advanced NW levels

[Hair4Days]

If someone is on their way to a NW 7, is it no longer recommended to start surgery? Forget about medication. Lets say your genetics are going to win in the end and you end up with an advanced pattern. With above average donor, what would you guys say? Is there too much demand vs the supply? Would you pass on surgery completely if youre not going to get full coverage?

[JJ1187]

Fr a NW 7 the demand is definitely greater than supply even with an above average donor. I would not say that surgery is out of the question, but you will have to make use of body hair in addition to the scalp donor to achieve acceptable amount of coverage. Also, I would not rule out medications unless you are already a Norwood 7. Even with the use of body hair, the density might not be what you expect, so you do need to have realistic expectations

[yesplease]

13 hours ago, JJ1187 said:

Fr a NW 7 the demand is definitely greater than supply even with an above average donor. I would not say that surgery is out of the question, but you will have to make use of body hair in addition to the scalp donor to achieve acceptable amount of coverage. Also, I would not rule out medications unless you are already a Norwood 7. Even with the use of body hair, the density might not be what you expect, so you do need to have realistic expectations

The truth is, at a NW7, you really cannot achieve the appearance of complete coverage or a full set of hair with an HT. The best case scenario is to reframe the face with a new hairline and have partial, possibly thin coverage in the front/vertex, likely with an open crown. 

[Jonboy81]

Eugenix seems to be doing amazing things with Norwood 6 and 7s

[Melvin- Admin]

Norwood 7 is a difficult case, not only technically, but managing expectations. Can you post some pictures? What are your goals?

[Hair4Days]

I’m a nw 3/4 with Apparent diffusing on top that can be disguised with the hair grown out.. My issue is i can tell my crown is going to dip down in the back. I can see it getting lighter under the top of the crown .. therefore I’m assuming I’ll be a nw 6 or 7. I refuse to take propecia. Minoxidil is fine. When the inevitable comes, I’m either shaving my head or putting my faith in HT .. however, I’m still not convinced you can get coverage from the hairline all the way back to a and into the crown. As for expectations.. i think I’d accept a dense front half, with less density as you move back, but i DONT want a wide open crown with nothing there at all.. so if it’s possible to Atleast have some crown coverage plus toppik in an advanced pattern then I’d do a HT, but i get so many 50-50 opinions it’s making me wonder if i should just do the shaved head once that time comes (10 years in my opinion)

[Panamera13]

This pic is from H&W site, 5169 FUT.

BTW - I'm advanced norwood with diffused thinning as well but I only will do FUE. Had Fin and left because of side effects.

 

Edited May 7, 2020 by Panamera13

[Melvin- Admin]

3 hours ago, James C said:

I’m a nw 3/4 with Apparent diffusing on top that can be disguised with the hair grown out.. My issue is i can tell my crown is going to dip down in the back. I can see it getting lighter under the top of the crown .. therefore I’m assuming I’ll be a nw 6 or 7. I refuse to take propecia. Minoxidil is fine. When the inevitable comes, I’m either shaving my head or putting my faith in HT .. however, I’m still not convinced you can get coverage from the hairline all the way back to a and into the crown. As for expectations.. i think I’d accept a dense front half, with less density as you move back, but i DONT want a wide open crown with nothing there at all.. so if it’s possible to Atleast have some crown coverage plus toppik in an advanced pattern then I’d do a HT, but i get so many 50-50 opinions it’s making me wonder if i should just do the shaved head once that time comes (10 years in my opinion)

Check out @Eugenix Hair Science YouTube channel, they have the largest NW7 portfolio online. 
 

This is probably the best you can expect from a true NW7

 

[Hair4Days]

1 hour ago, Melvin-Moderator said:

Check out @Eugenix Hair Science YouTube channel, they have the largest NW7 portfolio online. 
 

