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1978matt

Ray Konior, MD – 1145 FUE – August 2018 (Chicago Hair Institute)

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Hi Folks,

I’ve recently returned to the UK from Chicago following a second HT to improve density in the mid scalp area.  I actually made the booking way back in August 2017 and was advised by Dr K that first available date would be in the middle of August 2018.  We agreed to target an initial 700 FUE, rising to ~1000 depending on how things went on the day of the procedure.

Procedure day

A few of the pre-op instructions have changed since my visit 5 years ago.  You are asked to arrive at the office on time and to arrange a driver or an Uber.  Previously they used to collect you from the Comfort Suites on the morning of the surgery.  I had chosen to stay at the Comfort Suites anyway, which is very close to the office, and only had to wait about 2-3 minutes for an Uber.  The journey took about 5 minutes ($5-6).

I got there just as Lisa, Dr K’s main tech of 20yrs was arriving and it was great to see her again after all these years.  She took me through some of the paperwork I was asked to review in advance and also took my lunch order for later in the day (I went for the Turkey Club Sandwich which tasted great BTW).  Lisa is an absolute diamond and nothing is too much trouble.

I guess it must have been 7am or 7:15am by the time Dr K appeared.  I think he had already arrived around 6am …either that or they left the place unlocked overnight!

We had a good chat for about 45 mins and he was saying how he enjoys the challenge of FUE these days.  Funnily enough he asked me who were regarded as the “best guys in Europe these days?”  I said all the usual names get mentioned on the forums but hardly any of them actually do the surgeries themselves.  One Doctor I thought is good and who gets overlooked is Dr Jean Devroye.  Dr K was interested in my reply because Dr D’s FUE graft quality was some of the best he had ever observed.  He said he had seen some of the biggest ‘FUE names’ really struggle to perform it at live surgeries, but Dr D was an exception.

By about 8am the Doc started to check my donor area.  “I can’t see any signs of miniaturisation…anywhere”…This is what I want to hear lol.  Then without hesitation he started marking out the donor zone with a felt tip pen.  We then moved on to the recipient zone.  To be honest I couldn’t fully see what he marked because my hair was all over the place but was sure that whatever it was it was along the lines of what we discussed and on email.

Next up Lisa returned and started unpacking the hair clippers.  We were going for no-shave on top but obviously applying a grade 1 over the full back and sides.  She did her best but is no barber lol.  After that, a change of shirt and quick restroom break and we were off to the operating room.

Extractions

I’d had a couple of Valium by this point and I guess it was 8:15am.  The techs help you into a comfortable position and have special leg cushions to make it comfortable to lie on your side for long periods.

Dr K has the full high spec room with automatic adjustable operating table.  For the bulk of the time I had to lie on one side or the other, with only a short period in a face down position. 

The numbing injections went on for quite some time, maybe 5-10 minutes but were not painful at all.  It was then straight on to the extractions.  All I could hear in terms of noise was like a scratching sound each time the punch went in.  I couldn’t feel actual downward pressure or anything like that.

We had a couple of 5minute breaks to change position but I think the entire extraction process was over by 11:45am, at which point we took an early Lunch.  I guess we recommenced about 12 and Dr K started by removing an annoying mole on my hairline. (I’d asked him to do this earlier).  I remember thinking that he was sticking around the hairline for quite a while and much to my surprise he was actually putting a handful of singles in there lol.  I did say in the morning he could ‘do what he wanted’ as far as grafting goes.

I probably drifted off 5 minutes into it and the next part completely passed me by.  I didn’t wake up until 4pm.  Lisa and Dr K were asking if I wanted a break as there were only 200 grafts left to place.  We did, and as I was lying back down I asked the Doc which type of punch he used.  It was the WAW system by Devroye.  A bit of a coincidence that we spoke about him that morning.  He then showed me a dish with some of the remaining grafts.  You forget just how small they are but they all looked really neat and as if they had come from an FUT strip.

So we finished up at around 630pm after Lisa followed by Dr K each spent a good 10 minutes checking and adjusting the grafts.  Dr K was ecstatic with how it all went and said the grafts were really great quality thanks to both his skill and Dr D’s WAW punch. 

Post Op

I took 2 Ibuprofen prior to returning to the hotel, then another 2 prior to bed (I was not sure if I was going to need them).  The next day I woke up to find I did not need them at all – no pain!  In fact, for the first week I only took about 4 tablets at random times.  Even then it was for a headache, probably jet lag induced and little to do with the surgery itself.  The extraction sites were so small they were barely noticeable.

You do look a bit of a mess for the first few days and I had 3 routine visits back to the office on consecutive post op days.  Surprisingly I did not have to spray the grafts at all for the first 48 hours.  There was next to no scabbing or crusting anyway and now 11 days on the grafts have ‘grown’ a couple of mm and feel like a buzz cut.

Graft Breakdown

The plan was to target the larger grafts, hence the number of 3s and 4s:

Singles - 33

Doubles - 356

Triples - 617

Quads – 139

Total = 1145 (3152 hairs; 2.75 hairs/graft average)

[FUT = 4312 (7676 hairs; 1.78 hairs/graft average)]

Dr K was as highly impressive as ever and I can’t imagine there is a greater perfectionist out there.  I believe he is now booked until about December 2019.

