Dead NW7 in pursuit of hair

[NorwoodSeven]

Hi guys! I'm 34 and I've been NW6/7 for 10 years.
I noticed that I was going bald at the age of 15, I had a receding hairline and thinning hair on top of my head. It drove me to despair. At the age of 16, I started using minoxidil, but didn't notice any results. As soon as I turned 18, I started taking finasteride. By that point, my hair looked like complete sht. I took it for six months and noticed some improvement. But my hair was so bad that I decided it wasn't worth the fight (a stupid decision) so I stopped taking finasteride and minoxidil and started wearing a hair system. I was 18 and I was norwood 3 with diffuse thinning on top.
At first I wore a touppee, but then switched to a full cap, because it was easier to match the color and density. I always a comb down hairstyle because it was impossible to achieve a natural look of hairline and I was very afraid that I would be exposed. In general, I was happy with my hair system, but at some point I wanted to shave my head and live a full life without any restrictions.
At 24, I stopped wearing the system and shaved my head. By that time I was already Norwood 6 and looked disgusting. So I had smp done. A great solution, I was bald, but I looked as if I have hair and I just shave my head because I like it that way.
I didn't feel bald, smp gave me a lot of confidence. I could sweat as much as I wanted, let women touch my head, go to the sauna and not worry about the system flying off my head.

This has been going on for 10 years, but lately I decided i want to try a hair look. I am already a norwood 7 with a big head and thin hair, so I have no illusions that the transplant will help me.
Now I have started taking finasteride again. I also plan to add minoxidil and microneedling a bit later. I am not sure if it's worth it considering that I'm Norwood 7, but I've seen amazing transformations even on dead nw7 guys, so I decided to try meds again. I look good with smp, so it won't be a catastrophe if I can't get my hair back.

So what options do I have?
1. To have a hair transplant in the front hairline and temporal peaks only with a beautiful design and solid density and wear the hair system behind it. Fin to keep sides donor hair in decent condition/

2. If im a hyper responder to meds (which i highly doubt) then have a conservative ht done.

3. Dont bother with meds, hts and hairpieces and just enjoy shaved smp look.

I will add some pics soon.

[Melvin- Admin]

7 minutes ago, NorwoodSeven said:

 

So what options do I have?
1. To have a hair transplant in the front hairline and temporal peaks only with a beautiful design and solid density and wear the hair system behind it. Fin to keep sides donor hair in decent condition/

2. If im a hyper responder to meds (which i highly doubt) then have a conservative ht done.

3. Dont bother with meds, hts and hairpieces and just enjoy shaved smp look.

I will add some pics soon.

It's hard to give you advice without pictures. Not all Norwood 7's are created equal, there are Norwood 7s with good donors suitable for surgery.

Below is an example:

However, there are other Norwood 7s who don't have a donor supply or hair quality suitable for surgery. 

Example below:

In the latter example, you see the sides are very low, even beyond a Norwood 7 pattern, the donor hair is very sparse, and there simply isn't enough hair to transplant even a reasonable hairline. If you're in this situation surgery is not an option. 

I haven't seen any Norwood 7 hyper responders to medication. In fact, it's my speculation that meds rarely help Norwood 7s unless they're in the beginning stages of hair loss, even then it probably won't be enough to keep them from going bald. 

As a Norwood 7, you're in for a LONG road. You're talking serious money, if you want to have a hair transplant. A Norwood 7 requires at least 8K grafts, and that's leaving the crown bald. You're going to spend at least 20K conservatively. Is it worth it to you? Really ask yourself that question. You will never have a full head of hair, even if you have a 10/10 result. You're always going to be somewhat balding, if you're a candidate, which is a 50/50 as a Norwood 7. 

[NorwoodSeven]

Here are my pics at 6 and 17 days growth, guys, usually i dont wear them like that but i grew it out to see what my donor hair looks like. What do you guys think? How bad is my donor hair? How many grafts do you think i would need to bring my temporal peaks forward to match my smp drawn temporal peaks and 2 cm wide hairline? 

[Melvin- Admin]

Just now, NorwoodSeven said:

Here are my pics at 6 and 17 days growth, guys, usually i dont wear them like that but i grew it out to see what my donor hair looks like. What do you guys think? How bad is my donor hair? How many grafts do you think i would need to bring my temporal peaks forward to match my smp drawn temporal peaks and 2 cm wide hairline? 

