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Best overall surgeon in the US and Canada? Hasson? Rahal?


ryker94

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1 hour ago, BDK081522 said:

Cutting corners and Raymond Konior should not even be in the same sentence. Cmon mate, you're certainly entitled to your opinion and obviously chose someone else but don't negatively speculate about someone's work ethic that you truly have no firsthand experience with. His lead tech has been with him for around 20 years. Do you seriously think she would still be there if he was that difficult to work for?

Yes you are certainly right!  

I’m just sharing how his unusual approach to patient management made me feel as a potential customer, since that is what the OP was discussing as far as outreach.
 

As with yours, most of Konior’s work I’ve seen on this forum is  outstanding and it speaks volumes that he has devoted patients like you. I do stand by my thoughts about teamwork though.  I will edit my post for clarity - thank you. 

Edited by yalla8
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First person ever to complain about having direct access to the surgeon. 😂

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Dr. G: 1,000 grafts (FUT) 2008

Dr. Paul Shapiro: 2,348 grafts (FUT) 2009 ~ 1,999 grafts (FUT) 2011 ~ 300 grafts (Scar Reduction) 2013

Dr. Konior: 771 grafts (FUT) 2015 ~ 558 grafts (FUT) 2017 ~ 1,124 grafts (FUE) 2020

My Hair Transplant Journey with Shapiro Medical Group

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5 hours ago, yalla8 said:

Yes you are certainly right!  

I’m just sharing how his unusual approach to patient management made me feel as a potential customer, since that is what the OP was discussing as far as outreach.
 

As with yours, most of Konior’s work I’ve seen on this forum is  outstanding and it speaks volumes that he has devoted patients like you. I do stand by my thoughts about teamwork though.  I will edit my post for clarity - thank you. 

Without going into the details of my case, I went to a clinic where techs were “very involved.” In fact, they did all the extractions. When I look back, I WISH I would have gone with a doctor like konior that’s involved in all steps. I’ll tell you why….

 

A clinic that delegates a lot of its work to techs usually translates to one thing: the doctor is trying to squeeze out as much money as possible and does multiple surgeries per day. Secondary to this, the doctors time is taken up by other activities (tending to other patients, doing consults, or just browsing his stock portfolio in his office because he’s lazy). Time is limited in clinics like this so you get things like rushed consults, overlooked issues, decrease in quality control, etc. If you are a more complex case due to hair/surgical characteristics (like myself) it’s straight up Russian roulette. Your results are going to be messed up: bad yield, messed up donor due to improper planning, etc. 

 

A doctor that dedicates his time solely to one patient per day is worth their weight in gold.

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6 hours ago, 5BetaReductase said:

Without going into the details of my case, I went to a clinic where techs were “very involved.” In fact, they did all the extractions. When I look back, I WISH I would have gone with a doctor like konior that’s involved in all steps. I’ll tell you why….

 

A clinic that delegates a lot of its work to techs usually translates to one thing: the doctor is trying to squeeze out as much money as possible and does multiple surgeries per day. Secondary to this, the doctors time is taken up by other activities (tending to other patients, doing consults, or just browsing his stock portfolio in his office because he’s lazy). Time is limited in clinics like this so you get things like rushed consults, overlooked issues, decrease in quality control, etc. If you are a more complex case due to hair/surgical characteristics (like myself) it’s straight up Russian roulette. Your results are going to be messed up: bad yield, messed up donor due to improper planning, etc. 

 

A doctor that dedicates his time solely to one patient per day is worth their weight in gold.

Great points! I don't want to get into a protracted back-forth over this question and hijack this thread --  but maybe it would be interesting to have out this debate on a thread of its own, because I do see it come up often.

My  pushback to your point is that you're jumping to the conclusion "if the doc is involved, it will come out better" without any supporting evidence. Totally agree that if the team (eg doc + techs) is unprofessional and untrained, then the procedure is a game of Russian roulette. However, the same can be said if the doctor is untrained as well. But if the team is well trained, then I would argue that more people is only additive to the process. As one anecdote, I recently had a second surgery at a top clinic and there were 4-5 techs working alongside the doctor. These techs had a combined 50+ years of experience working with this doctor.

