Dr. Robert M. Bernstein / Norwood 7 / Results after 3238 grafts in 2 sessions

[Bernstein Medical]

Bernstein Medical - Center for Hair Restoration Patient CHS is a Norwood Class 7 with straight, medium, salt and pepper hair and a donor density of 2.0. Results after two hair transplant sessions of 1,734 and 1,504 grafts totaling 3238 follicular unit grafts

 

Click the thumbnails below for a larger view.

 

Before / After:

 

 

Left: Before Hair Transplant

Right: After Two Sessions

 

 

Detail of Hairline:

 

Light coverage with 1,734 grafts achieved in the first session. The light hairline accomplishes its main task of the hair restoration, namely providing a frame to the face.

 

 

Left: Before Hair Transplant

Center: After 1st Session

Right: After 2nd Session

 

 

* Visit our Hair Transplant Photos to view more before/afters of our patients. Browse our patient photo sets by their Norwood Class.

 

* View Patient CHS's photo profile at Bernstein Medical

[Blake Bloxham]

Nice work! Thanks for sharing.

[GreatPelo]

Excellent...looks like a very happy patient!

[Mickey85]

No other photos showing the top view??

[Patriot34]

Hairline looks pretty dense. I imagine the top view was intentionally left out because that is not the patients good angle, as he still has a bald crown. That's why I would always lean towards advising these patients to shave head completely instead of pursing a HT unless they care more about the 1 dimensional view from the front and say to hell with the rest. As long as they understand they can't mathematically cover the entire area with good aesthetics then I have no problem with it, to each their own.

 

Front coverage in this case looks good. I think it would be beneficial to see how it was tied into the rest of the hair and how far back the transplanted follicles go.

[bunnyman]

Hairline looks pretty dense. I imagine the top view was intentionally left out because that is not the patients good angle, as he still has a bald crown. That's why I would always lean towards advising these patients to shave head completely instead of pursing a HT unless they care more about the 1 dimensional view from the front and say to hell with the rest. As long as they understand they can't mathematically cover the entire area with good aesthetics then I have no problem with it, to each their own.

 

Front coverage in this case looks good. I think it would be beneficial to see how it was tied into the rest of the hair and how far back the transplanted follicles go.

 

 

Perhaps you are privileged enough to have a full head covering of hair, but not everyone can have this with a limited donor supply. I expect the patient, like virtually all HT patients wanted something that was aethestically pleasing for him, but unfortunately he knew it would be limited to only what the HT surgeon could perform using what was available. Focusing on the front and the top is a logical plan for a patient considering the front is what he sees whenever he looks in a mirror.

 

Shaving heads may be your thing, but it certainly is not for me and I suspect for the patient and many other people too. Not everyone wants to look like a marine! I personally think the patient would look strange and possibly out of character with a shaven head. A you rightly said, each to their own.

 

I think the result is a dramatic improvement and a great success for a Norwood 7 patient and the surgeon has done a great job. I am sure he could also utilise beard/body hair at the back/crown if he was so concerned with the baldness that remains.

[Shadow of the EMpire State]

Would like to see closeups of the entire scalp.

Edited October 28, 2013 by Shadow of the EMpire State

[Shadow of the EMpire State]

Shaving heads may be your thing, but it certainly is not for me and I suspect for the patient and many other people too. Not everyone wants to look like a marine!

 

Perhaps not, but it's infinitely less absurd than walking around with an obvious, gauze-thin transplant on your head. And that's precisely what tends to happen with patients who are beyond NW4.

 

Remember: bald may not be attractive, but it's not weird. A bad transplant is both ugly and weird. And weird is so much worse.

Edited October 28, 2013 by Shadow of the EMpire State

[bunnyman]

Perhaps not, but it's infinitely less absurd than walking around with an obvious, gauze-thin transplant on your head. And that's precisely what tends to happen with patients who are beyond NW4.

 

Remember: bald may be ugly, but it's not weird. A bad transplant is both ugly and weird. And weird is so much worse.

 

 

So no one in your opinion should have a HT if they are beyond a Norwood 4? What an utterly preposterous post!

[Shadow of the EMpire State]

So no one in your opinion should have a HT if they are beyond a Norwood 4? What an utterly preposterous post!

 

You may find it preposterous, but respectfully, it's a truth brick through your fantasy window.

 

I started on hair forums in 2003, and I've been on this site for several years. In that time, I've seen thousands and thousands of hair-transplant pictures; probably a hundred videos or so; and several in-person examples. And the truth is that once you go beyond NW4, the likelihood of achieving a non-detectable, cosmetically acceptable result (as measured by prevailing social standards) is low.