Based on these pictures, I don't surgery is a good idea. You're sides are very sparse. The crown dips down a lot. There just isn't enough donor to give you a reasonable result with density and coverage. You could transplant just the hairline and do SMP to the rest, that's a possibility. But I would probably try the SMP out first. If you're not happy with the SMP, you don't want to be left with just a hairline. 

[NorwoodSeven]

1 minute ago, Melvin- Moderator said:

You're sides are very sparse. 

That sounds sad

But i already have smp for 10 years, here is a pic of how it normally looks. I want a dense hairline with agressive temporal peaks to frame my face well and then wear hairsystem behind it. Do you think its achievable with my donor? 

 

[NorwoodSeven]

 

Thats my donor hair 16 years ago right before i stopped takin fin and went on hairsystems. Did it get worse?

[TorontoMan]

Unfortunately you are not a candidate for a hair transplant. Your donor does not contain enough grafts to cover the area of loss. 
 

The idea to hair transplant the front and have a system for the back isn’t very bullet proof either. In the case that at some point in the future you decide you don’t to wear a system anymore, you will be stuck with scars from donor incisions. If you were to consider a hair system anywya, then try the full thing now and see how you manage with it. 
 

how has smp treated you?

[HappyMan2021]

What is your end goal? As a NW6/7 you will definitely need 2 - perhaps even 3 - surgeries just to become a NW3. And all those surgeries really need to be homeruns.

You will see cases on here of NW6/NW7 getting a ton of hair back and really looking good, but those are rare outliers and chances are really against you that you will get as good luck as these rare and few guys did. 

A) Accept that this journey will be multiple surgeries and at the end of it you are likely to be a NW 3

B) Accept and embrace baldness

C) SMP

D) Hair system (nothing wrong with a hair system, and it really is the only way in your situation you will get a full and lush NW1 look again)

Edited January 26, 2023 by HappyMan2021

[Melvin- Admin]

1 hour ago, NorwoodSeven said:

 

Thats my donor hair 16 years ago right before i stopped takin fin and went on hairsystems. Did it get worse?

Yes, it most certainly got worse. Even in this picture the density is quite low. Now, it’s almost depleted, with large gaps. I’m not sure your donor hair is suitable. IMO you’re better of getting a full hair system. If you don’t like it, take it off. No scars. 

[BurnieBurns]

From the looks of things your beard ins't high density either (which should only be used as filler anyway). People on this forum are not Hair Transplant doctors, but it's pretty clear that any attempt to create something with your own hair will basically still look bald with a few stragglers. If keeping it shaved with SMP feels like an ok way to live, there's a lot of appeal there and very low maintenance. You've got a great shaped head by the way.

Alternatively, you could transplant just the hairline and use a hair system behind it as mentioned. They can be a hassle of course but sounds to me like that's pros and cons to weigh up.

Sadly, I wouldn't be thinking much about your option 2.

Edited January 27, 2023 by BurnieBurns

[Gatsby]

Be very careful when considering having a hairline constructed to make a hair piece look natural. You will be left permanently with this transplant marooned at the top of your scalp. Make sure that you really believe that you want to wear a hair piece for the rest of your life. I wore a hair piece for nearly 25 years and the last ten years of wearing it were hell. If I didn’t have the scars that the hair piece were hiding then I would have abandoned the hair piece long ago. It’s a big commitment. 

[mrmane85]

In my opinion you need to be on Finasteride and Minoxidil for at least 12 months before you can start to evaluate whether or not you're a good candidate for surgery. 

 

[Bandit90]

I would say grow your donor out too. Sometimes when buzzed gives the illusion of a poor donor (very much the case with me). I would also say get back on finasteride asap, I was a NW7 and it did really helped with my donor area. I would also reach out to an ethical clinic who specialises high norwood cases like Eugenix. The fact you have never had a surgery before makes me think you do have a chance, for example look at @garcimore75case they pulled near 3600 grafts from the scalp with what looked like a poor donor. I'll go out on a limb and say if you willing to give your beard up under the right clinic you have a shot at hair restoration (providing you have realistic expectations) 

[mr_peanutbutter]

13 hours ago, Melvin- Moderator said:

It's hard to give you advice without pictures. Not all Norwood 7's are created equal, there are Norwood 7s with good donors suitable for surgery.