This is probably the best you can expect from a true NW7

 

So although these results are more then acceptable for where he came from  being a NW7,  theres a few contradicting opinions Id like to bring up. First, for someone with such an advanced pattern as this guy, why was FUE done? Every clinic in the US has said to maximize your donor capacity, start with FUT, especially in advanced NW levels. Why is it a known fact across the HT board that FUE alone doesnt yeild as many grafts. (and shouldnt be used in advanced patients because youd be entering zones that arent safe like the lower crown.) Even FUE clinics admit this. They say go FUT first then FUE if youre on pace to be a be a nw 6 or 7. Secondly, If this guy in India can achieve  basically full coverage on a NW  7 like this, hes proving that scientifically it CAN be done. Why doesnt every clinic say its atleast achievable, considering you see some case of it being done. Does it come down to skill set? Not confident? Beucase its hard to believe its donor supply if you see results like this?? Im sorry, but theres so much contradicting information in this industry to feel confident enough to pull the trigger on a HT. To risk scarring and thousands of dollars, im going to need more reassurance i wont regret anything.

 

@Panamera13 @Jonboy81 @yesplease @JJ1187

Edited May 7, 2020 by James C

[Panamera13]

11 minutes ago, James C said:

So although these results are more then acceptable for where he came from  being a NW7,  theres a few contradicting opinions Id like to bring up. First, for someone with such an advanced pattern as this guy, why was FUE done? Every clinic in the US has said to maximize your donor capacity, start with FUT, especially in advanced NW levels. Why is it a known fact across the HT board that FUE alone doesnt yeild as many grafts. (and shouldnt be used in advanced patients because youd be entering zones that arent safe like the lower crown.) Even FUE clinics admit this. They say go FUT first then FUE if youre on pace to be a be a nw 6 or 7. Secondly, If this guy in India can achieve  basically full coverage on a NW  7 like this, hes proving that scientifically it CAN be done. Why doesnt every clinic say its atleast achievable, considering you see some case of it being done. Does it come down to skill set? Not confident? Beucase its hard to believe its donor supply if you see results like this?? Im sorry, but theres so much contradicting information in this industry to feel confident enough to pull the trigger on a HT. To risk scarring and thousands of dollars, im going to need more reassurance i wont regret anything.

 

@Panamera13 @Jonboy81 @yesplease @JJ1187

I'm advance diffused thinner. See pic. I spoke to two top docs and they both said go FUT and I refuse to go that route. I'd rather have a decent result with FUE then have an awesome result with FUT. I just don't want to do the scar thing.

Also, no "top" doc in US/Canada uses body hair. Indian, Turkish docs do that and I'm not sure why US/Canada docs don't because it seems to work. My goal is to go FUE 3000 in front/mid and leave the crown for two years down the line (to be filled by body hair).

One thing I'm not sure about is donor capacity - some docs have FUE with 7-9K grafts, which I guess is just luck for those high NW guys.

[Melvin- Admin]

35 minutes ago, James C said:

So although these results are more then acceptable for where he came from  being a NW7,  theres a few contradicting opinions Id like to bring up. First, for someone with such an advanced pattern as this guy, why was FUE done? Every clinic in the US has said to maximize your donor capacity, start with FUT, especially in advanced NW levels. Why is it a known fact across the HT board that FUE alone doesnt yeild as many grafts. (and shouldnt be used in advanced patients because youd be entering zones that arent safe like the lower crown.) Even FUE clinics admit this. They say go FUT first then FUE if youre on pace to be a be a nw 6 or 7. Secondly, If this guy in India can achieve  basically full coverage on a NW  7 like this, hes proving that scientifically it CAN be done. Why doesnt every clinic say its atleast achievable, considering you see some case of it being done. Does it come down to skill set? Not confident? Beucase its hard to believe its donor supply if you see results like this?? Im sorry, but theres so much contradicting information in this industry to feel confident enough to pull the trigger on a HT. To risk scarring and thousands of dollars, im going to need more reassurance i wont regret anything.

 

@Panamera13 @Jonboy81 @yesplease @JJ1187

FUT hands down is the best way to maximize your donor capacity, there is no disputing this fact. However, that doesn't mean you cannot achieve great results with FUE and BHT combined.  That said, keep in mind, hair texture is different for everyone, if you have a similar texture of beard and scalp hair, the results will look a lot better. I only showed you this result, because I wanted to highlight the best possible scenario for a NW7, by no means am I saying you will end up looking like this. 

