One problem I have noticed with Norwood 7 patients who go to Norwood 7 surgeons is that a strong proportion of these patients (like myself) have already had previous surgery/ies. When I see that a Norwood 7 patient shows no sign of recipient growth from these surgeries I worry a little bit on the gigs session outcome. Even when I had the punch graft plugs, as much as I hated it, every single one of them grew. When previous surgey doesn’t grow I think having a scalp biopsy to rule out other factors is a good investment before undertaking a gigga session.