Raymond J. Konior, MD

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 the Story

I’m a police officer who had a hair transplant three years ago. I was told that I would have no problem wearing a military cut on the job but now I have a very noticeable scar from the surgery straight across the back of my head. I specifically asked the person I signed up with if this would be an issue and he said absolutely not. That’s the only reason I decided on going through with the hair transplant. Now I’m always being asked about it. I am wondering if it could be fixed. Also is it unusual not to have the opportunity speak with the doctor until the day of the hair transplant? This was my experience.

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I am sorry to hear your story. It is my firm position as a professional that you have had your patient rights violated in a number of ways. It is beyond my comprehension why a physician was not involved with your initial consultation for a surgical procedure. Unfortunately, there are various surgical hair restoration offices that utilize so-called “expert consultants”, often to the detriment of proper patient education. These individuals often wear a white coat, like a doctor, so as to generate a sense of professionalism and competence. Unfortunately, these individuals are often nothing more than a sales-person for the clinic they represent. Read the Story

When I was 23 years old I underwent a Fleming Mayer flap hair transplant and I am very unhappy with my current appearance. I was told that is was far superior to a conventional hair transplant but I can tell you that this is not the case. The appearance of my hair line is very unnatural to me and now it is beginning to thin again 5 years later. Is it possible to regain a normal appearance with another hair transplant. I’m very unhappy with the way things have turned out for me and I’m hoping for some resolution.
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At one time the Fleming-Mayer flap was considered to be a viable option for surgical hair restoration. Flap restoration of the frontal hairline was acceptable during the era of “plug” transplantation because of the many well-recognized problems that were associated with the use of plugs.

The primary goal of surgical hair restoration is to produce a natural result. Plug graft techniques were notorious for the problems they created, the most obvious of which were unnatural corn-row hairlines and widespread donor sites scars. The less-than-perfect plug technique motivated physicians to look for alternative methods for recreating a frontal hairline, hence the introduction of frontal hairline flap procedures. Read the Story

I have had skin grafts on my head and have scar tissue. I have had some bald spots but generally had good hair growing up. As my head grew it didn’t look the same as when I was a kid. My hairline is now receding (the actual normal tissue) and I guess my question is, would I be able to get a hair transplant just where my normal hair was? Can they work around scar tissue without it being re-constructive surgery? I just want the hair transplanted where the tissue is normal again. Thank you, Jesse
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Thank you for providing photographs of your scalp. Although I do not know any of the specifics of your prior surgical procedures, it is clear that you have scarring present in what is considered the traditional zone for male pattern baldness. Your photos indicate that you do have a relatively early male pattern loss which is developing throughout the frontal, central and crown regions. The thinning appears to be worse in the frontal region, which happens to be the area affected by scar tissue.

First off, you have a relatively early pattern. By this I mean that you continue to have a significant amount of residual hair in the thinning zones. Read the Story

My 15 year old son has been losing hair in the shower and when he combs his hair. He feels his hair is thinning and is worried about it. We are also very concerned because he had surgery on his head when he was an infant which left a very large scar and also left his skill asymmetrical which has always been covered by hair. We are interested in finding a physician to help his hair loss and see if it is possible to have hair transplanted onto his scar. Does it sound like he would be able to have a hair transplant? What could be causing his hair loss at such a young age? Please help we need a Christmas miracle.

Your son’s situation is quite complex and needs to be carefully analyzed. Although he may be an excellent candidate for surgical hair restoration, surgical intervention can lead to a variety of problems later in life if he develops a more extensive balding pattern than what is being predicted at this time.

First off, follicular-unit grafts seem to grow quite well in many scars. Follicular-unit restoration has proven to be a very successful technique for camouflaging the adverse cosmetic appearance of scalp and facial scars. I tend to favor a much more conservative approach when placing grafts in scar tissue. Scar tissue has a significantly reduced blood supply compared to intact skin. A compromised blood supply can adversely affect healing and graft regrowth. Read the Story

I am curious to know what qualifies a woman as being a candidate for hair restoration. It seems that there are bunch or opposing views about this floating around on the internet and I just wanted to clear it up for myself. I am confused as to why some doctors state all women, or most women, are candidates even with androgenetic alopecia. Is it not the nature of female pattern hair loss that the thinning is overall, and because of this the donor hair is not stable? I ask on behalf of sister who is seriously considering this as a viable option. I think she stands a chance of being severely disappointed and perhaps in a worse hair loss spot than she is now. Her hair loss has been steadily occurring over the last 10 years and the thinning is equally distributed all over her scalp with perhaps more thinning on the sides. Please help to clarify the women’s hair transplant debate. Thanks.

I believe that hair loss in female patients is a much more complicated issue than it is for male patients. Most often I encounter three basic categories of female hair loss – two that are good candidates for surgical restoration and one that is not. Read the Story