With regard to your point about economic motives, while I see your point, I also disagree. Yes, more more patients per day = more revenue. However, it also means higher variable costs like real estate and labor (if each patient requires a team of 4-5 techs), so the math isn't as clear. Of course, it all depends how the clinic is set up. Hair mills will try to squeeze the most out of their spaces and techs to reduce these costs. But at top clinics that use techs, and in my experience, the team that was with me did not feel rushed and were assigned to my case for the entire day.

At the end of the day, I don't think there's a "best practice" on this question. I think it has to come down to the particular case.

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28 minutes ago, yalla8 said:

Great points! I don't want to get into a protracted back-forth over this question and hijack this thread --  but maybe it would be interesting to have out this debate on a thread of its own, because I do see it come up often.

My  pushback to your point is that you're jumping to the conclusion "if the doc is involved, it will come out better" without any supporting evidence. Totally agree that if the team (eg doc + techs) is unprofessional and untrained, then the procedure is a game of Russian roulette. However, the same can be said if the doctor is untrained as well. But if the team is well trained, then I would argue that more people is only additive to the process. As one anecdote, I recently had a second surgery at a top clinic and there were 4-5 techs working alongside the doctor. These techs had a combined 50+ years of experience working with this doctor.

With regard to your point about economic motives, while I see your point, I also disagree. Yes, more more patients per day = more revenue. However, it also means higher variable costs like real estate and labor (if each patient requires a team of 4-5 techs), so the math isn't as clear. Of course, it all depends how the clinic is set up. Hair mills will try to squeeze the most out of their spaces and techs to reduce these costs. But at top clinics that use techs, and in my experience, the team that was with me did not feel rushed and were assigned to my case for the entire day.

At the end of the day, I don't think there's a "best practice" on this question. I think it has to come down to the particular case.

It’s more to do with controlling variables as opposed to techs vs docs.
 

An experienced tech & doc team that have a track record of producing good results is fine, as long as you can guatentee it is the same technicians who will be working on your case that day, a long with the same doctor involvement. 

An experienced doctor who does ‘all the work’, and has a track record of producing good results - based upon the knowledge we have as the general public, is a more assured way of being able to control this variable - because how many technicians names do people know of from any of the top clinics? None - because they are often the unsung heroes, and it’s the doctors name who takes credit for the work. 
 

So you are relying on the fact that the technicians on your particular surgery will be the same ones that played the tech roles in producing the good results. 
 

Now this is fine, for the majority of the time, in most top clinics, as they tend to have smaller turn over in tech staff, and less overall numbers of techs on their payroll in general.
 

However - when clinics branch out, start to increase their volume of patients, and grow quicker than they can maintain quality control - this is when it becomes an issue.
 

We saw it happen to Asmed, we see it happen with Cinik, from the vastly varying degrees of success his patients have, and I wonder whether techs have been the issue with the poor results from Dr Arshad recently.
 

Basically, you are counting on the clinics word that they are using their regular techs or experienced techs with you - when in reality you have no way in properly being able to verify this. So, as far as being able to accurately ascertain a clinics success ratio - it is far easier to do so, when the Dr who you have heard of and physically know of, plays a large proportion of the role, as this is what you will be getting. 
 

This isn’t to say tech clinics aren’t as good - it’s to point out that it’s one more variable out of your control/knowledge. 

Edited by Curious25
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11 minutes ago, Curious25 said:

It’s more to do with controlling variables as opposed to techs vs docs.
 

An experienced tech & doc team that have a track record of producing good results is fine, as long as you can guatentee it is the same technicians who will be working on your case that day, a long with the same doctor involvement. 

An experienced doctor who does ‘all the work’, and has a track record of producing good results - based upon the knowledge we have as the general public, is a more assured way of being able to control this variable - because how many technicians names do people know of from any of the top clinics? None - because they are often the unsung heroes, and it’s the doctors name who takes credit for the work. 
 

So you are relying on the fact that the technicians on your particular surgery will be the same ones that played the tech roles in producing the good results. 
 

Now this is fine, for the majority of the time, in most top clinics, as they tend to have smaller turn over in tech staff, and less overall numbers of techs on their payroll in general.
 

