Rejected By Konior

[HappyMan2021]

I had a really insightful and good email consultation with Dr. Konior for a repair, but was ultimately rejected by him. Goes without saying I still think he is a legend, but still looking for feedback on his analysis and next steps for myself. 

The high-level reason was he thought he may not be able to ultimately deliver results I am happy with. He said extracting all the bad grafts could involve FOUR or more sessions (!!!), and there is a chance of scarring. We didn't even get to a price quote, which I assume would easily be multiple tens of thousands of dollars. From a patient profile perspective he noted that I can style and temporarily mask all my pain points quite well and that my hairline is decent, and asked me to seriously contemplate the investment and time needed for a repair vs. accepting my current state. 

He said, if I were to proceed with a repair, he recommends laser hair removal of my troubled grafts before proceeding with a surgery option. 

Without going into the intricate, granular detail, I have had 3 surgeries total thus far, 3400 grafts total. I believe at minimum 1200 grafts could be better angled. There are likely more that are badly angled as well, but the only ones I visually notice are the ones on the immediate hairline and right temple, which IMO would be 1200 or so-ish grafts. I could be wrong but I sense Dr. K in theory would remove the vast majority of these 3400 grafts, not just the immediate concerning ones. Take these #'s with grain of salt as I am just speculating, and specific extraction #'s were not discussed. I did show him all of these pictures. 

I have only consulted with Konior thus far and will still be consulting with other elite docs. But if the world's top doctor rejected me, it does shake my confidence that I will ever get a satisfactory repair... It also makes me skeptical of a  more convenient, simpler approach a different surgeon may suggest - bc I really do take stock on what Dr. K says. But perhaps Dr. K is a perfectionist, and another elite surgeon could offer a less-involved more pragmatic approach? I really don't know. 

The issue is that, without styling, all the hairline hair is curly and rigid and does not blend with the native hair. Also the right temple in general is badly angled. And the left side of the hairline is too rounded with a flared angle. To hair geeks like us, these are big issues. My saving grace tho, is that when I style my hair (or even just dry and brush it), all of these issues can be masked. I'm just sick of the maintenance and the fact that my hair will never look good in it's completely natural state. 

Thoughts on next steps if any? Perhaps seeing a therapist to work on self-acceptance is more appropriate than going under the knife again, given the effort it may entail?

The above picture shows some of this curly untame-able hair close up.

Again showing some of the troublesome hair close-up

My hair looks acceptable when dried and brushed, just hate that I'm dependent on styling it and limited to certain styles. 

The above picture is dried and brushed again. Perhaps the above issue is not really conspiciouos?

My hair looks pretty good in the above pic. But its obviously styled and has product in it. There are many occasions where I don't want such a formal look. 

Edited January 19, 2022 by SadMan2021

[Curious25]

Hmmm I understand why there was reluctance to address what your primary concern is - because the risk/reward just isn’t there, perhaps some angles aren’t absolutely perfect, but complaining about the contrast in texture between your donor hair and native scalp hair up top isn’t something that can be resolved, because your donor hair is all surgeons have got to work with.
 

I agree your left temple is too feminine looking - this is a fairly easy fix, and your hairline when pulled back looks slightly pluggy, and could do with some softening - so addressing the left temple with a new masculine design, along with softening the hairline is a pretty straight forward procedure for any surgeon worth his salt, and can be done in the one job.
 

The softening may also lessen the contrast you consider to be apparent between your transplanted and native grafts, as there will be a higher concentration of thinner hairs in that region . . . So potentially 3 birds with one stone for you there, and no need to remove any transplanted grafts either!
 

  

[HappyMan2021]

@Curious25 thanks, all good input. For what it's worth Dr. K seemed pretty dead set on extracting (and I assume re-implanting). I don't think he considered leaving these curly grafts as is, and building around, to be an option (but perhaps another elite doctor would)

I don't have enough knowledge to know what a 'pluggy graft' looks like. But yes all my graft hair is very rigid and stubborn. At least for the hairline and temples, it sticks straight out for a centimeter or so, before curling. I'm not sure if this was a surgical error or just my natural donor texture. My donor hair is crazy thick. 

My personal pain points in order 1. Right Temple grafts 2. Right side frontal hair 3. Left Side Rounded Hairline. While the Rounded Hairline is a clear flaw, this is almost always concealed, no matter how I style my hair. #1 &2 are a pressing priority for me, but on its own I could accept my rounded hairline at least for the time being, and don't think I would pay Konior-level $$$ if that was the only issue. Of course if #1 and #2 are addressed then definitely the roundness should be taken care of at the same time. 

