Author Archive for Raymond J. Konior, MD

Dr. Konior was born in the city of Chicago and now resides in the suburbs with his wife and children. He graduated college with honors from the University of Illinois and was awarded membership in the Phi Beta Kappa and Phi Kappa Phi honor societies. This was followed by the University of Illinois School of Medicine, a surgical residency in head and neck surgery at Northwestern University, and a fellowship in facial plastic and reconstructive surgery at the University of Texas. Dr. Konior has outstanding surgical credentials for hair restoration. He is board-certified by the American Board of Hair Restoration Surgery, the American Board of Facial Plastic Surgery, and is a Fellow of the American College of Surgeons. Dr. Konior and 14 other hair surgeons founded the American Board of Hair Restoration Surgery in 1998. Out of the fifteen founding members, Dr. Konior was the only Illinois surgeon. These top doctors in hair surgery set the current academic standards for assuring competency in hair transplantation. He has been an active member of the International Society of Hair Restoration Surgeons since 1994 and co-chaired the Chicago Hair Meeting for the AAFPRS in 1995. He is also the author of numerous research articles, journal articles, and book chapters. Dr. Konior is a member of the International Alliance of Hair Restoration Surgeons and recommended by the American Hair Loss Association. Visit Dr. Konior's Website: www.premierehairdoc.com

A Previous Hair Transplant Left Me With a Large Scar - Can This Be Repaired?

I had a hair transplant back in 2001 that left me with an unsightly scar in the back that goes practically from ear to ear. I have to grow my hair at least two inches to cover it, and when it’s wet it look horrible. I’d like to see if this could be corrected. What should be my next step and can this be accomplished?
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There is always hope that a less than ideal donor scar can be improved. The best method for correcting an unsightly scar in the donor region will depend on several factors including: 1) the width of the scar; 2) the location of the scar with respect to how high or low it was placed in the donor region; 3) the elasticity of the surrounding scalp; and 4) the baseline follicular-unit density in the region immediately adjacent to the scar.

There are two basic modalities available for correcting the scar. One can undergo a scar revision at which time the scar is excised and the remaining incision is meticulously repaired. An open scar revision like this will depend on the width of the scar and the elasticity of the surrounding scalp. A tight scalp may preclude this option since there needs to be some redundant scalp available to stretch into the defect which is left following removal of the scar. Tension is one of the single greatest contributors to the creation of a wide scar following a strip harvest procedure. You will have a high risk for developing another wide scar if the revised incision is closed under tension. Read more

Hair Transplant Repair: Can I Have My Old Hairline Grafts Removed and Placed In The Scar Area?

I had a transplant in 1995 that I am unhappy with. It left me with a strip scar and frizzy hair. Now all I want to do is to be able to buzz my hair short. I’ve had the scar partially filled in with FUE, and am satisfied with the result. Now I would like to remove the old hairline grafts, splice them, and have them transplanted into the scar to camouflage it some more. Also the old hairline grafts have caused cobblestoning, so this needs to be repaired (I guess with the removal it is?). Is it possible to achieve what I am looking for?
Many thanks,
Adam
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It is definitely possible to correct the appearance of unsightly grafts that are too big or that have been placed with poor direction, angle, depth or location. Unfortunately, many of these repair cases require multiple sessions to achieve maximum improvement since there is often a limit to how many grafts can be removed at any one time. There are several options available for removing the offending grafts. Follicular unit extraction techniques may be used to remove smaller grafts or to selectively reduce the density within a plug graft. Thinning out a large plug can improve its appearance by making it look less “pluggy”. Large grafts that would not benefit from thinning with follicular unit extraction may require complete extraction with a standard skin biopsy punch. The punch is used to first core out the offending graft from the recipient site. The residual defect is then sutured closed or left to close via secondary intention healing, i.e. leaving the wound open and letting it close down on its own. Read more

24 Year Old Female Hair Transplant - How Long Do I Have To Wait To See The Full Results?

I got a hair transplant 6 1/2 months ago and I am not seeing too much results, is that normal? Is it at 12 months that I will see the full effect or longer? Do grafts sometimes not grow? I also had a lot of shock loss.  By the way, I am a 24 years old female with PCOS. Thanks! – Melissa
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It is normal for hair-bearing grafts to enter a resting phase following surgical hair restoration.  The typical resting phase following a hair transplant lasts 3-4 months.  During this time the follicle does not produce any hair as it is resting and recovering from the stressful events relating to the surgical process.  Although hair begins its regrowth cycle at this 3-4 month mark, it takes several more months for full density to be achieved.  During this period the follicle recovers its ability to produce a thick and fully mature hair shaft.