I’ve marked up one of the photos below to show the area he worked on.  Blue zone is FUT grafts, green zone FUE, and red a possible crown work if I ever felt the need (no plans or desire at this stage).  Dr K estimates I could get another 2 to 3k FUE potentially before it might start to thin out the donor.

I’ll endeavor to provide photo updates, probably from month 4 or 5.

Any questions let me know.

1st set of pictures are the day after, second set 10 days.

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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

My HT results thread from 1st procedure.

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Looking good Matt...

Given that you already have a FUT scar, can I ask why you opted for a FUE for the second round?

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Wow, looks really good at the 10 day mark. Did you get any FUE into the scar or did you feel that would be a waste of graphs. Your FUT scar from your prior surgery looks very thin even with a shaved head so I am guessing once your hair gets about an inch long you can’t even see it. 

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Looking good Matt, I was actually there the same day you had your surgery. The salt and pepper is certainly working well for you. Please keep us updated on your progress.


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @htrestoration FacebookPintrest, Linkedin and YouTube.

 

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I remember you saying you were not entirely satisfied with your 'first pass'.  Looks strong. Good luck with this round, keep us updated.

 

6 hours ago, n00b said:

Looking good Matt...

Given that you already have a FUT scar, can I ask why you opted for a FUE for the second round?

Ah second this question.

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9 hours ago, n00b said:

Looking good Matt...

Given that you already have a FUT scar, can I ask why you opted for a FUE for the second round?

Thanks mate, it was a few considerations:

1)The rate I am losing hair is so slow to negligible there is not a need to take a further strip at this stage.

2)The number of grafts needed was relatively small.

3)I go to the gym 3 or 4 times a week and did not want too much down time (14 days recommended).

4)Dr K's FUE ability and ethics - he would have asked to switch if he thought it was a bad idea, or the extractions were not good.

5)I needed a lot of 2/3/4 hair grafts.  With an FUT you are more limited with what is in the strip, so why not achieve the same outcome with less grafts.

6)My hair at the back grows so damn thick so why not thin it out a bit.  It could take the hit of at modest sized FUE.

7)I was able to take a few weeks off work to allow the sides to grow back.

8)Not worth risking a slightly bigger scar at this stage.

That's it in a nutshell really. Dr K seemed to generally stay out of the strip zone so it is still there as an option.

6 hours ago, Triple7 said:

Wow, looks really good at the 10 day mark. Did you get any FUE into the scar or did you feel that would be a waste of graphs. Your FUT scar from your prior surgery looks very thin even with a shaved head so I am guessing once your hair gets about an inch long you can’t even see it. 

Nah, the scar is good and not worth any grafts at this point.  I think in about a week's time it will be covered enough and the sides back to about a grade 3.  I calculated my time off based on the rate my hair grows, typically half a mm a day: 18 days x 0.5 = 9mm (grade 3).

3 hours ago, Melvin-Moderator said:

Looking good Matt, I was actually there the same day you had your surgery. The salt and pepper is certainly working well for you. Please keep us updated on your progress.

Nice one Melvyn.  He did mention he had spoken to you but I just assumed it was on the phone and regarding forum matters.  He was telling me how Pat and Bill are quite a pair of characters lol.

3 hours ago, bismarck said:

I remember you saying you were not entirely satisfied with your 'first pass'.  Looks strong. Good luck with this round, keep us updated.

 

Ah second this question.

Thanks mate.  I always needed more hair behind the first one to achieve shorter hairstyles.  Blow drying a big mop of hair can get quite tiresome but now in time I should have enough density across the top to keep it no more than a couple of inches.


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

My HT results thread from 1st procedure.

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Looking good! Looking forward to the results! Dr. K definitely definitely spoke highly of Dr. Devroye when I saw him last.....

FUE was absolutely the right choice....not a chance you are getting 2.75 hairs per graft out of FUT. Matter of fact, I don't know that I've seen a higher per hair average in a surgery on here, ever.....

Remember, the number of grafts means very little....the amount of actual hairs moved is the better indicator.

 

 

Edited by matt3480

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Hey 1978Matt, 

Happy growing! I am sure you're gonna get a wonderful result. I would not expect anything less from a surgeon of Dr. Konior's calibre.

Perhaps the picture is a bit deceiving, but it appears that your strip scar is relatively low compared to what we sometimes see from some surgeons like Dr. Hasson. Were there any advantages of collecting the strip from that location? 

Also, do you happen to know what your donor density was per cm2 before having any surgery?

Matt3480, 

Out of curiosity, which other surgeons did Dr. Konior mention he was impressed by? 


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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2 hours ago, delancey said:

Hey 1978Matt, 

Happy growing! I am sure you're gonna get a wonderful result. I would not expect anything less from a surgeon of Dr. Konior's calibre.

Perhaps the picture is a bit deceiving, but it appears that your strip scar is relatively low compared to what we sometimes see from some surgeons like Dr. Hasson. Were there any advantages of collecting the strip from that location? 