Edited January 19, 2022 by SadMan2021

[NARMAK]

OP,  i remember your other thread asking for styling advice. I actually didn't realise you had 1200 or so grafts that seemed to be badly angled and need looking into. 

I think this is probably a good learning moment for obviously new members or people lurking, how important it is to make sure you properly evaluate all the aspects of the hair transplant, goals etc. and choosing somebody you can feel gets the angles etc. right because if you then need to repair, this will cause further issues. 

Ultimately i do hope you find a solution and as great as Dr K is in your eyes, he's not the only person out there that may be willing to offer you a potential solution. The only thing is whether your expectation can bend around perhaps what might be possible to do with limitations. 

[Hair Triggered]

I would consult with Dr. Cooley. I think he can fix this. He uses electrolysis to get rid of the bad angle hairs and he can repair your hairline. Look up repair cases from him on this forum.

[HappyMan2021]

36 minutes ago, NARMAK said:

I think this is probably a good learning moment for obviously new members or people lurking, how important it is to make sure you properly evaluate all the aspects of the hair transplant, goals etc. and choosing somebody you can feel gets the angles etc. right because if you then need to repair, this will cause further issues. 

 

yea, for reference I am only a NW 3, so my balding was never horrible to begin with. Yet I've had 3 HT's and have found myself in a situation where arguably the world's best HT doc is saying a repair may not be worth the financial and emotional investment. 

When I had my 1st HT I had never heard of this site, did not know the importance of angles, hair texture - I did not even know what a good hairline was supposed to look like. Patients should definitely be very educated and truly understand all risks before embarking on any cosmetic procedure. 

 

38 minutes ago, NARMAK said:

Ultimately i do hope you find a solution and as great as Dr K is in your eyes, he's not the only person out there that may be willing to offer you a potential solution. The only thing is whether your expectation can bend around perhaps what might be possible to do with limitations. 

thanks I appreciate it. I get a sense that Dr. K is a perfectionist in his work, which obviously is a great quality and why people pay top dollar to see him. So his solution to give me a perfect result is extract all the grafts over 4 procedures, etc. 

I'm not looking for perfection, I just want my hair to naturally blend and have all these issues improved so that they are up to normal HT standards. So yes I will definitely still be emailing other elite surgeons to see if there is a less arduous path forward.  

44 minutes ago, NARMAK said:

I actually didn't realise you had 1200 or so grafts that seemed to be badly angled and need looking into.

Amateur approximation just on my own, could be less, might be more 🥺. Dr. K himself didn't name specific #'s

[HappyMan2021]

30 minutes ago, Hair Triggered said:

I would consult with Dr. Cooley. I think he can fix this. He uses electrolysis to get rid of the bad angle hairs and he can repair your hairline. Look up repair cases from him on this forum.

thanks, I've heard good things from him. Since going to Konior I already have my HT life journey typed up and already have my photos, so can start emailing other doctors at a pretty quick pace. 

[mmokin]

why not rebuild a hairline below the one you have instead of lasering off hair? i've heard people also do forehead reductions as a way to get rid of bad grafts then reimplanting the hairs into donor to use later but obviously this also has risk of scarring

[HappyMan2021]

20 minutes ago, mmokin said:

why not rebuild a hairline below the one you have instead of lasering off hair?

this sounds like a potentially logical solution to me, but for whatever reason Dr. K did not mention it. 

I also told Dr. K that, despite all the issues, I honestly am happy with the placement of my current frontal hairline. I did add that I would be open to him restructuring or lowering it if needed as part of the repair. But even so he did not bring this up as a solution. 

[mmokin]

20 minutes ago, SadMan2021 said:

this sounds like a potentially logical solution to me, but for whatever reason Dr. K did not mention it. 

