# Hair Transplants > Hair Transplant: Start Your Own Topic >  NORWOOD 6 members who have had HT surgery

## Artista

My hair loss friends, 
I have started this thread to create attention to what HT surgery MAY do for NW6 sufferers and us all.  Joe from Staten claims that a NW 6 can NEVER get  feasible coverage from a HT(s) 
I personally know someone who WAS a NW6, had HTs adding up to over 8,000 grafts (Hasson and Wong) and NO LONGER SUFFERS! 
He is VERY HAPPY with his scalp to this day and it has been approx  6 years ago that he had his last session. 
Any of you members that had lost a significant amount of hair  and have had HT surgery..could you PLEASE comment here on the outcomes and possibly add photos too?
I am certain that there are many people who have had a successful HT or HTs  and then moved on with their lives never returning back to here..but there must be a &#37; of members who would still  come here to share and to help others that are suffering.
I would really appreciate all of your comments now..it would really help those that have no faith in having HT surgery. THANK YOU  :Smile:

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## fred970

I'm a NW5 going on 6 apparently after examination by Dr. Bisanga in Brussels and I'm gonna take the plunge in six months.

My first FUE is scheduled in february 2014 with Dr. De Reys. My case is special apparently as Bisanga said he didn't encounter people as worse off at my age (23) everyday.

I would also like to hear other success story of people recovering from the horror of true baldness (at a young age) through surgery. I'm sick of those "success stories" when you see people going from NW2 to NW1. Hair transplants should be for bald people, not 45 years old NW2's willing to risk their sexual health.

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## Artista

Hi Fred Thank you so much for starting off the comments With your Personal experience and upcoming Surgery!! I'm sure you're going to do okay My friend

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## Artista

Members,,please add to this thread , especially those that WERE *NW6*s -thank you

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## baldee

fred970, that's what Bisanga told me as well. I too was 23 at the time. I'm still a norwood 6.  :Frown:

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## newstart

I was a NW6, I had my session with Dr. Wong on June 6th 2013. 4500 Grafts. 
I'm just shy of 3 months & so far so Good.

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## UK_

> I was a NW6, I had my session with Dr. Wong on June 6th 2013. 4500 Grafts. 
> I'm just shy of 3 months & so far so Good.


 Man I cant wait for the day we hear more posts like this:

"I _was_ a NW6"... "I _used to be_ a NW4"....

I really hope to God we get a better treatment in the next 2 years.

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## 35YrsAfter

> My hair loss friends, 
> I have started this thread to create attention to what HT surgery MAY do for NW6 sufferers and us all.  Joe from Staten claims that a NW 6 can NEVER get  feasible coverage from a HT(s)


 Even the best hair transplant result on a Norwood 6 won't be sporting hair parted down the middle.  I remember a while back "Bobman" posted his result which is spectacular in my opinion, but refused a poster's request to provide a straight-on photo of the top of his head in the sunlight.

There is simply not enough scalp donor hair available to restore a Norwood 6 to a teen or pre-teen state.  The best results on a Norwood 6 are the result of great donor characteristics, a top doctor of course and careful styling.  Most Norwood sixes are OK with an illusion of coverage.  When you are young expectations are much higher.

I would personally be happy with a clean donor and the hint of a natural looking high hairline.  I would wear my hair very short if I could. ReCell spray-on skin shows promise for scarred donor areas but it's not available yet in the US.  Things are moving in a positive direction, but far too slow for most of us.

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## Jotronic

Bobman did not "refuse" anything, at least not in the context that he was hiding something. Bobman has posted more photos of his head than most other online patients and by the time he posted the photos in the thread you reference he was pretty much done with the photo taking routine. He's given back to the community a hundred fold and wasn't going to be called out by a newbie. He paid his dues already. 

And why is a part down the middle required? Who wears this style nowadays anyway? It is 2013, not 1978, and middle parts look silly on anyone without long hair. I find this point to be useless as even Bobman answered his critic by happily saying that his result was not full density and it was never intended to be. This is a numbers game and the numbers do not add up for full density. 

Btw, here is a video of Bobman getting unrehearsed reactions to his hair transplant and the final reaction is outdoors and you can see that it is not full density. The point of having a hair transplant as a NW6 is to get back as much as possible so you can have options and if one of those options is the ILLUSION of a full head of hair in some circumstances then so be it.

https://www.youtube.com/watch?v=43Pv...34A9A99D96A284

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## Jotronic

Oh yeah, forgot to mention. My name is Joe and I too was a NW6 (6.5 almost 7).

Check it... www.hairtransplantmentor.com

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## Artista

Jotronic, I am so APPRECIATIVE of your comments made today, THANK YOU Bro! As you had mentioned,   Bobman did not expect to achieve a full head of hair . He had  hoped for a realistic IMPROVEMENT to his scalp after surgery and he got it! It is POSSIBLE for NW6' guys!  Joe and Bob are just 2 of so MANY others who have experienced the same coverage via HTs.  Hopefully more members will share their experiences here .. ! :Smile:

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## 35YrsAfter

> Bobman did not "refuse" anything, at least not in the context that he was hiding something. Bobman has posted more photos of his head than most other online patients and by the time he posted the photos in the thread you reference he was pretty much done with the photo taking routine. He's given back to the community a hundred fold and wasn't going to be called out by a newbie. He paid his dues already. 
> 
> And why is a part down the middle required? Who wears this style nowadays anyway? It is 2013, not 1978, and middle parts look silly on anyone without long hair. I find this point to be useless as even Bobman answered his critic by happily saying that his result was not full density and it was never intended to be. This is a numbers game and the numbers do not add up for full density. 
> 
> Btw, here is a video of Bobman getting unrehearsed reactions to his hair transplant and the final reaction is outdoors and you can see that it is not full density. The point of having a hair transplant as a NW6 is to get back as much as possible so you can have options and if one of those options is the ILLUSION of a full head of hair in some circumstances then so be it.
> 
> https://www.youtube.com/watch?v=43Pv...34A9A99D96A284


 I'm simply stating the limitations of hair transplant surgery.  On average a patient has between 5000 and 7000 follicular units available for transplant to the top.  When this person was a teenager, he may have had 25,000 follicular units on top.  Replacing all of that hair is simply not possible, so any great result that a Norwood 6 gets from hair transplant surgery represents an illusion of coverage.  In other words, it's not going to look like a teenage head of hair in certain lighting and styling situations. 

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
Please feel free to call or email me with any questions.

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## Artista

Jotronic, I just got finished watching the video. What a great example to show  everybody out there on our forum! The spontaneous reactions by those  people interviewed are priceless-Thanks again Jotronic.   When I first met Bobman I didn't expect his hair transplants To look as good and natural as it does .  In person I certainly was impressed!!

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## Jotronic

> I'm simply stating the limitations of hair transplant surgery.  On average a patient has between 5000 and 7000 follicular units available for transplant to the top.  When this person was a teenager, he may have had 25,000 follicular units on top.  Replacing all of that hair is simply not possible, so any great result that a Norwood 6 gets from hair transplant surgery represents an illusion of coverage.  In other words, it's not going to look like a teenage head of hair in certain lighting and styling situations. 
> 
> 35YrsAfter also posts as CITNews and works at Dr. Cole's office
> Cole Hair Transplant
> 1045 Powers Place
> Alpharetta, Georgia 30009
> Phone 678-566-1011
> Please feel free to call or email me with any questions.


 Then why not reference one of your own patients? I mean, you referenced Bobman as a great result (appreciated) but then go on to talk about how he refused to show his result in a specific angle in bright sunlight. Was that even necessary? 

And there is no illusion of coverage. That is a misconception. Coverage is coverage, period. The illusion you get when an HT is done right is one of density.

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## Jotronic

Artista,

Glad to participate and glad you liked the video. It was a lot of fun. We shot it several years ago. We need to find time to do more like this. I've got sooo many ideas yet not enough time to bring them to fruition :Frown: 

Btw, TBT is live tonight and I'm on again as co-host.

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## John P. Cole, MD

jotroic, as a life long strip monger, i'm not surprised that you refuse to recognize that there is something called the illusion of coverage.  i guess that when you perpetuate the myth that strips in your hands don't leave disgusting, ugly scars, you can also perpetuate the concept that "coverage is coverage" and obviously erroneous myth you spread for years that strips produce better results than FUE.  in fact, it is possible to cover the entire scalp with a single hair that is grown long enough.  that is not coverage, however.  that is an illusion of coverage.  

you may refuse to face the fact there there is rarely enough hair to give the illusion of coverage in a nw 5 and never enough hair to give the illusion of coverage in a nw 6, but his is the simple God's truth.  one is never going to cover 225 to 250 sq. cm of bald skin with 5000 to 7000 follicular groups.  it is simply mathematically impossible.  now, i know you guys sometimes do 5000 grafts in one session and then do more, but you fail to explain that you typically split the natural follicular groups into smaller segments so that you actually place the same follicular group more than once and then bill double or three times for that same group.  

i'm no fan of discussing any specific patient whose had a hair transplant.  i also, have no taste in my mouth for salesmen that pick guys who are just trying explain their perspective of hair transplant surgery.  Since you did it, i'll be frank.  there is something quite different from a photo result and a real result and you are a master of the photo result.  that my friend is also called an illusion of coverage.

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## didi

wow..I didn't know H&W splits FUs too? at least he is not calling it stem cell hair transplant :Smile: 

Jotronic

You said in TBT radio show that average NW6 can get 6000-8000 grafts, that's not bad for nw6 but I would have thought its a bit of a stretch.

anyway,if nw6 lost 25 000 units...6000-8000 grafts will look too thin under sunlight, lets not full ourselves its illusion of density not real coverage

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## Jotronic

Wow, Camp Cole coming out swinging and for no reason at all. Let's get something straight. When I say that there is no such thing as an illusion of coverage, I'm talking about what we see with out eyes. Having enough hair transplanted to cover the scalp with a moderate and conservative hair style is not an illusion. My own coverage is not an illusion because my hair covers my scalp. I do not grow it super long to cover it either. It is clean, short on the back and sides, and a few inches long on top. I have enough hair to allow for real coverage. I do not have enough hair for real density. Seems to me that our definitions are complete polar opposites. 

I'm not sure what nerve I touched on but it seems to be one that you feel warrants a flurry of insults and bold faced lies. That's fine, I'm used to it. The one thing I've learned over the years is that when one hasn't anything tangible to say they tend to throw what they can against the barn door to see what sticks. 

Didi,

LOL! I think if we split FU's we could sell that quite easily as stem cell multiplication. We will mix in PRP, Acell, RU then stick a 9 volt battery in and let it sit overnight. If we're lucky, we may even get 70&#37; regeneration!!!! Whaddyathink?

Monger out!

And I stand by my statement. Remember, it is a range of grafts, 6000 being on the low end of average with "average" meaning average donor density and average donor laxity. I've seen guys that can't get past 5000 and of course I've seen guys that get way more than 8000. It is difficult to nail down but it is what it is, an average if not a loose one.

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## Artista

Unfortunately I'm working this evening and won't be able to attend the Live show ! It seems that this discussion will transfer to the show.. Hope there isn't any hostilities. We are all in this together

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## Follicle Death Row

Wow, surprised at the hostility in this thread especially as H&W have the most extensive hd video catalogue of Norwood 5 & 6 restorations with comb throughs.

Still amazed how people bash FUT. Both techniques have their places.

FUT will produce more grafts in the long run than FUE
FUT enables the best hair to be taken (if you don't know why read up on variable areas of donor density, donor thinning & miniturisation as well as retrograde alopecia)
With each FUT procedure 5-10&#37; of follicles end up in the waste bucket because they are dormant and not hair producing at the time of the procedure
FUE allows cherry picking of grafts for a higher hair to follicle ratio for the first 2000-3000 follicles
FUE will generally allow tighter haircuts
Open for debate where we stand on yield for the 2 techniques in 2013

Both have advantages & disadvantages.

If you're a Norwood 6 it's quite feasible for many to get 8000-9000 FU over 3 procedures. It's also likely that you can get 1500-2000 more via FUE on top of that. That puts many people in the region of 9500-10500 maxed out. The average Norwood 6 will have to tackle 240cm2 of bald scalp but it varies depending on the size of your head.

We're born with about 45000 follicles and a Norwood 6 will lose about 22-23000 follicles. That leaves about 22000 in a Norwood 6 donor and we are getting close to taking half of that these days. 10,000 over 240 cm2 will give an average density of 41.66 Fu/cm2. Of course you'll lose a tiny % yield wise.

Of course if you put 4200 in the rear half and 5800 in the front half you're looking at approx 48fu/cm2 in the front half and 35fu/cm2. For most people that will make them very happy but it's a long road.

Ever tempted to tap into FUE Joe?

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## Follicle Death Row

> On average a patient has between 5000 and 7000 follicular units available for transplant to the top.  When this person was a teenager, he may have had 25,000 follicular units on top. 
> 
> 35YrsAfter also posts as CITNews and works at Dr. Cole's office
> Cole Hair Transplant
> 1045 Powers Place
> Alpharetta, Georgia 30009
> Phone 678-566-1011
> Please feel free to call or email me with any questions.


 I presume you mean 5000-7000 via FUE. I've heard from multiple surgeons that 8000-9000 are available via FUT.

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## Dan26

Lets be honest anyone who gets an FUT nowadays is a certified bozo...

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## fred970

I'm getting my first FUE in 5 months but it's because I want to be able to buzz my hair, and because I have the money for it, oh and I almost forgot, I don't want an ugly ass scar at the back of my head.

But I understand why people would opt for FUT if they're short on money and if they're are absolutely sure they will not be forced to shave their head in the future.

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## UK_

> I'm getting my first FUE in 5 months but it's because I want to be able to buzz my hair, and because I have the money for it, oh and I almost forgot, I don't want an ugly ass scar at the back of my head.
> 
> But I understand why people would opt for FUT if they're short on money and if they're are absolutely sure they will not be forced to shave their head in the future.


 FUE is a no brainer really, a linear scar will only cause you to get FUE in the future to cover it up when you decide you want to shave.

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## Tracy C

> Lets be honest anyone who gets an FUT nowadays is a certified bozo...


 That is not true.  Both FUE and FUT each have their place.  For some people FUT is the better option.  There are more factors involved than you realize.

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## PayDay

I have to say that Dr. Cole is making himself look not so great. There is no question that FUT or "strip" is a great option for so many people and H&W present the best results on the internet.  Dr. Cole's post here  looks extremely self serving. Anyone who believes that FUT is outdated in anyway does not understand hair transplantation. I'm totally turned off  to Cole by this!

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## baldymcgee

> I have to say that Dr. Cole is making himself look not so great. There is no question that FUT or "strip" is a great option for so many people and H&W present the best results on the internet.  Dr. Cole's post here  looks extremely self serving. Anyone who believes that FUT is outdated in anyway does not understand hair transplantation. I'm totally turned off  to Cole by this!


 I'm torn on this, Spencer himself discourages young transplant patients from getting FUT (he says that FUT people should wait until they are at least 35 so they know what hairstyles they will want be happy with for the rest of their lives). But there's no doubt that FUT is cheaper, allows for larger sessions, and has a higher yield.

On the whole Norwood 6 question, Joe (bless him) has been very honest in the past when he has said that his result (and presumably Bobman's result) is not typical and that high norwood patients cannot go into the HT process expecting to have the same result. I suppose that's where it becomes important to talk to your surgeon to get a good idea of what (and isn't) possible FOR YOU.

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## Artista

> I was a NW6, I had my session with Dr. Wong on June 6th 2013. 4500 Grafts. 
> I'm just shy of 3 months & so far so Good.


 Hi *Newstart*, Once again, Thank you for commenting! 
Please stick with this thread as your HT progresses and *good luck to you. *

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## chrisdav

I believe Dr Cole is a talented surgeon and he is one of several whom have helped propel the field forward enabling it to make great strides in recent times.

However, I feel these regular outbursts are completely unprofessional and should not be coming from someone in his high position in the industry.

I have a huge amount of respect for Joetronic. He is an exceptionally knowledgeable, honest and a transparent guy who gives great advice. I do find it hard to criticise H & W when they are the only clinic that has hundreds of before and after photos & videos in HD which NO other clinic does.

Regarding the two procedures, they both have their positive & negative components and hence why they both have a place in the industry as every patient's situation is unique. A good surgeon that performs both procedures will confirm that.

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## Artista

> That is not true.  Both FUE and FUT each have their place.  For some people FUT is the better option.  There are more factors involved than you realize.


 *Tracy* is very much *correct.    
*

So is* Chrisdav,* Thanks Chrisdav Your using  nothing but* logic* !

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## 35YrsAfter

> Then why not reference one of your own patients? I mean, you referenced Bobman as a great result (appreciated) but then go on to talk about how he refused to show his result in a specific angle in bright sunlight. Was that even necessary? 
> 
> And there is no illusion of coverage. That is a misconception. Coverage is coverage, period. The illusion you get when an HT is done right is one of density.


 Let's say a Norwood 6 patient has 7,000 follicular units with a 2.6 hair average per follicular unit.  That's 18,200 individual hairs available for transplant to the bald Norwood 6 area.  65,000 hairs is an average and reasonable estimate a Norwood 6 could have had in his bald area before there was any hair loss.  18,200 is 28% of the original 65,000 hairs.  The concept of illusion of coverage should become obvious when you consider the math.

The following is a photo of our patient who had 3007 grafts placed.  The photo was taken in the sun and with styling, the illusion of coverage is created.  Neither FUE or FUT is the perfect solution to MPB.  People in the forums speak of FUE and FUT as if there were some product consistency like buying a car.  For instance, you buy a Chevy Volt in Washington state and it's going to be the same car you buy off a lot in North Carolina.  This principle is not a wise mindset for a prospective patient to have when it comes to FUT and FUE.  Check out the doctor's work before diving in.  BTW, I just recommended our patient go see Dr. Wong for a scar revision.  Our patient asked me about ACell and wants the doctor who does the scar revision to use ACell.  There were alternatives, but I recommended our patient see Dr. Wong even if he doesn't agree or see value in using ACell.  I have a history of being complimentary of H&W results in the forum when I think it's appropriate, but I'm not willing to venture into used car salesman territory, jumping on the bandwagon perpetuating myths that a 2013 technology hair transplant will give a Norwood 6 his full head of hair back.  Dive in the lake, the hair parts down the middle and the 9,000 graft Norwood 6 is going to look thin on top.  Under windy conditions the 9,000 graft Norwood 6 might wish he had given his hair an extra shot of super hold hairspray.
Regarding jabs at ACell and PRP, if you feel strongly they are ineffective, you should contact the FDA and question their approval of ACell as a regenerative product.  Also you might consider contacting Emory Hospital and University because they administer, teach, and promote the healing properties of PRP.

Again, here is our patient with a 3007-graft illusion of coverage as you requested.  You may have heard the term "Steve Jobs reality distortion field".  Bobman got a great result, on the other hand, reality distortion fields are not in the best interest of young men seeking a solution to their hair loss.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
www.forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions.  Ask for Chuck

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## didi

> Let's say a Norwood 6 patient has 7,000 follicular units with a 2.6 hair average per follicular unit.  That's 18,200 individual hairs available for transplant to the bald Norwood 6 area.  65,000 hairs is an average and reasonable estimate a Norwood 6 could have had in his bald area before there was any hair loss.  18,200 is 28&#37; of the original 65,000 hairs.  The concept of illusion of coverage should become obvious when you consider the math.
> 
> The following is a photo of our patient who had 3007 grafts placed.  The photo was taken in the sun and with styling, the illusion of coverage is created.  Neither FUE or FUT is the perfect solution to MPB.  People in the forums speak of FUE and FUT as if there were some product consistency like buying a car.  For instance, you buy a Chevy Volt in Washington state and it's going to be the same car you buy off a lot in North Carolina.  This principle is not a wise mindset for a prospective patient to have when it comes to FUT and FUE.  Check out the doctor's work before diving in.  BTW, I just recommended our patient go see Dr. Wong for a scar revision.  Our patient asked me about ACell and wants the doctor who does the scar revision to use ACell.  There were alternatives, but I recommended our patient see Dr. Wong even if he doesn't agree or see value in using ACell.  I have a history of being complimentary of H&W results in the forum when I think it's appropriate, but I'm not willing to venture into used car salesman territory, jumping on the bandwagon perpetuating myths that a 2013 technology hair transplant will give a Norwood 6 his full head of hair back.  Dive in the lake, the hair parts down the middle and the 9,000 graft Norwood 6 is going to look thin on top.  Under windy conditions the 9,000 graft Norwood 6 might wish he had given his hair an extra shot of super hold hairspray.
> Regarding jabs at ACell and PRP, if you feel strongly they are ineffective, you should contact the FDA and question their approval of ACell as a regenerative product.  Also you might consider contacting Emory Hospital and University because they administer, teach, and promote the healing properties of PRP.
> 
> Again, here is our patient with a 3007-graft illusion of coverage as you requested.  You may have heard the term "Steve Jobs reality distortion field".  Bobman got a great result, on the other hand, reality distortion fields are not in the best interest of young men seeking a solution to their hair loss.
> 
> 35YrsAfter also posts as CITNews and works at Dr. Cole's office
> www.forhair.com
> ...


 

Looking at the above numbers its pointless for most NW6s to have traditional HT...28% of original density is too thin and that's if guy is lucky to have 7000 grafts available..I always wonder what would this person look like under sunlight without hair sprays and makeup :Confused: .

We desperately need donor regeneration in order to solve high NWs


_35YrsAfter 

"Dr. Cole has been exchanging emails with Dr. Nigam and recently requested more information about his research related to his claim of 100% regeneration.
 Dr. Nigam may be on to something. Dr. Cole has an open mind and will check this out."_



Any update on this?

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## 35YrsAfter

> Looking at the above numbers its pointless for most NW6s to have traditional HT...28&#37; of original density is too thin and that's if guy is lucky to have 7000 grafts available..I always wonder what would this person look like under sunlight without hair sprays and makeup.
> 
> We desperately need donor regeneration in order to solve high NWs
> 
> 
> _35YrsAfter 
> 
> "Dr. Cole has been exchanging emails with Dr. Nigam and recently requested more information about his research related to his claim of 100% regeneration.
>  Dr. Nigam may be on to something. Dr. Cole has an open mind and will check this out."_
> ...


 Here is an example of our Norwood 6 patient who received a little over 6,000 grafts.  In my opinion his appearance from the front and sides is dramatically improved.  Many younger people have standards that are not reachable for advanced Norwood patients.  When I was 18 for instance a thinning spot on a man's head the size of a silver dollar was completely unacceptable.  My expectations changed when I got older.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
www.forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions.  Ask for Chuck

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## Dan26

> That is not true.  Both FUE and FUT each have their place.  For some people FUT is the better option.  There are more factors involved than you realize.


 Fair enough. I'm bein a bit of a ball breaker tbh. I would never want to keep my sides long personally (or my entire head of hair), unless I had great density. Not a fan of oldman hair, even if it is nw1-2, I see a lot of middle aged guys walkin around that I believe would be better served with shorter cleaner hair styles.

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## topcat

The illusion of density for those with extensive hairloss in my opinion outside of hair characteristics really comes down to placement. That small band about 3-4 cm behind the hairline really needs to be where most  of the hair should be placed with it being much thinner in the hairline and crown at least this is my opinion and it seems many good clinics plan the same way. I think these young guys that go for the super density in the hairline are making a very big mistake but they are also very hard to convince. Even in my own situation the hairline probably has more than enough hair its that band behind the hairline that gives the illusion.

