Nw 6 transplants

[Recession1]

I have always been confused on strategy for nw 6 transplant patients. Let’s say someone has 6,000 grafts to work with. It seems like most guys try to spread grafts and coverage out all over the top of the head and in my opinion are left with wispy thin results and they would look better if they just shaved their head instead. Why wouldn’t one get aggressive with the hairline and dense pack at the hairline and create great coverage of 4,000 grafts in the front half and then just use 2,000 grafts towards the crown to give a thinning crown look. In your late 30s onwards it would look much better to have a really solid hairline with great density in the front half and just a thinning crown as opposed to sparse hair everywhere. Everybody says to go conservative on hairline but in my opinion I would rather have aggressive hairline and dense front half as this is what frames your face. Anybody agree or look at this differently. 

[BackFromTheBrink]

I had 3100 grafts as a Norwood 5 and spread it with decreasing density towards the crown. I guess that's the equivalent of what you're suggesting, though ultimately it'll depend on what the ultimate goal of the patient is - density or coverage.

[A_4_Archan]

@Recession1

This is a subjective thing and there will be varying opinions on this though i did the same thing what you have mentioned...i didn't go over the board in lowering my hairline ,i kept it at a natural and reasonable height but i have made the frontal portion and the mid portion dense packed and now when i will go for a 2nd session for my crown area i will use some scalp plus beard hairs and will do an average density work there...

[Turkhair]

I don’t know what other people’s goals are with their hair transplants but mine was simple. To get my youthful looks back that were robbed of me.

When I first started balding noticing too many hairs falling after shower almost a decade ago, someone advised me to shave my head; it would help and new thick hairs would grow. When I told my barber to shave my head, he asked me twice to confirm he heard me correctly 😂 When he was done and I saw myself in the mirror, I was horrified. What ugly creature is staring back at me, it can’t be me…no!. I couldn’t get out of my room for months and I avoided friends and family rubbing essential oils on my head and trying everything for hairs to grow back ASAP! 

Hairs give impression of youth. Shaved head looks old and not really great. All my friends who are NW0 since childhood have not shaved their heads once now well into their 30s, they try different hairstyles but shaved head is never one of that, they’re terrified of it.

 

[Gatsby]

9 hours ago, Recession1 said:

I have always been confused on strategy for nw 6 transplant patients. Let’s say someone has 6,000 grafts to work with. It seems like most guys try to spread grafts and coverage out all over the top of the head and in my opinion are left with wispy thin results and they would look better if they just shaved their head instead. Why wouldn’t one get aggressive with the hairline and dense pack at the hairline and create great coverage of 4,000 grafts in the front half and then just use 2,000 grafts towards the crown to give a thinning crown look. In your late 30s onwards it would look much better to have a really solid hairline with great density in the front half and just a thinning crown as opposed to sparse hair everywhere. Everybody says to go conservative on hairline but in my opinion I would rather have aggressive hairline and dense front half as this is what frames your face. Anybody agree or look at this differently. 

I don't know your age but trust me and others on this. You will care about your hair as much as you do at 30, 40, 50, 60 as you did at 20. The only difference is that you will have a lot more wisdom and acceptance from experience.

[Doron Harati]

Every case is individual, at HDC we do giga sessions of 5000-7000 grafts if the donor is strong.

Aggressive youthful hairline can be done, but in some cases you'll need to do the crown separately even after having a giga session, conservative hairlines can save 1000+ grafts, also some candidates prefer that aesthetic, and some can have full coverage with agressive hairlines, all depending on your properties.

[Recession1]

How many grafts do you think I have available? 

[Hairwise1]

You have available over 10,000 grafts.

But what does NW class 6 has to do with your case?

[Recession1]

My dad is NW 6 and his dad is a NW 6  I may develop that pattern one day. You think I really have that many grafts available? 

[Turkhair]

39 minutes ago, Recession1 said:

My dad is NW 6 and his dad is a NW 6  I may develop that pattern one day. You think I really have that many grafts available? 

When you become NW6, this isn’t going to be your donor. Your donor will also become NW6. 

But you’re on two of the strongest hairloss medications and responding well. You’re not heading to NW6 in this decade or even next 

[Melvin- Admin]

You wouldn't say the same thing if you were a Norwood 6. What matters to a Norwood 2 is entirely different than what matters to a Norwood 6. A low, thick hairline with a large empty hole behind it looks terrible. But most importantly, it doesn't look natural. You never see a pattern like that in nature. Every single person would be staring at your head, thinking, wtf is with this guy's hair. It would only call more attention to your baldness. It's like those women who get huge butts with tiny little stick legs. It's not a good look, and it looks artificial.

