Dr. Konior - ~2,000 graft FUE, Asian Male

[Yoni]

I also wondering about an update it's been far to long did the dr konior end up doing a  touch up?

Didnt see good density coverage at he's last post or if no touch up do you have a recent month update maybe he is a slow grower where he's 6th month will be he's 10 or 12.. wonder if he took the Dr's free touch up or feels it wouldn't help base on hes results.

Hope OP can update I have a consultation with Dr konior coming up but this result worries me.

Had a Previous one with a different dr using those micro grafts gave me good hair in places I didn't have but the coverage looks similar to OP result space out and alot of see though to the scalp giving me a thinning or im balding appearance.

though I did like the Dr giving him more hair for free to make up. Mine gave me the wait 18 months see how it grows then after wait 2 years which in my case did improve alot I was a slow grower after He offered me a half off or more grafts/hair for a lower price FUT.

[consequence]

Sometimes FUEs may not be as consistent FUTs, though Konior certainly has had success with both.

@sbguy01 if you ever come back, please update us as to where things ended up and if you went back for a second pass etc. I hope things turned out okay.

Edited November 11, 2023 by consequence

[DermMD]

11 hours ago, consequence said:

I don't think its unreasonable to assume with how OP was at 6 mo things might not have ended up where he wanted them at a year.

Konior's FUEs are generally not as consistent as his FUTs, though he has had success with both. Extraction is something that can take decades to get right.

@sbguy01 if you ever come back, please update us as to where things ended up and if you went back for a second pass etc. I hope things turned out okay.

What makes you make this statement? can you provide references/rationale? The placement of grafts are the same regardless if its FUT or FUE (I am a board-certified dermatologist), so why would it be different?

[consequence]

12 hours ago, DermMD said:

What makes you make this statement? can you provide references/rationale? The placement of grafts are the same regardless if its FUT or FUE (I am a board-certified dermatologist), so why would it be different?

This is a very old debate that has been discussed extensively around these parts and on the interwebs in general.

The extraction method is different with strip than FUE. This is the alleged reason for different yields with the two procedures. You can read posts by Bloxham or Feller to see the discussion, particularly the FUT vs FUE megathread that Feller started awhile back. Wesley also gave a lecture about this awhile ago that you can look up when he was talking about his piloscopic approach to scarless FUE. There have been a scattering of small studies over time on both sides of the debate: Beehner saying FUE is inferior, Tsilosani saying they're equivalent, etc. No large scale studies as far as I know. The obvious response to any surgeon's criticisms of FUE is, well you're talking about your FUE.

The theory is that the dermal papillae at the base of the follicle has some soft tissue surrounding it that supports growth. There is more risk of trauma or transection of this tissue when boring out each graft individually vs together as a strip, and the grafts tend to be more skeletonized. This is a slide from Wesley's lecture showing more robust strip follicles above vs more barren FUE follicles below:

Strip proponents argue that these effects result in lower yields and the development of more narrow caliber follicles with FUE. This means more grafts are required for the same degree of coverage -- ie. the less dense implantation that you could "get away with" with FUT is more difficult to achieve with FUE.

Some docs try to make up for the alleged limitations of FUE with things like PRP or limiting patient selection to those with high follicle caliber which obscures the issue further.

The recommendation on this forum for a long time was first to strip to the limit of scalp laxity, then shift to FUE for the greatest amount of lifetime graft yield. This is probably the correct approach if you're never going to shave your head. But it's based on anecdotal data and inductive reasoning. There's no way to be certain until large peer reviewed, double-blinded, long term studies are done, which are cumbersome, expensive and probably not happening any time soon. The reason most people get FUE now is patient preference based on the successes of European surgeons (particularly in Spain). This drove a worldwide market shift from strip to FUE, and North American surgeons followed suit.

For myself, I went with FUE to avoid the scar. I take dutasteride to preserve my hair, but have a feeling that if I were to stop the rx my AGA would rapidly progress to a high Norwood, and I wanted to retain the option of shaving my head. Now looking back I realize that I might have sacrificed graft caliber to maintain an exit strategy that I may never need. Hard to predict the future.

Edited November 11, 2023 by consequence