Note Oliver Stones photo here with different lighting. That second photo, the illusion is lost due to poor lighting but if that band behind the hairline had more density it is quite possible the illusion would still hold up even in that lighting and you would not have the tell tale see though look of the hair transplant.

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## DesperateOne

Artists I am sick of you hiding the cure from us, stop it already!!

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## 3rd time

I began as a nw6 at 28 years old. In the past 6 years i have had three HT's. All up about 7500 grafts. The above picture of Oliver stone was roughly what I was able to achieve. Unfortunately I was only able to cover the crown with very little hair. 

The main problem for me is that I have no idea what the future will hold. Im in my early 30s I have a depleted donor and I cannot tolerate propecia even at very small doses. I'm so upset about this because it does wonders for keeping your native hair.

Through the whole process I can't say that so far I have been overjoyed with my results. I went to a very trusted doc who has a lot of respect from his peers and clients. My hair is dark and skin fairly pale so that doesn't help with the illusion of density. This doc gave me a terrible hairline and truly believe he could have utlilized the grafts in a better way.

My hair loss has continued to progress. This third procedure was done by a new Doc less than a month ago. The plan was to rejoin the side hair with the transplanted hair on the top. My native hair on the sides continued to recede and left the HT looking like an island of hair. This needed to be addressed. Also to add some density to the front hair line. Turned out to be a very long procedure due to popping and hoping I have no problems with yield. Finger crossed.

Currently under any type of harsh light I have no hair line. It just looks like a see through mess. I'm really hoping this third HT grows and gives me a hairline.
I can only style my hair one way. That is, slicking it all back and using that method to cover some crown. I use concealers and will probably continue to do so. Just not enough density in the crown.

I'm a very bad example of a hair transplant candidate. However, once you start this journey you really can't go back... In the future if I do need more work I will look at FUE BHT and PRP.

I remember reading jotronics posts and seeing both his and bobmans results and thinking wow!!!!! Unfortunately my baldness was a lot more aggressive and got no where near the results they got. No propecia = more balding for me.

So for those guys that are young and have aggressive baldness my advice is;
1. Get on propecia if you can. If you get side effects then try experimenting with a smaller dosage (speak to your HT doc) and hope your body can tolerate it. You need to halt future loss.
2. Go for a conservative approach. Make sure your doc uses your grafts wisely. Meaning, add density behind the hairline where it's needed so you get less of that see through effect. I think you will still get that ugly see through look under certain lighting. However, if you can minimize that you've done well.
3. Research your doc and be very specific as to what you want. You will have to make choices because your grafts will be limited so if a thin crown doesn't bother you then you can achieve something decent.
4. Concealers may be needed if you want to cover most of the crown.
5. Fancy hair styles are not an option. A simple slick back style will get you the most coverage.
6. If the crown bothers you, speak to your doctor about a partial crown restoration and use that hair to cover the bald area.
7. Take photos to see your results. As spex says, hair greed will occur and you will want more and more hair. 
8.Fix your hairline before you do anything else. After all that's the most important part. 

When I look back at how I was as a nw6 to where I am now its a big difference. Am I 100% happy with my results? No. BUT I do look better, people that knew me before have said the same thing, im more confident and happier.

Anyway I hope this helps. Good luck and be prepared for a long journey. Take care.

----------


## 3rd time

Topcat

Great post. And excellent advice.

----------


## 35YrsAfter

> Fair enough. I'm bein a bit of a ball breaker tbh. I would never want to keep my sides long personally (or my entire head of hair), unless I had great density. Not a fan of oldman hair, even if it is nw1-2, I see a lot of middle aged guys walkin around that I believe would be better served with shorter cleaner hair styles.


 It's interesting how styles have transformed over the years.  When I was a teenager and in my 20s, the popular short haircuts today would have been considered "oldman hair".  I prefer today's styles BTW.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
www.forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions.  Ask for Chuck

----------


## 35YrsAfter

> I began as a nw6 at 28 years old. In the past 6 years i have had three HT's. All up about 7500 grafts. The above picture of Oliver stone was roughly what I was able to achieve. Unfortunately I was only able to cover the crown with very little hair. 
> 
> The main problem for me is that I have no idea what the future will hold. Im in my early 30s I have a depleted donor and I cannot tolerate propecia even at very small doses. I'm so upset about this because it does wonders for keeping your native hair.
> 
> Through the whole process I can't say that so far I have been overjoyed with my results. I went to a very trusted doc who has a lot of respect from his peers and clients. My hair is dark and skin fairly pale so that doesn't help with the illusion of density. This doc gave me a terrible hairline and truly believe he could have utlilized the grafts in a better way.
> 
> My hair loss has continued to progress. This third procedure was done by a new Doc less than a month ago. The plan was to rejoin the side hair with the transplanted hair on the top. My native hair on the sides continued to recede and left the HT looking like an island of hair. This needed to be addressed. Also to add some density to the front hair line. Turned out to be a very long procedure due to popping and hoping I have no problems with yield. Finger crossed.
> 
> Currently under any type of harsh light I have no hair line. It just looks like a see through mess. I'm really hoping this third HT grows and gives me a hairline.
> ...


 Excellent post. Have you tried Avodart (Dutasteride)?

35YrsAfter also posts as CITNews and works at Dr. Cole's office
www.forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
Please feel free to call or email me with any questions.  Ask for Chuck

----------


## fred970

If he already has sides with finasteride, how will switching to a more powerful inhibitor make a difference?

Anyway, great story 3rd time. I'm a NW5 with very aggressive hair loss for my age (23) and donor density slightly below average. I can't take finasteride either because I've already undergone gynecomastia surgery a year ago. 

I don't know what the outcome of my FUE's will be but my main goal is just to restore as much frontal part as possible. Maybe I'll add some dermmatch in the mix afterwards.

----------


## Dan26

> It's interesting how styles have transformed over the years.  When I was a teenager and in my 20s, the popular short haircuts today would have been considered "oldman hair".  I prefer today's styles BTW.
> 
> 35YrsAfter also posts as CITNews and works at Dr. Cole's office
> Cole Hair Transplant
> 1045 Powers Place
> Alpharetta, Georgia 30009
> Phone 678-566-1011
> Please feel free to call or email me with any questions.


 I just find that when hair has thinned a bit, it has a flat, brittle/dry +weak appearance when it is long and sitting atop a head like a mop. Even when my hair gets long it just looks brutal on the top but when i get it cut it appears thicker.

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## 3rd time

35yrsafter
I haven't tried avodart I was under the impression that it was stronger than finasteride? I figured if I could not tolerate fin not to try avodart. 
I am willing to try it if it would help.. I'm going to do some research on it. Thank you for the suggestion.

----------


## John P. Cole, MD

it's really interesting.  some individuals who had side effects to Propecia did not have them to Avodart.  You'd expect more with Avodart.  I prescribed it for years.  I never noted an increase in side effects with Avodart.  

A short hairstyle can make a person with fine hair appear to have more hair.  

I did a study over the past two years with cross sectional trichometry.  I studied donor areas in patients with no previous surgery, patients after FUE, and patients after strip surgery.  What I found was that the average virgin donor area was a 74.  After my version of FUE, the number dropped to 66.  After a similar number of grafts done by strip the number was 52.  

This number reflects the cross sectional surface area of a bundle of hair from 4 square cm.  What it means is that the surface area drops significantly more following a strip procedure than from a proportional number of FUE grafts, at least harvested my way.  

Why does this occur?  In a strip, we remove a section of tissue containing hair.  We then must close this void with the surrounding skin.  We now have to use the remaining hair to cover a larger portion of the scalp or the portion that was removed.  In that you have the remaining number of hair must now cover more surface area, the density is reduced.  The traditional safe donor area is about 203 sq cm.  Thus, if you remove 40 square cm, the remaining hair in the remaining 163 sq cm must now cover 203 sq cm of scalp.  The number of remaining hair is the same, but the surface area they must cover is larger.  The density goes down and so does the cross sectional trichometry.  

In FUE, the surface area remains the same or decreases.  Density is reduced by the removal of follicles.  The remaining follicles are not stretched out to cover a void, however so the cross sectional trichometry is reduced, but not as significantly was with a strip procedure.  

In a strip procedure, the remaining hair must also cover a scar.  This is why you cannot remove as many grafts via strip as with FUE.  With FUE, you can take more because you don't have to worry about covering a scar.  

Now guess where the cross sectional trichometry is reduced the most following a strip.  Is it above the strip scar or below the strip scar?  It is reduced more above the strip scar.  Which hair is more important to cover a strip scar?  Is it the hair above the strip or below the strip?  It's the hair above the strip unless you want to walk around on your hands.  Thus, where you need the hair the most is where the hair density is reduced the most following a strip procedure.  

As an example, I had a patient in today who had two strips done by a well known and well respected physician.  I think he does good work.  The patient had a CST of 42 above the scar and 56 below the scar.  What does this mean?  We can't harvest as much hair above the scar as we can below the scar even if we correct his 5 mm wide scar, which was his primary concern.  The area below the scar is the area prone to retrograde alopecia so even though we can harvest more hair here, the hair is more prone to loss over the next 10 to 20 years.  This is why I'm no fan of combining strips and FUE.  It's just better to do FUE from the beginning.

----------


## 3rd time

Dr Cole, thank you for this information its very interesting to read. I have had three strip HT and have noticed thinning around the nape of the neck making this hair unusable for future treatments. Both docs told me this hair was thinning. 
I always had thick hair around the donor area but not anymore. I can defintely say my hair has declined in quality after these three procedures and no meds to halt further losses.

I may have to try avodart as a last alternative.

Dr Cole
For someone like me who has basically depleted their donor do you think FUE would be an option? I was told by another Doctor it's not a good idea for me as it may do more damage than good.

----------


## 3rd time

Fred970
It seems like you are in a similar category to me. You are correct in wanting to get your front hair line looking good. Wish you luck with your final results.
Unfortunately if your crown is completely bald the concealers will not work well.
However, if you have a little hair in the crown you can use toppik and dermmatch very well. I also liked couvre but eventually I stopped using it because I hated the smell.
Toppik is good if you still have some hair as it makes exisiting hair look thicker but i found it came off very quickly. IMO if you have a party or wedding that is going to be inside then toppik is good. 
On the other hand if you have a big day ahead of you and you will be outside I would recommend dermmatch as it stays on for longer and in harsher weather.

----------


## didi

> Fred970
> It seems like you are in a similar category to me. You are correct in wanting to get your front hair line looking good. Wish you luck with your final results.
> Unfortunately if your crown is completely bald the concealers will not work well.
> However, if you have a little hair in the crown you can use toppik and dermmatch very well. I also liked couvre but eventually I stopped using it because I hated the smell.
> Toppik is good if you still have some hair as it makes exisiting hair look thicker but i found it came off very quickly. IMO if you have a party or wedding that is going to be inside then toppik is good. 
> On the other hand if you have a big day ahead of you and you will be outside I would recommend dermmatch as it stays on for longer and in harsher weather.


 

3rd time,

You said you had 7500 grafts and your crown is still completely bald and hairline is non existent under light and now you ran out donor?

Good number of grafts you had  for NW6 but as 35yrsafter pointed out it all comes down to math, simple math that is , you lost 25 000 units and 7500 will not cut it.

I would suggest you buzz cut your head down to .5cm to make it appear thicker but I think strip scars would be visible at that length.

This is why I think strip sucks on NW6s, what if you get stuck in the middle, poor coverage to grow hair out and cant shave due to strip scars.

----------


## fred970

> Fred970
> It seems like you are in a similar category to me. You are correct in wanting to get your front hair line looking good. Wish you luck with your final results.
> Unfortunately if your crown is completely bald the concealers will not work well.
> However, if you have a little hair in the crown you can use toppik and dermmatch very well. I also liked couvre but eventually I stopped using it because I hated the smell.
> Toppik is good if you still have some hair as it makes exisiting hair look thicker but i found it came off very quickly. IMO if you have a party or wedding that is going to be inside then toppik is good. 
> On the other hand if you have a big day ahead of you and you will be outside I would recommend dermmatch as it stays on for longer and in harsher weather.


 My crown is thin but still holding pretty well thanks to minoxidil. Thanks man, it's just so hard for me to find solutions. I was told I was too blond for a scalp micropigmentation, too bald for a HT (yeah apparently, hair transplants are not meant for bald people) and even to get a wig by a clinic in Belgium. How nice of them.

----------


## 35YrsAfter

> My crown is thin but still holding pretty well thanks to minoxidil. Thanks man, it's just so hard for me to find solutions. I was told I was too blond for a scalp micropigmentation, too bald for a HT (yeah apparently, hair transplants are not meant for bald people) and even to get a wig by a clinic in Belgium. How nice of them.


 We had a patient in yesterday in his 50s who was somewhere between a Norwood 5 and a 6.  He had never had any hair restoration surgery before and his donor was somewhat thin.  He had 2148 grafts placed in his frontal area to frame his face.  He had a shaven procedure and he looked great with his head shaved.  He has the perfect head for it.  I told him he looked great with his head shaved when he got our of surgery for photos and he looked at me like I was crazy.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant Atlanta
Phone 678-566-1011

----------


## 35YrsAfter

Our patient this morning came in for 2,000 grafts to his crown for added density.  I didn't think he had previous surgery because the work in his crown and frontal area was outstanding.  After I was finished taking photos, I asked our patient if he had any previous hair restoration surgery.  He answered, yes, he had a strip surgery.  At that point I asked him if he was happy with his strip scar.  He said he never paid any attention.  He wears his hair long and has plenty of donor hair to cover the scar.  I suggested we take some photos of his scar so he could decide whether he wanted Dr. Cole to place any grafts into it while he was here.  He told me he wanted to focus on his crown.  Our patient doesn't want to wear his hair short so the scar is not an issue.  A scar like this can be successfully repaired allowing a shorter haircut but as you can see, a scar 10mm wide will not work with shorter hair.

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## 3rd time

Didi, I will explain the best i can.
I had a big area to cover 209 square cm of measured bald area, the plan for the first HT was to transplant 4000 grafts in 114 sq cm approximately. I was told I had an average density of 38% The doc advised that if we went for a lower, square hairline we could not cover a decent area as too many grafts will be used to fill the temple and not enough for mid scalp. So we decided on a bell shape hairline. Hair was placed In a way where I got coverage but a very thin front hairline. Needed more work.
The second HT was about 3 years later. I had more hair loss (had to stop FIN as sides did not improve but got worse) The Doc said we would need to add more grafts to improve the front and rest in the crown. Ended up getting around 2000 grafts. This made a big improvement but again under bright light the front was not great.
(New Doc)Third HT which I had less than a month ago was about 1500 grafts. Reconnecting the hair transplant with native hair and adding some grafts behind the hairline to combat the see through look and more into the crown.
A lot of 1 hairs were placed at the front hairline in my first 2 HTs.The Doc said it looked more natural but the final result was a thin wispy hairline.  
With this last HT a lot of 3 hairs were placed behind the hairline for more density. The first Doc didn't really do this. 
Regarding the crown I did start with a completely bald crown as a Nw6 but grafts were added there just enough to give me a little coverage. I still use concealers for crown only. Hoping to see a difference once this HT grows. It's amazing how quickly the crown continued to go without FIN. I know the crown will never look great but I knew that going in.
In regards to depleted donor. The doc did save a small amount of grafts for any future work but i don't have many after three strip surgeries and further hairloss. This is what I was told.

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## Follicle Death Row

This is an example of what I always say about Norwood 6; they need 9000 grafts or more. 2000 more by FUE in select areas can make a big difference. You could put 1000 in the frontal third and then build up parts of the crown laterals with another 1000. Would probably be the best use of the remaining donor. Might get you up over the threshold of density in the most important spots.

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## Follicle Death Row

> The area below the scar is the area prone to retrograde alopecia so even though we can harvest more hair here, the hair is more prone to loss over the next 10 to 20 years.  This is why I'm no fan of combining strips and FUE.  It's just better to do FUE from the beginning.


 I guess it depends on where the strip is taken from. I notice Dr. Hasson goes slightly higher than most but still within the boundaries. He gets the best hair which is not vulnerable to retrograde alopecia. I agree that with lower strips the amount of grafts below that can be harvested by FUE is low. The way Dr. Hasson takes strips allows the donor to be maximised not just with strip but with FUE afterwards.

It would be interesting to see you debate the pros and cons with Dr. Bisanga since he developed his skills under your guidance yet he feels FUE is more restrictive in terms of restoring Norwood 6s than you feel.

How many grafts can we extract after stripping out in your opinion Dr. Cole? I've seen some docs come out with some high numbers which I don't really buy. My own opinion is 1500-2000.

I guess one of the bigger drawbacks with FUT imo is that 5-10% of follicles are dormant and end up in the bin with any strip.

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## 35YrsAfter

> This is an example of what I always say about Norwood 6; they need 9000 grafts or more. 2000 more by FUE in select areas can make a big difference. You could put 1000 in the frontal third and then build up parts of the crown laterals with another 1000. Would probably be the best use of the remaining donor. Might get you up over the threshold of density in the most important spots.


 Don't forget beard grafts.  Dr. Cole has taken up to 5,000 from a single patient. The area below the jaw heals remarkably well.  Beard hair is often twice the caliber of scalp hair and twice the caliber offers four times the coverage.  Beard hair must be placed carefully for it to look natural.  Styling is an important consideration as well.  It makes a great filler and looks good cut short.

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## 3rd time

Follicle death row
Thanks for the info about FUE. I'll keep that in mind for the future. 
35yrsAfter
I've heard beard hairs don't always get a good yield. For someone like me who needs extra crown work it would be ideal to get this done. How successful have results been for Dr Cole? also do you get a lot of patients after 12 months with no growth?

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## John P. Cole, MD

FDR, it is funny how your name matches a president of the USA.  Your questions are good ones.  

Dr. Bisanga worked for me about 4 years.  In our last year together we took one or two days off each month and we did around 800 strip procedures that year.  When I returned to my hometown in Atlanta, he elected to remain in Washington.  He spent only a few days with me after that.  I showed him an early version of my FUE about a year later.  His FUE is built upon that because prior to this he had never been involved in FUE.  

In 2004 I began to train a team in Cyprus for strip surgery, but they mostly saw FUE.  In 2005, I suggested that Dr. Bisanga would be a good fit in Cyprus for them.  Dr. Bisanga elected to go there.  Soon after arriving, Dr. Bisanga decided that he would open a practice in Belgium so he began encouraging the patients from the Cyprus clinic to go to his new Belgium clinic.  It was not the most ethical thing to do.  I had no financial interest in the Cyprus clinic at that time so it did not impact me.  However, financial ethics are the most important reflection on a man as far as Im concerned.  He did not hurt me, but he did damage a good friend of mine who employed him without malice.  My opinion of Dr. Bisanga has not been high since then.  This does not reflect on his talent.  His talent is good.  That I respect.  I think you can get a good result with him.  

Since the origin of FUE, there have been physicians who claim they offer FUE.  These are well-respected physicians.  I could name them if you like, but that really does not matter.  What matters is that any good physician can offer FUE.  When you arrive for a consultation with such capable physicians, you are generally told that you are not a candidate for FUE.  Rather, you need a strip procedure.  You might ask, why a strip procedure?  You are met with the same argument.  You can get more grafts with a strip.  You will get a better result with a strip.  You should have a strip procedure.  

In their hands, they might be accurate.  You see, one is never going to be great at anything that they do not love, respect, and practice.  All of these physicians do not love the procedure so they do not respect it and they do not practice it.  One can never become great at anything they do not practice.  I think we all know that we do not practice anything that we do not love and respect.  I could make my son play tennis every day.  I could push him.  He could become very, very good.  However, if he personally did not love it, he would burn out eventually and stop.  With adults it is different.  We cant force them.  They have to recognize the benefits and accept it as a labor of love.  If adults dont love it, they will never be great at it.  

Now why would a strip physician refuse to get more involved in FUE?  Well, for one thing, FUE takes more effort.  FUE is far more taxing on the physicians body, especially his neck and back.  Thats one reason, but there are perhaps others.  Suppose you never really get behind the procedure.  Will you ever be great at it?  Most likely not.  In such, you should stick with what you like such as strip surgery.  

The farthest one can push a donor area is to the point where the cross sectional trichometry (CST) matches the CST in the recipient area.  If one must also leave enough hair to conceal a strip scar, one might not be able to reach this point.  It is far easier when one does not have to worry about a strip scar.  
Then there are other variables to consider.  Most physicians will continue to tell you that the safe donor area is permanent.  It is not always.  When patients headed to NW 6 enter their early 50s, the donor area begins to thin and so does the recipient area.  Would it surprise you to tell you that many strip patients I have refuse to allow me to take any more hair from their donor area simply because it is already too thin?

That leads us into the final question.  How many grafts may be obtained after striping a guy out?  Well, that depends.   How old is he?  How much hair do we think he will loose long term?  What are his hair characteristics such as diameter, follicular density, and hair density?  How wide is his strip scar?  How many strip scars does he have?  This is an individual question and often based on patient age as the donor area gets worse over time though physicians will rarely tell you this.  

One must also define striped out.  I had a patient from Spain in this week.  He was striped out after two procedures though he clearly could have done a third strip.  He had a fine strip scar after the first procedure and he was happy.  Then he had the second and Walla, he had a ½ cm scar.     He could have done a third strip taking the original scar or done a third strip making a second strip scar and then done FUE.  However, he is now stripped out.  

So the number varies based on the patient, the age of the patient, the characteristics of the donor area, etc.  It might be 3000 in some and 500 in others or 0 in yet others.  

When I evaluate a patient, I record a ton of data.  I can tell you how many follicular units are in your donor area, how many hairs you have per follicular unit, your hair diameter, your surface area of hair loss, your CST in multiple locations, how many grafts we harvest from each zone, your transection rate, your telogen ratio, your average hair per graft, your strip scar surface area, and so forth.  All of this data helps me define what I can and what I cannot do short term and long term.  Data is the most compelling objective influence on what we can and what we cannot do.  

What I cannot do is debate the pros and cons of FUE with a physician who predominately does strip surgery.  Those of us who do FUE daily already know the benefits of FUE over strip surgery.  Today we debate other factors such as how to approach a donor area.  The debate of strip Vs. FUE is over.  Now more than 50% of all hair restoration surgery procedures are FUE.  We no longer think in terms of converting strip patients to FUE.  Patients are doing that themselves just as they converted themselves from plugs to micrografts and from micrografts to follicular units and single hair grafts.  Patients determine the flow based on results.  

In 2003, there were two physicians in the world advocating FUE over strips, Ray Woods and myself.  Today, there are many.  I went from a strip surgeon who had done over 8000 strip procedures to a FUE surgeon over night simply because I recognized the benefits of FUE.  Now that Ive done over 5000 FUE procedures and closing in on 6000, I am probably the most experienced FUE surgeon on the planet.  It is impossible for me to debate FUE vs strip with a surgeon who does a handful of FUE procedures each month.  We would be talking on different wave lengths.  

Now in regard to Dr. Hasson, yes, he directs his incision more vertical in the lateral aspect of the donor area.  This allows him to harvest a longer length and as such obtain more grafts.  Im no fan of this simply because a vertical incision in the donor area lends itself to a wider scar.  This was first documented by Dr. Brandy back in 2003 when he noted that his vertical incisions to ligate the occipital artery prior to a scalp lift resulted in a wider scar.  The lateral scalp is the location where all sorts of different types of hair exist (fine vs. coarse) and where hair growth angles vary the most (anterior to posterior).  Vertical incisions here marry coarse hair with fine hair and also marry anterior directed hair with posteriorly directed hair.  All it does is create a new set of problems to deal with long term without allowing for an increased number of grafts.  

