is nw7 doomed?????

[nm315]

i think i am headin towards nw7.. had a HT few years back that was a total disaster.. i been in this forum for last couple of months.. nw7 i understand does not have any hope of a full coverage with descent density.. now i am thinking... can a nw7 get a full coverage with a density of say 20fu/cm2.. proly after that i can have concealers like dermmatch+toppik do the rest of the job? what say brothers???

[nm315]

i think i am headin towards nw7.. had a HT few years back that was a total disaster.. i been in this forum for last couple of months.. nw7 i understand does not have any hope of a full coverage with descent density.. now i am thinking... can a nw7 get a full coverage with a density of say 20fu/cm2.. proly after that i can have concealers like dermmatch+toppik do the rest of the job? what say brothers???

[Bill - Seemiller]

nm315,

 

Welcome to our community. Unfortunately NW7s are not good candidates for hair transplantation surgery for a number of reasons.

 

I have just recently written a hair loss Q&A blog about this that can be found here. I recommend it's worth a read.

 

However what makes you think you are heading toward a NW7? Are you currently on any hair loss medication? If so, is it helping?

 

Best wishes,

 

Bill

[nm315]

thanks Bill for the reply.. i understand that nw7 wont acheive clean density with HT.. but i was thinking of a light density + hair concealers like dermmatch+toppik..

 

how do i know i am heading towards nw7? i dont know.. i look at the mirror i am confused.. i think i am 6.. but than maybe its 7.. i dont know.. i hate to hear i cant get this fixed... no i dint try medicine.. after all the reading abt medicine i dont beleive in it much..

[nm315]

"At best one could hope to receive a light dusting of hair over the entire balding area or have to focus on one particular area such as the frontal third of the scalp".

 

Bill i am quoting u.. can u tell me what u mean light dusting.. i mean in terms of fu/cm2 how much is it?

[Pat - Community Publisher]

NM315,

 

You might want to consider recreating a "frontal forelock", which is basically a receded mature hairline with central density. You will still be bald in back but the new receded hairline will reframe your face and then gradually transition into a naturally balding crown.

 

To see examples of patients with class 6 or more baldness who restored their hairlines, visit our gallery of Class 6 results .

 

Best wishes for at least going from a bald look to a thinning receding look.

 

Pat

[Bill - Seemiller]

mm315,

 

Pat has given you a great suggestion - though it may or may not line up with your hair restoration goals. Be sure to click on the link that he gave you to view patient before/after pictures that are similar in your norwood class.

 

A light "dusting" is certainly vague and subjective as many people look at acceptable density differently.

 

The average density per square cm for native hair is 80 FUs per square CM. To create the illusion of density, one needs approximately 50% of the native hair density which would be about 40 FUs per square CM.

 

Measuring briefly the area of my head, I've determined that I had approximately 187 CM to cover. If i wanted a density of about 20 FUs/sqcm evenly distributed over this area, I'd need about 3740 grafts. To receive 40 FUs/sqcm, I'd need about 7480 grafts.

 

Keep in mind also that talking in FU per CM is a bit deceiving because 40 FU per square CM using double haired FU grafts will certainly appear more dense than 40 FU per square CM using single haired grafts.

 

NW7s typically have less of a safe zone to work with therefore not as many donor grafts will be available.

 

Pat's suggestion is definitely worth considering though because it will most likely leave you with the most natural looking hair transplant even though you'll still have bald/balding areas.

 

Best wishes,

 

Bill

[Dr. Michael Beehner]

I was sorry to hear the poster sound so pessimistic about a Norwood VII stage of baldness. These men can be helped. By definition, a Norwood VII stage means that the side fringe is somewhere down the side of the head. Obviously, there is an awful lot of bare real estate up on top crying out for hair - which is pretty short in supply precisely because of the low fringes.

