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Raymond Konior, MD - Frontal Hairline Restoration with 3165 Grafts


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This is a 39 year old male who requested frontal hairline restoration. He presented to my office with a history of previously undergoing a frontal restoration that did not accomplish his density goals. A total of 3165 grafts were placed in his thinning frontal tuft and empty frontotemporal recessions. Two year postoperative photographs demonstrate his final hairline. A comparison view uses arrows to identify several skin markers so as to provide a perspective of the lowering that was achieved.

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  • Senior Member

What an outstanding hairline! Excellent density too. Perfect.

Finasteride 1.25 mg. daily

Avodart 0.5 mg. daily

Spironolactone 50 mg twice daily

5 mg. oral Minoxidil twice daily

Biotin 1000 mcg daily

Multi Vitamin daily

 

Damn, with all the stuff you put in your hair are you like a negative NW1? :D

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  • Senior Member

That is a impressive result Dr Konior.

 

Patient must be thrilled.

2 poor unsatisfactory hair transplants performed in the UK.

 

Based on vast research and meeting patients, I travelled to see Dr Feller in New York to get repaired.

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  • Senior Member

Im not the most educated on the subject, but this is one of the best results I have ever seen !!!

HT No1 : Nobel clinic, Gatwick 500 grafts - Terrible result, left with bumpy skin

 

HT No2 : Marwan Saifi 1680 grafts. Great result

 

HT No3 - Marwan Saifi 1250 grafts. Another good result.

 

HT No4 - Hakan Doganay 2134 grafts. Result TBA

 

Total 5134 grafts.

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ManinSpace – You pose an outstanding question regarding his decision to aggressively fill the frontotemporal recessions. I believe that the strategy of how one approaches hairline design in terms of location and density is based on several key parameters – each of which must be factored into the final decision as to what should or should not be done with respect to designing the frontal restoration zone. Here are some of the key components that I factored into his plan.

 

A prediction as to the final hair loss pattern – Although there is no way to assess the definitive final pattern for many patients, an educated prognosis can often be made based on age, examination for presence or absence of miniaturization and family history. Analysis of these factors for this case suggested that his final pattern would support the long term aesthetic benefit of the restoration that was performed. Personally, I spend much more time trying to convince patients to be conservative with respect to hairline location and density as there seems to be more patients presenting to my office with the potential for progression to an advanced pattern that would not support aggressive hairline restoration. Fortunately this patient appeared to have just the right combination of factors to allow for the restoration performed.

 

Stabilization therapy – This patient has been on stabilization therapy with finasteride for over 10 years. His examination showed advanced miniaturization confined to the frontal region and very limited miniaturization in the crown. He stated that he had maintained a good response over the treatment period and that he had no plans to alter the treatment regimen.

 

Donor site availability for future treatment – Careful assessment of graft availability within the donor site must be completed to generate a treatment plan that includes planning for any potential future grafting needs that may arise from progression of a pattern. This particular patient had ideal donor characteristics – excellent density, elasticity and healing characteristics. His graft “reserve” was factored into a treatment plan that should allow his overall long-term goals to be fulfilled if his pattern progress.

 

Patient goals – Both short-term and long-term goals need to be prioritized in developing such a grafting scheme. With the understanding that the donor site is finite and that a full head of thick hair is impossible for patients with advanced patterns, a discussion of what would be done in the event of pattern progression must be undertaken with all patients prior to committing to any hairline restoration plan. A patient who has no concern about crown restoration in the short-term or the long-term has the ability to do more in the frontal region than someone who prioritizes coverage from front to back. With respect to this case the front was defined as the highest priority from both a short-term and long-term perspective.

 

Thanks to everyone for their positive comments. This patient had absolutely wonderful hair characteristics which contributed significantly to his final result.

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  • Regular Member

Thank you Dr Konior for taking the time to send such a detailed respond, It is very helpful to see the processes behind the decision laid out so clearly. I find the temple regions to be an interesting point of discussion and I have mixed opinions about whether or not to get mine closed, but I will probably err on the side of caution and not address them.

 

This is an absolutely fantastic result and i must say one of the best I think I have seen. I imagine he must be ecstatic with his new look.

Edited by ManinSpace
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Thanks Dr Konier for such a personal and informative post. This result is undoubtedly, as good as it gets and both you yet more so your patient must be so pleased. Your results are consistantly up amongst the best, always look forward to seeing your work!

Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@bhrclinic.com   -    BHR YouTube Channel - https://www.youtube.com/channel/UCcH4PY1OxoYFwSDKzAkZRww

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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