However - when clinics branch out, start to increase their volume of patients, and grow quicker than they can maintain quality control - this is when it becomes an issue.
 

We saw it happen to Asmed, we see it happen with Cinik, from the vastly varying degrees of success his patients have, and I wonder whether techs have been the issue with the poor results from Dr Arshad recently.
 

Basically, you are counting on the clinics word that they are using their regular techs or experienced techs with you - when in reality you have no way in properly being able to verify this. So, as far as being able to accurately ascertain a clinics success ratio - it is far easier to do so, when the Dr who you have heard of and physically know of, plays a large proportion of the role, as this is what you will be getting. 
 

This isn’t to say tech clinics aren’t as good - it’s to point out that it’s one more variable out of your control/knowledge. 

Totally see your point. I think it comes down to if you trust the doctor's judgement to surround themselves with the best team. What I'm simply saying is that if they do, then I don't see how more, capable people in the process isn't always net positive. So I think we are saying the same thing!

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Dr. Konior used to have a consultant @Spanker he was very active a few years back. I believe he may be in the healthcare field and got overwhelmed after the pandemic, but I could be wrong. It would be great if he came back and could help Dr. Konior with some of the inquiries, etc, he's a very knowledgeable guy. Now, as for technicians vs. doctors, of course it all comes down to ability and capability. 

Dr. Hasson said he would put his two technicians up against any surgeon in the world, that's how good their extractions are, and I believe it. He has said they do cleaner and better extractions than him, which I felt was a very humble thing to say, given his status and reputation. My point is, extracting grafts and implanting grafts are motor skills, you don't need to go to medical school to do it. For sure, there are some technicians out there that can extract better grafts than a lot of the top surgeons in the world.  

Consistency and a long track record is what matters the most. I will agree that a revolving door of technicians is what makes going to a tech-driven clinic a gamble, because you don't know who will be performing your surgery. There's a right and a wrong way to make money. The wrong way to make money, is to lower the quality and standards by performing the most surgeries as possible, while charging the lowest price possible, and paying your staff the lowest wages possible (AKA the hair mill). 

The right and ethical way to make money is to raise your prices and raise your quality. There is a market for everyone. For example, I recently got married as you guys know, and there are two types of guys. Guys who rent suits off the rack from places called cheap-tuxes-for-rent, and guys who go to a tailor to get a bespoke made suit for their special day. I would say most of us in this community are the latter, and Reddit is the former. There's nothing wrong with offering a more bespoke experience and charging accordingly. End of the day, quality and consistency is what matter the most. 

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On 1/15/2022 at 10:49 PM, ryker94 said:

Thanks for all the great suggestions and thoughts, mates. I totally agree and realize how vague my ask was lol. 

Given these other considerations, I narrowed it down to Hasson and Rahal still... except I'm leaning towards Rahal because my primary goal right now is reconstructing my hairline and temples conservatively (keep a healthy donor amount for another surgery in the future). However, I am concerned with Dr. Rahal over two things:

  1. Dr. Rahal seems to have better results with FUT procedures, which he does not do anymore.
  2. I read one post on reddit claiming that a past patient had 3 different botched FUE surgeries with him and got a full refund. 

Do you guys think Rahal is good with FUEs still? I had trouble finding good, recent FUE results from patients... Maybe I'll do more research into Konior. 

Also, Hasson is great for megasessions (prob choose him in the future), but is he just as good with hairlines?

Thanks again.

I had a HT with Dr. Hasson in 2014 (4000+ grafts), and I can tell you that he does hairlines very well!  I've included pictures from today and a few months ago and also those showing my hairline just prior to surgery for comparison.  He's expensive, but no regrets.  I am interested in Melvin's results from Eugenix - wondering if it is a cost effective procedure.

IMG_7108.jpeg

2013.jpg

IMG_0093.JPG

IMG_7106.jpeg

IMG_6112.JPG

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1 hour ago, jceaves said:

I had a HT with Dr. Hasson in 2014 (4000+ grafts), and I can tell you that he does hairlines very well!  I've included pictures from today and a few months ago and also those showing my hairline just prior to surgery for comparison.  He's expensive, but no regrets.  I am interested in Melvin's results from Eugenix - wondering if it is a cost effective procedure.