Although the majority of patients begin their regrowth cycle around the 3-4 month mark, there are some patients who are fortunate to see earlier growth and there are those who see a much latter regrowth.  These variations are simply related to the normal variations of all human characteristics such as height, weight, IQ, etc.  Extremes which deviate from the average are much less common, but they do occur.  Read more

Female Hair loss at 24 Years Old - Is a Hair Transplant Right For Me?

I am a 24 year old African American female. I noticed approximately 3 years ago that my hair was thinning at my temples (more so on the left than right). Approximately 2 years ago I notice that my hair line (top-middle) is receding and has now gotten to the point were it is noticeable to others (it is still pretty minor, but has progressively gotten worse). I initially thought that the thinning around my temples was due to traction alopecia and immediately changed my hair styling routine. I didn’t expect the thinning to get better but, as it continues to progress I am more convinced that this is genetic (even though no females in my family this problem). I was recently informed by a dermatologist that my loss is not consistent with female pattern hair loss and that Rogaine probably would not help.

If my hair loss is not of female pattern loss, can it still be considered genetic? And, as I’ve described my loss, do you think I could be a candidate for a hair transplant?

Please know that this has caused and is causing severe emotional distress and I need to know if there is anything I can do about it.

Thank you.
A. Smith
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Hair loss at a young age can be very devastating for anyone.  This is especially true for women who never expect hair loss to be a problem for them. Read more

Hair Transplant Repair - Looking To Remove Old Plugs

Ten years ago I had 300 round circular plugs taken from the donor area and placed on the middle and crown area. I have 100 round “white” circles on the crown, but what is worse are the indentations. They appear to be “crater like” scars on the middle of the scalp. Is there any method(s) to correct the craters and smooth out the skin? The donor area is too thin for future use and I would like to just correct the scalp issue and be able to live without wearing a baseball hat in public. I tried a hairpiece but the thinning hair on sides could not hold it in place. Your insight is appreciated! Thank you for your time and consideration. ~Dante
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Dante

Unfortunately large plugs become very detectable when they are located in the middle of a large balding area. Indentations suggest that the grafts were placed too low in the scalp. Improper graft placement results in a cobblestone appearance when positioned too high and in a crater or pit-like appearance when positioned too low. The “white” circles you describe suggest that there is little or no hair growing out of the grafts. The combination of a white plug and no hair means that the graft did not survive the original transplant procedure. What you are now seeing is the residual scar tissue that has replaced the once healthy plug tissue. Read more

“Long Hair” Hair Transplant Procedures - Do They Make Sense?

I have been reading about “long hair” hair transplant procedures where you can have the ability to see the basic outcome of the hair transplant the very day you have the surgery done. Is there a downside to having this done or will the outcome remain the same?
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I have never embraced the concept of “long hair” surgical transplantation. There are simply too many disadvantages with this method that far outweigh the single advantage of being able to see long hair in the grafts immediately upon completion of the procedure. The list of disadvantages includes, but is not necessarily limited to, the following:

1) Many patients who undergo large graft sessions will need to have the recipient site shaved to facilitate accurate graft placement. Long hair grafts make no sense in this case since they will not give an accurate idea of the final result with the recipient site having been shaved in the first place.

2) Working with long hair grafts will dramatically prolong a procedure. Long hair grafts slow virtually every component of the procedure, i.e. - the donor strip harvest, the microscopic graft dissection, and the graft insertion. Read more

Is It Possible To Repair a Bad Mini-Micrograft Hair Transplant From 2005?