I know of very few patients who can pass beyond 7000 natural follicular units via strip.  I think that a safe FUE number is the same.  Still one can pass this number via FUE more readily simply because one does not need to worry about leaving enough hair to cover a strip scar.  Strip scars are finer after one procedure, but the risk for a wider scar increases exponentially with each subsequent procedure.  Its best simply to avoid them altogether.   If you surgeon predominately does strips, I would not trust his opinion on FUE.  If you surgeon predominately, does FUE, I would not ask him to do a strip.  In the hands of a good FUE surgeon, one can obtain more grafts via FUE than a good strip surgeon can obtain doing strips because maximal FUE leaves a better overall aesthetic donor area than maximal strip surgery.

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## Bobman

Wow...pretty long thread.  

First off...Thanks Joe (jotronic) for clarifying my response to the "sunlight" photo.  And appreciative of having the good fortune of "giving back".  Many have met with me in the first 5 or so years who were considering having a procedure done.  I was happy to do so and from what I've gathered, they all appreciated my open, honest and no bullshit responses to their questions.  And of course...they all dug my results...as the results speaks for itself.

Artista: I've been enjoying my hair transplant from H&W for 9 years now...fyi.

_Wow...when you say it like that._

Anyway...All I can say is I'm very VERY happy.  I'm no longer "obsessed" with it since I've been able to conquer that issue and have embraced my new chapter most comfortably.

To clarify once again...I'm very happy and am told I look great.  In the end, no matter how it's achieved...isn't that the idea.  Looking good, feeling good.

 :Cool:

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## Artista

*Bobman* my friend,,*THANK YOU * for adding to this discussion.
Might I say, the reason why we dont see you as active  here is because GOOD FUT work to your *then NW6 scalp did the job*  and you are no longer obsessed with how your scalp looks to this day. You are HAPPY.
Decent coverage of the scalp if one is a good candidate for it.
*REALISTIC expectations= common sense. *

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## topcat

I suppose there are plenty of ways to explain it especially to younger guys who really dont understand and I like this example. You have 100 marbles and you have lost 50 of those marbles. Regardless of what you conjure up in your mind you will never have 100 marbles again and to plan on having 100 marbles again is very foolish so you need to come to terms with this reality. Out of the 50 marbles you may have 15 marbles you can use to cover the area where the 50 marbles use to be. That is providing you dont waste the marbles and lose some along the way as you replace them. You can arrange those 15 marbles any way you like to cover that area but its only 15 marbles. So you will end up trying to move those marbles strategically to really make it look like you have the area covered maybe even use some spray to hold them in place and you know in the right light it might just look like you have those 50 marbles back again. When someone turns the lights up guess what chances are the illusion will be up and this applies to the greater percentage of patients regardless if a very few can still keep the illusion going. If someone tells you something different they are lying to you plain and simple.

My experience having had several different types of procedures and not being in the business of having to sell you something and has taught me a few things. When I had a large chunk of flesh excised from the back of my head I had a tightness that seemed to last forever probably close to 20 years before it finally felt normal again. I also had numbness for equally as long with an area that itched but impossible to relieve by scratching it. I had the shooting pains which I found bearable but I did sometimes say to myself wow as the nerve connections started to come back. If I wore my hair long it wasnt a problem to cover up the scar but if I went swimming the hair could easily part in such a way that it would be exposed and easily seen. Same thing for resting your head anywhere you always needed to have access to 2 mirrors to check that everything was in place and the scar was not exposed as the hair had a natural tendency to part in that area. So if you are a young guy doing the sleep over thing than does become an issue that needs to be constantly dealt with.  Chances are very good if you are a NW6 and you have a procedure you will become a slave to your hair plain and simple and it becomes very tiring much worse than being bald. 

If I were a Norwood 6 today with a virgin scalp I would only consider reversing the balding process a few years by way of fue. High thin mature hairline with the hairs all angled in the right direction. It frames the face and you can keep it short to medium length and look good. You will not become a slave to your hair because you tried to do something about it. If it goes well you will have nothing to hide.  Dont really need to make the explanation sound too technical because when it comes down to it, it really is common sense when its all pointed out.

If you are a NW6 and are considering a procedure just take a look at others around you with similar hair loss. Look at that donor area and if you can visualize how you are going to take a small percentage of that area and use it to cover the bald area and you really can see it and it makes sense than its your choice. But chances are reality will kick in.

Most NW 6 guys cannot grow their hair long in the back because it looks ridiculous so that does become an issue when trying to cover up a scar. In reality strip is probably best left for someone that is going to be a NW3 or 4 for the rest of their life and they can deal with some of the issues involved with having that procedure.  As far as FUE if you are going to keep you hair short and neat it can be an ideal procedure. If you want to shave to the bone depending on how much you have had extracted from the donor region and the size of the punch along with the skill of the doctor it can become an issue. But guess what if you want to shave to the bone dont have a hair transplant. You have unrealistic expectations and you should be told that flat out at the beginning.

A good example of what a NW6 can achieve in my opinion would be a look like Jason Straham. Maybe you could do better and maybe not but its a good gauge in my opinion. Have a little bit more hair, look normal without issues of having to constantly hide something and get on with your life.



If you are a NW 6 find a picture of yourself from 5 years ago or so and chances are that it what you can bring back and maybe you will be happy with that which is okay just be realistic. And yes if your beard hair is a very close match you might be able to do a little better just fully understand what you are getting into and only stick your toe in the water.

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## fred970

Excellent post topcat. I loved the marbles analogly  :Smile: .

This is exactly what I plan to do. Restore my NW5 as much as possible with FUE. If for some reason, I don't achieve what I want, I'm ready to use dermmatch which had worked amazingly well for me in the past.

I know I won't be able to treat the crown but it seems to be holding very well with minoxidil alone. I'm reaching the point on no return, almost no frame at all to my face. I'm a good looking guy but I'm really starting to look very odd without a frame to my face. I've never known the horror of a receding hairline (my hair just faded equally in the NW5 area), but in a few months, I'll be a full-blown NW5.

I think I've done my homework. I've seen an IAHRS surgeon who told me I won't be happy without a crown. Another clinic told me to go get myself a rug. And finally Dr. De Reys who truly understood what I wanted. Anyway this is my only option left, besides accepting looking like an old man at 24 years old.

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## gillenator

Individuals with outstanding hair characteristics like Bobman have far more potential to achieve the illusion of coverage.

And the higher degree of coarseness, the better potential in achieving the illusion of coverage.  After all, it is the single most critical factor considered in achieving this illusion of coverage.

HT surgery was never intended to get anyone back to original or juvenile levels of density.  HT surgery is without a doubt gaining an illusion of coverage and if individuals are happy with their own respective results regardless of density, then that's all that matters in the end.  :Cool:

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## UK_

God help us.

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## topcat

This is what I mean by turning the clock back a few years. This picture of Bruce Willis with a little bit of hair would be a very sensible approach for a NW6 maybe a little less maybe a little more and leave the crown bald. But going in thinking you are going to get this thick mop of hair would  be very unrealistic. That is simply selling you something that in the majority of cases is just not possible.

The majority of guys that walk into a clinic are at a complete disadvantage. Just the fact that you have the balls to walk into one in person means you are desperate enough to want to do something. You have already lost and if the guy you are dealing with is not honest and ethical you are in very big trouble. 

High thin hairline with a bald crown is a very reasonable expectation. Its good solid advice.

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## topcat

The real problem is these guys that start too young and are destined to be a NW6. They too often get bad advice and the hairlines are still too low and dense. 

Of course they are easy sells for many clinics. Its like the young woman that walks into the doctors office with her A cups. She is so bothered about it that she is willing to take her top off in front a doctor in hopes of being helped. Her insecurities outweigh her embarrassment. She is a very easy sell. That insecurity that she feels that no man will want her because of her tiny breasts is very easy to take advantage of and hopefully the doctor does the right thing and does not use that insecurity to his advantage. Many of you young guys are the male equivalent to Betty and many concerned with climbing the financial ladder know it, they salivate when you walk in the door and yes I was that same guy at 23 wish I would have had someone to explain it to me.

In this case lets name the patient Betty. Maybe Betty really wants to wow everyone and be the center of attention so she pleads to the doctor to set her up with the double Ds. Hopefully the doctor convinces Betty to go for a B cup and at the most maybe a C cup. But many doctors would be happy to oblige Bettys wishes if it meant more money because really they dont care about Betty and why would they as showing off the double D work is apt to bring in more business.


Certainly Betty will become the center of attention and every man will want to date Betty, she is on top of the world. The real problems for Betty come years later when not only do the double Ds not matter so much but they aint looking as good as they use to and the men are not paying Betty much attention with those double Ds sagging down to the waist line. So eventually just like the majority of women who have this procedure at some point in time Betty needs to go in for repair and have those once dazzling delights removed. She might opt for something that makes more sense or just say screw it as it really doesnt matter anymore. Now Betty has gone back to A cups and whats even worse is her whole body is deformed and scarred up for just a little glory that lasted only a few moments in time. Betty with the big boobs is no more.

Chances are if Betty would have gone to the right doctor and had the B cups she would still be going strong today and so it is with hair. If you are a young guy and your hairline is too low and dense from hair transplant surgery and that position is higher than most young guys think then you will end up like Betty trying to reverse the procedure and get back to normal. As having a low dense hairline with nothing behind it looks very odd. Yes you will still be attracting attention but not the kind you would probably welcome.

High thin hairline with just a little density behind it is the only sensible approach for a very high norwood.

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## Artista

Topcat,,great points of view..being REALISTIC in expectations would be everyone's major tool in treating hair loss

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## topcat

Well I think that Betty analogy can really help a lot of these young guys out. Maybe by seeing it in a different way they will better understand and see themselves. If most were honest they would say that Bettys A cups really dont matter as much as she thinks they do. They also can see how easy it would be to take advantage of Bettys insecurity, just a friendly voice and a pat on the back telling her it can easily be remedied is all it takes.

But if it is really going to help Betty feel good about herself most people that cared about her would probably tell her yeah sure bump up a bit to the next cup size..that would be good advice. They certainly would not tell her to go for the gianormous DDs.

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## Artista

*Hey Jotronic..*
Could you please post what the  approximate  _donor hair averages_ have been  for the basic NW6 patients :Confused:  
I would appreciate it Joe ~Thanks

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## fred970

I'm not far from the dreaded NW6 and Dr. Bisanga told me I had 65 hairs/cm&#178; in the donor area. So slightly below average.

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## Artista

Fred, hopefully something good will be available , sooner than later bro !

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## fred970

I hope so Artista. I'll be going for my fist FUE in February despite my seemingly hopeless situation. 

I think I'm in good hands with Dr. De Reys. There's not much left I can do besides a HT anyway. My main goal is to have somewhat of a frame to my face, even if it means only the first third of my scalp. As long as it looks natural.

I could live with something like that:



PS: he didn't have a HT, this is his natural hair.

I wish I could go slick but my morphology and skin tone make me look like I'm undergoing chemotherapy.

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## topcat

Fred that is a very realistic goal that makes sense.

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## Artista

Fred that's GREAT that your being REALISTIC as to knowing what a good HT could do for you.  Decent coverage , relatively speaking, can be achieved through an EXPERIENCED IAHRS certified Doctor.  I wish you luck bro,, I'm sure you will be happier

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## FearTheLoss

From FUE results I've seen today from top doctors, I believe someone with good hair characteristics and a decent beard can go from nw6-nw2 granted they have the finances backing them. Throw in some SMP in your donor, overharvest it a little and you could have a really good head of hair. 


..and if consistent, legit donor regeneration comes into the picture...beard hair won't even be needed. 

scarless surgery plus 50% regeneration or more would cure most nw6.

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## Follicle Death Row

As I've said before, hair restoration can make a difference for norwood 6s but the problem is that patient expectations and the reality of what's possible are often way out of line. Of course if we could all have Jotronic's, Bobman's, NicNitro's or LondonLad's results we'd go for it but I can't help but feel they are the exceptions rather than the rule. That being said if you have above average laxity, density and coarseness it may well be worth it. Pretty important to get a truthful assessment of these characteristics I feel.

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## gillenator

> As I've said before, hair restoration can make a difference for norwood 6s but the problem is that patient expectations and the reality of what's possible are often way out of line. Of course if we could all have Jotronic's, Bobman's, NicNitro's or LondonLad's results we'd go for it but I can't help but feel they are the exceptions rather than the rule. That being said if you have above average laxity, density and coarseness it may well be worth it. Pretty important to get a truthful assessment of these characteristics I feel.


 I agree totally with you FDR and also still waiting for more examples of a matured beard hair result, but I don't see updates (pics) from regrowth to evaluate.  :Roll Eyes (Sarcastic):

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## 3rd time

Most of the nw6s that have had great results have all had success with propecia. They have been able to take it with no side effects which is so important. They also have great hair characteristics and their hair colour and skin tone is not a major contrast. 
Also, keep in mind that you will more than likely need 3 HTs to get almost full coverage. If you can't take propecia and your hair continues to fall out you will need more work... I.E body hair transplant and concealer.
The best thing I've heard in this thread was topcats comment about becoming a slave to your hair. Meaning you worry about getting concealer on pillow cases... Especially when with a girl. Constantly checking your scar is covered. Fearing certain lighting conditions. Having people stare straight at your hairline. Swimming and getting your hair wet. Rain and worrying about concealer running. Strong winds. Hair transplant thinning out. Seasonal Hair shedding. 
For those happy with some decent front coverage and a bald crown then you should be fine. But for those that want the crown covered the above examples I gave will come up from time to time.

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## topcat

3rd time in the past I would have to work in very close proximity to people mostly females. Anyhow one night I was laughing it up with one of my co-workers and she did her female thing and  went to wipe my forehead with a tissue..lolcan you imagine.I can laugh about it now..lol.

I also use to worry about going to the dentist as the concealer could easily come off onto the white covering thankfully most use plastic now. I had my dental work done while I was on vacation this year in Macedonia. Quite an experience as the dentist convinced me I didnt need the anesthetic. He said dont worry its not necessary..lol..well my wife and nephew were in the room as I needed an interprator. He drilled out 4 molars to fill them with new composite the old stuff was there for 38 years.lolas you can imagine I was squirming and sweating in that chair. I was completely exhausted by the time he was done. When I got back to where I was staying I looked into a wall mirror with a hand mirror and my hair was sticking up all over the place with concealer clearly smudged off.

Anyway the next day I made sure he gave me an anesthetic and the hair oh well not much I could do about that. It wasnt so bad since I used a little less hairspray so my head wouldnt stick to the chair.

I had one repair patient tell me about an experience on a date and going on a roller coaster..lol I couldnt stop laughing. I had a similar experience go to a show here in Chicago, The Blue Man Group.they did some crazy stuff at the end of the showOMG.and then there was the time I was almost forced into going on a speed boat, just couldn't get out of it and longer...............ran out of excuses.

The best approach is to frame the face, high mature hairline and leave the crown bald. Preferably FUE in my opinion if you can be happy with what can be accomplished. With the right doctor you will never have to hide anything.

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## Follicle Death Row

> Most of the nw6s that have had great results have all had success with propecia. They have been able to take it with no side effects which is so important. They also have great hair characteristics and their hair colour and skin tone is not a major contrast. 
> Also, keep in mind that you will more than likely need 3 HTs to get almost full coverage. If you can't take propecia and your hair continues to fall out you will need more work... I.E body hair transplant and concealer.
> The best thing I've heard in this thread was topcats comment about becoming a slave to your hair. Meaning you worry about getting concealer on pillow cases... Especially when with a girl. Constantly checking your scar is covered. Fearing certain lighting conditions. Having people stare straight at your hairline. Swimming and getting your hair wet. Rain and worrying about concealer running. Strong winds. Hair transplant thinning out. Seasonal Hair shedding. 
> For those happy with some decent front coverage and a bald crown then you should be fine. But for those that want the crown covered the above examples I gave will come up from time to time.


 I think the real power of propecia is in slowing the rate of hairloss down. In other words if you're norwood 3 and get 3000 grafts in the frontal third you could be happy for 5 or 6 years before you have to consider another session. Without propecia you may get 2 or 3 years before it progresses. I think the real benefit is that it keeps you out of the chair for longer.

However if you have aggressive hairloss and a norwood 6 pattern in the genes  I think most get to norwood 6 eventually with or without propecia. I know Jotronic stills takes it as he is concerned that the lateral humps may drop over time.

I know that Jason Gardiner does not use meds as he has lost all the hair across the top and Dr. Ziering must feel the lateral humps are not miniturising.

It really is a case by case basis. Everyone is different. There's actually a really interesting case that Dr. Feller posted here a number of years ago about a 24 year old norwood 3 that began the restoration process. His hair continued to thin over the years and his norwood 6 pattern eventuallly stabilised. Dr. Feller I believe did 3 transplants in total over the years and the patient always looked better than he did before the first session. He also has more in the tank in case of any further unforeseen loss. I don't recall the exact number of grafts he had transplanted but I think he had 7300-7500 with more than 2500 left in the tank by strip.

In other words you can sweep against the tide but you need:

1) The money
2) The donor
3) The patience & perseverance
4) The right doc who will use your donor wisely over time

http://www.baldtruthtalk.com/showthread.php?t=2326

It's a lifetime commitment. It's almost never one and done.

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## greatjob!

> jotroic, as a life long strip monger, i'm not surprised that you refuse to recognize that there is something called the illusion of coverage.  i guess that when you perpetuate the myth that strips in your hands don't leave disgusting, ugly scars, you can also perpetuate the concept that "coverage is coverage" and obviously erroneous myth you spread for years that strips produce better results than FUE.  in fact, it is possible to cover the entire scalp with a single hair that is grown long enough.  that is not coverage, however.  that is an illusion of coverage.  
> 
> you may refuse to face the fact there there is rarely enough hair to give the illusion of coverage in a nw 5 and never enough hair to give the illusion of coverage in a nw 6, but his is the simple God's truth.  one is never going to cover 225 to 250 sq. cm of bald skin with 5000 to 7000 follicular groups.  it is simply mathematically impossible.  now, i know you guys sometimes do 5000 grafts in one session and then do more, but you fail to explain that you typically split the natural follicular groups into smaller segments so that you actually place the same follicular group more than once and then bill double or three times for that same group.  
> 
> i'm no fan of discussing any specific patient whose had a hair transplant.  i also, have no taste in my mouth for salesmen that pick guys who are just trying explain their perspective of hair transplant surgery.  Since you did it, i'll be frank.  there is something quite different from a photo result and a real result and you are a master of the photo result.  that my friend is also called an illusion of coverage.


 The biggest thing I got out of this thread, and every other thread he posts on, is that someone at Dr. Coles office should hide the keyboard from him. You may be a very talented hair transplant surgeon Dr. Cole, but you do yourself no favors every time you come on here and get involved in some kind of juvenile internet flame war. It's very unprofessional and not something you would expect to see from a well educated doctor.

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## 3rd time

topcat, i laughed when i read your last post. Similar thing happened to me in the dentist's chair. I completely forgot about the white paper on the chair. I was in a rush in the morning and used mainly toppik. Such a bad idea.
It was all over the paper. Usually if i use a little dermmatch and it dries its not that bad and stays on.
The female co worker story made me cringe LOL. I guess we can laugh about it now but at the time its pretty embarrassing. I honestly think the person who invents a concealer that doesnt come off with sweat or on pillow cases will make millions. Most concealers claim they dont come off but thats just not true. Even these holding sprays that come with the fibres are a complete joke and just dont work.
The one that bothers me the most is being with a woman for the first time. If you are wearing concealer you just know its coming off on the pillows... Try explaining that one in the morning LOL. I really thought that these issues would be gone after 3 HT's but baldness progresses and the battle continues.
I really hope it tapers off soon and I stop losing hair. Cant wait to see the results I get with this last procedure. Almost at 2 month post now..Shockloss and shedding. Great combo.

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## topcat

I use prothik which does not come off when you swim or sweat but once you start rubbing on it as in a dentist chair or on a pillow it will come off for sure. I took a dive into a pool this summer with concealer and it was all good. Here is a picture I do spray it on only lightly now which is good.

Sorry for being off topic here but this might be helpful for those that use concealer and if you are a NW6 chances are even with a ht you might still need it.

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## 3rd time

I've never used prothik. I have heard of it. Might try some for my crown area.

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## 35YrsAfter

> I use prothik which does not come off when you swim or sweat but once you start rubbing on it as in a dentist chair or on a pillow it will come off for sure. I took a dive into a pool this summer with concealer and it was all good. Here is a picture I do spray it on only lightly now which is good.
> 
> Sorry for being off topic here but this might be helpful for those that use concealer and if you are a NW6 chances are even with a ht you might still need it.


 Looks very good topcat.  You have come a long way.

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## Jotronic

> However if you have aggressive hairloss and a norwood 6 pattern in the genes  I think most get to norwood 6 eventually with or without propecia. I know Jotronic stills takes it as he is concerned that the lateral humps may drop over time.


 Actually, my lateral humps were already non-existent which is why I sometimes say that I was a NW6.5, not a NW6. Yes, I know a 6.5 does not technically exist, but it's the easiest way to classify my pre-repair condition.

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## Artista

*Jotronic , THANK YOU for posting your own 'before and after' photos!!*
As I have said before,,you and *Bobman* are 2 great examples as to what a great hair transplant clinic like
*Hasson and Wong* (IAHRS members) can* possibly* do for a* NW6.* 
Jotronic had repair work done by H&W, Bobman had a standard series of HTs by H&W.    
The cool thing is this,  *Hasson and Wong* are not the only kids on the block, so to speak.
There are quite a few great clinics out there with GREAT IAHRS skilled surgeons ,nationally and internationally, who could also provide a NW6 with decent enough coverage from the donor areas. Even with limited donor availability like that of Jotronic's situation. 
*It is NOT an impossibility for a NW6 to have an adequate HT treatment * 
If you do your research and  take your time to REALISTICALLY comprehend 'what is' and 'what is not' available out there, it is possible that you could make a change through hair surgery.
*Thanks again Jotronic *

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## topcat

No doubt Jotronics result is superb. But if we were realistic my guess would be that most NW6 patients would have a very difficult time achieving the same result and that is what they should be told. With an average of 100,000 ht procedures per year  or more we would probably see many more complete restorations. That is simply not the case because it is an unrealistic expectation for most and that is exactly what they should be told so that they can make a fully informed decision and not a decision based on hope.

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## topcat

If I were in the business of selling hair transplants I would tell a NW6 you lost 50% of your hair we can maybe give you back 20%-30% on top but you would also have 20%-30% less on the back. If you go for full coverage it will definitely be see through in the majority of cases. If you leave the crown bald than you can eliminate the face on view where a person can see right through your hair  and see the wall you are standing in front of. I would recommend this method leaving the crown bald because that see through look just does not look right and you end up with people looking at you trying to figure what is going on up there.

Maybe I wouldnt sell a lot of hair transplants but nobody could back and tell me I wasnt honest with them.

Let me know if my numbers are off.

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## Jotronic

> No doubt Jotronics result is superb. But if we were realistic my guess would be that most NW6 patients would have a very difficult time achieving the same result and that is what they should be told. With an average of 100,000 ht procedures per year  or more we would probably see many more complete restorations. That is simply not the case because it is an unrealistic expectation for most and that is exactly what they should be told so that they can make a fully informed decision and not a decision based on hope.


