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This is a 63 year old professional hairdresser who requested restoration of his balding scalp. He presented to my office with a history of using hair dye to camouflage his graying hair. He underwent a total of 5250 grafts which were performed in two sessions, each one year apart. The initial 3000 graft session provided restoration of his frontal hairline. The second session used 2250 grafts to enhance density in his midscalp and crown. Presented are photos taken three years following his original procedure. He opted to discontinue using hair dye following regrowth of his transplanted hair.

 

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I can't fault the result but as can be readily seen in photo #19 despite the pt's excellent hair characteristics, the density contrast between the non androgenic affected zones and the recipient area is quite apparent. This is not the fault of the surgeon but rather a inherent limitation of the strip technique. Compared to a high NW Lorenzo case with a similar number of grafts, I believe the blending of densities between these zones is generally much less noticeable.

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I can't fault the result but as can be readily seen in photo #19 despite the pt's excellent hair characteristics, the density contrast between the non androgenic affected zones and the recipient area is quite apparent. This is not the fault of the surgeon but rather a inherent limitation of the strip technique. Compared to a high NW Lorenzo case with a similar number of grafts, I believe the blending of densities between these zones is generally much less noticeable.

 

You're fast establishing yourself as the most prominent Lorenzo 'shills' on this forum.

 

The only reason it looks so thick on the sides is that he has kept it grown out, probably because he likes that style. I can find you several high NW Lorenzo cases that do not look at all 'blended' either and it is because hair on the sides is kept relatively long.

4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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You're fast establishing yourself as the most prominent Lorenzo 'shills' on this forum.

 

The only reason it looks so thick on the sides is that he has kept it grown out, probably because he likes that style. I can find you several high NW Lorenzo cases that do not look at all 'blended' either and it is because hair on the sides is kept relatively long.

Could say the same about your fascination with Konior.

 

"The only thing he needs is a cape". - Matt1978

 

He's right though, there is a clear contrast between recipient and donor. Not that Dr Konior did anything wrong, but since one of the shortcomings of FUT work are being pointed out, we know why you don't like hairweare's criticism.

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This is not the fault of the surgeon but rather a inherent limitation of the strip technique.

 

What "inherent limitation of the strip technique" (vs. FUE) are you referring to? I can't for the life of me figure out what you're talking about.

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He underwent a total of 5250 grafts which were performed in two sessions, each one year apart. The initial 3000 graft session provided restoration of his frontal hairline. The second session used 2250 grafts to enhance density in his midscalp and crown. Presented are photos taken three years following his original procedure.

 

 

Could you also provide pictures of the patient showing the result of his first HT with 3000 grafts??

 

You presented some patients with 4000-4500+ grafts in one session. In this patient, why didnt you transplant more than 3000 grafts in the 1st session?

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What am I missing here? Does anyone here think that it's a good idea to remove grafts all of the way up the parietal humps with FUE so that there is less contrast between native and transplant hair?

 

Does any one think that FUE magically gives you more hair mass per graft?

 

Does anyone here think that there is no difference in the density of a transplanted zone and native zone?

 

I've heard some good arguments in my day for FUE, but this isn't a great one. I don't see very many well regarded doctors not leaving a buffer for further loss in the transition zone. Most leave that boarder at natural density in strip and FUE.

 

I don't want to turn this thread into a flame war, but I don't think it's good for prospective patients that are high NW to think that they can have FUE and then there will be a nonexistent boarder between there native and their prior bald area.

 

Let's do some math real quick. To do an area the size of a cd, at 50 g per cm2, it would take 5652 grafts. Obviously, this area it's larger than that and fewer grafts were used.

 

If his donor area is 75 g per cm, and his transplanted area was 50 grafts per cm2, which it isn't, that would still leave him with a 33 percent deficit in the transplanted area.

 

Point is, you see a difference because there is a difference. But not because it's strip. When we talk about strip/fue differences, we should use legitimate points. I think it would also be a mistake to go to a nice FUE case and say, "Ya know, looks good, but Dr. Konior gets a fuller result with the same about of grafts. Must be because that's an FUE case."

 

I think a lot of 63 year old men are very envious of this guy's hair.

 

This thread is about this case, and if we want to debate how FUE magically creates fuller results, let's start a new thread. Or not, I think it's a nice result to have pinned at the top of the page for 2 weeks.

I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians.

View Dr. Konior's Website

View Spanker's Website

I am not a medical professional and my opinions should not be taken as medical advice.

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Could say the same about your fascination with Konior.

 

"The only thing he needs is a cape". - Matt1978

 

He's right though, there is a clear contrast between recipient and donor. Not that Dr Konior did anything wrong, but since one of the shortcomings of FUT work are being pointed out, we know why you don't like hairweare's criticism.

 

Now now.

 

That was one comment I made on a Konior thread. Call me paranoid and maybe I'm overreacting but it seems like every other post from 'hairweare' is in some way promoting his doctor.

