BackFromTheBrink

I thought you believed that all follicles were identical and therefore equally resistant (or not) to DHT? I'm not saying that I believe that DHT doesn't impact all follicles eventually, just that they're not all identically resistant. The article you quoted jumps to quite a few conclusions unnecessarily - the first few paragraphs are especially bad when making definitive statements about things that 'must be'. I'd therefore question it's usefulness. I guess what we really need to do is transplant a hair from the hairline and another from the back of the head of a 16 year old into the traditionally safe donor area and see if the hairline graft miniaturises over time.

Looking great - like the design and it appears you've had good growth, especially on the hairline. Sure it'll look great when you've grown it out a little, though understand you waiting until after the crown surgery for that.

There's intelligent placement also - some doctors seems to be far more economical with grafts than others. I am amazed by the number of grafts possible with modern surgical techniques. However, I do look at some of the estimates and wonder why they're so much larger that I've had, especially as I started in largely the same position.

I'm interested in why you're interested. Norwood is an imperfect measure, doesn't fit everyone's balding pattern, is somewhat subjective and isn't really used for anything other than to give an indication before a proper assessment.

It sounds like you've found a 'top 10 clinics in Turkey at social media and marketing' list from somewhere. Take a look at the recommended clinics list at this top of this forum.

Hattingen Hair are excellent. I'd consider him a 5 as he still has a bridge in his midscalp, though as you say, his crown dip is substantial. I guess we have slightly differing views - mine is based on my own surgery and hair characteristics (which are near identical to his). I think I'll achieve good coverage and shave my donor to a 1 or 2 guard without issue. Regardless we can both agree Bosley is not the answer!

Why NW6 and why not a candidate for FUE? H@W are a good option in Canada but would cost far more than the 16k quoted. I'd personally suggest he has a strong looking donor and FUE by a reputable surgeon would be fine. Someone like Zarev or Pittella may even be able to offer a one time giga session.

I'd say your classifiation of NW5 is correct. As for graft count, the quoted numbers are on the low side, though it does obviously depend on your desired density and coverage. My advice would be to continue with finesteride and see if that impacts you (hopefully positively) for a few months, then consult with recommended surgeons for other opinions on treatment and cost. I would say you should not focus on geography but rather find similar cases to your own and results/aesthetics that appeal, then shortlist a handful to speak to. You have a similar hair loss situation to myself. I've had 2 surgeries and 5600 grafts in total (I did have a higher crown but more loss in the midscalp). Your crown is going to be demanding on graft count, and it's likely most surgeons would also treat you as a 2 surgery patient (at least). In your position I would also consider whether the US and Canada are as far as you could travel. Good surgeons are very expensive compared to elsewhere, and whilst you could get a good result with that limitation it would certainly add to the cost.

As could someone double or triple his age. I really don't see why we need to focus on things outside of a patients hair, especially when not asked to.

Does it matter? Maybe he bought bitcoin when he was 13, perhaps he's a genius and just sold off his 3rd billion dollar enterprise. Maybe his parents are helping out....

Given the midscalp, I suspect one more top up will be required. It's a great result for 6 months, and will be a knockout at 12.

The man is a pioneer and a genius - artistic, scientific, innovative and displays incredible dedication to his craft and patients. My only concern is whether he's actually human (though I'm not sure if that would disqualify him?)

Lucky indeed, and nowhere NW7, probably closer to 5. You've taken a gamble with that amount of grafts in one surgery, it's the highest I've heard the Hair Dr perform. However, with the early growth you've had, it looks like it's definitely going to pay off! Best of luck, and do keep updating!

It ultimately depends on your hair characteristics. A large number of multi grafts, thick hair and a good response to meds may do the trick. It's also hard to see how much your crown dips. As a NW5, I've had the same number of grafts and hope for full coverage. The Hair Dr made excellent use of 3100 grafts in my first surgery

That's a sizeable surgery for one sitting. However it does look like you've had good early growth. Usually NW6 would need more grafts for fill dense coverage. Did you get a breakdown of the draft count?

No, it will not.

If you've grown your hair, I'd say there's a high chance it'll mess your hair up and you'll need a comb to fix it. Other than that, no impact whatsoever.

I cannot explain why, but it appears that dutasteride can (and anecdotally appears to in most cases) have less side effects than finasteride. Perhaps consider switching a day or two per week to it initially?

He does use body hair, but considers them a last resort / solution when no more scalp extractions are possible.

I would also consider surgery outside the UK. Mainland Europe is easily accessible and widens your options.

People have been making suggestions. If you feel such a result is worthy, why not suggest it?

I'm not so sure. People sharing their journey for the benefit of other patients are one thing. Having additional attention, and potentially additional promotion of the result on social media etc due to 'winning' is another.

It's hard to accurately predict. For example, I have no idea if I'm a hyper responder. I went from Norwood 5 to 'appearance of full head of hair-ish' in 3100 grafts. Logic would say that meds contributed through regrowth but since I started just before surgery, I'll never know.

What are you planning to do with the extra 500? In all seriousness, 4000 grafts would give a strong hairline, medium midscalp and would barely touch the crown. It all depends on what you would be satisfied with.

When you say high Norwood doctors, I think or 4 surgeries - Hattigen, Zarev, Pittella and Eugenix. They all have different approaches. Hattigen are FUT and FUE combo, Eugenix are body hair and scalp and often over multiple sessions. I'd say the other two are different. Zarev is the outlier since he appears to carry out more donor analysis, uses .45 punches, uses the whole donor for a homogenous look, and unique extraction methods for very high survival rates. I'm not sure about methods, but Pittella also achieves high graft counts in single sessions. How many grafts do you need for full coverage? I'd say your choice is sound, and there have been superb results on high NWs by your doctor on this forum in 2023. I think there are better (I'd have chosen Zarev if money and time were not a factor as I believe he's unique and his results are unrivaled), but you have selected a top surgeon.