Below is an example:

However, there are other Norwood 7s who don't have a donor supply or hair quality suitable for surgery. 

Example below:

In the latter example, you see the sides are very low, even beyond a Norwood 7 pattern, the donor hair is very sparse, and there simply isn't enough hair to transplant even a reasonable hairline. If you're in this situation surgery is not an option. 

I haven't seen any Norwood 7 hyper responders to medication. In fact, it's my speculation that meds rarely help Norwood 7s unless they're in the beginning stages of hair loss, even then it probably won't be enough to keep them from going bald. 

As a Norwood 7, you're in for a LONG road. You're talking serious money, if you want to have a hair transplant. A Norwood 7 requires at least 8K grafts, and that's leaving the crown bald. You're going to spend at least 20K conservatively. Is it worth it to you? Really ask yourself that question. You will never have a full head of hair, even if you have a 10/10 result. You're always going to be somewhat balding, if you're a candidate, which is a 50/50 as a Norwood 7. 

is the crown bald  in the after in the guy from hasson and wong?

[mr_peanutbutter]

check this out op:

 

https://www.hairrestorationnetwork.com/topic/64547-can-you-get-away-with-a-lower-density-if-you-you-opt-for-buzzcut-and-combine-fue-with-smp/

[NorwoodSeven]

4 hours ago, Gatsby said:

I wore a hair piece for nearly 25 years and the last ten years of wearing it were hell. 

Wow, that's huge experience, what made those last 10 years hell after first 15 years of wearing? I wore a hair piece for 6 years (from 18 to 24) and was overall happy with it, except the fact that i wanted to wear my hair combed back but had to comb it down to hide the lace. I didn't hate wearing, i just stopped it spontaneously and went for shaved look with smp. Anyway if i have a ht for my front and temples and eventually will hate wearing a hairpiece i will just shave it and go back to a clean shaven smp look which im rocking now. Fue scars won't be too noticeable and i might smp them too.

2 hours ago, Bandit90 said:

I would say grow your donor out too. Sometimes when buzzed gives the illusion of a poor donor (very much the case with me). I would also say get back on finasteride asap, I was a NW7 and it did really helped with my donor area. I would also reach out to an ethical clinic who specialises high norwood cases like Eugenix. The fact you have never had a surgery before makes me think you do have a chance, for example look at @garcimore75case they pulled near 3600 grafts from the scalp with what looked like a poor donor. I'll go out on a limb and say if you willing to give your beard up under the right clinic you have a shot at hair restoration (providing you have realistic expectations) 

Man, i think the same, ьy donor looks sparse because it is short in lenghth. Im back on fin now btw, i don't have much hope on regrowth on top or crown but i think it will make my donor hair thicker. 

 

Guys, i dont think i can pull off a full coverage with hair transplants only, given that im nw7 with a karge head and fine hair, im not that optimistic.

What im talking about is just have a hairline + temples transplant and combine it with low density hair system. Im sure it will look great. 

[Melvin- Admin]

3 hours ago, NorwoodSeven said:

Wow, that's huge experience, what made those last 10 years hell after first 15 years of wearing? I wore a hair piece for 6 years (from 18 to 24) and was overall happy with it, except the fact that i wanted to wear my hair combed back but had to comb it down to hide the lace. I didn't hate wearing, i just stopped it spontaneously and went for shaved look with smp. Anyway if i have a ht for my front and temples and eventually will hate wearing a hairpiece i will just shave it and go back to a clean shaven smp look which im rocking now. Fue scars won't be too noticeable and i might smp them too.

Man, i think the same, ьy donor looks sparse because it is short in lenghth. Im back on fin now btw, i don't have much hope on regrowth on top or crown but i think it will make my donor hair thicker. 

 

Guys, i dont think i can pull off a full coverage with hair transplants only, given that im nw7 with a karge head and fine hair, im not that optimistic.

What im talking about is just have a hairline + temples transplant and combine it with low density hair system. Im sure it will look great. 

What if you want to ditch the hair system eventually?

You’ll be left with this:

 

Before committing to surgery, try the full system. To see if you would like it. You might not like the maintenance, etc. You might be happier shaving. Do not take surgery lightly.