 Thank you, Topcat but I can tell you that your "guess" would be spot on. Most NW6 patients cannot have a result like mine and whenever someone tells me they wish for a result like mine I tell them it won't happen, or words similar. I've always been up front about this.

However, I thought about your statement and I think that there is another reason why we don't see a lot (relatively) of NW6 patients with drastic results. Of the surgeries being performed I can honestly say, in my opinion, that the majority of clinics shouldn't be performing surgery to begin with. Of those clinics that are worth their mettle I think very few can pull off what Dr. Wong achieved with me. Remember, I'm not a megasession patient by today's standards. Not a single procedure of my broke the 2500 graft mark. I'm a patient that has a doctor that knows what he's doing and had a strategy with each graft placed. I know you understand this as your doctor is being strategic with you and your placement, with your input of course. 

That said, I'm not an isolated case and neither is Bobman. We're just more public and that makes us easy targets, for better or for worse. There are results from Dr. Wong and Dr. Hasson that are far better than my own with just as much loss. My case is unique only because I had a bunch of work before my turn around and of course because I've been pretty much the most documented patient in the world. 

Regarding your post about selling hair transplants, your position is the same as mine for the majority of NW6 cases. I always recommend, even if we are getting 4000 plus grafts, that the grafts should go in the front and then leave the back for a another day if need be. I regularly repeat to patients how, many times, when we plan out two procedures( one for the front and one for the crown) that the patient decides against having the crown done because it doesn't bother them any more. The front is done, which is what they see in the mirror, so the part they don't see is no longer an issue. This is a success in my book.

Anyway, it's late; time to go lift :Smile:

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## 3rd time

Placement of grafts is so important to a NW6 patient. I think any HT doc can place grafts on a scalp but it's the artistry of the Doctor that will create that great look. The areas that need further attention is what a good doctor will spot. Transplanting 5000 grafts to cover a bald head will not give you a good result. A skilled Doctor can take those 5000 grafts and create a fairly strong hairline and make great use of limited supply.
A bad Doctor will place those grafts anywhere thinking only about coverage of bald scalp and not really how it will look at the end for the patient. A good doctor will spot bad work or wasted grafts 100% of the time.
So for those guys considering a HT that's what you need to ponder. Question your Doctor about hairline design and how he will use your grafts to give you a hairline that won't just be a thin, see thru mess. Be informed when you make your appointment and make your priorities known.
Like Jotronic said once you have a nice hairline the crown may not even bother you.

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## Artista

*3rd Time*  I agree and great post! * Jotronic*,,thanks as always for your recent posting too!  
Half the battle in fighting our hair loss is to be *100% REALISTIC.* and *100% EDUCATED.* 
*We should NEVER go by any speculations or by our own emotions!*

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## topcat

I think if it is given more in terms of percentages it gives a prospective patient a more realistic view. Then they can decide if increasing the percentages in certain areas would give them a better look as opposed to spreading all available resources over a very large area. Spoken in these terms young guys would be less apt to go for a very low hairline and extensively bald patients would be less apt to plant into the crown.

Its best to just tell patients the real deal which is what good clinics do. If the patient wants it fine if not then hit the road pal. Because the fact is after some thought I believe many would come back knowing that some hair might be better then no hair and now they fully understand what it is they are getting without any misunderstandings.

As far as the many clinics they purposely neglect to fully inform the patient. There is an interesting book by  Phillip Zimbardo The Lucifer Effect which is based on a Stanford prison experiment which shows just how quickly people can turn bad give the right circumstances. One really needs to be aware.

Jotronic good to hear you are still lifting as making it a habit is what is really important. Any anyone that is aware can take what they see in the HT industry and compare it exactly to what happens in medicine in general. So if you end up in poor health your chances of finding the right doctor is very, very slim maybe only about 10% of what there is to choose from. Most simply cannot grasp this concept and it is the same with the prospective ht patient. They simply cant grasp that 90% in the field are complete crap. So taking care of your health in every way is very important to avoid even being put in a position where you need to depend on the medical system.

I would suggest moving the workout to early morning when testosterone levels are higher. Add in some slow repetitive type movement for about 20 minutes, something as simple as walking to really raise serotonin levels which will make you less apt to reach for cheap carbs during the day. Working out in the evening is better than nothing but you are raising cortisol levels at a time when you should be winding down before sleep.anyway just a thought.

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## Jotronic

Topcat,

I recognize the benefits of working out in the morning and I've tried a few times to make the switch permanent. I just have to find the right balance to do so. Problem is, mornings are tough for me especially since the gym I prefer is a fifteen minute drive (30 minutes round trip). I've tried mornings where I take my work clothes with me and get ready for work at the gym but it means more crap to carry around :Smile:  Today however, I did workout in the morning (leg day). I'm up at 6:15 a.m. every day but instead of reading the news and taking time to wake up I hopped in the car and drove to the gym. My workout last night was cut short so this morning was a make up session. 

Lifting is a lifestyle for me now. I'm not a power lifter but I love doing it and I enjoy the positive changes I've seen. I started one year ago as of September and friends that have not seen me in a while say that I look like a completely different person. I can't imagine NOT doing it and when circumstances arise that prevent me from getting to the gym for whatever reason (rare) I feel guilty and even bloated, lol! I'm currently out of my lean phase (lost nearly 30 pounds) and slowing building my carb and calorie intake. Over the past 3 weeks I've seen a 30% to 50% increase in my strength which has me shocked. Breakfast consists of plain Greek yogurt (30% fat) mixed with blended spinach and six boiled eggs. Mid-morning I eat a can of tuna with mayo mixed in, lunch is a couple of chicken breasts and a green salad, mid afternoon is maybe another can of tuna then after my evening workout I have a post-workout protein shake with carb powder then 45 minutes later I have meat and green vegetables or lots of sushi and spinach gomae for dinner. This will change of course if I can finally make the transition to morning workouts. Taste for me is irrelevant now. Food is fuel. 

Anyway, I digress, but once the subject of exercise comes up I get excited. Consequently, I am a firm believer now that the quality of one's nutritional intake and physical fitness directly correlates with the quality of one's hair. My hair is shinier now than I can remember. The strands of each hair seem healthier, stronger and overall my hair looks and feels thicker. I take no MSM or hair pills/lotions save for Proscar every day. It makes sense when one says there is a correlation but it really hits home when one experiences the change first hand.

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## topcat

Well I dont want to take the thread off topic either but really good for you and Im happy to hear it. Your progress speaks for itself. Here is a quick interesting thought. People that cant eat healthy are really spoiled and overfed they just dont know, victims of very good marketing.  A good experiment for most to try would be fasting for a day or so just plain water. Now try that healthy meal and tell me just how delicious and satisfying it truly tastes.

Most give nutrition too little regard during the healing process and I understand as doctors are part of a system that keeps them doing what those that control the system want them to do. I think garlic is superior as an antibiotic but any doctor that recommended this would have his license revoked. Garlic works with the body and doesnt kill the beneficial gut bacteria which are essential during the healing process.

Of course I could tweak your diet a little bit but I think what you will find in time is that you will do that on your own as its all part of goal setting and wanting to do better which is an endless journey. One thing I do know for certain happiness is directly related to how we feel so feeling good would definitely make one happy. Sure one can have loads and loads of money and buy all kinds of crap but those moments of happiness are fleeting in my opinion. Feeling good as in feeling physically vibrant and being around good people are much more important.

So here is a thought on what I would do with your current regimen as its really all about health or at least that is what is should be about. Swap out that Greek yogurt for some homemade yogurt. Find a local goat farmer in your area, buy some of that bulgaris culture and make your own, very simple to do. You avoid damaging the proteins with heat as you only heat the milk up to about 100 degrees. The problem with store bought yogurt is not only the heat they used to pasteurize the milk but more importantly where is that milk coming from. Hormones if being used get trapped in the fat and that is what makes commercial dairy and meat extremely carcinogenic. Then of course we can start getting into what the animal is fed and how that starts to affect the fatty acid ratio. Same thing with the protein powder, dump it as the source is more than likely heavily hormone fed dairy which is cheap. Why would anyone drink a product so heavily laced with estrogen, very simple good marketing.

I would also swap out the chicken breast for some chicken backs. Plenty of fat and you can eat the bones.

Having information is good too. My wife always has some story about one of her customers that is dying from something or other. Here is an absolute perfect example of not having the right information when one needs it. One of her customers about a week ago confided in her that his son who was only 46 was dying. He was having headaches and losing vision and went in to check it out, it was an inoperable brain tumor. As soon as I heard her say that I told her you have to tell this person about Dr. Burzynski who has an incredible cure rate with brain tumors that those in control of the medical system have been trying to suppress for the last 20 years, I know because I have followed it for that long. She said it was too late they did a biopsy and he never came out of it, they gave him 48 hours to live. Now why would someone drill a hole into someones head if it was inoperable? Did they know about Dr. Burzynski and even if they did would they even say something. Its all very sad yet amazing to watch.

Its kind of a coincidence too as I just posted something on this same subject a few weeks back. Well I have about 5 more pages of comments but I seem to be going off topic here.

BTW the Bruzynski info is always good to have in your back pocket. Personally I think we will see an explosion if gilomas in the near future from all the cell phone use .

----------


## Jotronic

Topcat,

To keep from straying further off topic, I responded in this thread...

http://www.baldtruthtalk.com/showthr...475#post150475

----------


## Artista

Lets *HOPE* for the best

----------


## TheEmperor

> I began as a nw6 at 28 years old. In the past 6 years i have had three HT's. All up about 7500 grafts. The above picture of Oliver stone was roughly what I was able to achieve. Unfortunately I was only able to cover the crown with very little hair. 
> 
> . . .
> 
> When I look back at how I was as a nw6 to where I am now its a big difference. Am I 100% happy with my results? No. BUT I do look better, people that knew me before have said the same thing, im more confident and happier.
> 
> Anyway I hope this helps. Good luck and be prepared for a long journey. Take care.


 I am/was a NW5 and had FUT 6500 grafts from a respected surgeon and wanted to chime in on this thread.  Haven't been on the forums in a couple years, and its not because I am happy with my hair and moved on, only that it wasn't worth investing any more energy into.    I came back to the forum to see it's reaction to the recent development in hair cloning and then saw this thread and thought I could help someone.

There are a number of problems that I was not aware of prior to getting FUT, and based on extensive interviews with consultant and doctor, thought I would get a much better result.

Yes a NW5/6 *can* get a "homerun", but if you read the forums long enough you will see that the really great results keep getting reposted, and the unhappy patients seem to fade away. 

I believe I had a problem with yield    There seems to be evidence that the grafts planted in the hairline did not grow nearly as well as the larger grafts, this is either because they were overpacked or cut down too much. The hairline hairs that came in are much finer, and I have roughly about 20-25 hairs cm^2 in an area that should be the thickest.  The larger grafts behind the hairline seem to have largely grown in.

The FUT doctors all have different cutting strategies, some subdivide them more than others.  Some use skinny grafts to get higher packing density, others use chubby grafts for greater survival.  When shopping docs, look at graft economy and cutting strategies.

The megasession clinics tend to hypercut the grafts into the smallest possible groupings to maximize graft counts and profit.  This may be advised for someone with thick coarse hair, but for someone with fine hair it will cause lack of density and unneccesary death of grafts.  

They also use skinny grafts so they can pack with more density in a given area (the fat around the graft is removed so they are skinnier.)  Fat grafts are shown to have higher yield.  Unfortuantely, skinny grafts are more delicate and require greater precision from techs.  There is evidence that certain techs got significantly better yield than other techs.

Also, FUT docs have less selection of individual grafts.  My sides had smaller and finer hairs so many of the grafts came from this area.  Had I gone to a FUE doctor, he would have been able to choose more grafts from the better stock on the back of my head.

To summarize, I had 6500 grafts that looks more like 3500-4000 and I am pretty much maxed out how much more FUT I can get.  The scar is pretty nasty so I have to keep the hair longer on the sides, the top is a comb-forward that I keep in place with hairspray.  It doesnt look horrible combed forward, but it requires careful styling.  Cant comb it back because the hairline does not look natural.

If I had gone to a FUE doc, even if I only got half as many grafts, he would have been able to cherry pick grafts and reconstruct a thin see through hairline like the Willis pic above.  And this would have looked good because I could then cut the sides really short.  Now I am a slave to a daily styling routine all because I need enough hair to cover up the scar.

If one is set on going to a FUT clinic, I would consider going to a doc that employs multiple strategies and incorporates FUE into his routine, and whose pricing is not designed to move you into larger sessions.  Two high yield 2500 sessions are better than a 4500 + 2000 that gets compromised yield.  Slow and steady wins the race, I think megasessions will show more "home runs" but are also higher risk and can damage grafts.  

If someone is a NW6, its a given that they will need more than one session.  Either go with an "economy" look with FUE, or make it your highest priority to maximize yield with a doctor who uses chubby grafts and does not hypercut to maximize graft counts.  That can produce home runs, but it is also higher risk.

----------


## Artista

Hi *TheEmperor*  thanks for your contribution here on this thread.
I appreciate your point of view and personal experience.
I hope you are OK with what you see in the mirror even though it seems to be  less than 6500 grafts used.
Sorry if I overlooked anything but, what year did you have your HT done?

----------


## Number47

Hey Emperor you have my sympathies my friend, i guess you don't get many responses when a story is sad. The forums have changed over the years, there was sympathy back then, worry and support. On the other hand there was excitement also, anticipation and hope. 

Now i think we are all a bit more cynical, less excited and less sensitive when we see a bad result. There is a lesson here to be learned, more than ever you have to do your homework and search multiple doctors, search the truth ask questions, talk with patients. Cause when you take your decision and do it you are all alone in failure. The doc will disappear, your friendly consultant will disappear and no one from the forums will really care after a while. 

People say we don't have real evolutions in the forums there is no progress, i agree to an extent but there is for sure one evolution in hair transplant industry. The evolution of FUE hair transplants and none of the old arguments can stop it anymore, the work of great surgeons took them out one by one. But that doesn't mean all fue surgeons are angels cause they don't do strip leaving a scar on the back of the head , we still have to be extremely careful who we choose! 


This evolution didn't happen cause some guys acted like fanatics in forums preaching antistrip and making all FUE surgeons look like saviors. This evolution happened cause the market demanded it and surgeons improvised and worked on it to deliver and the results are everywhere. The simple truth is strip is dying as FUE progresses and you can see it clearly in the forums where the FUE results get most of the attention.

----------


## topcat

Would disagree, its the patients who change the industry at least those that are willing to come back and post. As far as those that have a poor result or the result that didnt quite meet their expectations and decide to move on without warning others well that does become part of how the industry can keep it all going. But I do have to give Emperor credit as he did come back to the forums and posted often which Im sure helped many in their own decisions.

Many of the forums and clinics actively worked against those performing fue and they did it day in and day out. Some forums even had the nerve to state that recommending fue was very dangerous as their bread was being buttered elsewhere and this is why the forums have limited value in researching. Sure you can look at results but it really comes down to speaking to those patients that are very vocal at least that has been my experience, to point out all the guys that are full of crap. Its only after taking a step back and looking at the big picture that you can connect all the dots.

I think Emperor had a good result at least in my eyes. In my opinion from what I remembering seeing its close to 30% of the original hair that he had and as long as he was aware of that number before the procedure then there is not much one can say. As far as the crown area becoming lower because of the strip removal itself Im sure he knows what he sees in the mirror.

6500 grafts is about 15,000 hairs which is about 28%. I think if the number were explained to patients in terms that can be more easily understood then they would know the limitations of the procedure.

----------


## fred970

I don't know if Jotronic will see this but I have my first FUE scheduled in a few months and I'm still not sure if I should go for it. I can't send private messages so could reply to me here please?

This is my most recent picture (a month ago):



I will be 24 in a few days and my hair situation is quite bad. Almost NW5, all the hair left you can see on this picture is thanks to minoxidil which I've been using for 4 years now. I've never had a receding hair line. It was pure diffused pattern alopecia.

I can't use finasteride or any DHT blocker because I'm gyno prone and had gynecomastia surgery last year.

What I'm really, really scared of is losing the "frame" I can still barely see when I look at myself in the mirror. I think it's OK now, but what about in a year? Maybe a few months?

I know I'm really young for a first FUE, I've seen Dr. Bisanga in Brussels who turned me down right away. Dr. De Reys in Belgium said he would do it even if I would not have enough donor to cover it all in the end.

I still like how I look, even if sometimes, the lightning will be too harsh and I will get very depressed. Maybe I should wait a little longer? I just don't like when I'm being told there is no solution for me or that I should glue a wig on my head. I just want to do what's right for me. And wearing a wig or looking like a 55 years old man at 25 is not right for me. What should I do?

----------


## Artista

Hi Fred! You can better contact Jotronic by visiting his website.. www.hairtransplantmentor.com/
Good luck brother!!

----------


## Follicle Death Row

Fred if it's FUE you want then maybe go into with the idea that it may not be possible to do the crown down the road. 4000 FUE in the front half can look awesome.

----------


## fred970

That has always been my idea  :Smile: . My main concern is to look worse after the FUE's because of horrible shock loss. I'm quite of a pessimist. I've seen that even Spex had quite a bad shock loss, but even then, I'm used to shaving my head, and you almost don't see the scars of my gynecomastia surgery for example. Maybe I worry too much and a FUE would definitely make me happier.

----------


## TheEmperor

> I don't know if Jotronic will see this but I have my first FUE scheduled in a few months and I'm still not sure if I should go for it. I can't send private messages so could reply to me here please?
> 
> This is my most recent picture (a month ago):
> 
> 
> 
> I will be 24 in a few days and my hair situation is quite bad. Almost NW5, all the hair left you can see on this picture is thanks to minoxidil which I've been using for 4 years now. I've never had a receding hair line. It was pure diffused pattern alopecia.
> 
> I can't use finasteride or any DHT blocker because I'm gyno prone and had gynecomastia surgery last year.
> ...


 Fred,

I empathize with your situation.  I think you still look good, and if you are comfortable with the "less is more" approach, I would ONLY consider FUE.

The look you have now, with really short sides, and an outline of a hairline on top, could easily be accomplished with FUE, without many grafts.

If you get strip, there is a good chance you will have to keep the sides longer and that will emphasize the baldness.

Try to wait as long as you can.  At least with FUE you have the option to buzz down.

Even with strip, there is a really good chance you wont be able to complete the crown with your degree of loss.

----------


## TheEmperor

> Hey Emperor you have my sympathies my friend, i guess you don't get many responses when a story is sad. The forums have changed over the years, there was sympathy back then, worry and support. On the other hand there was excitement also, anticipation and hope. 
> 
> Now i think we are all a bit more cynical, less excited and less sensitive when we see a bad result. There is a lesson here to be learned, more than ever you have to do your homework and search multiple doctors, search the truth ask questions, talk with patients. Cause when you take your decision and do it you are all alone in failure. The doc will disappear, your friendly consultant will disappear and no one from the forums will really care after a while. 
> 
> People say we don't have real evolutions in the forums there is no progress, i agree to an extent but there is for sure one evolution in hair transplant industry. The evolution of FUE hair transplants and none of the old arguments can stop it anymore, the work of great surgeons took them out one by one. But that doesn't mean all fue surgeons are angels cause they don't do strip leaving a scar on the back of the head , we still have to be extremely careful who we choose! 
> 
> 
> This evolution didn't happen cause some guys acted like fanatics in forums preaching antistrip and making all FUE surgeons look like saviors. This evolution happened cause the market demanded it and surgeons improvised and worked on it to deliver and the results are everywhere. The simple truth is strip is dying as FUE progresses and you can see it clearly in the forums where the FUE results get most of the attention.


 I got caught up in the wave of megasession hype about five years ago, when the top strip docs were posting greater and greater graft counts.  The clinic I went to is/was very anti fue.

Ironically, the consultant whose results  wowed me did not have any megasessions himself.  In fact he started out with a significant number of mini grafts which probably helped his density down the road.  And his sessions were generally smaller and I dont remember that they dense packed him, so he probably got the best yield.  They also were able to respond to his concerns over something like 4-5 surgeries and make small adjustments to the hairline.

The point is that the quality of even a top doc can go off a cliff in a short period of time (changing methods, staff, apathy, etc.)  I based my decision on results I saw from 3-5 years prior to my first surgery, not on the results I saw coming out at the time from the particular surgeon I chose.  When I objectively looked back through all the results, I realized there were more unhappy patients than I originally thought.  There were also some guys with really shitty results that everyone was patting on the back and cheering on because the forums (rightly) wanted them to feel better about themselves.

I agree that the forums have gotten alot more discriminating and people are more likely to call it as they see it.

----------


## John P. Cole, MD

I don't think you can finish the whole head.  With that much hair loss at age 24, it is probably best if you can put off the procedure altogether for a couple of years.  While it is impossible to completely predict your future pattern, I would say that you are at least heading to a NW 6.  You could progress further, however.  You might find that you can tolerate hair loss better as you get older.  if it's really bugging you, don't go beyond a very high, conservative hairline and I'd avoid a strip procedure.  Also avoid robotic surgery at this point.  the technology just isn't quite that good yet.

----------


## Artista

*Dr Cole*, great advice given to *Fred* !

----------


## 35YrsAfter

> I will be 24 in a few days and my hair situation is quite bad. Almost NW5, all the hair left you can see on this picture is thanks to minoxidil which I've been using for 4 years now. I've never had a receding hair line. It was pure diffused pattern alopecia.
> 
> I can't use finasteride or any DHT blocker because I'm gyno prone and had gynecomastia surgery last year.
> 
> What I'm really, really scared of is losing the "frame" I can still barely see when I look at myself in the mirror. I think it's OK now, but what about in a year? Maybe a few months?
> 
> I know I'm really young for a first FUE, I've seen Dr. Bisanga in Brussels who turned me down right away. Dr. De Reys in Belgium said he would do it even if I would not have enough donor to cover it all in the end.
> 
> I still like how I look, even if sometimes, the lightning will be too harsh and I will get very depressed. Maybe I should wait a little longer? I just don't like when I'm being told there is no solution for me or that I should glue a wig on my head. I just want to do what's right for me. And wearing a wig or looking like a 55 years old man at 25 is not right for me. What should I do?


 Here is a photo of our patient who had 2840 FUE a little over 6 months ago.  He still has more growth to come.  He was a Norwood 5a.  Men in the higher Norwood categories can expect improvement mostly from the viewing angles I have provided in the photos.  This can be achieved without going overboard with the graft numbers.  More coverage in the future will depend upon your donor characteristics and your willingness to use alternative hair sources.  Beard hair is growing at about a 90% reliable yield.  When it is placed properly it looks natural.

35YrsAfter also posts as CITNews and works at Dr. Cole's office

----------


## Number47

That is a nice result 35 years after, for such a small amount of grafts(small compared to the balding area i mean) it looks very descent! The crown is left untouched from what i can understand. Can we see some more pics from other angles?

----------


## gillenator

And even with the higher placement of his frontal care and hairline, the visual improvement is outstanding.  :Wink:

----------


## yeahyeahyeah

> Here is an example of our Norwood 6 patient who received a little over 6,000 grafts.  In my opinion his appearance from the front and sides is dramatically improved.  Many younger people have standards that are not reachable for advanced Norwood patients.  When I was 18 for instance a thinning spot on a man's head the size of a silver dollar was completely unacceptable.  My expectations changed when I got older.
> 
> 35YrsAfter also posts as CITNews and works at Dr. Cole's office
> Cole Hair Transplant
> 1045 Powers Place
> Alpharetta, Georgia 30009
> Phone 678-566-1011
> Please feel free to call or email me with any questions.