Also, do you happen to know what your donor density was per cm2 before having any surgery?

Matt3480, 

Out of curiosity, which other surgeons did Dr. Konior mention he was impressed by? 

Thanks Delancey,

The strip is taken from the boney bit at the bottom of the skull (occipital hump I think it is called).  I think you can stray a cm or two from this area (above and below) and would guess he picked the highest density part in this region.  He told me the strip was an average 2.7cm wide..  I did do a couple of months scalp exercises in advance.

He did say my density was 80 at the back and 60 at the sides.  What I lack in density I make up for in caliber.

Dr K recommends Nadimi and Gabel to people unwilling to accept his waiting list.

  • Thanks 1

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

My HT results thread from 1st procedure.

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1 Month

The top has mostly shed with a few hangers-on.  I had a haircut at week 3 which didn't really touch the donor area so what is seen on the back and sides is basically growth from day 1.  Apart from very very minor soreness and itchiness in the donor areas it has been a walk in the park.

Resizing phone photos is a bit rubbish so apologies for the picture quality.

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Edited by 1978matt

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

My HT results thread from 1st procedure.

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The donor area looks completely healed, thanks for keeping us updated on your progress.


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @htrestoration FacebookPintrest, Linkedin and YouTube.

 

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Looks great. I'm about to have my first procedure and often wonder what future touch ups might look like, so it's good to see you were able to reinforce your midscalp through FUE and conceal it pretty easily.

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Everything looks great. Your hair looks good at its current length. When the new hair grows in, you will have a home run result. 

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The hairline is incredibly natural looking. 


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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Looking good 1978Matt! Dr. Konior does some amazing work! Your strip scar looks very thin too, I take it he did a tricophytic closure on it? I’ve seen great results from Nadimi & Gabel as well!

Remembering your previous surgery, was the healing more painful having the strip vs the FUE? Curious, as I’m thinking of FUE myself assuming I’m a candidate largely due to the way my skin heals, it always tends to scar badly.

PS are you on any meds( Finasteride) to slow the loss at all? Or just the HT?

Thanks! Looking forward to more updates!

 

On 8/28/2018 at 8:38 AM, 1978matt said:

Thanks Delancey,

The strip is taken from the boney bit at the bottom of the skull (occipital hump I think it is called).  I think you can stray a cm or two from this area (above and below) and would guess he picked the highest density part in this region.  He told me the strip was an average 2.7cm wide..  I did do a couple of months scalp exercises in advance.

He did say my density was 80 at the back and 60 at the sides.  What I lack in density I make up for in caliber.

Dr K recommends Nadimi and Gabel to people unwilling to accept his waiting list.

 

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27 minutes ago, vinzaf19 said:

Looking good 1978Matt! Dr. Konior does some amazing work! Your strip scar looks very thin too, I take it he did a tricophytic closure on it? I’ve seen great results from Nadimi & Gabel as well!

Remembering your previous surgery, was the healing more painful having the strip vs the FUE? Curious, as I’m thinking of FUE myself assuming I’m a candidate largely due to the way my skin heals, it always tends to scar badly.

PS are you on any meds( Finasteride) to slow the loss at all? Or just the HT?

Thanks! Looking forward to more updates!

 

 

I don't think it was a trico closure but I could be wrong.  I think they can be overrated because the hair that grows through the scar can exit at a weird angle.

Yeah, it sure is more painful for Strip.  I think the size of the procedure also plays a factor, since I had 4 times as many grafts the first time.

Yeah I take 1/4 Proscar twice weekly.  Usually Friday/Tuesday but sometimes Friday/Monday.

Edited by 1978matt

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

My HT results thread from 1st procedure.

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13 hours ago, Spanker said:

Man...you have come soooooooo far.

 

You probably dont remember that person. 

 

A distant memory.  Hair dye masks the problem a bit in that one.  These are clearer.  Feb 2012 and April 2012 respectively.  At least they show very little progression since.

before.jpg

top.jpg


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

My HT results thread from 1st procedure.

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2 Months

A token photo attached but nothing to see really.  I can see some of the hairline grafts didn't shed but are sitting static at about 2 or 3mm and not growing.  The same thing happened on the first HT so no concerns there.

I've noticed 2 or 3 pimples in the donor with one near the left nape which is sticking around for a while. Probably an ingrown hair.  Will keep an eye on it.

I'm not using rogaine this time so not expecting fast growth.  Maybe see something in December or January (4th and 5th months) if I'm lucky.

DSC_0711.JPG


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

My HT results thread from 1st procedure.

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Hey matt,

just saw your previous thread and wow, what an amazing result, super fantastic.

congrats on both of the procedures.

how much grafts did you add to the front of the scalp and where? and why? you wanted more density to that area?

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Hard not to be impressed so far.


Hair loss patient and transplant veteran. Once a Norwood 3A.

Received 2,700 grafts with coalition doctor on 8/13/2010

Received 2,380 grafts with Dr. Steven Gabel on 9/30/2011

Received 1,820 grafts with Dr. Steven Gabel on 7/28/2016

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