 

Admittedly, there have been a few extraordinary results like those achieved by the early H&W guys, but they're few and far between. Most people beyond NW4 simply do not have the combination of available grafts, hair characteristics, scalp laxity, etc., to produce a good result.

Edited October 28, 2013 by Shadow of the EMpire State

[bunnyman]

You may find it preposterous, but respectfully, it's a truth brick through your fantasy window.

 

I started on hair forums in 2003, and I've been on this site for several years. In that time, I've seen thousands and thousands of hair-transplant pictures; probably a hundred videos or so; and several in-person examples. And the truth is that once you go beyond NW4, the likelihood of achieving a non-detectable, cosmetically acceptable result (as measured by prevailing social standards) is quite low.

 

Admittedly, there have been a few extraordinary results like those achieved by the early H&W guys, but they're few and far between. Most people beyond NW4 simply do not have the combination of available grafts, hair characteristics, scalp laxity, etc., to produce a good result.

 

 

Utter rubbish!

 

So in your opinion it seems Dr Bernstein's patient in this thread should not have been allowed to have a HT because he was NW4 or over. Should he have been made to shave his head instead?

 

I think you are deluded if you think everyone who has a HT expects to have an undetectable, full head of hair. Most people at least are sensible in their expectations of what they are likely to end up with after a HT, especially those with larger Norwood scales. It is also an ethical requirement and certainly moral obligation of all HT surgeons to make clear to patients what they can realistically expect to end up with.

 

I too have seen thousands of HT pictures and the vast majority of those of NW4 and over have resulted in good natural looking results. This does not mean they have ended up with a full head of hair, but they have ended up with a result that is aethetically acceptable and natural-looking. Of course there will be some exceptions, there always are.

 

I am sure if you were to ask all those patients on this forum who have undergone a HT of NW4 and over whether they were happy with the results of their HT (given the fact that most could not realistically expect to have 100% full head of hair) 9 out of 10 would say yes.

[Shadow of the EMpire State]

So in your opinion it seems Dr Bernstein's patient in this thread should not have been allowed to have a HT because he was NW4 or over. Should he have been made to shave his head instead?

 

Who said anything about whether he should be "allowed" to get a hair transplant? This isn't Stalinist Russia; he should be allowed to undergo any procedure he chooses. But do I think hair transplants produce cosmetically acceptable results for the majority of high-Norwood cases? No, I don't. Do I think that the inherent limitations of hair transplantation should dissuade most high-Norwood people from getting transplants? Yes, I do. Do I think some men wind up making themselves look ridiculous because they're unable to face reality? Absolutely.

 

I think you are deluded if you think everyone who has a HT expects to have an undetectable, full head of hair.

 

I certainly think that nearly everyone expects to have an undetectable result. Are you actually suggesting to me that you would accept a result that's immediately recognizable to strangers as a transplant?

[Mickey85]

Who said anything about whether he should be "allowed" to get a hair transplant? This isn't Stalinist Russia; he should be allowed to undergo any procedure he chooses. But do I think hair transplants produce cosmetically acceptable results for the majority of high-Norwood cases? No, I don't. Do I think that the inherent limitations of hair transplantation should dissuade most high-Norwood people from getting transplants? Yes, I do. Do I think some men wind up making themselves look ridiculous because they're unable to face reality? Absolutely.

 

 

 

I certainly think that nearly everyone expects to have an undetectable result. Are you actually suggesting to me that you would accept a result that's immediately recognizable to strangers as a transplant?

 

i agree with alot of this post.

[hairthere]

The problem with high NW HTs, imo, is that unless the temple points are addressed/established the work ends up looking like a hair piece. I think this is even more problematic in achieving a natural-looking result than density. Also, high NWs tend to go for the combover style which never looks quite right. So I agree, some of these high NW guys probably would look better just accepting fate and forgetting surgery.

 

That being said, I think this patient looks good, and you can certainly tell by his smile that he is elated with the results. Some top-down shots would be helpful in fully evaluating this outcome, though.

[bunnyman]

We clearly have differences of opinion.

 

I will never agree with you that majority of high Norwood cases produce cosmetically unacceptable results as you state, and I am sure 9 out of 10 NW4 and over patients wouldn't agree with you either.