 To be honest, I totally agree with him.

Yes these guys look like they have hair on the top of their head, but the hairstyle looks outdated and as a result doesn't look good. Bobman only looks better if you know what he looked like when he was bald. But if I saw Bobman down the street, I wouldn't think that he looked particularly stylish.

If you are a young man, you want to be styling your hair like David Beckham, defeats the whole point otherwise.

I really hope HT and hairloss treatments advance enough so that NW6s because less common.

----------


## John P. Cole, MD

But, you have to work with what is available in the donor area and what the degree of hair loss is.  One should attempt to create a natural state of coverage or hair loss.  In other words, it's impossible to create a low hairline in a NW 6 to 7 because you don't have enough hair to make the crown look good.  The degree of loss in the crown has to match what you see up front.  The carpet and the drapes have to match.  Otherwise, it stands out.  One can stretch a donor area a very long way by accepting a shorter hairstyle and a lower density.  Is it better to look like you are thinning or like you are a bald NW 6?  My idea is that you try to make the most of what you are dealt with, but you can't create the same thing for everyone that is in the same state of hair loss because the donor area varies.  

Take for example my patient today from Boston.  He had a transplant about 10 years ago.  He has 4 strip scars in different locations.  The hairline is 7 cm.  He has fine hair.  He is already a NW 6 at 40.  There is already a gap between his temple points and his hairline.  He just wants more hair right now, but what he has to come to grips with is that we need to create something that is going to look good long term.  Ultimately, grafts have to come out.  His hairline has to be softened.  He needs a front and rear hairline.  We need to think about his scars.  

Sohe schedules for 1000 grafts, which is way too low, but figures a way to go to 1300 grafts.  He needs more.  Much of my progress today was to do my best to turn something that looks like a hair transplant and make it look natural.  He just wants more coverage.  Fine hair and maximal loss don't necessarily equate to what he wants.  He needed more so i just did it.  I took him to 2500 grafts, which is a better procedure for him.  I ultimately, know that the hairline needs to come back up at least one centimeter.  Then i wanted to see how he responded to beard hair and how he liked it so i did 50 beard hair grafts.  I would have liked to do more scalp grafts, but I was worried about his strip scars becoming evident.  


Not everyone has the optimal donor area.  Not everyone has the financial capacity to do what needs to be done.  Sometimes we just have to do things at no charge because the only thing anyone should be thinking about when they do a hair transplant procedure is how to make a result as good as it can be.  Maximal loss cases can be very complex.  At the end of the day, the treated area, the area of persistent loss, and the donor area must all match.  I think we are far more limited with strip scars than without them because we have to conceal them with the remaining hair, but this is just one more variable to be dealt with in the process.  

In complex cases, there is no right or wrong formula.  There is what works on an individual basis.   Accomplishing this is not always easy, but it can be done.  What we continue to struggle with is getting patients to understand that we can't always get them to the result they expect.  If you have enough bricks for a 2000 square foot home, you are going to fail if you frame out a 10,000 square foot home.  Everyone has to be on the same page.

----------


## yeahyeahyeah

> But, you have to work with what is available in the donor area and what the degree of hair loss is.  One should attempt to create a natural state of coverage or hair loss.  In other words, it's impossible to create a low hairline in a NW 6 to 7 because you don't have enough hair to make the crown look good.  The degree of loss in the crown has to match what you see up front.  The carpet and the drapes have to match.  Otherwise, it stands out.  One can stretch a donor area a very long way by accepting a shorter hairstyle and a lower density.  Is it better to look like you are thinning or like you are a bald NW 6?  My idea is that you try to make the most of what you are dealt with, but you can't create the same thing for everyone that is in the same state of hair loss because the donor area varies.  
> 
> Take for example my patient today from Boston.  He had a transplant about 10 years ago.  He has 4 strip scars in different locations.  The hairline is 7 cm.  He has fine hair.  He is already a NW 6 at 40.  There is already a gap between his temple points and his hairline.  He just wants more hair right now, but what he has to come to grips with is that we need to create something that is going to look good long term.  Ultimately, grafts have to come out.  His hairline has to be softened.  He needs a front and rear hairline.  We need to think about his scars.  
> 
> Sohe schedules for 1000 grafts, which is way too low, but figures a way to go to 1300 grafts.  He needs more.  Much of my progress today was to do my best to turn something that looks like a hair transplant and make it look natural.  He just wants more coverage.  Fine hair and maximal loss don't necessarily equate to what he wants.  He needed more so i just did it.  I took him to 2500 grafts, which is a better procedure for him.  I ultimately, know that the hairline needs to come back up at least one centimeter.  Then i wanted to see how he responded to beard hair and how he liked it so i did 50 beard hair grafts.  I would have liked to do more scalp grafts, but I was worried about his strip scars becoming evident.  
> 
> 
> Not everyone has the optimal donor area.  Not everyone has the financial capacity to do what needs to be done.  Sometimes we just have to do things at no charge because the only thing anyone should be thinking about when they do a hair transplant procedure is how to make a result as good as it can be.  Maximal loss cases can be very complex.  At the end of the day, the treated area, the area of persistent loss, and the donor area must all match.  I think we are far more limited with strip scars than without them because we have to conceal them with the remaining hair, but this is just one more variable to be dealt with in the process.  
> 
> In complex cases, there is no right or wrong formula.  There is what works on an individual basis.   Accomplishing this is not always easy, but it can be done.  What we continue to struggle with is getting patients to understand that we can't always get them to the result they expect.  If you have enough bricks for a 2000 square foot home, you are going to fail if you frame out a 10,000 square foot home.  Everyone has to be on the same page.


 Sigh, we really need unlimited donor supply.

----------


## John P. Cole, MD

I agree.  But we don't have it.  Thus, we have to figure a way to make it work with what we have.  What does not work is a low hairline and a huge bald surface area in the back.  A now 2V or 3V looks natural because they are natural.  

I hit the donor with Acell/gel today.  Hoping for the best.  Patient was a great guy.  He deserves it.  

Keep the faith.  We've made progress.  We simply have not reached the goal we all have.

----------


## yeahyeahyeah

> I agree.  But we don't have it.  Thus, we have to figure a way to make it work with what we have.  What does not work is a low hairline and a huge bald surface area in the back.  A now 2V or 3V looks natural because they are natural.  
> 
> I hit the donor with Acell/gel today.  Hoping for the best.  Patient was a great guy.  He deserves it.  
> 
> Keep the faith.  We've made progress.  We simply have not reached the goal we all have.


 Are you getting decent donor regeneration with acell?

I am a NW2 at 28, and want to straighten my hairline out as it is currently a V shape. Donor regeneration will help me decide whether to go ahead with it or not.

----------


## Jotronic

Wow, this thread really has grown. 

yeah,yeah,yeah,




> Yes these guys look like they have hair on the top of their head, but the hairstyle looks outdated and as a result doesn't look good. Bobman only looks better if you know what he looked like when he was bald. But if I saw Bobman down the street, I wouldn't think that he looked particularly stylish.
> 
> If you are a young man, you want to be styling your hair like David Beckham, defeats the whole point otherwise.


 With all due respect this comment tells me you have no idea what you're talking about. But of course, how could you? You're 28 and a NW2. Bobman was a strong NW6. He may not be able to pull off a Beckham hair style, but he's 40 plus years old and looks fantastic. The point of getting a hair transplant isn't to look like a celebrity or to impress others with how stylish you are. It is to look better overall and to feel better about oneself and Bobman certainly achieved this, in spades. 

It's all relative really. Us bald guys just want to not be bald any more. You young'uns want the hairline that you had when you were 18 but your loss is just as bad for you as losing everything was for us.

----------


## greatjob!

> Wow, this thread really has grown. 
> 
> yeah,yeah,yeah,
> 
> 
> 
> With all due respect this comment tells me you have no idea what you're talking about. But of course, how could you? You're 28 and a NW2. Bobman was a strong NW6. He may not be able to pull off a Beckham hair style, but he's 40 plus years old and looks fantastic. The point of getting a hair transplant isn't to look like a celebrity or to impress others with how stylish you are. It is to look better overall and to feel better about oneself and Bobman certainly achieved this, in spades. 
> 
> It's all relative really. Us bald guys just want to not be bald any more. You young'uns want the hairline that you had when you were 18 but your loss is just as bad for you as losing everything was for us.


 yeahyeahyeah is completely mental, he literally has a full head of hair at 32 and yet spends a crazy amount of time on hairloss forums and claims that his life is ruined from hairloss. His opinion is completely useless because he is a superficial, self-absorbed, narcissistic d-bag.

----------


## yeahyeahyeah

> Wow, this thread really has grown. 
> 
> yeah,yeah,yeah,
> 
> 
> 
> With all due respect this comment tells me you have no idea what you're talking about. But of course, how could you? You're 28 and a NW2. Bobman was a strong NW6. He may not be able to pull off a Beckham hair style, but he's 40 plus years old and looks fantastic. The point of getting a hair transplant isn't to look like a celebrity or to impress others with how stylish you are. It is to look better overall and to feel better about oneself and Bobman certainly achieved this, in spades. 
> 
> It's all relative really. Us bald guys just want to not be bald any more. You young'uns want the hairline that you had when you were 18 but your loss is just as bad for you as losing everything was for us.


 Fair enough.

I personally wouldn't go through the hassle if I couldn't style my hair properly. That's what having hair is about IMO.

The recovery period/financial expense after surgery needs to be justifiable.

----------


## Artista

*Hi Joe Hi everyone*, 
Just to add to the conversation..
As some of you may know, *Bobman* and i are very  good friends, its a kinship.
 Because we live _relatively_ close to each other ,we agreed to meet (at the very beginning of 2013) to have a discussion about his hair transplant(s) experience and HTs in general. 
He had called me 2 days ago via Skype. The topic was unrelated to hair but I could not help but remark that, to this day, his head of hair looks just as impressive as it did some time ago.
As* Jotronic* has said,,
*Bobman WAS* a * strong NW6* 
I do understand the speculation that we all have at various times in our lives. 
Especially you youngsters.  
Do your own due diligence, research-research-research.

----------


## fred970

yeahyeahyeah, stop it please, you don't even suffer from male pattern baldness.

Personally I couldn't care less about "styling my hair", I've never been able to style it anyway, having at least some hair would be a nice start, considering I'm NW5 at 24. Of course you can't understand what I'm talking about with your mature hair line yeahyeahyeah.

Bobman's case is really inspiring. I'm still afraid that I will end up worse than I've predicted, or that my donor will start to thin. Anyway there's no other solution than FUE for me now, except accepting to feel ugly for the rest of my life.

----------


## John P. Cole, MD

There is no question that we are getting some regeneration with Acell.  

I think beauty is in the eye of the beholder.  About 90% of guys with bad hair transplants seem to be happy with them at least up to a point where it becomes more and more obvious.  About 10% with a bad hair transplant can't stand it and about 3% become almost suicidal.  

It's better to do it right from the beginning.  However, some people are happy with just a little bit of hair to help frame their face and they top it off with products when they want it to look fuller.  Others, want as much as they can get.  Others want more than we can offer.  

With all the cow licks on my head, i've never been able to really style my hair, but at least I have it.  It's  going to go where it wants to go, but at least I have it.  

I think all opinions are important.  The beauty of what we do is the ability to satisfy many different opinions.  

I never met Bobman, but it seems like a great result especially based on where he came from.

----------


## Dan26

^^^

Drcole what do you think of ppl who are destined for nw6 get a conservative and somewhat dense hairlien via FUE (say nw2-2.5) and perhaps SMP in the crown just to make the head appear full. Assuming they are ok with shaving their head now or down the road.

For me, especially as a younger guy, rocking a shaved head (lets say 1 guard) with atleast a hairline to frame it is much better than spending my 20's bald.

This way you can escape the 'bald/balding' stigma and just be a dude with a shaved head.

You could actually use the best donor area for the hairline and some of the donor area that is bordering the nw5-7 area for less important parts.

May sound crazy but I acutally think if you are a young guy destined for nw6 by 30, it is a good idea to get on meds RIGHT AWAY and see if you tolerate it...then just go for a conservative frontal/hairline HT so you can stop worrying about your hairloss (even if at the time you are a strong nw2 but know your destined for full reession)...If i had the money I think I would have done that...could definitely hold on to my crown for a solid 5-10 years with treatment, and worse case scenerio you start losing, shave ur head, perhaps SMP in the crown, no/limited scar in the donor so looks good at 1 guard, and ur good to go...

----------


## yeahyeahyeah

> There is no question that we are getting some regeneration with Acell.  
> 
> I think beauty is in the eye of the beholder.  About 90% of guys with bad hair transplants seem to be happy with them at least up to a point where it becomes more and more obvious.  About 10% with a bad hair transplant can't stand it and about 3% become almost suicidal.  
> 
> It's better to do it right from the beginning.  However, some people are happy with just a little bit of hair to help frame their face and they top it off with products when they want it to look fuller.  Others, want as much as they can get.  Others want more than we can offer.  
> 
> With all the cow licks on my head, i've never been able to really style my hair, but at least I have it.  It's  going to go where it wants to go, but at least I have it.  
> 
> I think all opinions are important.  The beauty of what we do is the ability to satisfy many different opinions.  
> ...


 If you are getting regeneration with ACell, then why is donor limitation an issue?

----------


## John P. Cole, MD

Definitely an option with a few unknowns.  

We know medical treatment can slow down loss and in instances reverse it.  What we don't know is how long it will last.  

We know that SMP can help.  What we don't know is the long term issues (pluses and minuses) with SMP.  I'm going to visit Rob Jones soon to see what he is doing with SMP.  He went to Milan, but said it was a waste of time as he saw very little.  People who are doing SMP say that results tend to vary.  Depth is key.  if you go too shallow, the result is not there.  If you go too deep, the pigment will bleed and last too long and turn blue.  There is not pigment that just fades away on it's own.  It's tricky.  

Here is another option.  Build a great hairline now and then relocate it later on  in other places as you loose more hair.  Good option if you doctor knows how to do it.  

We talk about the safe donor area and worry about extracting outside it.  Ok, sure, we worry, but isn't it better to use this potentially non-permanent hair in places it can do more good when you are young?  If you loose it later on, at least you had it to do some good when you were young and needed it most in cosmetically significant areas.  You could even put this hair in the frontal hairline and let it potentially recede over time to a more natural, more mature hairline.  Just a thought.  

I think the most important thing is to discuss options with individuals and let them decide what to do based on a long term approach.  

What I would not recommend is a strip in an individual heading to a NW 5 or 6 or 7.  You eliminate plenty of options doing it this way.  Of course individuals like bowman refute this approach, but it is important to know that not all individual have a bowman donor area that allows a more aggressive approach.  We also don't know what his situation will be like in another 10 or 20 years when the grafted hair is prone to fade with time.

----------


## John P. Cole, MD

> If you are getting regeneration with ACell, then why is donor limitation an issue?


 Great question!  Suppose you take out a three hair graft and get only 1 hair to regrow.  Suppose you take out 20 grafts and get only 50&#37; of them to regenerate a single hair.  It's just too early in the process to make any exaggerated claims.  We need more time to study what we are seeing.  I think we have a tendency to be too positive about something new.  We must take a wait and see philosophy first.  It's like Pilofocus.  It seems great, but there are plenty of things that can go wrong.  Also, consider body hair.  We had great results early on and then some not so good results and then some terrible results.  We can't over promote a technique or approach until we have a firmer grasp on long term results and the percentage of responders.  Just wait.  Be patient.

Put simply, it is an issue until it is no longer an issue.  For now, it is still an issue.

----------


## Dan26

Appreciate the insights/info Dr.Cole!

I think nowadays FUT is only reasonable in a select few scenarios...I hope it becomes extinct in the near future!

----------


## brunobald

Dr Cole, 

I have a few questions I have been thinking over regarding donor regen.

First off have you ever tried transecting a thinning hair in the front of the scalp and then applying acell to see if it will regenerate into a healthy follicle. I know this does not have many practical applications but it would be interesting to see the results.

Secondly I was wondering just how little of the follicle needs to remain post transection for regeneration to occur. If we are talking about small fractions of the follicle, would it be possible to culture a replacement mix of follicle cells and inject them into the wound site. Maybe some dp and dermal sheath cells, im hoping the healing action of the fue punch closing over may induce a regeneration effect with the addition of the cultured cells. The healing wound would be producing tissue to close the hole we just need to push it in the right direction with the correct signals to produce a follicle not just skin.

----------


## yeahyeahyeah

> Great question!  Suppose you take out a three hair graft and get only 1 hair to regrow.  Suppose you take out 20 grafts and get only 50% of them to regenerate a single hair.  It's just too early in the process to make any exaggerated claims.  We need more time to study what we are seeing.  I think we have a tendency to be too positive about something new.  We must take a wait and see philosophy first.  It's like Pilofocus.  It seems great, but there are plenty of things that can go wrong.  Also, consider body hair.  We had great results early on and then some not so good results and then some terrible results.  We can't over promote a technique or approach until we have a firmer grasp on long term results and the percentage of responders.  Just wait.  Be patient.
> 
> Put simply, it is an issue until it is no longer an issue.  For now, it is still an issue.


 When will your studies of the application of acell and donor regeneration be concluded. I am aware that you have been conducting it for a while.

----------


## thinkingaboutit

I was about to write a lengthy reply to this post, and then I stopped my self and deleted my reply. I have learnt to not get into discussions or arguments on forums where it can get a bit clicky etc. I won't go into why etc.

Anyway, I would consider myself a close a a Norwood 6, I think I am borderline, I am VI to 6, and I just turned 38, a few months ago. I had FUE about 14 months ago, and now I have almost a full head  of hear. Some well known people (I am not going name names at this moment in time) said I was not a suitable candidate. Those clinics that met me in person, said I had very good donor hair and I would need about 5,500 to 6,000 grafts. Some said I would need to 7,000 to 8,000 grafts. However, the vast majority said I would need about 5,500-6,000 grafts. 

So in short, I now have a hair. For me it's a miracle. It's not as thick as I would like it to be. However, considering what it was 14 months ago to now, it's a world pf difference. I was someone who shaved my head dialy religiously for more than 7 years, and wore my bold hair proudly. Know I love the fact that I have a choice. It's one of the best decisions I made. I wish I had done it sooner. I was told my most clinics that I would need a minimum of 2 or 3 transplants. So I would need t go back after 12 or 18 months, depneding on how I felt. Anyway, that's my story. A lot of people have asked me to post pictures. Which I don't. Some some may think I may be a fake. I am not here promoting any company. I will post pictures soon. I realised that I could post a picture and blurr my face out using photoshop.

Anyway, that's my story. These forums can be great places, but there are also some not so nice people. That's my 2 cents.

----------


## fred970

Thank you for your contribution, it gives me so much hope. Less than 3 months before my first FUE now. I'm so nervous. I'll keep you guys posted on various forums of course.

----------


## thinkingaboutit

Some pictures....for a number of people who have asked for them before before. So I was Norwood VI To 6. Although English/British born my ethnicity is  Indian as you will see from pictures, and at the moment my hair is very short I am growing it, and it looks a lot better when it is longer but it will give you guys an idea of going from a Norwood 6 if you have Donor hair. Also I took these pictures in the last 5 -10 minutes using my iPad Mini so not the best photos - sorry. But it's something.

I have never uploaded pictures here, so i hope it works. I hate having my pictures on the internet. Hopefully it will show that I am a real person. And give some hope to not "always" listen to the experts who say it's not possible. There many people with agendas.  :Wink:

----------


## thinkingaboutit

A quick last note, I believe I will need another session in another 12 or 14 months, so long as there is enough donor hair. The clinic seems to think there is enough donor hair left. Anyway, thank you to everyone who has advised me and shown support during my interactions on this forum. Some good people here. However, I also need to remind myself occasionally that hair is not everything in life. There are more important things. But it sure helps to have hair.

----------


## Clark Kent

I was told by dr wong that i am a nw 6. although the there was still a lot of hair there you could see where the hair was receding too. I had my first ht 11 days ago. sucks im only 21 but hopefully this will wield good results.

----------


## John P. Cole, MD

I think your result is good, Thinking about it.  the photos are a bit blurred, but it seems good.  It also appears that your hair is at least medium.  Medium and coarse hair will fair better than fine hair.  One should always remember to compare apples and oranges.

I think the level of transection probably affect survival of both top and bottom halves of the follicle.  A low bisection will probably result in a higher survival for the top half and not as good for the bottom half.  A middle cut probably has the best survival for both top and bottom.  A top cut probably has a best survival for the bottom half.  

i just returned from the Japanese society meeting last weekend in Japan.  MOst of the lecture are on basic science here.  There was a lot of talk about stem cells including the Japenesse equivalent to the Jahoda/Chritiano study.  There is considerable confidence, as well.  

Robert Hoffman gave a great lecture on Nestin producing follicle stem cells. these cells need very little stimulus to carry on minor regeneration of structure such as nerves and blood vessels.  It the right setting, it is not surprising that they can carry out more complex structures such as intact hair follicles.  

One not is that in our initial Acell trial we used other pro-inflamatory induces and we got faster growth than we are seeing in our follow up study where we used Acell alone.  The combination, as expected, may turn out to be the optimal recipe.

----------


## 35YrsAfter

> Robert Hoffman gave a great lecture on Nestin producing follicle stem cells. these cells need very little stimulus to carry on minor regeneration of structure such as nerves and blood vessels.  It the right setting, it is not surprising that they can carry out more complex structures such as intact hair follicles.  
> 
> One not is that in our initial Acell trial we used other pro-inflamatory induces and we got faster growth than we are seeing in our follow up study where we used Acell alone.  The combination, as expected, may turn out to be the optimal recipe.


 This is why I believe that advances in regenerative medicine will lead to more effective treatments for men in the higher Norwood categories.


35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
I am not a doctor and the content of my posts are my opinions, not medical advice.
Please feel free to call or email me with any questions.  Ask for Chuck

----------


## thinkingaboutit

> I was told by dr wong that i am a nw 6. although the there was still a lot of hair there you could see where the hair was receding too. I had my first ht 11 days ago. sucks im only 21 but hopefully this will wield good results.


 Clark Kent, it does suck. However on a positive note, if you have the donor hair and the money, there are solutions out there now that can deal with the problem. When I started going bold at young age of 17-19, it ruined my life, and almost 20 years ago now, the options were also limited in terms of hair transplant technology and medicines etc. 

So it does sucks to suffer hair loss. Life is not fair. You just need to accept it for what it is and deal with it and move on.

I hope that helps.

----------


## Artista

_Scientifically speaking_, a hair transplant can NEVER give you back a full head of hair. That is just *COMMON SENSE*. 
If a NW-6 sufferer decides to have hair transplant surgery the objective should be to achieve an IMPROVEMENT and not to HOPE for a full head of hair.
Yes 'good' donor hair numbers are limited depending on each individual.
A qualified and reputable hair transplant surgeon who is experienced and has GREAT *artistry concepts* could do wonders. A good friend of mine who use to be a NW 6 has a good looking head of hair to this day--NOT a full head of hair...an improved appearance! He is happy.    
*REALISTIC GOALS for IMPROVEMENT is key.*

----------


## yeahyeahyeah

> _Scientifically speaking_, a hair transplant can NEVER give you back a full head of hair. That is just *COMMON SENSE*. 
> If a NW-6 sufferer decides to have hair transplant surgery the objective should be to achieve an IMPROVEMENT and not to HOPE for a full head of hair.
> Yes 'good' donor hair numbers are limited depending on each individual.
> A qualified and reputable hair transplant surgeon who is experienced and has GREAT *artistry concepts* could do wonders. A good friend of mine who use to be a NW 6 has a good looking head of hair to this day--NOT a full head of hair...an improved appearance! He is happy.    
> *REALISTIC GOALS for IMPROVEMENT is key.*


 Waste of time to be honest.