 

Maybe I'm wrong but it seems like whenever someone posts something like: 'how common is shockloss?' this guy pops up and tells how his doctor 'hardly ever causes it' because of his 'great technique', or something along those lines.

 

I could pick out a few examples but I'm sure we all have better things to do with our time.

4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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What "inherent limitation of the strip technique" (vs. FUE) are you referring to? I can't for the life of me figure out what you're talking about.

 

I agree. Hairweare - you need to back up such silly comments with further explanation of your position if you expect anyone to take it seriously. People come here for real real help, and this is not a statement anyone should believe is accurate, especially when we are talking about the recipient zone specifically.

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It is a simple concept of HT relating to supply and demand that the recipient zone can never achieve the same density as the donor zone. The higher the NW class and the more grafts required due to greater surface area to be covered the more this unfortunate equation applies. Sure this gentlemen could cut his sides shorter to lessen the effect but men of this age group often prefer hair of more equal or proportional length, and cutting the top shorter negates the "layering" effect that creates the perception of more fullness.

 

It is common sense that a donor zone which has been evenly and diffusely thinned by FUE extraction will have less contrast with the obligatory thinness of a larger recipient area. This concept really shouldn't be that difficult to understand. Study some of Lorenzo's higher NW cases if you need to see evidence of this effect.

 

HT is a very lucrative and competitive business. I have made it clear to anyone bothering to read my comments carefully that I spare no criticism for any physician who places his commercial interests blatantly ahead of that of his patients. I am a veteran of both strip and FUE as well as a physician myself, to call me a shill or to question my contributions as being anything other than generous and objectively helpful is quite absurd.

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Great result. The grey hair looks very distinguished.

 

The idea of thinning out the donor area with FUE to more evenly match the less dense recipient area as being some how "better" does not make much sense to me. Having a slightly less dense recipient area is by far and away the more natural result. Conversely, having a thinning donor area is much more noticeable and does not mimic nature at all, unless the patient is on his way to complete baldness or is not well.

 

If anything, the fact that FUE noticeably thins out the donor area in some cases is a definite argument against it not for it. And not to beat a dead horse but I see many FUE cases that take hair from what has to be considered the "unsafe" zone, particularly very high on the head.

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It is a simple concept of HT relating to supply and demand that the recipient zone can never achieve the same density as the donor zone. The higher the NW class and the more grafts required due to greater surface area to be covered the more this unfortunate equation applies. Sure this gentlemen could cut his sides shorter to lessen the effect but men of this age group often prefer hair of more equal or proportional length, and cutting the top shorter negates the "layering" effect that creates the perception of more fullness.

 

It is common sense that a donor zone which has been evenly and diffusely thinned by FUE extraction will have less contrast with the obligatory thinness of a larger recipient area. This concept really shouldn't be that difficult to understand. Study some of Lorenzo's higher NW cases if you need to see evidence of this effect.

 

HT is a very lucrative and competitive business. I have made it clear to anyone bothering to read my comments carefully that I spare no criticism for any physician who places his commercial interests blatantly ahead of that of his patients. I am a veteran of both strip and FUE as well as a physician myself, to call me a shill or to question my contributions as being anything other than generous and objectively helpful is quite absurd.

 

Why would your contributions be seen as generous? Or at least any more generous than anyone else's? I understand you're a physician, and congratulations on that. I know you're proud of that because you've mentioned it several times, but that doesn't make your observations, ht knowledge, or opinions more valuable than anyone else's.

 

I can respect that you have your own opinion on this result, but what I can't respect is that it looks like you're saying that Dr. Konior put commercial interest ahead of patient needs, which isn't just untrue, it's absolutely ridiculous (among other things). It sounds like an unfounded personal attack on him. I initially didn't comment back on this because the work speaks for itself and the patient is very happy but when I just read this again I couldn't keep from speaking out. So you weren't a fan of this case? Ok. But adding the bit about physicians, and I'm assuming you meant Dr. Konior in this case, not having the patient's interests at heart, is so ridiculous that I don't see myself or very many others respecting your advice or opinion on future matters.

 

For the most part as posters to this forum, only the reputations of our hidden identities and fake forum names are accountable for what we say. It's easy to throw into question someone's integrity sitting behind a keyboard in our homes. I can tell you without a doubt that he certainly holds his patient's interest above all else when it comes to his practice. Yes, I know I'm his online rep but even so, he is a good and honest man. I know because I know him. If the entire physician community operated with his skill and ethics, we wouldn't even need a forum like this.

 

Bottom line is take a look at this result, if you were this man's age with this man's pattern and loss, would you be happy with it? If not, maybe Dr. Konior (or a hair transplant for that matter) isn't for you. But this patient was thrilled, and that is really the only thing that mattered.

I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians.

View Dr. Konior's Website

View Spanker's Website

I am not a medical professional and my opinions should not be taken as medical advice.

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