Lastly, listen, i'm not here to convince you to get surgery, quite the contrary, if you're adamant on getting full coverage, DO NOT GET SURGERY! Your best bet is to either A. shave your head, or B. Get a hair system. Hair transplants are not perfect, and you will 100% have scarring, regardless of the procedure. Also, the video I posted, even though his results are amazing, there's no doubt that he is using the 'illusion of density' he does not have true density. If you need to be "convinced" to get surgery, surgery is not for you period.Theres more to life than hair.

Best wishes,

 

[HTHope]

46 minutes ago, Melvin-Moderator said:

FUT hands down is the best way to maximize your donor capacity, there is no disputing this fact. However, that doesn't mean you cannot achieve great results with FUE and BHT combined.  That said, keep in mind, hair texture is different for everyone, if you have a similar texture of beard and scalp hair, the results will look a lot better. I only showed you this result, because I wanted to highlight the best possible scenario for a NW7, by no means am I saying you will end up looking like this. 

Lastly, listen, i'm not here to convince you to get surgery, quite the contrary, if you're adamant on getting full coverage, DO NOT GET SURGERY! Your best bet is to either A. shave your head, or B. Get a hair system. Hair transplants are not perfect, and you will 100% have scarring, regardless of the procedure. Also, the video I posted, even though his results are amazing, there's no doubt that he is using the 'illusion of density' he does not have true density. If you need to be "convinced" to get surgery, surgery is not for you period.Theres more to life than hair.

Best wishes,

 

Melvin, knowing what you know now, would you have gone down the FUT route first?

[Melvin- Admin]

3 minutes ago, HTHope said:

Melvin, knowing what you know now, would you have gone down the FUT route first?

That's a complicated question, but the short answer is no.

[yesplease]

9 minutes ago, Melvin-Moderator said:

That's a complicated question, but the short answer is no.

Still hoping for that featured post on this topic :) 

[Hair4Days]

1 hour ago, Melvin-Moderator said:

FUT hands down is the best way to maximize your donor capacity, there is no disputing this fact. However, that doesn't mean you cannot achieve great results with FUE and BHT combined.  That said, keep in mind, hair texture is different for everyone, if you have a similar texture of beard and scalp hair, the results will look a lot better. I only showed you this result, because I wanted to highlight the best possible scenario for a NW7, by no means am I saying you will end up looking like this. 

Lastly, listen, i'm not here to convince you to get surgery, quite the contrary, if you're adamant on getting full coverage, DO NOT GET SURGERY! Your best bet is to either A. shave your head, or B. Get a hair system. Hair transplants are not perfect, and you will 100% have scarring, regardless of the procedure. Also, the video I posted, even though his results are amazing, there's no doubt that he is using the 'illusion of density' he does not have true density. If you need to be "convinced" to get surgery, surgery is not for you period.Theres more to life than hair.

Best wishes,

 

So what i meant by needing more reassurance, is i would like to see more people on board with the fact that it is possible to get coverage front to back. This is a prodecure that will change your life as well as your wallet forever, so gathering all necessary information is crucial in my opinion...When we say coverage,  i dont mean thick 80% density from front to back bro, i obviously know this game is illusion based. I said earlier that i would be happy with a dense front half with compromised density going back into the crown if need be, just as long as its possible to get something there IF i end up a nw 7.. i wouldnt mind sprinkling toppik time to time to make the crown darker. But since you just said "If youre adamant on getting full coverage, dont get a HT" are you now also admitting a majority of patients cannot get what I just described above? Which is totally Fine because my overall point of this topic is that theres legit 50% of people who think its doable and 50% think it isnt.