What is the point of getting HT surgery just so that you are looking like you are balding afterwards?

----------


## Artista

*Hi Yeah'* I understand your point of view on this. 
It is all a matter of objectivity, perception  and what someone would be _COMFORTABLE_ with.
For me, if I could get my scalp improved enough to look as it did back in 2004 (a natural looking NW 3 to 4-ish) Id be *comfortable with it.*

----------


## fred970

And I'd be very happy with a diffuse NW5 when I'll be slick bald. Yeah I'm not very demanding, I shave my head. I just want even a faint frame.

I totally understand what you're saying Artista. yeahyeahyeah isn't even balding so, I don't understand his contribution here. When you're bald, adding a few thousand grafts can be a huge improvement. Little hair is always better than no hair.

I cancelled my FUE and I'm now waiting for pilofocus. I hope everything goes right for you with Dr. Wesley Artista!

----------


## Artista

*Hi there Fred' !*
Thanks bro'..Have a great day

----------


## 35YrsAfter

> Waste of time to be honest.
> 
> What is the point of getting HT surgery just so that you are looking like you are balding afterwards?


 Most younger men have this point of view.  I felt the same way myself when I was a teenager and in my twenties.  Some men, even in their fifties have this point of view.  For instance we had a man come in for a small session of FUE, whose hair looked similar to Ronald Reagan's with the exception of a silver dollar-sized thin spot in the back.  To this man, not even a small thinning area was acceptable.

Guys like me for instance who were headed toward a slick Norwood 6 in their thirties can often be satisfied with light coverage and a natural hairline that frames the face.  Most of us in that category are satisfied by avoiding being greeted in the mirror by an older, shiny dome, mega forhead version of ourselves.  That image in the mirror feels like a downgrade.  At least it did to me.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## win200

> Wow, this thread really has grown. 
> 
> yeah,yeah,yeah,
> 
> 
> 
> With all due respect this comment tells me you have no idea what you're talking about. But of course, how could you? You're 28 and a NW2. Bobman was a strong NW6. He may not be able to pull off a Beckham hair style, but he's 40 plus years old and looks fantastic. The point of getting a hair transplant isn't to look like a celebrity or to impress others with how stylish you are. It is to look better overall and to feel better about oneself and Bobman certainly achieved this, in spades. 
> 
> It's all relative really. Us bald guys just want to not be bald any more. You young'uns want the hairline that you had when you were 18 but your loss is just as bad for you as losing everything was for us.


 Joe's comment is dead on.  The reality of hair loss changes as you get older and the loss accumulates.  If you're a NW6, of course you'll always want that high school hairline... but I have a hunch you'll be ecstatic at the prospect of having a NW2V hairline to frame your face and avoid the "chromedome" look.  Also, context matters... as you get older, more and more of your peers will have loss.  This won't make things OK, of course, but it'll make you less conspicuous and mitigate the feelings of being singled out.  Even at 31, many of my friends are getting to the NW2-3 range, whereas virtually no one was at that phase at 20.  And it'll be different still by 35.  High Norwoods will always sting, but guys that fall into the NW2-4 camp will have more and more company as time goes by.  Different ages, different loss, different goals.

----------


## thinkingaboutit

I would say I am satisfied. I still don't have the "original" head of hear I had in my late teens. However, that would be unrealistic. However, it has given me a hairline, which has made the world of difference. Your perception definitely changes with age.

I would still want more hair ...but don't we all!

----------


## UK_

Acell is only as useful as its capabilities of activating the WNT pathway, that's where the signal to (1) form new hair follicles and (2) go into anagen come from (it's a regenerative pathway).

The literature still supports the WNT hypothesis, which many have rubbished over the years with a combined attack on the the companies that are researching this area, funny how while all other companies have fallen, the companies looking into WNT proteins are still conducting trials.

Any HT surgeon will tell you when looking at bald areas with a magnifying device, one can see approximately 80&#37;+ miniaturized hairs, the rest would have either miniaturized below the level of the skins surface or are simply now dormant follicles resting inside the dermis.  The factory (follicle) has shut down, and the only way to commence operation (the generation of progenitor cells) is to reactivate a disrupted signal (via WNT signalling).  

So WNT signalling may have a positive effect on the 80% minaturized follicles that can still be seen, rescuing those dormant follicles below the skins surface may prove more difficult, but in this scenario, _breath-taking coverage_ would no longer be tough work for even the most inept hair transplant surgeon.

----------


## Artista

Hi *Thinkingaboutit* I really APPRECIATE your recent comment on your experience .
Its common sense. Thanks

----------


## Notcoolanymore

> Waste of time to be honest.
> 
> What is the point of getting HT surgery just so that you are looking like you are balding afterwards?


 I am not attacking you or anything, but this is an easy thing for somebody who still has 99% if their hair to say.  For a slick NW6, it may be worth it.

----------


## Artista

While opening up the forum this morning I saw a HT surgery image done by 
* Dr.Paul McAndrews, MD* 
I clicked onto his page here and was impressed by his work. I had not known of him til today.
I went to his site and one of the statements made  was 
"He does not believe that the responsibility of performing a hair transplant should be handed off to a medical technician..."
Its imperative that all doctors  feel that way when performing this type of surgery. When looking for the right clinic - Research research research. 
When considering the option of hair transplantation as a NW 6
(or ANY NW scale for that matter ), the most important tool  to use is that of _'REALISTIC EXPECTATIONS' _  
These two image links that I have  added here of *Dr McAndrews* works shows that, *if you have realistic expectations* and if you are willing to *ACCEPT the idea of scalp IMPROVEMENT* , then you can be a satisfied individual.
With both of these men here, im sure that if you were to brush their hair  at different or at extreme angles, their  scalps would be obvious.
It is a matter of acceptance within. 

http://www.baldtruthtalk.com/album.php?albumid=18
http://www.baldtruthtalk.com/album.php?albumid=79

I am not a shill nor paid to promote Dr McAndrews or any of our forum Doctors. I created this thread to talk about the possibilities of HT surgery for a NW 6 (and all others) 
*Dr McAndrews* , you do some great work out there!

----------


## 35YrsAfter

> I am not a shill nor paid to promote Dr McAndrews or any of our forum Doctors. I created this thread to talk about the possibilities of HT surgery for a NW 6 (and all others) 
> *Dr McAndrews* , you do some great work out there!


 I doubt anyone thinks you are a "shill". IMO good work should be recognized.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## yeahyeahyeah

> While opening up the forum this morning I saw a HT surgery image done by 
> * Dr.Paul McAndrews, MD* 
> I clicked onto his page here and was impressed by his work. I had not known of him til today.
> I went to his site and one of the statements made  was 
> "He does not believe that the responsibility of performing a hair transplant should be handed off to a medical technician..."
> Its imperative that all doctors  feel that way when performing this type of surgery. When looking for the right clinic - Research research research. 
> When considering the option of hair transplantation as a NW 6
> (or ANY NW scale for that matter ), the most important tool  to use is that of _'REALISTIC EXPECTATIONS' _  
> These two image links that I have  added here of *Dr McAndrews* works shows that, *if you have realistic expectations* and if you are willing to *ACCEPT the idea of scalp IMPROVEMENT* , then you can be a satisfied individual.
> ...


 He should have just shaved it off.

That hairstyle does not do anything for him.

There is no point having hair if you can't style it properly.

----------


## 35YrsAfter

> He should have just shaved it off.
> 
> That hairstyle does not do anything for him.
> 
> There is no point having hair if you can't style it properly.


 It's a matter of personal preference.  I prefer the look of the patient's hair to the big-hair style pictured below.  I think too much hair makes a man look feminine.  Just my point of view.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## yeahyeahyeah

> It's a matter of personal preference.  I prefer the look of the patient's hair to the big-hair style pictured below.  I think too much hair makes a man look feminine.  Just my point of view.
> 
> 35YrsAfter also posts as CITNews and works at Dr. Cole's office
> forhair.com
> Cole Hair Transplant
> 1070 Powers Place
> Alpharetta, Georgia 30009
> Phone 678-566-1011
> email 35YrsAfter at chuck@forhair.com
> ...


 The person with the big afro hair has styling options.



An example of a style which can be achieved with a good set of hair that makes a man looks classy.

That's what makes having hair fun, the ability to change your look.

The NW6 with a HT cannot achieve that look.

I honestly think HT for higher norwoods is just a case of damage control, either way - I can see it only benefiting them if they want to buzz their hair with a better hairline.

----------


## Dan26

^^ I agree with that for the most part. If I was a high NW getting an HT I would prob just try and and make a decent hairline to frame the face and have it less dense in the back and buzz it + possibly SMP.

Or even if possible a nw2.5-3 with a short fade type cut would look decent on the right type of person. (ie not some pale skinny white dwebe lol)

----------


## Notcoolanymore

yeahyeahyeah, I think you are a pretty entertaining dude and enjoy reading your posts, but your contribution to this thread is pretty offensive.  You are shitting on people who have either had a transplant or are thinking about getting one.  You've made posts about them being worthless, not looking good, can't achieve certain look, no point in getting one, etc.  These are pretty effed up things to say, especially since the whole point of somebody getting a transplant is to feel better about themselves.  You might as well just say "You are bald/balding so don't even try to do anything because without a full/thick head of hair you will still look like shit.

I understand you are not happy/frustrated about you "hair loss", but coming on here and making guys feel worse about their situation is just messed up.

----------


## fred970

I second this. The guy has no idea of what real hair loss can feel like and comes here to put people down. I would be thrilled if only I had a few thousand more hairs on my NW5. It's all about improvement, not perfection.

----------


## yeahyeahyeah

> yeahyeahyeah, I think you are a pretty entertaining dude and enjoy reading your posts, but your contribution to this thread is pretty offensive.  You are shitting on people who have either had a transplant or are thinking about getting one.  You've made posts about them being worthless, not looking good, can't achieve certain look, no point in getting one, etc.  These are pretty effed up things to say, especially since the whole point of somebody getting a transplant is to feel better about themselves.  You might as well just say *"You are bald/balding so don't even try to do anything because without a full/thick head of hair you will still look like shit.*
> 
> I understand you are not happy/frustrated about you "hair loss", but coming on here and making guys feel worse about their situation is just messed up.


 Not as harsh as that, but yeah, HT technology is VERY primitive for higher norwoods.

I have gone through cosmetic surgery - it is counter productive to do it if it doesnt knock you up a few points

----------


## greatjob!

> yeahyeahyeah, I think you are a pretty entertaining dude and enjoy reading your posts, but your contribution to this thread is pretty offensive.  You are shitting on people who have either had a transplant or are thinking about getting one.  You've made posts about them being worthless, not looking good, can't achieve certain look, no point in getting one, etc.  These are pretty effed up things to say, especially since the whole point of somebody getting a transplant is to feel better about themselves.  You might as well just say "You are bald/balding so don't even try to do anything because without a full/thick head of hair you will still look like shit.
> 
> I understand you are not happy/frustrated about you "hair loss", but coming on here and making guys feel worse about their situation is just messed up.


 He is exactly what is wrong with the forum, too many narcissistic, superficial d-bags with perfect heads of hair complaining about how hairloss is ruining their lives, and that people with extensive loss should just shave it off and move on because he is the real victim of hairloss because he lives in fear everyday of not being able to style his hair like Brad Pitt....

----------


## Notcoolanymore

> *Not as harsh as that, but yeah, HT technology is VERY primitive for higher norwoods.*
> 
> I have gone through cosmetic surgery - it is counter productive to do it if it doesnt knock you up a few points


 I agree with that. 

I think many people including myself sometimes, miss the whole point when it comes to transplants.  I have heard bobman brought up in this type of conversation before, so I will use him as an example.  Some have had negative things to say about his new look, but none of those opinions matter.  None!  The only opinion that matter is his own.  If he likes his new look, which it definitely seems like it does, then eff what everybody else thinks.  Being happy with the way you look should be the main goal of getting a transplant.  Not impressing other people that really don't matter.  Happiness will lead to confidence, which will ultimately effect every other aspect of your life: love, career, etc.  Eff what anybody else thinks, even with a full head of hair you are not going to be able to impress/attract everybody.

----------


## 35YrsAfter

> I agree with that. 
> 
> I think many people including myself sometimes, miss the whole point when it comes to transplants.  I have heard bobman brought up in this type of conversation before, so I will use him as an example.  Some have had negative things to say about his new look, but none of those opinions matter.  None!  The only opinion that matter is his own.  If he likes his new look, which it definitely seems like it does, then eff what everybody else thinks.  Being happy with the way you look should be the main goal of getting a transplant.  Not impressing other people that really don't matter.  Happiness will lead to confidence, which will ultimately effect every other aspect of your life: love, career, etc.  Eff what anybody else thinks, even with a full head of hair you are not going to be able to impress/attract everybody.


 Couldn't agree more.  I have mentioned before that I know a guy who is now in his late fifties.  He has a full head of hair and to my knowledge, has only had one girlfriend his entire life.  I have mentioned several times in this forum another friend who is a Norwood 6, shaves his head and has more women than he knows what to do with.  It's mostly all about self confidence and a positive attitude.  The guy I mentioned with the full head of hair and a dismal love life is a walking pity party. He treats friends like they're his personal psychological counselor. Every conversation I remember having with him turns into a discussion his personal problems and how life sucks.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## Artista

*" It's mostly all about self confidence and a positive attitude..."*

*That is so TRUE 35Yrs'* .

When one creates, revives or builds up those two life-skills , issues related to hair loss *CAN* 'fall by the wayside'.
* Two main things contribute to self-confidence:
 self-efficacy and self-esteem!!* 
That is a  PROVEN FACT.
If there are those out there of whom you may know  that would define you based on your hair or  hair loss, then who really has a problem? 
*NOT YOU.* 
For the younger men out there, if any woman would define you based on hair then those women are NOT WORTH considering at all. (regardless of how they look)
There are so many women out there that are very much worth considering because they will look beyond the  hair-loss.   
Back to the main issue..self confidence, positive attitude, self-efficacy and self-esteem..you CANT GO WRONG with these skills. Its historically proven to work. 
Consider Stephen Hawking. Of course he has hair on his head but as most know he was seriously afflicted at the age of 21 with *MND*  aslo known as  '_Lou Gehrig's disease'_ !  He also has had a ton of serious personal issues , relationship wise etc. 
Most know that he is an accomplished genius and very successful REGARDLESS of all of those handicaps.  
The point is that he had self confidence and a positive attitude intact to live his life.  Guess what , you dont have to be a genius to acquire that within. 
Ill stop my rant now guys.. Lets all look out for each other here on the forum. 
Hang in there...back to the topic at hand...hey you NW 6 guys --research

----------


## yeahyeahyeah

> I agree with that. 
> 
> I think many people including myself sometimes, miss the whole point when it comes to transplants.  I have heard bobman brought up in this type of conversation before, so I will use him as an example.  Some have had negative things to say about his new look, but none of those opinions matter.  None!  The only opinion that matter is his own.  If he likes his new look, which it definitely seems like it does, then eff what everybody else thinks.  Being happy with the way you look should be the main goal of getting a transplant.  Not impressing other people that really don't matter.  Happiness will lead to confidence, which will ultimately effect every other aspect of your life: love, career, etc.  Eff what anybody else thinks, even with a full head of hair you are not going to be able to impress/attract everybody.


 The issue here is whether HT is worthwhile for a NW6.

Let's be objective, you are paying what, 10k (maybe more) , have downtime of about 6 months to a year. Is it worth it if you are still looking like you are balding afterwards?

HTs surgeons will say "manage your expectations", but for those who haven't got a clue about HL or HTs (Women etc), they will look at that guy for the first time and think he *is balding*.

Defeats the whole point.

It's the equivalent of getting a nose job,only to be left with a slightly crooked nose.

I have got a nose job done, and I was pissed off with assymetrical swelling making one nostil appear larger then the other - thank god it is normalising.

That's my only gripe with this.

Best case scienario is Bobman, but the hairstyle Bobman is sportting belongs in the 70s.

----------


## win200

> The issue here is whether HT is worthwhile for a NW6.
> 
> Let's be objective, you are paying what, 10k (maybe more) , have downtime of about 6 months to a year. Is it worth it if you are still looking like you are balding afterwards?
> 
> HTs surgeons will say "manage your expectations", but for those who haven't got a clue about HL or HTs (Women etc), they will look at that guy for the first time and think he *is balding*.
> 
> Defeats the whole point.
> 
> It's the equivalent of getting a nose job,only to be left with a slightly crooked nose.
> ...


 Balding > bald.

A NW6/7 is never going to look like they're not balding, but having something up top to provide some kind of framing beats the hell out of slick bald.  Women are funny about the way they look at hair loss--I've noticed that if there's any cosmetically significant amount of hair on top (even like 3,000 grafts), they won't categorize a guy as "bald."  To most people, "bald" means you're a chrome dome.  For a NW 6, a good transplant can keep you out of that category, even if styling options are limited.  My dad is a NW 5 at 72 with SUPER sparse coverage on top, but he doesn't look "bald."  If he shaved the top of his head and left the ring only, he'd look really different.  And a transplant can give a NW 6 better coverage on top than my dad currently has.

----------


## yeahyeahyeah

> Balding > bald.
> 
> A NW6/7 is never going to look like they're not balding, but having something up top to provide some kind of framing beats the hell out of slick bald.  Women are funny about the way they look at hair loss--I've noticed that if there's any cosmetically significant amount of hair on top (even like 3,000 grafts), they won't categorize a guy as "bald."  To most people, "bald" means you're a chrome dome.  For a NW 6, a good transplant can keep you out of that category, even if styling options are limited.  My dad is a NW 5 at 72 with SUPER sparse coverage on top, but he doesn't look "bald."  If he shaved the top of his head and left the ring only, he'd look really different.  And a transplant can give a NW 6 better coverage on top than my dad currently has.


 Guess it depends on the individual on if they suit the significant balding look.

99&#37; of the time they don't.

Every time I have overheard my female mates talk about a guy with hairloss, they go "he should shave it off".

The only benefit I can see from a high NW having a HT is just having a hairline to frame their face so they can buzz it with a hairline.

Again, it annoys me how HT drs justify their work on higher norwoods acting like if it is age related. No - all it highlights is how primative HT tech is.

----------


## fred970

Why are you even arguing on this yeahyeahyeah, you're obviously someone suffering from BDD who will never know the horror of balding.

100&#37; of bald people would look better with some hair on their dome. Who cares about what women say, it's what they do that matters. My girlfriend would like me to shave it all off instead of keeping a buzz cut for my NW5, I don't care.

win2000, Artista and many more here are right, even a really diffuse coverage on top can make a world of a difference compared to being slick up there.

HT have improved big time over the decades. There was a lot of butchering when we only had FUT, and now soon we'll be able to have a completely scarless procedure thanks to Dr. Wesley. What's primitive about that?

----------


## yeahyeahyeah

> Why are you even arguing on this yeahyeahyeah, you're obviously someone suffering from BDD who will never know the horror of balding.
> 
> 100&#37; of bald people would look better with some hair on their dome. Who cares about what women say, it's what they do that matters. My girlfriend would like me to shave it all off instead of keeping a buzz cut for my NW5, I don't care.
> 
> win2000, Artista and many more here are right, even a really diffuse coverage on top can make a world of a difference compared to being slick up there.
> 
> HT have improved big time over the decades. There was a lot of butchering when we only had FUT, and now soon we'll be able to have a completely scarless procedure thanks to Dr. Wesley. What's primitive about that?


 
Am I not entitled to my opinion? I am a hairloss sufferer, just haven't lost a significant amount.

Anyway, it is for NW6s to decide whether they want a HT or not. But personally I think it isnt worth the aggrevation.  Hair for me is about having styling options.

----------


## 35YrsAfter

> *" It's mostly all about self confidence and a positive attitude..."*
> 
> *That is so TRUE 35Yrs'* .
> 
> When one creates, revives or builds up those two life-skills , issues related to hair loss *CAN* 'fall by the wayside'.
> * Two main things contribute to self-confidence:
>  self-efficacy and self-esteem!!* 
> That is a  PROVEN FACT.
> If there are those out there of whom you may know  that would define you based on your hair or  hair loss, then who really has a problem? 
> ...


 This morning, I was thinking about how my life would have been different if I never had any hair loss.  My own hair loss has actually contributed to a better life.  I had hair restoration work done, but don't obsess over thin coverage.  Hair loss inspired me to get off my ass to exercise and learn many different skills.  Without my hairloss, I can see myself ending up with the wrong woman.  I have the best wife, a great family and generally an excellent, happy life.  I wouldn't even consider for a minute trading that in for a Norwood 2. 

Chuck

----------


## yeahyeahyeah

> This morning, I was thinking about how my life would have been different if I never had any hair loss.  My own hair loss has actually contributed to a better life.  I had hair restoration work done, but don't obsess over thin coverage.  Hair loss inspired me to get off my ass to exercise and learn many different skills.  Without my hairloss, I can see myself ending up with the wrong woman.  I have the best wife, a great family and generally an excellent, happy life.  I wouldn't even consider for a minute trading that in for a Norwood 2. 
> 
> Chuck


 I have become much more depressed since having mild hairloss. Self esteem is considerably less. Feels like my looks have a sell by date.

----------


## Dan26

I think both sides are partially right here. The goal is to maximize your looks. 

In my personal opinion (based on my preference of what looks best aesthetically), you have TWO options if you are a high NW seeking a HT.

1) FUE for a decent hairline (1.5-2), buzz down. Consider some SMP too.
2) Be very conservative with a hairline (nw2.5-3), and go for basically a tapered thickness ie thicker near the front and its ok to be a bit thin in the back. 

HOWEVER, option 2 only works if you keep your sides short. On one hand nobody wants to be SLICK bald, and on the other no one wants to get an HT and have thin wispy coverage that objectively does not or very minimally enhances your appearance.

This is an example of the #2 option. Hairline is high, nw2.5-3, but because sides are short the end result is a solid boost to appearance overall.

Having buzzed sides/back really makes a big difference, but you seldom see older men doing this. 
http://www.baldtruthtalk.com/album.php?albumid=803

----------


## topcat

Would have to agree with Chuck, its been a good experience in many ways and has given me more character as one learns to adapt. Knowing how the medical system works along with other systems has really been of great benefit and its a direct result of my bad HTexperience. It becomes a choice in ones own mind, one can choose to give up or one can choose to overcome the obstacles they encounter in life and try to do good with those experiences. We are here to help others along the way and part of that is passing on the lessons in life we have learned to others.

It really does become a choice. Why are some able to work it out in their head while others cant. Maybe find out what they are doing. What is their thought process and maybe give it a try. My favorite Rocky quote. Some people give up while others keep going..why?

_The world aint all sunshine and rainbows. Its a very mean and nasty place, and I dont care how tough you are, it will beat you to your knees and keep you there permanently if you let it. You, me, or nobody is gonna hit as hard as life. But it aint about how hard you hit. Its about how hard you can get hit and keep moving forward; how much you can take and keep moving forward. Thats how winning is done! Now, if you know what youre worth, then go out and get what youre worth. But you gotta be willing to take the hits, and not pointing fingers saying you aint where you wanna be because of him, or her, or anybody. Cowards do that and that aint you. Youre better than that_

----------


## greatjob!

> I am a hairloss sufferer, just haven't lost a significant amount.


