Raymond Konior, MD | Chicago Hair Institute | Hairline Repair - A 14 Year History

[JayLDD]

You are both right. One of my favorite hairline clinics is (as far as I know) not (!) using microscopes. But I still believe there has to be improvement.

 

And there are different cases which require different solutions.

I do have a very uneven hairline with soft baby baby hair on one side.

This baby hair was always there and is lost on one side.

 

If I want to even the hairline I need to work with fine hair on the "bad" side.

Nape hair might be one solution (at least I think so).

That is why I am so interested why Konior promotes the usage of it, and Joe T denies it.

 

The problem people don't seem to understand is that like you mention for many their hair at different parts of the scalp can be extremely different, and what's viable for one person isn't for another in terms of a natural result. My nape hairs don't grow long enough to be used in a hairline, are quite curly which wouldn't be appealing and are lighter colour than the rest of my scalp hairs. Originally my hairline was similar to my temple point hairs in that they almost appeared colourless and are extremely fine in comparison to the hair right behind it, nowhere else on the scalp are they like this so I never expected that it would look 100% authentic because it wasn't ever a possibility.

 

From a couple of videos people now seem to think that if they aren't completely happy with a hairline or someone else's that they'll just blame it on multi-grafts even if they clearly aren't there to begin with, or are so spread out that its not a noticeable issue. There are other major issues at play and once an original, 100% natural hairline is gone it isn't coming back.

 

That said, microscopes in FUE are almost certainly worthwhile, just not fundamental to consistently good results.

[JayLDD]

You are both right. One of my favorite hairline clinics is (as far as I know) not (!) using microscopes. But I still believe there has to be improvement.

 

And there are different cases which require different solutions.

I do have a very uneven hairline with soft baby baby hair on one side.

This baby hair was always there and is lost on one side.

 

If I want to even the hairline I need to work with fine hair on the "bad" side.

Nape hair might be one solution (at least I think so).

That is why I am so interested why Konior promotes the usage of it, and Joe T denies it.

 

 

In this case there's clearly a distinction between natives and the nape hair, although density is an issue too, likely made worse by the use of nape.

[Dr. Raymond Konior]

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

[Gasthoerer]

Thank you very much for this detailed explanation.

 

For the record: I totally agree with what you have said about cherry picking, and another clinic told and showed (!) my similiar things. But JoeT publicly said otherwise, therfore I think other public opinions like yours are very helpful.

[harryforreal]

Once again, Dr. Konior, thank you very much for this information.