Also, you are nowhere near a Norwood 6, not even close. Your father's hair loss pattern is irrelevant. My father is a Norwood 2/3 at 66. I went fully bald before 30. I didn't follow his pattern. You don't always follow your father's pattern. You may have an uncle, grandfather, or even great-uncle whose pattern you will follow. 

If you're over 30 years old, your chances of becoming a Norwood 6 are low. If you're over 35, they're really low. If you're over 40, the probability is like winning the lotto. 

Edited September 6, 2023 by Melvin- Moderator
Removed photo

[Britanium]

I don’t think posting the ladies pic is appropriate here, nor do I think you’re analogy is particularly relevant to this thread. From a outsiders perspective its body shaming the female, where in actual fact she looks pretty happy ! 

[Recession1]

Melvin, I’m not saying leave a hole behind the hairline. Let’s say you have 6,000 grafts available. Why not put 4000 to the front of your head and start with the hairline you want and then put the remaining 2000 grafts in the back half coupled with body hair if you can. Create solid front and then transition to thinning crown. My surgeon who you guys speak very highly of spoke to me about this. I expressed concerns of going to NW 6. He told me to be aggressive out of the gate where I want my hairline and then as I age and if I lose my crown I will have great front half transitioning into thinning back. It seems like a lot of guys have very conservative hairlines and then they just distribute grafts all over the head and never get good coverage and with that approach I think it looks better shaved than having a straggly thin transplant. Just my opinion!! 
 

Also as far as age of going to NW 6… while it seems most people reach NW 6 before 30 it definitely still is fairly common after 30. For example my dad was around NW 3-4 at 38 years old and went to NW 6 by the time he hit 45. I think many people have miniaturization in a NW 6 pattern even at 30-35 that don’t notice it and then in the next 10 years it gone. Also, without meds I would probably be NW 6 by now. I have been on finasteride since 24 and now take 2.5 oral Dutasteride and 5mg oral monxidil daily. I think that has stabilized my loss but I still have had some thinning in areas and my hair isn’t as dense as it was 2 years ago.  It just looks dense because it’s long now. I personally think genetics eventually over powers meds… I think with meds you are slowing process… and just “kicking the can down the road”… that’s why I always find it very odd that people say wait to get transplant until stabilization… it’s never stable unless you are 60. 

[Melvin- Admin]

53 minutes ago, Recession1 said:

Melvin, I’m not saying leave a hole behind the hairline. Let’s say you have 6,000 grafts available. Why not put 4000 to the front of your head and start with the hairline you want and then put the remaining 2000 grafts in the back half coupled with body hair if you can. Create solid front and then transition to thinning crown. My surgeon who you guys speak very highly of spoke to me about this. I expressed concerns of going to NW 6. He told me to be aggressive out of the gate where I want my hairline and then as I age and if I lose my crown I will have great front half transitioning into thinning back. It seems like a lot of guys have very conservative hairlines and then they just distribute grafts all over the head and never get good coverage and with that approach I think it looks better shaved than having a straggly thin transplant. Just my opinion!! 
 

Also as far as age of going to NW 6… while it seems most people reach NW 6 before 30 it definitely still is fairly common after 30. For example my dad was around NW 3-4 at 38 years old and went to NW 6 by the time he hit 45. I think many people have miniaturization in a NW 6 pattern even at 30-35 that don’t notice it and then in the next 10 years it gone. Also, without meds I would probably be NW 6 by now. I have been on finasteride since 24 and now take 2.5 oral Dutasteride and 5mg oral monxidil daily. I think that has stabilized my loss but I still have had some thinning in areas and my hair isn’t as dense as it was 2 years ago.  It just looks dense because it’s long now. I personally think genetics eventually over powers meds… I think with meds you are slowing process… and just “kicking the can down the road”… that’s why I always find it very odd that people say wait to get transplant until stabilization… it’s never stable unless you are 60. 

Trust me 2,000 grafts to cover the rest of a Norwood 6 scalp will leave a big empty hole. It’s a terrible idea, in my opinion. You could, however, transplant the hairline and use a hair system for the rest. Now that would look good aesthetically. 