I am 36 years old and had a mini-micrograft hair transplant in 2005. My hairline looks extremely unnatural and I have heard more than my share of jokes and comments made by co-workers and friends. I am writing you today to find out if this can be repaired, and if so how would that be accomplished? Are the grafts removed or is more hair transplanted around the existing grafts?
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The adverse effects of a poorly performed minigraft hair restoration procedure can be improved upon using contemporary repair techniques. The manner in which the repair is performed depends on a variety of factors which include: 1) hairline location - i.e. is it too low or does it have an aesthetic shape and height; 2) graft direction and exit angle from the scalp; 3) graft appearance - i.e. severity of plugginess, presence of pitting or cobblestone formation; and 4) the availability of donor material for supplemental grafting. Some of the methods that are used to repair an unnatural minigraft hairline include: 1) complete removal of the objectionable grafts; 2) removing selective portions of the objectionable grafts; 3) adding follicular-unit grafts to the minigraft region. Read more

29 Year Old Female Dissatisfied With Hair Transplant Results - Do You Do Repair Work on Women?

I had a hair transplant about two years ago from a well known hair loss clinic here in Chicago. I am very disappointed in the results and was wondering if you do repair work on women. I an 29 years old and had 400 hair grafts placed in a thin area of my hair line. My hair seemed to have gotten worse after the hair transplant. Can this be fixed?
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Repair work traditionally refers to a surgical procedure that is designed to improve, remove or camouflage the adverse effects of a poorly performed surgical hair restoration. Common problems requiring attention during a repair procedure include detectable plugs or minigrafts, asymmetric hairlines, and visible scars. Your letter seems to imply that you have had one or a combination of the following: 1) poor graft growth; 2) not enough grafts to satisfy your density needs; or 3) damage to the residual native hair follicles.

The fact that your hair density has deteriorated may be related to progression of your hair loss process, or it may have arisen from shock loss secondary to the transplant procedure itself. Read more

Ability To Cover a Progressively Balding Scalp After a Hair Transplant

I understand that my male pattern balding will continue to progress throughout the crown area on my scalp, leaving the typical horseshoe effect that I’m sure I will inherit from both of my grandfathers. I will be having a hair transplant in about 8 months to restore my receding hair in the front. It recedes about two inches from where my original hairline was once located, and also in that very flattering spot right in the very back.

I am 26 years old and will be 27 before my surgery, have very light blond and extremely curly hair. I will be having follicular unit hair transplants by a reputable company (HC). My question: If I continue to bald in the crown area over my lifetime, can I have additional surgeries to assure that the crown area is covered by hairs not affected by DHT by having this done?

Also, I have read about donor areas and the amount of one’s own hair available to use as transplantable hairs. Say I will eventually develop a horseshoe pattern without surgery and Propecia, does one have enough donate-able hair to cover the whole crown area, and thus keep undetectable natural looking hair transplants? Read more

Forehead Lift Caused Hair Loss - What Are My Options?

I am a 52 year old female. A little over 1 month ago I had a forehead lift which left me with a bald spot around the front forehead incision line. The area is approx. the size of a quarter which is mostly in front of the incision line but extends slightly behind as well. The surgeon states she is unsure why this area lost hair. She says she has not had this happen with any other patients. I also have lost hair volume throughout my head. Is this a normal hair loss issue after a forehead lift and do I have any options that might help regrow the hair.
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Hair loss is a potential complication of surgical brow lifting and forehead lifting. Fortunately, this problem is uncommon for most patients who undergo surgical rejuvenation of the brow and forehead regions. There are several factors that can influence ones predisposition to losing hair following surgery and two primary patterns in which hair can be lost.

Technical issues related to the performance of the surgery can contribute to postoperative hair loss. Factors which compromise blood flow to the hair-bearing scalp set the stage for unexpected hair loss. Inadvertent disruption of the scalp’s blood supply, aggressive surgical cautery at the wound edge and excessive tension along the incision line are three of the most common causes of post-surgical hair loss. Read more

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