I also told Dr. K that, despite all the issues, I honestly am happy with the placement of my current frontal hairline. I did add that I would be open to him restructuring or lowering it if needed as part of the repair. But even so he did not bring this up as a solution. 

in any case i think what you have is already pretty good, maybe not perfect, but we cant expect perfection from surgery.

you said you can mask the issue by styling your hair with different products i would just keep doing that, otherwise you could try shorter hair and see if this helps mask the issue, at the end of the day you have to decide what kind of struggle you are willing to live with.

i wish you all the best

[HappyMan2021]

10 minutes ago, mmokin said:

in any case i think what you have is already pretty good, maybe not perfect, but we cant expect perfection from surgery.

you said you can mask the issue by styling your hair with different products i would just keep doing that, otherwise you could try shorter hair and see if this helps mask the issue, at the end of the day you have to decide what kind of struggle you are willing to live with.

i wish you all the best

thanks man I sincerely appreciate it. I realize a lot of guys who don't even have hairloss might spend a lot of time styling their hair on a daily basis. So even though styling is now a requirement for me, its something that a ton of people - hair transplant or not - have to put up with in order to look good. 

Buzzing my hair or making it otherwise short would totally solve all these issues! (except the rounded hairline lol). If only I desired short hair lol. 

And yea there does come a point where I have to seriously ponder and consider the pursuit of looking good vs the baggage and drama it entails. Maybe that time is now. 

[aaron1234]

@SadMan2021 I agree your hair looks good when styled.  How old are you?  The reason I ask is that it is likely that you'll want more surgeries down the road just for more density.  Perhaps during a larger session, you can focus on punching out the most egregious of the poorly angled grafts (say somewhere 50-100).  So it wouldn't be a full on repair surgery.  Sometimes more hair hides these imperfections... for me it helped disguise the cobblestoning I had from my first surgery.  

Edited January 19, 2022 by aaron1234

[1978matt]

2 hours ago, Hair Triggered said:

I would consult with Dr. Cooley. I think he can fix this. He uses electrolysis to get rid of the bad angle hairs and he can repair your hairline. Look up repair cases from him on this forum.

This was my immediate thought too.  Would suggest seeing him in person first before booking anything.  It's difficult to see what's going on just from pictures.

You able to say who the surgeon was?

[HappyMan2021]

7 minutes ago, 1978matt said:

You able to say who the surgeon was?

I honestly just don't want to mention the name lol. I will say the surgeon only does hair transplants as a side-gig, and I have not seen any reviews of the doctor on this site (I was really uneducated about hair transplants when I got my 1st one). 

I'm definitely going to reach out to Dr. Cooley. Realistically I'm not sure I can fly just for an in-person consult, but I'll see what he says. I agree it's hard for him to give me exact quotes or a count on anything, but hopefully my abundance of photos give him a good overview. 

[HappyMan2021]

13 minutes ago, aaron1234 said:

I agree your hair looks good when styled.  How old are you?  The reason I ask is that it is likely that you'll want more surgeries down the road just for more density.  Perhaps during a larger session, you can focus on punching out the most egregious of the poorly angled grafts (say somewhere 50-100).  So it wouldn't be a full on repair surgery.  Sometimes more hair hides these imperfections... for me it helped disguise the cobblestoning I had from my first surgery.

thanks. I'm 32. I have a marginally thinning crown as well, but it does not distress me. Hopefully it does not get worse, but I could see myself getting it filled in in 5 or 10 years time. If I can just learn to accept my hair in its current state and be ok with always having it styled, I would be ok holding off for the near future and getting all this done down the road. I also concur maybe there are just a few hundred particularly egregious grafts. It's just hard for me to give an exact count because all the hair is very thick, dense, and intertwined. 

[AA1989]

2 hours ago, SadMan2021 said:

thanks, I've heard good things from him. Since going to Konior I already have my HT life journey typed up and already have my photos, so can start emailing other doctors at a pretty quick pace. 

This is a mistake.

You mention your desire for an elite surgeon to carry out the remedial work. Your 1st attempt has rejected you. 

As much as you are selecting a surgeon, they are selecting patients. You have specific requirements which need to be discussed face to face. An email of requirements can appear uncompromising. In a face-to-face meeting, you can weigh your priority and find a compromise, at least to the degree the doctor will feel he can provide a desirable outcome.

If you are unhappy with previous results, you can't afford more disappointment. You'd get on a plane for a vacation, and this is FAR more important for your physical & mental well-being.

[hairlossPA]

it might not be the answer you wanna hear, but I think your hair looks relatively normal and the points you made, like you said wouldnt be picked up by anyone in day to day activities. maybeeeee that one temple where the hairs are a bit mis-directed, but when its laying natural, I would just think you have messy hair for the day or something. it doesnt look unnatural.

I'd probably wait until I truly needed another HT because I was losing more hair and fix these small things, rather than go back around and try to fix this as a stand alone procedure.