 You may have hairloss (may), but your not a "hairloss sufferer", all your suffering is in your head.

----------


## topcat

Don't want to take this off topic but for those guys that are really experiencing some distress this might be helpful.

Here is a good book recommendation. When I read this book several years ago I thought it was interesting because everything in the book was something I do naturally and I scored very high on the self test. Just my natural thought process which I honestly believe is something that instead of making me reclusive like so many repair patients I have spoken to helped guide me in the exact opposite direction constantly being in front of people and just living my life and reaching my own personal goals. Learned Optimism: How to Change Your Mind and Change Your Life. (Martin Seligman)

Now if your first thought is that it would be a waste of time then you are exactly the person that needs the book. I see so many with defeatist attitudes when it doesn't have to be that way.

Another interesting book that I read that kind of made me laugh because some of the techniques listed in the book are ones I just naturally used over the years to deal with the damage that was done to my scalp. Didnt need to read about it or have someone tell me, they were techniques that just naturally kind of came to me. What I found funny was I would never have had a need to come up with these strategies if it were not for the original hair transplant procedure. I thought to myself I was much more normal before any of this and the subject material is very interesting.


Cognitive-Behavioral Therapy for Body Dysmorphic Disorder (Sabine Wilhelm, Katharine Phillips, Gail Steketee)

----------


## garageland

I haven't contributed to this thread before but as a Norwood 6 who has been able to restore as much loss as possible that I am very happy with I thought it time I did contribute.

Norwood 6 patients look much better with a hairline that frames the face rather than slick bald this is a fact and only when you are a Norwood 6 (or heading that way) can you understand and appreciate that.

Guys who are banging on about Norwood 6's not getting surgery because they can't get full coverage and what they would consider good density just don't understand.

Now I am not saying all 6's should have surgery because the plain fact is that many do not have the donor hair to get enough grafts to make it worthwhile but if you have good donor density, good hair characteristics like coarse wavy hair and good laxity if going for strip then a decent improvement can be made with one but ideally two transplants.

Now I have been through several procedures to get where I am today but I am much happier to be the guy on the right rather the one on the left.

BTW that was photo was created using Bald booth I have never looked that way it was done for the purpose of this thread to hopefully demonstrate how much better people look with a hairline and framing the face.

----------


## yeahyeahyeah

> I haven't contributed to this thread before but as a Norwood 6 who has been able to restore as much loss as possible that I am very happy with I thought it time I did contribute.
> 
> Norwood 6 patients look much better with a hairline that frames the face rather than slick bald this is a fact and only when you are a Norwood 6 (or heading that way) can you understand and appreciate that.
> 
> Guys who are banging on about Norwood 6's not getting surgery because they can't get full coverage and what they would consider good density just don't understand.
> 
> Now I am not saying all 6's should have surgery because the plain fact is that many do not have the donor hair to get enough grafts to make it worthwhile but if you have good donor density, good hair characteristics like coarse wavy hair and good laxity if going for strip then a decent improvement can be made with one but ideally two transplants.
> 
> Now I have been through several procedures to get where I am today but I am much happier to be the guy on the right rather the one on the left.
> ...


 Whilst I agree - the trouble is , the guy artista posted, his hair didn't flatter him. His forehead was massive.

I actually think he would have looked better if he shaved it off. He has a very masculine face.

----------


## yeahyeahyeah

> Don't want to take this off topic but for those guys that are really experiencing some distress this might be helpful.
> 
> Here is a good book recommendation. When I read this book several years ago I thought it was interesting because everything in the book was something I do naturally and I scored very high on the self test. Just my natural thought process which I honestly believe is something that instead of making me reclusive like so many repair patients I have spoken to helped guide me in the exact opposite direction constantly being in front of people and just living my life and reaching my own personal goals. Learned Optimism: How to Change Your Mind and Change Your Life. (Martin Seligman)
> 
> Now if your first thought is that it would be a waste of time then you are exactly the person that needs the book. I see so many with defeatist attitudes when it doesn't have to be that way.
> 
> Another interesting book that I read that kind of made me laugh because some of the techniques listed in the book are ones I just naturally used over the years to deal with the damage that was done to my scalp. Didn’t need to read about it or have someone tell me, they were techniques that just naturally kind of came to me. What I found funny was I would never have had a need to come up with these strategies if it were not for the original hair transplant procedure. I thought to myself I was much more normal before any of this and the subject material is very interesting.
> 
> 
> Cognitive-Behavioral Therapy for Body Dysmorphic Disorder (Sabine Wilhelm, Katharine Phillips, Gail Steketee)


 The BDD argument knocked to death.

When I was a teenager, I had 0 recession.

I did not worry about my hair at all. Actually, I used to get complimented a lot for it. It was my best feature.

I remember at the time thinking to myself "I really hope I don't bald"

Worse nightmare happened.

Since I started receeding slightly, the compliments stopped, and I am now obssessed with my hairline going back, or losing density.

BDD is thrown around the forum A LOT. When the truth is, I would not be here to begin with if I didn't lose hair. Same goes with others. It's because I noticed changes in my hair, that I seeked hairloss forums.

Hairloss is shit irrespective on what stage you are at, at least with a NW6, you know it will not progress anymore.

----------


## yeahyeahyeah

> You may have hairloss (may), but your not a "hairloss sufferer", all your suffering is in your head.


 I have lost hair, I did not always have this sharp V hairline (with receeded temple points) that I have right now.

People who become NW6s, are not born one, hairloss is a progressive process.

At one point that NW6 was a NW2 like me.

----------


## Dan26

See what your saying yeayeayea but to most people your degree of loss is normal/natural...Just as wrinkles and other changes in physical appearance are natural and unavoidable with age

Nothing wrong with wanting to improve your look if you can, and I'm assuming your loss is still 'progressing' and not at a stand still.

Im sure if you had your exact hair at 40 or 50 you would have no qualms about it...but at under 30 there still are  a lot of guys with NW0-NW1

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## fred970

No one's ever complimented my hair, and I had great hair.

Who would compliment someone's hair seriously?

I'm sorry yeahyeahyeah, but we're all sure you don't have any hair loss.

Average people don't notice the difference between NW1 and NW2, even NW3.

You should seek help. You may have your place here, but certainly not in the hair transplant section.

----------


## yeahyeahyeah

> No one's ever complimented my hair, and I had great hair.
> 
> *Who would compliment someone's hair seriously?
> *
> I'm sorry yeahyeahyeah, but we're all sure you don't have any hair loss.
> 
> Average people don't notice the difference between NW1 and NW2, even NW3.
> 
> You should seek help. You may have your place here, but certainly not in the hair transplant section.


 Women. 

I can notice it, the fact that I can't style my hair how I used too is more then enough evidence.

Fred - I just think you are a bitter NW6, who won't acknowledge anyone with hairloss until they are significantly balding.

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## Notcoolanymore

yeahyeahyeah, I think you have nice hair, no homo.....no you know what forget that, homo.

----------


## topcat

Looks really good garageland and I agree some guys that are NW6 can move forward with a procedure while others cant for whatever reason.

Some guys without good donor might be able to just build up that lateral hump area, connect them at the top and then place a few hairs in front of it which would look normal as it is a normal balding pattern. Its the guys that start at the hairline when they are fully bald or eventually will be there that seem to be getting bad advice. Too often it just does not look normal.

As always it comes down to numbers and the numbers for all NW6 will not be the same for many reasons, some guys might not understand this part.

Some guys have better hair caliber, higher lateral humps, smaller heads, less skin/hair contrast, higher number of multi hair groupings, etc. So most importantly there is just no one size fits all.

My comments regarding the book recommendations are not focused on BDD but the thought process. Much of cognitive therapy has been taken from neuro linguistic programming. Yes it could very well be true that you are receiving less comments about how great your hair looks but your thought process and perception of this issue if it were toned down a bit would make it easier to deal with. Some guy's don't give a rat's ass about hairloss, while some do. What are the guys that don't care doing that might be helpful to you.

Like I wrote those with defeatist attitudes can never reach the next level or learn because they don't even try. Sometimes it takes consistent trying and failing until you get there.

----------


## greatjob!

> No one's ever complimented my hair, and I had great hair.
> 
> Who would compliment someone's hair seriously?
> 
> I'm sorry yeahyeahyeah, but we're all sure you don't have any hair loss.
> 
> Average people don't notice the difference between NW1 and NW2, even NW3.
> 
> You should seek help. You may have your place here, but certainly not in the hair transplant section.


 He's a crazy person. The fact that he has also had multiple other cosmetic procedures, plus he has a perfect head of hair that is "ruining his life" only cements the fact that he has mental problems. He can say whatever he wants to try and justify his psychosis, but the mere fact that someone with his loss at his age even knows this forum exists, let alone is one of the most over-dramatic active members, only proves he is completely detached from reality.


(Cue all the other NW 1/2 members who are in the same boat and wasting their life being concerned with their non-existent hairloss coming to yeahyeahyeah's defense....)

----------


## gillenator

I also think you look remarkably different with a very nice result garageland.

Any pics of the top view and crown?

----------


## garageland

Hi Gillenator,

Thanks for the comment I put the two photos up to emphasize how important framing of the face on a Norwood 6 is. The photo on the left is what I would look like today if I had no surgery as I mentioned in the post I made the photo as you can see I am wearing the same clothes in the before and after. All my photos and story have been posted on here and my updates from my latest surgery can be found here 

http://www.baldtruthtalk.com/showthread.php?t=14947

I had 3 mini and micro graft procedures all around 400-500 grafts in the mid 90's so which gave me some coverage but it was very unnatural and sparse and left me with 3 separate scars. This was me in 2006 before my first session with Dr Hasson.

----------


## Artista

*Garageland's words-*

"Norwood 6 patients *look much better with a hairline that frames the face* rather than slick bald *this is a fact* and only when you are a Norwood 6 (or heading that way) can you understand and appreciate that.

Guys who are banging on about Norwood 6's not getting surgery because they can't get full coverage and what they would consider good density just don't understand.
Now I am not saying all 6's should have surgery because_ the plain fact is that many do not have the donor hair to get enough grafts to make it worthwhile_ *but* if you have *good donor density, good hair characteristics like coarse wavy hair and good laxity* if going for strip then a decent improvement can be made with one but ideally two transplants". 

*Garageland*  thank you for contributing to this discussion and sharing your personal experiences!
I especially liked your thread :
http://www.baldtruthtalk.com/showthread.php?t=14947

You had  great HT experiences and end results!
I would also emphasize that *you are not one of a very 'rare' or very small &#37;* of men who were_ 'lucky'_ to have had great results.
As you reiterated, it is all a matter of donor availability AND where one would go to to have consultation and surgery. 

*Thanks again Garageland - Cheers! * 

One more thing,having *REALISTIC GOALS is IMPERATIVE* l

----------


## Artista

*It would be great to hear from more hair loss members who have had a HT(s) done.
Reading your experiences, positive or negative, would be so very helpful for members who have been considering hair transplant surgery, major or minor.
Thanks all.  *

----------


## garageland

Couldn't agree more with your post, I was not lucky, in fact I was unlucky to be cursed at such a young age but I had good characteristics and choose my repair wisely.

----------


## gillenator

garageland,

I know exactly what you mean as I had the minis and micros in my first HT procedure in 1996.  But it freed me from wearing those dreadful hair systems with Hair Club.

But having the procedure with H&W established the artistic quality and today no one would know that you had the micros and minis.

Are you going to have another pass for density?  Just curious... :Wink:

----------


## garageland

Hi Gillenator,

Thanks for your interest in my case, do you mean another pass after the one I had 3.5 months ago?

No I am done now after 5 transplants and a scar revision, I have noticed that there is an improvement in my front at this stage already so I am looking forward to seeing the results in another 6 months. SMP has worked well in giving the appearance of density into the crown so I will have another pass of that later this year.

I have seen you many posts offering good advice over the years but can't recall seeing any photos of what your hair looks like today, do you have any to share?

----------


## fred970

I'm amazed that patients like garageland can have the luxury of being repaired successfully after not one, but three failed transplants and I'm being told I'll never be a HT candidate even if I start from scratch with an IAHRS surgeon. I don't get it, Bisanga turned me down and another clinic in Belgium told me to get a wig. This is so depressing.

----------


## Artista

*Fred,* Im so sorry to hear that. 
Do whatever it is that you can to overcome this! 
Your overall health and happiness is much much more important than the volume of hair on your head.
I speak from experience!
Fred, I feel that there will be something available, i.e. a *BETTER* treatment,  for us all. If not this- next year.
Not to put all 'hope' on *Pilofocus* but *Dr Wesley* IS a good man of _INTEGRITY_.
He is in the middle of something that I was entirely _IMPRESSED_ with,,so was *Spencer Kobren.*
As you may know, I will be a member of* Dr Wesley'*s next phase testing sometime this year. The instrumentation that he has created and enhanced is being improved upon.
Fred *HANG IN THERE Bro!*  We should all be here for each other for the moral support that each of us so needs. 
Dr Wesley's need method is not the only thing that is coming our way either!! 
Try to not allow hair loss to completely trample your day to day existence.
Once we all just FOCUS 100%  of the time  on personal HAPPINESS and our HEALTH (not spend so much time on here or other HL forums for example) 
A BETTER treatment WILL sneak up on us. Life's wisdom have proven that to be factual.   I will be updating everyone on my progress once its all underway..CHEERS all

----------


## Artista

I just reread my posting   Please excuse the bad grammar-LOL. 
Proof reading is so essential..

----------


## garageland

Hi Fred,

I wouldn't call it a luxury that is for sure having 3 strip scars and terrible unnatural results and living like that for 10 years from the age of 23 to 33. I get what you are saying but it all comes down to donor supply if you don't have the donor hair then the clinics are doing you a big favour by turning you down rather than taking your money and performing surgery that you are not going to be happy with.

As mentioned elsewhere on this forum, if you have the both the donor and realistic expectations a Norwood 6 can be a decent candidate. If you only have one or neither of these it will not work.

You are not alone many Norwood 6's are just not candidates and should shave their head and try to move on with their lives. If two clinics have told you no then you must try to accept that a transplant is not going to be in your best interest.

----------


## Artista

http://www.baldtruthtalk.com/showthread.php?t=15349

*Dr Panine, a CHICAGO SURGEON, is GREAT*

----------


## fred970

I don't know. I was clear that I only wanted the front done to frame my face though. But apparently,  I'm asking too much. The problem is that I still have some hair thanks to minoxidil. Without it, I would be slick.

Thanks for the posts Artista. If that guy can have work done, I surely can. The problem is that, I saw two tops surgeons. One said no (Bisanga) and the other (De Reys) said yes. The other that said no was in fact a clinic representative.

I know I'm not an ideal candidate, I don't take finasteride. I'm still treating my hair loss, but minoxidil is often brushed under the carpet, as if it were useless.

I just want a frame for my face. Some people don't even know that I'm balding, they just assume I shave it off thanks to the sparse coverage minoxidil gives me. You can see the outline of a NW5 at the back. I have dark blond curly hair.

Shave my head and move on? Easy to say. I already "shave" my head, but not with no guard, I'll never do that. For now, I'm waiting, everything's quite fine. I'm just scared about losing the faint frame I have left. I'm sure it's better if wait until I have almost nothing left.



Do I really look that hopeless "tansplant-wise"? If I could have what I have left on the left picture, even with a slick crown all my life, I would be very happy.

----------


## gillenator

> Hi Gillenator,
> 
> Thanks for your interest in my case, do you mean another pass after the one I had 3.5 months ago?
> 
> No I am done now after 5 transplants and a scar revision, I have noticed that there is an improvement in my front at this stage already so I am looking forward to seeing the results in another 6 months. SMP has worked well in giving the appearance of density into the crown so I will have another pass of that later this year.
> 
> I have seen you many posts offering good advice over the years but can't recall seeing any photos of what your hair looks like today, do you have any to share?


 Garageland,

Thanks buddy, and I am so sorry, I forgot about your recent procedure 3.5 months ago.  So no, I retract that question and I bet you are going to look awesome when this recent procedure fully matures. 

I did have my before and after pics put up in this community under blogs but somehow it was removed including my story.

But then the dreadful lung cancer came in late 2009 and I had to undergo three types of chemotherapy.  My hair is not the same although it did grow back but much more diffused... :Embarrassment: 

And I cannot afford any more surgery because I am a volunteer chaplain now and never take any salary or compensation for what I do to help others.  Mostly do hospice ministry for others dying of cancer.

My sweet and kind wife still loves me...and thanks for your interest in me my friend... :Wink:

----------


## gillenator

Maybe it's time to change my Avatar because that will show what my hair looked like before cancer... :Roll Eyes (Sarcastic):

----------


## garageland

Hi Gillenator,

I am sorry to hear about your lung cancer I am sure that puts the hair issues into perspective. Good for you in the job that you do it. I have over the years always found your posts very helpful, honest and sincere. It would be nice to see the man behind the Terminator avatar.

----------


## gillenator

Thanks for the kind words my friend.

If you go to the home page here at TBT, and click on the blogs link, there should be a photo when I wrote some articles for Spencer before the cancer days.

Am holding my lil' pug dog in the photo so it may be hard to tell who's who... :Wink: 

Looking forward to your update pics as your recent procedure matures... :Smile:

----------


## baldymcgee

> One more thing,having *REALISTIC GOALS is IMPERATIVE* l


 I wholeheartedly agree with this, the trouble is always around trying to understand what "realistic goals" are.

Sure we understand that "full density" isn't an option and (some) surgeons tell us that we'll only have coverage with certain hairstyles, but I don't think that any of us know what that means practically.

Will we spend our mornings carefully placing each strand and then panicking each time the wind picks up? Will we fret with each haircut about donor scar visibility?

I realize that these questions are virtually impossible for a surgeon (or rep) to answer but these are the questions that worry NW5-6 people.

PS.

And, sure, we can meet transplant recipients but:
a) We have little idea how well results from others will translate to us (different hair, scalp, skin characteristics).
b) I'm not accusing surgeons of dishonesty, but they're far far far more likely to "showcase" the really outstanding results.

----------


## youngin

I am a NW6 and I think with today's technology you could have very good looking coverage for significantly less than times before... if you keep your hair short. Consider if you got about 3000 grafts including frontal 3rd and some diffused scattering through the rest and then you got SMP for the rest. You would have realistic coverage. At least your face would be framed and look good. That's my plan if nothing new comes out soon.

Like this: http://fue-hairtransplant.blogspot.c...alp-micro.html

----------


## Artista

This patient of *Dr Dorin's* was not a NW6 but his hair loss was extensive enough to warrant hair transplant surgery.
*
Dr Dorin* ,you did a _GREAT JOB_ on this man's scalp!

check this out guys (and gals)  :Smile: 

http://www.baldtruthtalk.com/album.php?albumid=628

----------


## baldymcgee

Question for those NW6-ers who have had hair transplants (or the docs who helped them):

With the progressive nature of hairloss, how comfortable are you with your predicted final loss pattern?

I've been looking at photos of people like Bruce Willis or Jeff Bezos (CEO of Amazon) and in their younger-days I could imagine them thinking "oh, I just need 2-or-3 thousand grafts and I'll look fine".

But then you watch them over the years and their sides get lower and their back recedes to the point that they're probably beyond help from current HT technology (at least with what I would consider "acceptable" density[1]).

To the patients: how big a concern was/is this for you? How long did you spend with your Doc. talking about this?

To the docs: How accurate are the predicted final loss patterns? Can you get to within an inch? Half an inch?

[1] Yes, this is a personal judgement -- different people will almost certainly have different expectations.

----------


## Notcoolanymore

> Question for those NW6-ers who have had hair transplants (or the docs who helped them):
> 
> With the progressive nature of hairloss, how comfortable are you with your predicted final loss pattern?


 This right here is huge.  I responded to a thread earlier today of a guy in his 20's planning to get a transplant without using finasteride.  How will you look as you continue to recede?  Recession even happens while on finasteride.

----------


## Artista

Great question to ask* Baldymcgee* !
Hopefully we will get responses.  Thanks Bro

----------


## Artista

Very impressive work by hair transplant surgeon* Dr Doganay!*
I would not want to use beard hair for coverage.

http://www.baldtruthtalk.com/album.php?albumid=789

----------


## baldymcgee

> Very impressive work by hair transplant surgeon* Dr Doganay!*
> I would not want to use beard hair for coverage.
> 
> http://www.baldtruthtalk.com/album.php?albumid=789


 That's an *incredible* result.

(Though, as always, I wonder if Finasteride was part of the equation).

----------


## Artista

Another great before and after - another great doctor..
*Dr. Sara Wasserbauer* 
http://www.baldtruthtalk.com/album.php?albumid=850

----------


## Artista

*Dr Fargo*,,wow !
http://www.baldtruthtalk.com/album.php?albumid=289

----------


## win200

> *Dr Fargo*,,wow !
> http://www.baldtruthtalk.com/album.php?albumid=289


 The doctor who put the crop-row plugs in that guy's head should be hanged.  What an abomination.

That said, Dr. Farjo's work is outstanding.  This is no longer a bald guy.  Not a *ton* of hair on his head, but a world of difference.

----------


## Artista

Your so right *Win200* ..
*Joe from Staten*, reread what Win200 has said--
"...*Dr. Farjo's work is outstanding. This is no longer a bald guy. Not a *ton* of hair on his head, but a world of difference.* "
Joe, you have met with Dr Fargo have you not?

----------


## DAVE52

> Another great before and after - another great doctor..
> *Dr. Sara Wasserbauer* 
> http://www.baldtruthtalk.com/album.php?albumid=850


  :Confused: 

I wouldn't consider that great

----------


## fred970

He only got half his regrowth in this picture. 6 more months are needed to see the full result.

----------


## Artista

You must keep in mind that,,IF you are ever a NW6 , there is a *POSSIBILITY* of  IMPROVING your hairline by way of a qualified & sincere hair surgeon. 
It is ALWAYS a matter of realistic expectations and not to UNREALISTICALLY expect a full head of hair again.
When my hair loss became pronounced, it was mostly at the back of my crown area.
I STILL HAD a *DECENT* framing of my hairline and that was OK with me because I stayed *REALISTIC.*

----------


## 35YrsAfter

> You must keep in mind that,,IF you are ever a NW6 , there is a *POSSIBILITY* of  IMPROVING your hairline by way of a qualified & sincere hair surgeon. 
> It is ALWAYS a matter of realistic expectations and not to UNREALISTICALLY expect a full head of hair again.
> When my hair loss became pronounced, it was mostly at the back of my crown area.
> I STILL HAD a *DECENT* framing of my hairline and that was OK with me because I stayed *REALISTIC.*


 I sometimes see the results of a doctor's aesthetic error with regards to hairlines on men in the higher Norwood range. A broad, well-defined hairline and thin coverage simply does not look natural on a Norwood 6.  I have even seen that approach on a Norwood 7!

According to surveys, the majority of men prefer hair in the front when complete coverage is not an option.  Imagine a timelapse headed backward in time.   As a man loses hair it of course looks natural every step of the way.  A skilled hair restoration physician can make your hair appear to go back in time and weight the loss more heavily toward the back if frontal improvement is your main goal.  The mark of a true hair restoration master is a result that is natural to the point no one can tell even up close.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## fred970

I've seen NW7 with a very well defined Brad Pitt hairline, like with hair only at the hairline up to 1 cm and behind that and the rest: cueball. 