As Pat suggested, the only thing that works for these men is some type of "forelock" pattern. A "wall to wall" filling in of hair is impossible. What is a forelock pattern and what are the essentials for creating one in hair transplantation?

The first and most important point is that a forelock attempts to FRAME THE FACE of the patient, with its maximum density being in the front-center of the scalp (or the "frontal core," as Ron Shapiro has named it).

Secondly, to create a forelock,the surgeon must create a GRADIENT of hair density, with the greatest density being down the front-center aspect of the head. The gradient can be created from "strong" to "sparse" in a number of ways, but the two best ways to accomplish this are to use grafts with larger numbers of hairs within them centrally and grafts of less hairs in the side "mirror image" areas. The second way to create a gradient, and probably the most important one, is to VARY THE PLANTING DENSITY of the grafts. This certainly applies if all FU's are used. I tend to use DFU's centrally, then 2-hair FU's just outside them, and finally 1-hair FU's in the sparsest areas. Between the body of the forelock and the side fringe a "blur" of sparse hair is created, which visually connects the forelock and fringe, but doesn't use up a lot of hair. The same is true in the two rear triangle areas where sparse FU's are placed. If you look carefully around you at men who are gradually losing their hair, there is a subset of men who have this exact stage of hair loss on their heads at some given time.

The third part of a forelock plan is to NOT fill in certain areas of the scalp. These would include the vertex in the rear (the downhill circular area way in back) and the fronto-temporal gulfs in front to either side of the forelock.

I have had men style their hair in a variety of ways after receiving a forelock transplant, but I the one that works best in my opinion is to sweep it back to the rear right corner of the scalp.

So, the bottom line is: if a man is willing to lower his expectations and wants a natural pattern of hair that frames his face and which, for all intents and purposes, from the front view looks almost like a full head of hair, then this is a worthwhile way to transplant such a patient.

To give an idea of what these projects look like, I will post some photos of some forelock results in the "photos" section of the Forum where they might be easier to view.

Mike Beehner, M.D.

[nobuzz4me]

Your plan for concealers makes some sense as they work better when there is some hair to attach to.

 

I would strengthen the forelock and corners first to frame your face. Then with what is left, maybe dust the midscalp and leave a small bald spot in the crown. Depends on your age and future as to how to proceed, and it all about your donor.

 

BTW, if you are heading NW7, you will notice the big difference is the sides dropping as well as the back. This is why as Bill says the safe zone is smaller and you will not be able to harvest enough grafts. You will also spend precious grafts to build up the sides again, (grafts which could have been used for the top or crown) this leaves less for the top. NW6's with high, strong sides like Bill for example, have a much better chance to restore a full-looking head of hair. I do hope you do not go NW7, are you on finasteride??

[Pat - Community Publisher]

When I was thinking of the "Frontal Forelock" I was thinking of Dr. Beehner in particular since he is recognized as one of the world's foremost experts and presenters on this technique.

 

I'm glad to see that he has shared his considerable expertise on this technique. I do think it's the best option for a NW 7 and Dr. Beehner is certainly an excellent choice for getting it done right.

 

Best wishes, Pat

[TheHairLossCure]

NM-

 

I think you are doing yourself a disservice by trying to quantify a "dusting" in terms of follicular grouping per cm2. Density does not equate to the quality of hair coverage since hair characteristics are variable.

 

The reason a Norwood 7 is difficult to treat is that more than half the hair on the scalp is gone. Therefore, even if you surgically removed every DHT resistant follicle from the donor area - leaving it bare - you would still have not have enough hair to fully restore the front, top, and crown. I think of this when I see class 7's with shaved heads, since the donor follicles are the only hairs that remain. If you "spread out" the hair mass from the narrow zone in back to all over the head, would it be enough? For a TRUE class 7, the answer is most likely no - not for overall cosmetic density, not for overall scalp coverage.

 

What is possible is isolated areas of coverage -as Pat and Dr. B suggest. If you and your surgeon opt for this sort of realistic approach, I think you can definitely further enhance the look with concealers like you propose.