IMG_7108.jpeg

2013.jpg

IMG_0093.JPG

IMG_7106.jpeg

IMG_6112.JPG

What a great transformation - holding up nicely after 4 years as well! Good for you man! 

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Shapiro should be on this list as well in my opinion. Konior continues to speak highly of Dr. Shapiro, and actually turned me down when I requested a surgery with him because I had prior surgery with Shapiro at that point in time. He told me the was one of the best and that I should stay with him. So take that information as you will...

Edited by hybonix
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1st Procedure: 3332 FUE Grafts | Shapiro Medical Group | 10.29.20
2nd Procedure: 1908 FUE Grafts | Shapiro Medical Group | 11.13.23

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22 hours ago, yalla8 said:

I think in a labor intensive surgery like HT, it is important for doctors to surround themselves with a capable team. Specialized teams almost always perform better work than individuals in any field. Having been in the army I analogize it to a military operation. Even the very best combatant is nothing without a supporting team.

Dr K's techs actually do a lot of work so that he doesn't have to.  They organise everything:  Get the patient all prepped up and all the instruments ready.  He literally just walks into the room, scrubs up and does the work, usually with 3 or 4 techs assisting, or more if it's FUT.

Then on breaks he can go to his office, attend to emails for 5-10 minutes while the patient has a comfort break etc.  The techs then sort everything out for the next session, e.g. FUE extractions from another area.

It's like a military operation.

I watched him perform an FUT surgery for a few hours in 2014, so have observed it both in and out of the chair.

Edited by 1978matt
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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

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

Proscar 1.25mg every 3rd day

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Just want to say that every comment thus far has been SUPER insightful and I feel so much more comfortable in my decision making after joining this site just a few days ago. I keep adding more notes and questions to ask during consults each day 😆 

Also @jceaves, you were blessed with a great face for the bald look but cheers on your results with Hasson. It looks so good. 

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1 hour ago, 1978matt said:

Dr K's techs actually do a lot of work so that he doesn't have to.  They organise everything:  Get the patient all prepped up and all the instruments ready.  He literally just walks into the room, scrubs up and does the work, usually with 3 or 4 techs assisting, or more if it's FUT.

Then on breaks he can go to his office, attend to emails for 5-10 minutes while the patient has a comfort break etc.  The techs then sort everything out for the next session, e.g. FUE extractions from another area.

It's like a military operation.

I watched him perform an FUT surgery for a few hours in 2014, so have observed it both in and out of the chair.

Super important insight! I feel like the perception around here is that he's a one-man shop, so this is valuable intel. Goes to show that techs are critical to any successful clinic.

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Just now, yalla8 said:

Super important insight! I feel like the perception around here is that he's a one-man shop, so this is valuable intel. Goes to show that techs are critical to any successful clinic.

Yes, this is very true. Dr Konior has a very well trained staff that works like a well oiled machine. It's not just him and a tech doing the surgery. He has a whole team who sorts and dissects grafts before implantation. If you've ever seen his immediate post op pictures the grafts look extremely clean with no unnecessary surrounding tissue. There is no excess dried blood anywhere to be found. This is because of his team and the meticulous nature how they trim, sort and spray grafts intraoperatively.  Of note, Dr Nadimi uses the same team and her post op pictures look extremely clean as well. This proves that the CHI team has a very important role in why they get such stellar results. Even though Dr. Konior personally does all the consultation and scheduling, his administrative part of the clinic is fantastic as well. They offer information whenever needed and keep in touch leading up to and after the surgery. They always accommodated me when I had a schedule request like getting seen super early before he started his next days' case so I could catch a flight. Overall, no one surgeon can physically do all the work without a  strong team supporting him to get consistent results.

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Bosley 11-2016 FUE - 1,407 grafts

Dr. Diep 09-2017 FUE - 2,024 grafts

Dr. Konior 03-2020 FUE - 2,076 grafts

Dr. Konior 09-2021 FUE - 697 scalp to scalp, FUE - 716 beard to beard Total scalp FUE - 6,204 grafts 

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