Probable NW7-- HT possible?

[herroprease]

Hi!

 

Im 22 and currently a NW3/NW4 with deep temporal recession. My dad is a NW 6.5 . For a while I thought I might not go that deep down, but recently, I am seeing the beginning of thinning in the deep crown.

 

I am fairly certain I am heading down the path to a NW7.

 

I recently went to a respected HT surgeon (recommended on this site), who told me that I have some strong factors in my favor. I have thick coarse hair. He said he could probably pull 6000 grafts via FUT.

 

My question is whether 6000 grafts FUT will be enough to fill in my head if I was NW7. I have a fairly large forehead.

Im not bent up on having a low hairline. I just want to be able to have my face framed and also have full coverage.

 

 

One major thing for me is that I never want to take propecia. Even if that means I need multiple HT's , I don't want to take Propecia.

[Bill - Seemiller]

herroprease,

 

The short answer is yes, sometimes 6000 grafts can be enough to fill your scalp if you were to become a level 7 on the Norwood scale. However, the long answer to your question isn't cut and dry.

 

While your entire head can be covered, the hair may not be very dense and thus, you will most likely have a very thin appearance and may not be happy with the kind of density you can achieve on a level 7 with only 6000 grafts.

 

Density is affected by several factors. For starters, this includes the number of hairs per graft. For instance, if the average number of hairs per graft is 2.2 for one patient who received 6000 grafts while another patient averages 1.7 hairs per graft, the patient with 2.2 hairs per graft will have greater density.

 

Another factor is hair characteristics and color. Depending on the thickness of the hair shaft and the scalp to hair color ratio, the same number of hairs may appear more dense on one scalp than the other. Scalp size (or more accurately, balding area) plays another role.

 

Placement of the hairline (conservative versus liberal) and overall placement of the grafts also play another role.

 

Plucking and planting may sound easy enough, but experienced hair restoration physicians will strategically place grafts to maximize the illusion of density and coverage.

 

I recommend viewing the following hair transplant photos on Norwood level 7 patients for examples of what can be accomplished. These photos will show a number of patients with various numbers of grafts, hair color and characteristics, different hair counts, etc.

 

I hope this helps :-).

 

Bill

[herroprease]

Bill thanks for the detailed reply!

 

One thing I saw in the album was many patients who just had the front half done, which frames the face. But they left a big gaping crown..

 

I wonder if its possible to "kill two birds with one stone"-- lets say I have 6000 grafts possible. If I spread 3000 over the frontal third to acheive good density up front. And then I use the remaining 3000 in the latter 2/3 with the emphasis here on coverage (as opposed to density), will this work?

 

 

Im attachign a picture of my head with the light on my head, if that could help give some context.

 

 

Thanks alot for the fast reply -- your website is very helpful to so many.

Edited July 9, 2015 by herroprease

[gillenator]

herroprease,

 

Did you by chance remove a photo of yourself as I see your past post was edited by yourself.

 

After reading your initial post, my first thought was to see some pics of you. That would help greatly.

 

Even without pics, I highly doubt that 6,000 grafts would cover both the frontal zone and crown area. It could be possible if you were to lower the density level throughout the entire recipient area, however the degree of visible coverage would be compromised. So it depends on what you are willing to accept in expectations as it related to your donor limitations.

 

My concern for you is more related to the confined area of your donor being a more permanent zone. In other words, could the area under your crown in the back have any miniaturization and/or diffusion going on?

[JoeTillman]

My question is whether 6000 grafts FUT will be enough to fill in my head if I was NW7. I have a fairly large forehead.

 

6000 grafts on a NW7 will not achieve what you ask, for the average patient. 3000 grafts for the frontal third would probably give you a nice result (assuming at least average characteristics) but with an additional 3000 grafts for the remaining 2/3 you will not get a direct ratio of coverage as what would be achieved in the frontal 1/3. In other words, your density won't be half that of the frontal 1/3, it will be much less. The rotational direction of growth found in all crowns, and the need to reconstruct this pattern, reduces the degree of coverage that can be achieved in the front due to the lack of "overlap" from one follicular unit to the next. When you think of tiles on a roof you can see how the front can have coverage just from proper placement to achieve a similar overlap for coverage. The same is much more difficult to achieve when the direction of growth is changing from one folliucular unit to the next as is found in the crown region.

 

The general rule of thumb is that it takes roughly 1000 grafts per NW level to achieve a satisfactory result but it is my opinion that the number of grafts per NW level climbs as one increases on the NW scale itself with the real differences occuring once the crown opens up. The only way to get meaningful coverage for a NW7 with 6000 grafts is to pack them in the front 2/3 and grow the hair long to cover the back as much as possible. If you are hoping for shorter hair styles, your chances of meaningful coverage are next to zero.

 

If you are a probable NW7 in the future then do whatever you can to prevent yourself from actually getting to this point. This way your question will potentially only be a hypothetical:)

[voxman]

The concern I have is that you are now only 22. If you were 32 or 42 and a NW3/4 you would have a pretty good idea of the speed of your balding. If you are dead set against meds, there is little ammunition available to combat the progression. As hard as it is, with no meds on your to-do list, a wait and see would be in order, since all of the above advice is spot on as far as what you can expect. You can get a nice framing with 3000, of course, but the density as you head back to the crown is going to decrease.

[gillenator]

My premonition is that there are other NW 7s in your family history such as father, grandfather, uncles, brothers, etc.

 

If so, that's a good indicator of future hair loss and without meds, changes the equation dramatically.