It’s a lifelong commitment, and so is medication. Any hairs that are improved with meds will be lost without them. Both on top and the donor. 

[Al - Moderator]

@NorwoodSeven Here is a case that's basically what you are talking about. The front is transplanted and the patient wears a hair piece behind it to get full coverage with a real hairline.

 

 

[mr_peanutbutter]

is there a shot of the crown in this one?

 

[Rahal Hair Transplant]

@NorwoodSeven,

There are cases of men with advanced baldness, even those as advanced as a Norwood class 7 restoring a relatively full, natural looking head of hair. Keep in mind that even in the best case scenarios, it will appear on the thinner side and the hairline will be very conservative. If you have enough donor hair and realistic expectations, you could certainly improve your appearance and confidence with surgical hair restoration in the right surgical hands.  just keep in mind that physician selection is vital to ensure optimal results and is even more important for men with very limited donor hair in comparison to the advanced, large area of baldness needed to be filled in so to speak.

it looks like a number of people have replied and shown you examples of what can be accomplished in the best of circumstances. I think your best bet is to research surgeons and then consult with a few that impress you the most in order to narrow down your selection and select the best doctor for you.

I’m certainly willing to speak with you more personally if you’re interested in a one on one information session with Dr. Rahal.  I think it would also be helpful if you presented photos either here or sent them to me privately if you’d like more personal input on your case.

I hope this helps 

Rahal Hair Transplant 

[shiba1985]

On 1/27/2023 at 5:46 AM, NorwoodSeven said:

Wow, that's huge experience, what made those last 10 years hell after first 15 years of wearing? I wore a hair piece for 6 years (from 18 to 24) and was overall happy with it, except the fact that i wanted to wear my hair combed back but had to comb it down to hide the lace. I didn't hate wearing, i just stopped it spontaneously and went for shaved look with smp. Anyway if i have a ht for my front and temples and eventually will hate wearing a hairpiece i will just shave it and go back to a clean shaven smp look which im rocking now. Fue scars won't be too noticeable and i might smp them too.

Man, i think the same, ьy donor looks sparse because it is short in lenghth. Im back on fin now btw, i don't have much hope on regrowth on top or crown but i think it will make my donor hair thicker. 

 

Guys, i dont think i can pull off a full coverage with hair transplants only, given that im nw7 with a karge head and fine hair, im not that optimistic.

What im talking about is just have a hairline + temples transplant and combine it with low density hair system. Im sure it will look great. 

You should contact @drtaleb barghouti. He has experience with exactly what you are asking for. It is doable as long as you realize it’s a life long commitment.  
dr barghouti has a case posted somewhere that has a hair system in back and transplant in front 

[NorwoodSeven]

On 1/28/2023 at 5:47 PM, BeHappy said:

@NorwoodSeven Here is a case that's basically what you are talking about. The front is transplanted and the patient wears a hair piece behind it to get full coverage with a real hairline.

Yeah, i saw this case, it is interesting but unfortunately there are not many cases like that.

 

I started taking fin to improve my donor hair. Could you guys tell how much worse my donor is now compared to 15 years ago? The 2008 pic shows 9 days growth, the 2023 one shows 6 days growth. Is it worse by far? 

Below my donor hair in 2008 when grown out

 

 

 

[A_4_Archan]

@NorwoodSevenu r looking super cool with that bald look...why shud u risk the surgery..cause if u dont succeed thn u will be in a situation whr u wont be able to keep a bald look cause of the tiny scars on back...better embrace ur bald head..its jst my opinion...still if u wanna go for surgery u cn consult a good surgeon in person with ur hair grown and thn take decision 

[Melvin- Admin]

I know this is NOT what you want to hear. Getting surgery at this level is a SERIOUS financial commitment. The strategy of doing just the hairline is a bad idea IMO. 

Your donor has gotten worse. At 19 your lateral humps we’re still intact, now they’re visibly receding downward. At 34 they might continue. It’s very possible you end up like Jon Polito.

Hopefully not, but given your level of baldness at this age, definitely plan for that possibility in the future. I would give it at least 6-9 months to see how your donor improves on medication. But then also consider that you will need to stay on meds forever to keep that transplanted hair.
 

[Melvin- Admin]

On 1/28/2023 at 7:35 AM, mr_peanutbutter said:

is there a shot of the crown in this one?