Edited May 7, 2020 by James C

[Melvin- Admin]

1 minute ago, James C said:

So what i meant by needing more reassurance, is i would like to see more people on board with the fact that it is possible to get coverage front to back. This is a prodecure that will change your life as well as your wallet forever, so gathering all necessary information is crucial in my opinion...When i say coverage,  i dont mean thick 80% density from front to back bro, i obviously know this game is illusion based. I said earlier that i would be happy with a dense front half with compromised density going back into the crown if need be, just as long as its possible to get something there IF i end up a nw 7.. i wouldnt mind sprinkling toppik time to time to make the crown darker. But since you just said "If youre adamant on getting full coverage, dont get a HT" are you now also admitting a majority of patients cannot get what I just described above? Which is totally Fine because my overall point of this topic is that theres legit 50% of people who think its doable and 50% think it isnt

The goal of hair restoration should always be improvement, the reason why it's 50/50 is because not everyone will achieve the same result. It really comes down to expectations, expectations, expectations. I agree that hair transplantation should not be taken lightly, and as a NW7 you should expect a minimum of 3-4 surgeries, you should also expect to use concealer to make the results look better, the crown is generally out of the question. Again, i'm not here to convince anyone or to give you reassurance. That's why this board is so valuable, you get no BS information without bias. Take some time and research NW7 results, not from one clinic, but from several, if possible ask to meet with past patients, see if those results are something you would want to invest time and money in, if not step away and move on with your life.

[Melvin- Admin]

7 minutes ago, yesplease said:

Still hoping for that featured post on this topic  

I've been meaning to film it, but in a way that explains everything well. I've been busy with the "best hair transplants of the week" which I feel would interest more people. Perhaps, I will write an article on why I chose FUE over FUT.

[yesplease]

6 minutes ago, James C said:

So what i meant by needing more reassurance, is i would like to see more people on board with the fact that it is possible to get coverage front to back. This is a prodecure that will change your life as well as your wallet forever, so gathering all necessary information is crucial in my opinion...When we say coverage,  i dont mean thick 80% density from front to back bro, i obviously know this game is illusion based. I said earlier that i would be happy with a dense front half with compromised density going back into the crown if need be, just as long as its possible to get something there IF i end up a nw 7.. i wouldnt mind sprinkling toppik time to time to make the crown darker. But since you just said "If youre adamant on getting full coverage, dont get a HT" are you now also admitting a majority of patients cannot get what I just described above? Which is totally Fine because my overall point of this topic is that theres legit 50% of people who think its doable and 50% think it isnt.

IMO, what you describe here isn’t likely for a NW7

[Hair4Days]

1 hour ago, Melvin-Moderator said:

the crown is generally out of the question.

There it is. That answers my question. Although the guy from India did give that guy what he needed, my gut still tells me if i end up a nw 7 then HT shouldn’t be done. There’s just too much loss. I’m going to add some photos here. I may be buggin. Do you think I’ll end up a severe case? I’m going to be 30 in July. Do you see what I’m talking about with that light spot under the crown?

 

Edited May 7, 2020 by James C

[Panamera13]

1 hour ago, Melvin-Moderator said:

Perhaps, I will write an article on why I chose FUE over FUT.

Because of the scar?

I see many people with shaven head and have a scar which means the HT didn't work. At least with FUE, you have a bald head without scar.

[Tbcruz]

21 minutes ago, Panamera13 said:

Because of the scar?

I see many people with shaven head and have a scar which means the HT didn't work. At least with FUE, you have a bald head without scar.

You’ll have a bald head with thousands of scars instead that’s if the ht didn’t work but we’re all praying it will work regardless fue or fut lol 

Edited May 7, 2020 by Tbcruz

[Hair4Days]

3 minutes ago, Tbcruz said:

You’ll have a bald head with thousands of scars instead that’s if the ht didn’t work but we’re all praying it will work regardless fue or fut lol 

Facts lol. Scarring is inevitable regardless of the harvest type 

[Al - Moderator]

A few things:

1. FUE cost in the USA is very high and it can be even higher if you use body hair grafts, so if you need many thousands of grafts the cost is usually too high for most people in the USA and FUT would be a lot cheaper. It's impossible for USA clinics to do large sessions of FUE and compete on price with Turkey and India FUE clinics

2. Most Middle Eastern men who make up the majority of the Turkey and India clinics have very thick, coarse hairs which provide excellent coverage without requiring as many grafts. They also usually have very thick donor areas even though they may be completely bald on top. This allows them to get more grafts without looking thin in the donor area. They also usually have extremely thick beards which allows them to get thousands of beard grafts pretty easily.