 

And no one should be dissuaded from having a HT if they are NW4 or over. If this forum contained the results of large numbers of NW4 and over HT 'freaks', then my opinion might have been different, but there is no evidence of this on this forum. As I said before, what is important is managing people's expectations of what they are likely to end up with after a HT. A good HT surgeon will not only help patients to manage their expectations, but will perform a HT in a way to make the result as natural-looking as possible.

 

There is nothing wrong with having post HT thin hair, particularly if the patient was completely bald before. I am sure Dr Bernstein's NW7 patient is very pleased with his result even though his 'new hair' is thin and does not cover the whole of his head.

[Shadow of the EMpire State]

We clearly have differences of opinion.

 

I will never agree with you that majority of high Norwood cases produce cosmetically unacceptable results as you state,

 

Well, they may be acceptable to you, but in my experience, they're not acceptable to most people whom we meet on our travels. Now I suppose that personal happiness is paramount, but if it comes only by ignoring reality, I'll pass. Have you ever seen a guy wearing a terrible, obvious rug? I have. And every time I see one, I think, "My God, does he actually think this looks good? Doesn't he realize how ridiculous he looks and that people are laughing at him?" And then I stop and realize that the obvious answer is "no." After all, if he realized that, he wouldn't be wearing a terrible rug. So yes, there are some people who think that high-Norwood transplants look good, but in my opinion, they're prisoners to their own denial.

 

Now, as I said, there are exceptions. The early H&W guys come to mind. But they're few.

 

and I am sure 9 out of 10 NW4 and over patients wouldn't agree with you either.

 

Nine out of 10? The hair-transplant satisfaction rate isn't 90 percent even on Norwood 2s and 3s, let alone people beyond Norwood 4.

 

And no one should be dissuaded from having a HT if they are NW4 or over. If this forum contained the results of large numbers of NW4 and over HT 'freaks', then my opinion might have been different, but there is no evidence of this on this forum.

 

Respectfully, there's significant evidence of it on this forum. Of course, there's nothing to be gained by telling someone that he has a bad result, so it's not often pointed out. But it's there. Worse still, the actual incidence of bad results tends to be underreported in online forums because, as a general rule, people tend not to post pictures of bad results.

 

As I said before, what is important is managing people's expectations of what they are likely to end up with after a HT. A good HT surgeon will not only help patients to manage their expectations, but will perform a HT in a way to make the result as natural-looking as possible.

 

"[A]s natural-looking as possible." Well, either it looks natural or it doesn't. It's not really a question of degree. It's like being pregnant: either you are, or you're not. If the transplant doesn't look good enough to fool the vast majority of people, then it's bad, the surgeon's best efforts notwithstanding.

 

There is nothing wrong with having post HT thin hair, particularly if the patient was completely bald before.

 

If it's recognizable as a transplant---and most high-Norwood cases are---then yes, it's very bad.

Edited October 28, 2013 by Shadow of the EMpire State

[bunnyman]

As I said before we will never agree and I am not going to waste any more time on this issue as this is going nowhere. You are entitled to your opinion that most of those patients with a hair transplant that is a case NW4 or above look as if they have had a recognisable bad HT, but in my opinion you are very wrong.

 

Fortunately, most of us live in a world where we have a choice. And most people who are NW4 and above who seek a HT will ignore your advice and will freely go ahead with a HT and remove years - of not decades - of shame, depression and generally bad feeling about themselves and their appearance. You might want to dissuade them from removing their misery, but I certainly don't.

[Blake Bloxham]

Hi Guys,

 

At the risk of sound biased, I think I agree with Bunnyman on this one. Over the years, I've had the privilege of reviewing hundreds of cases of quality hair transplantation performed on high NW patients and I've seen countless excellent, natural results. While it takes a talented, practiced physician with the skill to transplant at densities of 50 grafts/cm^2 and higher, great results are achievable. Granted, nothing in surgery is guaranteed and hair transplant surgery (in its current state) is always a struggle between a finite number of grafts needed to cover a large area of bald scalp, but I still think quality surgeons possess the ability to transform NW 4+ patients effectively.

 

Again, just my opinion ... and the beauty of our forums is that all members are open to honestly share their own thoughts and ideas without excessive moderation!

[Mickey85]

There really should be top down photos, how are we to analyze this result when only the front is shown? We have no idea how far back the hair goes to or how natural it looks..

[Spanker]

I think it really depends on the age. I have seen some nw5 guys in their mid 50's that looked great. It was kind of thin, but totally normal looking and they looked much better with hair.

 

A nw5 in their 30's can still look good, it's just harder you do.