[MrJobi]

Nobody has mentioned meds at all?

 

Do you think it is worth it to take them at this point. Obviously, you will not get thick density but maybe a bit for concealers??

[Bill - Seemiller]

mm315,

 

Dr. Beehner has posted some examples of patients who received a frontal forelock hair transplant. You can view patient photos here.

 

TheHairLossCure,

 

Thank you for mentioning the importance of hair characteristics. That is certainly a factor in determining the "illusion of density".

 

Best wishes,

 

Bill

[calvinmd]

The poster has said he "already got a HT" a while ago.

 

There have been some guys in the HT community who got several HTs done after feeling committed with the first one, and then actually regretted the later ones. The first hair-mill disaster HT may not do much good, but the scar may not be huge yet by megassion standards because the crap mills like to do those little 1200-graft jobs all the time.

 

I've read at least a couple of guys saying they got multiple HTs, and later kinda wished they had just shaved-down and exposed their first strips-scar because it seems pretty small compared to the later ones in retrospect.

 

 

 

Maybe this doesn't apply to this case. I dunno. But I thought I'd mention it since NW#7s are a pretty bleak outcome in general and this is all a lesser-of-evils situation.

 

Scar-revisions with trico-closures and later FUEs into the scar can do a lot to reduce the appearance of a small hair-mill job. We all know this stuff won't get rid of the scar's appearance entirely, but it can sometimes reduce it to a pretty minor thing instead of an attention-getter from across the room.

 

And that Juvista stuff is most likely gonna do even more for scar-healing in a few years.

 

 

------------------------------------------------

[nm315]

the pics of ur works look real great.. fantastic turnaround.. i have my us visa intv on 27th this month..if i get visa.. the first doc i will be heading to is Dr.Beehner.. i been reading the posts in here for last month or so.. very tuf to make up which doc to go to.. Dr. Bern stein, Sha piro, Epst ein, Raha l, Fell er.. too many there.. expense wise i narrowed down the last two.. but now seeing the pics in Dr. Beehner websites i hope you are the one for the extreme cases.. if i get the visa on 27th i will send an appointment request to Dr. Beehner clinic.. will revive this post then.. special thanks.. to all others till then.. Pat, Bill, Mrjb(-i am not keen on taking pills), nobuzz, calvin..

[Bill - Seemiller]

mm315,

 

All of the doctors you have mentioned would give you a quality hair transplant. Good luck in your consultations.

 

Feel free to ask any additional questions you might have and we'll be happy to help you.

 

Best wishes,

 

Bill

[nm315]

thanks Bill..

 

 

yes i agree that they are all accomplished docs.. but when i look at affordablity Dr. Bern stein is, i quote from his website

 

"In our New Jersey hair restoration facility, the fee for follicular unit hair transplant sessions is $5.66 per unit for the first two thousand that are placed. For procedures using two to three thousand units, the cost of each additional unit is $3.77. The hair transplant cost for procedures of more than three thousand follicular units is $2.83 for each additional unit."

 

so for a 3000 graft it is (11200+3700=$14900)...

did i get that rt?

 

now Dr. Shap iro and Dr. Eps tein are more affordable.. but then there is Dr. Rahal and Dr. Fell er who are even better.. Dr. Beehner does not quote by follicular units but by area..

 

All these info i gather from the respective doctors website..

 

So Bill when you say that all these docs are really good.. ppl like me starts looking at the next factor...->cost..

 

and so docs for me are Dr. Beehner, Dr. Fell er, Dr. Rahal...

 

I dont know whether this post is appropriate with all the cost concerns in it... let me know if it is not..

[Bill - Seemiller]

mm315,

 

I agree that cost should be the last factor in determining who you go to. It sounds like you are doing all the necessary research and taking all the appropriate steps to ensure a quality transplant.

 

Best wishes,

 

Bill