3. Thick hairs are better suited for FUE than thinner hairs because the follicles hold together better when removing them if they are attached to thicker, stronger hairs, so those Middle Eastern men have the FUE advantage there too. This is partly why American clinics say FUT provides better quality grafts than FUE while some foreign clinics say it's the same quality either way. They are getting different types of clients for the most part.

4. If you are looking for a top notch Dr in the USA who does large FUE sessions and lots of body hair, then search for Dr Sanusi Umar in California. His clinic doesn't post here much anymore (I don't think), but he was one of the first (maybe the very first) to use body hair FUE and had a lot of excellent results in men who were turned down by other places. I personally have been going to Dr Dorin at True & Dorin in NY for body hair grafts, but they don't do extremely large FUE sessions. I think they stay at 1500 grafts and below for FUE, but that may have increased in the last few years (I don't know).

 

 

Edited May 9, 2020 by BeHappy

[elicochin]

On 5/7/2020 at 2:15 PM, Melvin-Moderator said:

FUT hands down is the best way to maximize your donor capacity, there is no disputing this fact. However, that doesn't mean you cannot achieve great results with FUE and BHT combined.  That said, keep in mind, hair texture is different for everyone, if you have a similar texture of beard and scalp hair, the results will look a lot better. I only showed you this result, because I wanted to highlight the best possible scenario for a NW7, by no means am I saying you will end up looking like this. 

Lastly, listen, i'm not here to convince you to get surgery, quite the contrary, if you're adamant on getting full coverage, DO NOT GET SURGERY! Your best bet is to either A. shave your head, or B. Get a hair system. Hair transplants are not perfect, and you will 100% have scarring, regardless of the procedure. Also, the video I posted, even though his results are amazing, there's no doubt that he is using the 'illusion of density' he does not have true density. If you need to be "convinced" to get surgery, surgery is not for you period.Theres more to life than hair.

Best wishes,

 

 

On 5/7/2020 at 3:06 PM, Melvin-Moderator said:

That's a complicated question, but the short answer is no.

Dear Melvin,  I have a follow-up question on this FUE Vs. FUT topic. I was under the impression that you were supportive of FUT as the first surgery, then FUE(s) for subsequent surgeries if/as needed. I also understood the logic here was that the donor will not be completely depleted with the first FUT. I am a high Norwood (VI+) case and have been reading quite a lot on this forum for the last couple of years and was struggling to make a choice between FUT and FUE. However, now I think I am sensing that you may be actually supporting FUE even as a first surgery. I consulted with Dr. Sethi couple of months ago in NY and recently reached out to H&W and Dr. Bloxham. Obviously you can see my confusion here at this point if I should get an FUT first and then an FUE later, or just go for a mega FUE session with someone like Dr. Sethi. I would greatly appreciate any light you can shed here.  

Thank you!

[Melvin- Admin]

9 minutes ago, elicochin said:

 

Dear Melvin,  I have a follow-up question on this FUE Vs. FUT topic. I was under the impression that you were supportive of FUT as the first surgery, then FUE(s) for subsequent surgeries if/as needed. I also understood the logic here was that the donor will not be completely depleted with the first FUT. I am a high Norwood (VI+) case and have been reading quite a lot on this forum for the last couple of years and was struggling to make a choice between FUT and FUE. However, now I think I am sensing that you may be actually supporting FUE even as a first surgery. I consulted with Dr. Sethi couple of months ago in NY and recently reached out to H&W and Dr. Bloxham. Obviously you can see my confusion here at this point if I should get an FUT first and then an FUE later, or just go for a mega FUE session with someone like Dr. Sethi. I would greatly appreciate any light you can shed here.  

Thank you!

I believe that starting out with FUT first will maximize your donor supply. However, I myself started out with FUE, and I have had (in my opinion) excellent results. What are your goals? If you don't mind wearing your hair long, I would say FUT first would be the best option. However, Dr. Sethi and Dr. Arika Bansal, have proven that FUE alone can restore NW 6/7, but you may need to do some BHT. It all depends on your goals. Personally, for me FUT was out of the question.