Number of grafts needed for NW 6

[Birdness]

I am thinking of undergoing a HT and am a Norwood 6. I was wondering what is the minimum number of grafts required to have an acceptable cosmetic result. I have no illusions about having a thick head of hair, so my expectations are realistic. Thanks.

[tacolinowest]

anywhere from 6k-8k,, id imagine with 6k you can get a great result and be happy

[Jotronic]

Birdness,

 

What is deemed as being "acceptable" is subjective. It all comes down to your expectations, your hair type, hair color, etc. Do you want crown coverage? On a NW6 6000 grafts could get very light and sparse crown coverage. So light in fact that the word "coverage" may not be applicable. If your hair is right though it may actually give a good cosmetic improvement. On other patients upwards of 8000 or more grafts may be needed. It all just comes down to what kind of hair you have and what your "realistic" expectations really are.

 

Photos would help if you care to share them.

[Thehairupthere]

It really depends on how your donor supply is. Some Norwood 6's may not be able to touch the crown at all, but may be able to handle the front half very well with a nice cosmetic change. You need to consult with a surgeon to see how many grafts you have to work with and then they will be able to tell you realistically where those grafts can be placed to give you the best overall look.

[Birdness]

I am of slightly olive Mediterranean complexion. My hair is fine. My barber thinks I have above average donor density but my HT surgeon thinks it is average. I have good scalp laxity. My HT surgeon thinks he can get 3500 grafts first round and 1500 second round. I can't be sure but he may be under promising and over delivering at the time of surgery. How accurate are the estimates in general ?? Would 5000 grafts give me a significant improvement???? Any Norwood 6's out there and how many grafts did you get and what as the level of satisfaction??Thanks

[nativeremdies]

great post Jotronic. Every new person reading this forum should be required to read that

[Thehairupthere]

5000 grafts is a good amount of grafts, which can make a significant difference. Without seeing photos it's hard to say how the placement of the grafts would be as some Norwood 6s have a larger area to cover than others, and sometimes the crown has gone further down into the donor than others. Is your surgeon planning on covering the crown, or focusing on the front half?

[1978matt]

For the illusion of full coverage it would be:

 

no of square cm x 40 = number of grafts required

 

so it's probably going to be at least 25 x 40 = 10,000 grafts.

 

If you're prepared to have a thin crown then of course the numbers are reduced, and if you have thick curly hair then you can get away with less density.

[Birdness]

If the surgeon concentrates on the front, how would 5000 grafts look and how far towards the crown would it extend??

[michaeljames]

I am thinking of undergoing a HT and am a Norwood 6. I was wondering what is the minimum number of grafts required to have an acceptable cosmetic result. I have no illusions about having a thick head of hair, so my expectations are realistic. Thanks.

 

Hello Birdness,

 

The number of grafts definitely varies. In our US Hair Restoration clinics (I'm a patient advocate there) we have had some good success with NW 6 patients who have had grafts from 2000 to 4500 FUs with excellent results. Some HT surgeons also count grafts differently.

 

I do know that the satisfaction and Los Angeles based centers we are proud of the satisfaction our patients with more advanced cases of MPB have. So be certain that in the hands of the skilled recommended HTN surgeons there is hope.

[nativeremdies]

"I am thinking of undergoing a HT and am a Norwood 6."

 

I agree with Matt1978, a NW6 would need 7,500 to 10,000+ grafts

 

5k of grafts in the front third with a good clinic would give a good illusion of coverage. Which I think you would be satisfied with the results.

[Davis91]

10,000 grafts would be great if achievable. However, check H&W site--coverage on NW6s using tactical placement with 6-8,000 grafts, depending on hair characteristics and extent of baldness (head shapes and hence space to be covered are different; baldness NW patterns are diagnostic assessments applied to all).

[nativeremdies]

I love H&W. At the start of my 'journey' I was too focused on the hairline, and not the big picture. being a NW5A, if I could go back, I would have just gone with them, and never looked twice.

[Zup]

Everything I read seems in line and touches on the principles of coverage and density regarding a type 6 pattern.

 

As Jotronic mentioned "acceptable" is subjective, ones donor density and characteristics makes a difference, as well and the surface area to the Male Pattern Area.

We have been measuring the MPA (basically the top plane of the head) on our patients for over 12 years. In type 6 patterns the balding is retained to the top plane of the head, vs a type 7 that has left the top plane and receded down on the sides and back, increasing the surface area. We have found the surface area on the average patient is approx 200cm2, and does not vary too much.