[Ryan Rap]

Your hair looks good to me honestly.

If it bothers you then Cooley is worth a video consult. He will want to do video especially if you are repair, I think he charges for the consult though

[NARMAK]

8 hours ago, SadMan2021 said:

thanks. I'm 32. I have a marginally thinning crown as well, but it does not distress me. Hopefully it does not get worse, but I could see myself getting it filled in in 5 or 10 years time. If I can just learn to accept my hair in its current state and be ok with always having it styled, I would be ok holding off for the near future and getting all this done down the road. I also concur maybe there are just a few hundred particularly egregious grafts. It's just hard for me to give an exact count because all the hair is very thick, dense, and intertwined. 

Not sure if you tried, but maybe try using a hair straightener. Could work wonders during styling and more easily bend some of those hairs. You don't need to use much contact, just a light hold and pass with a good one. 

It definitely helps tame hair down generally and might help with problem areas for you. Get a styling product with a matte hold and also some strong hair spray for a final little holding solution. 

You can then try to part the hair a little different to mask those problem areas talked about in your previous thread. 

I think Eugenix and Dr Sethi might be a good shout to consult with as well as Dr Cooley to see what contrast they discuss in options available to you. Each Dr has their own approach but at least you can try decide what might best meet your expectations and requirementss.

It's also a chance to maybe adjust what you currently think to do and what is realistically achievable. It's why repair cases cost more, because you have to get them to deal with prior work. Even Dr Blake Bloxham of Feller Medical showed on his YouTube once how a patient had badly angled grafts and they couldn't remove those for risk of destroying them, so had to work in new grafts and even position them differently to how they would because pointing hair two different angles would stand out visually a lot more. 

[HappyMan2021]

15 hours ago, hairlossPA said:

it might not be the answer you wanna hear, but I think your hair looks relatively normal and the points you made, like you said wouldnt be picked up by anyone in day to day activities. maybeeeee that one temple where the hairs are a bit mis-directed, but when its laying natural, I would just think you have messy hair for the day or something. it doesnt look unnatural.

I'd probably wait until I truly needed another HT because I was losing more hair and fix these small things, rather than go back around and try to fix this as a stand alone procedure.

I appreciate it! I do agree, completely unstyled, the hairline curls say "messy hair" and not "unnatural botched hair transplant" . When the right temple grows at length, it curls out horizontally outwards and then curls back towards the scalp, which IMO is legitimately unnatural, but at the same time as you say, to the vast majority of people still says "messy temple hair day" and not "badly angled temple grafts"

Maybe i am being overly critical to some extent. Boo-hoo I have a dense full head of hair NW 1 hairline but have to spend time styling it everyday, just like millions of people who have never even had a hair transplant lol. 

Just mentally all the maintenance is very draining, and the fact that I am now a hair geek and am microscopically aware of all these issues (even if casual observers aren't), it causes anxiety for me. And I am a fan of a classic, refined hairstyle and dislike having it look messy. 

Ultimately I totally get what you're saying though. 

Edited January 20, 2022 by SadMan2021

[George Clooney]

17 hours ago, hairlossPA said:

it might not be the answer you wanna hear, but I think your hair looks relatively normal and the points you made, like you said wouldnt be picked up by anyone in day to day activities. maybeeeee that one temple where the hairs are a bit mis-directed, but when its laying natural, I would just think you have messy hair for the day or something. it doesnt look unnatural.

I'd probably wait until I truly needed another HT because I was losing more hair and fix these small things, rather than go back around and try to fix this as a stand alone procedure.

This is the right answer. The issues you have, at least from your pics, don't really stand out to me and are not worth another roll of the dice. Wait till you need another surgery and just put up with cutting that part of your hair shorter or styling it until then.

We can be our own worst critics, don't beat yourself up needlessly.

[Style22]

Like others have said I understand what you are wanting but your hair really does look good. A lot of us would trade in a heartbeat! Take Dr. Konior advice.

[Coverdale]

I haven’t read any of the other comments, and I have only reviewed a couple dozen results so far, but to be totally honest, I dont think it’s noticeable at all. I think your hair looks great when dried and styled and I don’t think you need another HT. Just my personal opinion. 

[BaldReaper]

doesnt look bad at all

[SeanT1]

Looking at this man I think you're overthinking the situation.  It looks great, hair transplants have the tendency to curl a little, it saves me money on hair products lol.