker SS, Champagne JP. Hairline lowering. Facial Plast Surg Clin N Am 2013; 21: 479-86.”
  15. This 28 year old requested frontal hairline restoration. A session consisting of 2884 grafts was performed using a “stick-and-place” insertion technique and dense-pack placement. Presented are 18-month postop photos, immediate graft placement photos and a 10-day postop photo.
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