Average donor yields approx 4000-8000fus, this is supported by the text books, and many of the long existing clinics experience.

 

It is actually hard for clinics to know exactly what a patients donor density is, we can usually tell if it is low, if it is not low it is either average or above, and since we don't know for sure we always evaluate what we know the patient has, not what he might have. We do take close up magnified photos and do math to calculate things more accurately, but there are other variables to, so no one real know for sure.

Unless someone clearly has above average density, we are going to base things on moderate, 6000fus.

 

Now, it is math, average patient who progresses and becomes a type 6, has 6000fus, you distribute 6000fus over 200cm2 that's bald that yield 30FUs/cm2 over the entire pattern. What is 30fus/cm2, depending on one’s hair characteristics; 30FUs/cm2 could be the low end of a fuller appearance. So, that's not bad for someone who would be otherwise totally bald. Now, how most patients would most likely distribute the hair, would be rather then 30fus evenly over the entire head, most would prefer 40fus/cm2 in the front 100cm2 and the crown the back 100cm2, 20fus/cm. 20fus/cm2, is approx a quarter of original density, and may be just enough hair to hide the scalp, when the hair is dry or a coverage that appears as more hair then scalp (but, see scalp), in others cases a film of coverage.

 

Many men, are not that concerned with the crown, and even the ones that are, they don't have the highest expectations. All they generally need is just enough hair to hide the scalp, anything more doesn't look much different.

 

Also, concealers as well as SMP, could work as a nice adjunct, and could take a crown where one is seeing as much scalp as hair, to seeing no scalp. If you don't see scalp, things look full.

 

I hope with the other posts, this helps put a proper perspective on things.

Edited February 25, 2013 by Zup

[Davis91]

Native,

 

I just read your background story. I was wondering:

 

-if the first hair transplant with Rahal was successful (although you regret the straight across hairline), why did you go to Dr. Lindsey in round 2 (which you say was not successful)?

-what has Dr. L. said about the lack of results?

-any estimation by either doctor on total grafts you have available?

 

Thanks

[Davis91]

Good post Zup

[nativeremdies]

Right, I'll update my profile with additional info, but I don't want to high jack this thread

In a glance way back when, my long term goals, were, FUT, FUT, FUE

 

I wanted Rahal for the hairline, Lindsey for a small strip scar, and then to FUE with Shapiro. (at the time Rahal was not doing FUE)

[Jotronic]

Just to be clear, there is no such thing as an "illusion of coverage". Coverage is coverage. The illusion is the density that the coverage makes it appear one has. I saw this mentioned a couple of times so I thought I'd clarify the difference.

[nativeremdies]

"illusion of coverage". Coverage is coverage. The illusion is the density

Very good point to make, and you are 100% correct.

 

The illusion of density which will be clear when you step out of the shower.

Or that your pictures will need the right lighting so that your hair looks full

 

 

However, the illusion of coverage still holds merit, and accurately describes a HT.

 

My coverage works when I comb my hair the right way so the hairs all cover each other. I also use a excellent barber that gives me that coverage look. With the right blend of concealers my coverage and density look amazing (providing its not sunny or strong lighting) I also have illusion of coverage problems with short hair. My hairline has coverage, but up close but my density is sparse

 

illusion of coverage and illusion of density go hand in hand.

 

That's how I see it.

Edited February 25, 2013 by nativeremdies

[hairtodaygonetmrw2]

With 5000 grafts, you could likely get a very nice cosemetic change! Your hairline and mid scalp region, would look good. Keep in mind this would look worse when wet and youll never be as full as someone with no hair loss.

 

I suggest doing a consultation with a high end doctor to see what your realistic thoughts are

[Brad3451]

Establish a hairline has got to be the first realistic goal and reasonable coverage on back with the remaining. I personally was a 6 and I got 3451 in one session and really couldn't be happier. I was one of those guys that almost always wore a cap out now never. Good Luck

[Paulygon]

I went from NW5A to an excellent head of hair with 2710 grafts + meds.

Going from NW6 would be challenging.. but I would agree 6-8000 makes sense.

I would love to see some pics of NW6 who are happy with their results.

[JohnGage]

It depends on your donor + doctors skills. For example, can you afford to have your hair transplant with Dr. Lorenzo?

 

Have a look at these two patients:

 

3939 grafts Dr. Lorenzo

 

6202 grafts Dr. Lorenzo