How many grafts for NW 7

[Guest dude1]

How many grafts on average whould make a difference for an NW 6, bordering on a 7? My hair is fine, dark - I know, not the best as far as coverage goes. I'd be satisfied with a frontal forelock design.

 

Opinions would be appreciated.

[Dr. William Parsley]

dude 1

How old are you? If over 50, then it is possible that you are a candidate. If under 35, I would really be cautious. There are many factors that make a person a good candidate and you need to be evaluated. I also recommend getting several opinions and take very seriously an opinion for you to avoid transplantation- particularly if it comes from an experienced transplant doctor.

[Dr. Michael Beehner]

Dear Dude1,

From the description you give of your degree of hair loss, it sounds like there is probably a lot more bald (or thinning) scalp than there is donor hair area. In such cases it is important for the transplant surgeon to use a strategy that creates a natural-looking result that frames the face, but which is not wall-to-wall carpet of hair from one fringe to the other. In most such cases the rear "crown" (vertex) area is pretty much ignored, although at the last procedure I often will put a couple hundred 1-hair FU's in a sworl there for some natural cover and to serve as "tacking hairs" to help hold in place the hair up front which is styled toward the rear. The important thing is to create a gradient of density, such that the front-center of the scalp is the strongest (densest) area and creates that all-important "framing" of the face when you are looked at from the front by people you meet. Styling with this kind of pattern can be either side to side or, better, straight back or toward one of the two side corners (I like that of taking it back to the right rear corner best).

As to the number of grafts necessary, that depends most importantly on what your age is, since if you are in your 20's or early 30's, you have to assume you will get quite a bit more bald before you're through. It is probably better to talk about the number of HAIRS necessary, rather than grafts. The reason it is best to communicate about number of hairs, rather than grafts, is that many doctors, in addition to the majority of grafts being FU's, also use "combination" grafts to get density centrally, made up of 2-3 adjacent FU's. I find that most men need around 8,000-12,000 hairs to get a final result that looks relatively "full." Persons with coarse hair may look better with 8000 hairs than a man with fine hair looks with 12,000. With a forelock design, sometimes wonderful results can be achieved with 6000 or 8000 hairs. A lot depends on your hair characteristics, chiefly the caliber and color of your hair, and the density of your donor hair. I have seen near-Norwood VII patients who had incredibly dense donor hair without any characteristic thinning in the lower nape of the neck, where the hair often thins in middle age. In terms of FU's only, I would probably use 2000-2200 the first time, follow in 8 months or more with 1200-1500, and then step back for a year and see how things look, before deciding on further "touch-up" work.

Another thing about your individual situation that can make a big difference is the shape and size of your head. Some men with a Norwood VI have a very wide head, and the distance from one fringe to the other fringe side can be a lot further than in a narrow head with a more elongated facial structure. This can make a big difference in the square area of scalp that requires coverage.

As you probably know by now, in reading these boards, each doctor has his own philosophy of transplanting. It is important to communicate with several, so that you match up with the one you feel comfortable with.

Mike Beehner, M.D.

[Guest]

When Dr. Beehner says 8000-12000 hairs for a look that's relatively full, what about guys who would be satisfied with just a light sprinkling? How would doctors approach this situation? Would they be easier to work with because of their lower expectations/goals?