As for your dad, I’m sure he had a diffuse pattern way before his 40s. If you truly were Norwood 6 genetics, you would have at least some miniaturization in the crown. A Norwood 6 person is extremely sensitive to DHT. Even dutasteride won’t stop thinning completely, it only slows it. You have no demarcations or diffusion. There would be some.

Like I said, why don’t you try shaving now. It would show you what your true pattern is, and also, let you know if it’s a look you could accept. In your mind, you’re envisioning something that may or may not be acceptable. But you can find out by doing it now. If you can’t accept it now with a full head of hair you won’t as a Norwood 6. 

[hairman22]

6 minutes ago, Melvin- Moderator said:

Trust me 2,000 grafts to cover the rest of a Norwood 6 scalp will leave a big empty hole. It’s a terrible idea, in my opinion. You could, however, transplant the hairline and use a hair system for the rest. Now that would look good aesthetically. 

As for your dad, I’m sure he had a diffuse pattern way before his 40s. If you truly were Norwood 6 genetics, you would have at least some miniaturization in the crown. A Norwood 6 person is extremely sensitive to DHT. Even dutasteride won’t stop thinning completely, it only slows it. You have no demarcations or diffusion. There would be some.

Like I said, why don’t you try shaving now. It would show you what your true pattern is, and also, let you know if it’s a look you could accept. In your mind, you’re envisioning something that may or may not be acceptable. But you can find out by doing it now. If you can’t accept it now with a full head of hair you won’t as a Norwood 6. 

Great idea to shave your head

Can help with planning for the future as it would show a potential NW pattern.

If I kept my hair long I would never have know about my potential NW5-6 in the future & i may have went for too low of a hairline.

[Recession1]

You don’t think I have a some diffuse thinning when my hair is wet here? 

[mr_peanutbutter]

if you are really interested you could also go to your doctor and check for miniaturized hairs

 

or you buy yourself one of these electronic portable microscopes that you can connect via bluetooth to your smartphone and check for yourself

 

the thing is you are on dut right? so your hairloss is on hold at the moment anyways

 

Edited September 7, 2023 by mr_peanutbutter

[Turkhair]

Hard to say. Everyone’s hairs looks a little thin when wet. 

 

[Melvin- Admin]

1 hour ago, Recession1 said:

You don’t think I have a some diffuse thinning when my hair is wet here? 

I do not see anything remotely close to a Norwood 6 pattern. But like I said, the only way to truly find out is to buzz your head. That will show whether you are Norwood 6 with diffuse loss, and whether your idea is something you’d want to do. Hypothetical and reality are two different things. But you’ll know for sure when you do it.

[Recession1]

One last question… let’s say I go in and they say i am NW 6 diffuse. Do you think I’m still okay to to do frontal third transplant… or is that risky and I should wait until I have further loss and get a little older… say around 40.

[Turkhair]

45 minutes ago, Recession1 said:

One last question… let’s say I go in and they say i am NW 6 diffuse. Do you think I’m still okay to to do frontal third transplant… or is that risky and I should wait until I have further loss and get a little older… say around 40.

If you’re going to be on medication, you can even lower your hairline. Go crazy

Nobody goes bald while on medication. 

If you intend to stop medication then yeah it’s better to wait out your final Norwood level and decide from there 

[Grouse]

29 minutes ago, Turkhair said:

If you’re going to be on medication, you can even lower your hairline. Go crazy

Nobody goes bald while on medication. 

If you intend to stop medication then yeah it’s better to wait out your final Norwood level and decide from there 

I've seen a lot of people continue to go bald with medication over time. Also, what happens if you get hit with side effects later?

[Turkhair]

1 hour ago, Grouse said:

I've seen a lot of people continue to go bald with medication over time. Also, what happens if you get hit with side effects later?

To become slick bald despite being on medication….sucks for them I guess 🤷‍♀️

 

 

[Melvin- Admin]

5 hours ago, Grouse said:

I've seen a lot of people continue to go bald with medication over time. Also, what happens if you get hit with side effects later?

These patients are usually Norwood 6/7 genetics. That because of high sensitivity to DHT, even a small amount. That’s why OP isn’t likely to be anywhere close to a Norwood 6. 

[Grouse]

Sure, wasn't necessarily referring to OP. Was speaking more generally - have seen and heard of cases where people continue to lose hair even on finasteride over time. OP seems like he'll be just fine, but I'm not a doctor