You may think "well it's not natural" after surgery but the rare cases I've witnessed, they just had that weird kind of MPB naturally.

I may go for a FUE in a few years, but I'll ask my surgeon for very low density and a NW2,5 hairline.

----------


## Jotronic

> I've seen NW7 with a very well defined Brad Pitt hairline, like with hair only at the hairline up to 1 cm and behind that and the rest: cueball. 
> 
> You may think "well it's not natural" after surgery but the rare cases I've witnessed, they just had that weird kind of MPB naturally.
> 
> I may go for a FUE in a few years, but I'll ask my surgeon for very low density and a NW2,5 hairline.


 This is not as rare as you may think but I'm glad you pointed it out. I think it is more rare in western Caucasians as I see it more on SE Indians, Persians, Greeks and Mediterranean men. It is fairly common in those with these ethnic backgrounds.

----------


## 35YrsAfter

> I've seen NW7 with a very well defined Brad Pitt hairline, like with hair only at the hairline up to 1 cm and behind that and the rest: cueball. 
> 
> You may think "well it's not natural" after surgery but the rare cases I've witnessed, they just had that weird kind of MPB naturally.
> 
> I may go for a FUE in a few years, but I'll ask my surgeon for very low density and a NW2,5 hairline.


 Having hair loss on both sides of my family, I began noticing people's hair back when I was 14 years old.  I remember when I was 14, seeing a mechanic at an auto repair shop that had a natural band of hair forming a low hairline and the top of his head was nearly slick.  I remember thinking it looked odd.  As a recipient of poor hair restoration surgery years ago, I personally prefer to avoid any kind of hair placement that draws attention.  It's like, if I were to get a nose job, I wouldn't have mine modeled after Karl Malden's, unless of course I lived north of the Arctic Circle where they kiss with their noses.  There, I might be regarded as a sex symbol.  :Smile: 

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## Artista

*Hi Chuck,,Hi Jotronic!  *

----------


## Artista

*Spencer is on live tonight 3/4/14   ,,8:00 pm est*

----------


## 35YrsAfter

Dr. Cole - FUE 3605 Grafts 11 Month Result NW 6
Our patient was a Norwood Class 5 upon his first visit to our clinic. Appears closer to a Norwood 6 in the photos taken immediately before his first surgery.  At this present time, he has undergone two surgeries with Dr. Cole, the first on 3/13/2013 and the second eleven months later on 2/20/2014. During his first surgery, our patient received 3605 grafts in the frontal area (see photo). In addition, ACell and PRP were administered at the time of his procedure and following his surgery. While our patient was pleased with his outcome following his first surgery, he returned for a second procedure to add grafts to his crown, an area that had not been addressed during his first procedure. Dr. Cole mentioned to me it will take around 4,000+ grafts to the crown to achieve reasonably good coverage there.  

Please note that our patient has excellent scalp donor density and hair caliber.  Men with less than "home run" donor characteristics can still achieve reasonable cosmetic improvement because beard hair is a viable option.  We get a 90% yield with beard hair when ACell and PRP are administered during and after surgery.  As mentioned in another thread, we have had great success with beard hair growth even in formerly necrotic areas where scar tissue has formed.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## fred970

Thanks for that kind of results.

Gives me hope for the future  :Smile: .

----------


## Artista

Thank you Chuck!

----------


## 35YrsAfter

> Thank you Chuck!


 Here are some update photos of our NW6 patient I posted previously in this thread. He addressed his crown on 02-20-2014 with 1807 grafts and returned today, 03-12-2014 for an additional 1272 grafts.  His total to date is 6679, front and back.

We will post results photos of his crown on February or March of 2015.  We used ACell gel in his extraction sites and I have included a closeup photo of a random area in the back.  At the very least, ACell reduces hypopigmentation.  Our patient didn't get any white dotting as you can see in the photo.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## Artista

Surgical artistry is just one of the needed requirements in this type of repair work for a former NW6.

*Dr Bessam Farjo's  patient*- before and after photos :

http://www.baldtruthtalk.com/album.php?albumid=289

Years earlier this man obviously had had PLUG surgery .
He must have gone through a lot of distress and agony prior to Dr Farjo's  great repair work.

No, he does not have a full head of hair but if you were to ask this man directly of his satisfaction level Im sure that he would give it high marks!

----------


## 35YrsAfter

> Surgical artistry is just one of the needed requirements in this type of repair work for a former NW6.
> 
> *Dr Bessam Farjo's  patient*- before and after photos :
> 
> http://www.baldtruthtalk.com/album.php?albumid=289
> 
> Years earlier this man obviously had had PLUG surgery .
> He must have gone through a lot of distress and agony prior to Dr Farjo's  great repair work.
> 
> No, he does not have a full head of hair but if you were to ask this man directly of his satisfaction level Im sure that he would give it high marks!


 He looks a lot better.  Most men who are repair patients (myself included) will concur, an unnatural appearing hair transplant is far worse than being really bald.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## Granastasis

Great thread!

Check this guy: http://imgur.com/a/hyVtt#0

He was Norwood 6 and now almost 0!! He was one of the clients i saw live before deciding to go to DHI.

----------


## Artista

A very decent  link *Granastasis*
*Thanks for posting* but, Im not sure that that patient would have been defined as a NW6. He seemed to have coverage albeit thinned.

Hey *Chuck* (35YrsAfter), could you take a look at those before/after images and give us your thoughts on the patients hair loss prior to the surgery? 
Thanks..

----------


## 35YrsAfter

> A very decent  link *Granastasis*
> *Thanks for posting* but, Im not sure that that patient would have been defined as a NW6. He seemed to have coverage albeit thinned.
> 
> Hey *Chuck* (35YrsAfter), could you take a look at those before/after images and give us your thoughts on the patients hair loss prior to the surgery? 
> Thanks..


 From what I see in the photos, he got good growth.  I'm sure he's happy.  The whorl looks natural in the photos.  Didn't see a mention of age.  Age is a very important consideration regarding hairline height.  If he is 40+ I believe he will be in much better shape down the road.  If he's in his twenties, he will undoubtedly lose more hair so the use of singles on top is critically important to a natural appearing result as his hair loss progresses.  Multiple hair grafts, even twos can stand out when native hair is lost.  I see some twos near the hairline which shouldn't be a problem if his hair stays dense and combed forward.


35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## Artista

Not a NW6 but what great work by* Dr Panine* (Chicago). 
http://www.baldtruthtalk.com/album.php?albumid=339

----------


## gillenator

Doubles can be easier hid "if" the commencement of the newly constructed hairline is done in only singles.  It's when doubles or even triple hair grafts are used in commencing the hairline that they really stick out visually speaking.

And the color contrast is critical as well.  The more wider the hair color to scalp complexion is, the more noticeable the larger grafts are and the angulations as well.

Any grafts above the single hair graft should be at least 1/2 cm above the start of the hairline if not further.

----------


## Artista

Again,* not* a NW6 *BUT* what *great work by Dr Jerry Cooley* !!!

http://www.baldtruthtalk.com/album.p...pictureid=1646  :Smile:

----------


## Artista

Once again, not a *NW6* BUT what *great work* by *Dr Bessam Farjo !!!*


http://www.baldtruthtalk.com/album.php?albumid=273

----------


## fred970

Thanks for those results Artista, they have the same degree of hair loss as me, though they may me twice my age  :Frown: .

18 days to go before my first FUE as a NW5. I hope my results will fit in here in a few years.

----------


## Artista

Wow* Fred970* ! 
I wish you the BEST luck ..Im sure that you will be *AOK!*
Can you mention which doctor you had decided to go with?

----------


## Artista

By the way Fred and all else..
Check out my friend *Bobman's*  blog page regarding his hair transplants.
http://bobmans-hair-transplant.blogs...t_archive.html

*Bob's* experience is a GREAT example of what a NW6 *actually COULD have done* by a qualified and experienced doctor..
like *Hasson & Wong.*

Most of you know of him-He is very well known member of our hair loss community!
He just happens to be a very good friend of mine too.
*I can state as fact that those 'after' photos were NOT enhanced nor altered to make it look better.*
Ive seen his hairline in person because he *IS* my friend. We dont live too far away from each other.
(by the way-he will be coming to our house-warming party this summer)

_Hasson & Wong_ did a fantastic job on his scalp. This just goes to show that a doctor also *must have  artistic endeavor* when treating a patients hair loss.

Now the only things that have stopped me from having had a ht is-- 
1) I started using *Finasteride* almost 10 months ago-(so far so good)
2) I will be a phase test patient of_ Dr Wesley's Pilofocus_ advancements.
To all my brothers out there..*STAY STRONG..* I feel that this will be a good year for us all. If you decide to have hair transplant surgery..do not go by who is cheapest.  *Bobman* didn't and he is a very happy and satisfied man for it to this day.
 :Smile:

----------


## fred970

Thanks for this example.

I'm going with Dr. De Reys, I don't know if you've heard of him  :Smile: .

----------


## Artista

I think I have seen that name before Fred..where is he based ?

----------


## fred970

Not far from Antwerpen. He was the lead surgeon of the prohairclinic in Belgium before.

He has some astounding results, and uses a very small punch  :Smile: .

----------


## Artista

I noticed that the link I had provided on my last comment didn't go through well..here it is!!
*"Check out my friend Bobman's blog page regarding his hair transplants"*

[Promotional link removed]

*"Bob's* experience is a GREAT example of what a NW6 actually COULD have done by a qualified and experienced doctor..
like *Hasson & Wong"*
"*Hasson & Wong* did a fantastic job on his scalp. This just goes to show that a doctor also *must have artistic endeavor* when treating a patients hair loss."

----------


## delancey

> Thanks for this example.
> 
> I'm going with Dr. De Reys, I don't know if you've heard of him .


 Hi Fred,

What is your donor density like on the sides and back? How many grafts do you have available via FUE?

----------


## fred970

Dr De Reys said up to 4500. Bisanga said less than 2000.
I have 65 hairs per cm2 in the donor.

----------


## 35YrsAfter

> Dr De Reys said up to 4500. Bisanga said less than 2000. I have 65 hairs per cm2 in the donor.


 Do you have a pretty good "run" (big area) of donor?  You may want to go with 2,000 to start.  I'm not familiar with Dr. Reys or Bisanga's work.  Topcat favors Bisanga.  Another doctor in you neck of the woods worth seeing is Dr. Patrick Mwamba.  

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## fred970

That's what I'm doing: 2000 grafts for the front. If it all goes according to the plan and if I still have donor hair available, I'll do another 2000 grafts FUE next year  :Smile: . My donor is still amazingly thick if I grow it out for a month.

----------


## 35YrsAfter

> That's what I'm doing: 2000 grafts for the front. If it all goes according to the plan and if I still have donor hair available, I'll do another 2000 grafts FUE next year . My donor is still amazingly thick if I grow it out for a month.


 fred:
Have you posted any photos in BT or elsewhere?  2,000 grafts is a decent start. 

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## fred970

That's me a few weeks ago:

----------


## Artista

*Hi Fred,*,First off, your a good looking guy _regardless_ of the hair loss. Thats the truth.
Secondly,  It seems to me your hair transplantation should do very well for you! 
*Cheers bro!* :Smile:

----------


## 35YrsAfter

> That's me a few weeks ago:


 Thanks Fred:

Sorry, I had a Brain F.  I remember your pictures.

See it the doctor can use at least a .85 punch.  If your hairs grow parallel, a good Dr. like Cole, Bisanga or Mwamba can thin out follicular units rather than taking the entire FU.  Also use singles. This way with short hair, your donor will look fuller and your hair on top will continue to look natural if/when the surrounding hair continues to thin.  Carefully placed beard and chest hair looks great when carefully sprinkled.  Have extracellular matrix gel placed in your donor sites and if possible have PRP treatment.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

----------


## gillenator

> That's what I'm doing: 2000 grafts for the front. If it all goes according to the plan and if I still have donor hair available, I'll do another 2000 grafts FUE next year . My donor is still amazingly thick if I grow it out for a month.


 If your donor is that strong, then you should have an amazing result.

----------


## Artista

Yet another _ 'before and after'_ photo collection of a great hair transplant by a great surgeon.
 Check it out~
http://www.baldtruthtalk.com/album.php?albumid=48

 This time you can define this patient's *PAST* hair loss scale as being  a *NW6+*. 
*Dr Robert M. Bernstein, M.D.*
Founder of Bernstein Medical *- 'Center for Hair Restoration'* in New York, NY,  and being a world-renowned hair transplant surgeon--of course.
http://www.baldtruthtalk.com/member.php?u=65 

*Dr Bernstein -keep up the good work!!*  :Wink:

----------


## delancey

Fred, your sides are relatively high. Do you think they will stay that high? Also, have you asked how large your area of baldness is in cm2?


Artista, that is an excellent result, especially considering the number of grafts and severity of his hair loss.

----------


## fred970

If they still did not show any sign of thinning after now 7 years of DPA, I don't think they will change. My father still has his sides high too.

Yes, 150 cm&#178; of baldness area.

----------


## delancey

Best of luck to you. I consulted with Bisanga too, and he proposed a very conservative hairline (NW3 hairline). I am going to hold off for 3-5 years and reevaluate as I am headed towards a NW6 within a few years. Just like you, however, I have blonde hair. 

I bet you were able to hide the baldness for a long time though, as my blonde hair and low scalp contrast allowed me to hide it very effectively for years. I am now almost 29 and a diffused NW5 going in 6.

----------


## fred970

True! Some people still question the fact I'm balding because of the low contrast between my hair and scalp, and also because they always see me with a shaved head. All that helped me to hold off the surgery.

Thank you for the support  :Smile: . You're lucky, Bisanga didn't even proposed that to me, he just said I wasn't a candidate. But I don't think he has the same approach as De Reys. He demands that his patients take finasteride, and I just can't take it because I already underwent gyno surgery.

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## gillenator

Wish there were more cases of Norwood 6s with photos, the ones with outstanding hair characteristics.

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## fred970

Well, this is it. I've done it. Here's the link to the topic about my recent FUE:

http://www.baldtruthtalk.com/showthread.php?t=16218

I'd like to thank to the people in this thread for their precious advices  :Smile: .

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## delancey

Fred, congratulations on having your first hair transplant. 

Did Dr. Bisanga reject you because you only wished to have FUE? Or was it because of your young age and/or donor density?

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## fred970

Thank you delancey  :Smile: .

Young age, still had some hair at the top (wasn't the case anymore when I went to De Reys a year later as you can see on the before picture) so Bisanga could not draw a "beautiful hair line" like he said.

Also, I didn't want to be on propecia because I was gyno prone, and he sort of demands that his patients are on it. And of course, because of my young age and advanced balding, he thought I would eventually become NW9000, even though my relatives are all stuck at NW5 going on 6.

My donor density was very good in fact, De Reys was impressed by how much he could extract and by the quality of the grafts. Bisanga told me I wouldn't be able to have 2000 grafts extracted. And here I am, with about 1500 grafts sill available for harvest after a 2000 grafts procedure.

I respect Bisanga's choice not to operate on me. It's just so depressing to be told: "Nothing can be done, just live with it." Isn't that the most horrible thing to hear when you're a bald 24 year old?

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## delancey

Thank you for sharing Fred!

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## Artista

*Hi Fred,* I just saw your 'after' image ! 
I am very HAPPY for you bro!!
I have no doubts that you shall be a *SATISFIED* young man! 
Thank you for sharing your ongoing experiences here Fred.
Cant wait to see your scalp in approx 6 months from now. 
Wow !

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## baldee

> Thank you delancey .
> 
> Young age, still had some hair at the top (wasn't the case anymore when I went to De Reys a year later as you can see on the before picture) so Bisanga could not draw a "beautiful hair line" like he said.
> 
> Also, I didn't want to be on propecia because I was gyno prone, and he sort of demands that his patients are on it. And of course, because of my young age and advanced balding, he thought I would eventually become NW9000, even though my relatives are all stuck at NW5 going on 6.
> 
> My donor density was very good in fact, De Reys was impressed by how much he could extract and by the quality of the grafts. Bisanga told me I wouldn't be able to have 2000 grafts extracted. And here I am, with about 1500 grafts sill available for harvest after a 2000 grafts procedure.
> 
> I respect Bisanga's choice not to operate on me. It's just so depressing to be told: "Nothing can be done, just live with it." Isn't that the most horrible thing to hear when you're a bald 24 year old?


 
In 2011, aged 23 I went all the way to brussels to consult Dr Bisanga and I got the same reply. Those words are still echoing in my mind. I too respect his decision. 

I took a different approach from you and tried to shave it off thinking I could live with it. Yet here I am reading this forum, trying to see what can be achieved. Despite all this I still can't decide if I should take the plunge or not.

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## delancey

> jotroic, as a life long strip monger, i'm not surprised that you refuse to recognize that there is something called the illusion of coverage.  i guess that when you perpetuate the myth that strips in your hands don't leave disgusting, ugly scars, you can also perpetuate the concept that "coverage is coverage" and obviously erroneous myth you spread for years that strips produce better results than FUE.  in fact, it is possible to cover the entire scalp with a single hair that is grown long enough.  that is not coverage, however.  that is an illusion of coverage.  
> 
> you may refuse to face the fact there there is rarely enough hair to give the illusion of coverage in a nw 5 and never enough hair to give the illusion of coverage in a nw 6, but his is the simple God's truth.  one is never going to cover 225 to 250 sq. cm of bald skin with 5000 to 7000 follicular groups.  it is simply mathematically impossible.  now, i know you guys sometimes do 5000 grafts in one session and then do more, but you fail to explain that you typically split the natural follicular groups into smaller segments so that you actually place the same follicular group more than once and then bill double or three times for that same group.  
> 
> i'm no fan of discussing any specific patient whose had a hair transplant.  i also, have no taste in my mouth for salesmen that pick guys who are just trying explain their perspective of hair transplant surgery.  Since you did it, i'll be frank.  there is something quite different from a photo result and a real result and you are a master of the photo result.  that my friend is also called an illusion of coverage.


 

Dr Cole, 

how many grafts do you believe a Norwood 5/6 needs (blonde hair/fair skin) to get a good result? Let's assume an area of 200 cm2 to cover. Hair characteristics: medium-fine. How many grafts?

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## hairquestions

> What I cannot do is debate the pros and cons of FUE with a physician who predominately does strip surgery.  Those of us who do FUE daily already know the benefits of FUE over strip surgery.  Today we debate other factors such as how to approach a donor area.  The debate of strip Vs. FUE is over.  Now more than 50% of all hair restoration surgery procedures are FUE.  We no longer think in terms of converting strip patients to FUE.  Patients are doing that themselves just as they converted themselves from plugs to micrografts and from micrografts to follicular units and single hair grafts.  Patients determine the flow based on results.  
> 
> In 2003, there were two physicians in the world advocating FUE over strips, Ray Woods and myself.  Today, there are many.  I went from a strip surgeon who had done over 8000 strip procedures to a FUE surgeon over night simply because I recognized the benefits of FUE.  Now that Ive done over 5000 FUE procedures and closing in on 6000, I am probably the most experienced FUE surgeon on the planet.  It is impossible for me to debate FUE vs strip with a surgeon who does a handful of FUE procedures each month.  We would be talking on different wave lengths.


 Thank you Dr. Cole.

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## John P. Cole, MD

A NW 5/6 has a ton of hair loss.  

Let's assume a 5 has up to 180 cm2 and a 6 has up to 225 cm2.  Multiply these surface areas by an average of 80 fu/cm2 and you have the total number of missing follicular units.  Complicate this by noting follicular unit densities often approach 100/cm2 in the crown.  

We always need more hair in a crown/vertex/or back of the scalp.  We often need more than 50% of what was lost to look full.

I don't think we can get the illusion of full coverage in the crown beyond a NW 3V.  If you have home run hair, you might approach a full look in a NW 5 with a higher hairline, but you can't fully reach the goal.  We can change the equation using beard hair or body hair that grows, but it's an uphill battle beyond a NW 3V.  Recognize that beard hair has a yield of about 60%.  Other forms of body hair give good coverage in only 25% of patients and the degree of coverage in this 25% is variable.  

I really don't think physicians acknowledge the limitations of hair replacement surgery.  I know the ones I met over 20 years ago led me to believe the donor area was nearly limitless.  It's not.  We can obtain good coverage with less than 50% of what was there originally in the front, but not the back.  Of course larger diameter or coarser hair changes the scenario, but not enough to change the possibilities in  NW 5 or 6.  So....imagine you have 200 cm2 of hair loss.  You have lost 16,000 FU. we need more than 50% in the rear 100 cm2.  50% in the rear could be 5000 FU but you lost 10,000 FU.  Maybe you need 8000 in the rear alone.  3500 should do it in the front, but you have only an average of 15,300 in the safe donor area.  You can't cover the rear with the remaining 4000 FU so the answer is impossible.  you can't do it.  You have to accept a thinner look in the crown or use concealers like toppik or SMP.

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## hairquestions

> A NW 5/6 has a ton of hair loss.  
> I don't think we can get the illusion of full coverage in the crown beyond a NW 3V.  If you have home run hair, you might approach a full look in a NW 5 with a higher hairline, but you can't fully reach the goal.  We can change the equation using beard hair or body hair that grows, but it's an uphill battle beyond a NW 3V.  Recognize that beard hair has a yield of about 60%.  Other forms of body hair give good coverage in only 25% of patients and the degree of coverage in this 25% is variable.


 This is upsetting.  I talked to someone at your office who told me that I was a NW 5.  I had a HT 10 years ago that I think damaged the donor area.  I can't shave my head because I would have scars in the back, possibly holes in the front and a HT won't give me coverage.  So I feel stuck. 

Will more hair fall out on the sides after a HT?  Then I'd really have a mess.

The cost is also a concern.

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## hal

Some excellent advice and observations, Dr. Cole. I'd add that of course expectations are the key. 

I was a Norwood 5A moving in to Norwood 6 territory 4 years ago when I went for my first hair transplant procedure. I had a 3,700 graft FUT with Dr. Ron Shapiro. The focus was to rebuild my front hairline/frontal 3rd. I could not be happier with the result.

I was 47 years old at the time, had no hairline, and had a dying "island" at the front of my head. I am blond, with fair skin and somewhat fine hair. 

Many younger patients seem to be looking for, or have expectations of, a full restore. My goals and expectations were more modest, and have been fulfilled in spades.

Which brings me to your comments-- I have a bald spot on my crown the size of a softball. No hair at all. With a cover product and bringing hair down from the top of my head I can actually cover this spot. But the fact remains I'm basically painting my bald scalp. And I hate it.

I am planning a procedure of 2,500 grafts or so for the crown this spring with Dr. Shapiro. My expectations are that this *might* give me something like 20-25% density. Maybe a little higher if I'm very lucky and graft harvest level is in the 3,000 range.

The point is that I will have hair back there for the first time in years. I will have to use a lot less cover product and will not have to use my current styling techniques to conceal the bald spot. I will also have a few other overall styling options for my hair in general that are not open to me now.

If the planned procedure can get me to the above, than I am a happy camper. I think my expectations are in line with what is possible.

So I agree with your comments 100%-- but there are happy mediums which will leave the patient with better alternatives.

Hal

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## FearTheLoss

> I think the real power of propecia is in slowing the rate of hairloss down. In other words if you're norwood 3 and get 3000 grafts in the frontal third you could be happy for 5 or 6 years before you have to consider another session. Without propecia you may get 2 or 3 years before it progresses. I think the real benefit is that it keeps you out of the chair for longer.
> 
> However if you have aggressive hairloss and a norwood 6 pattern in the genes  I think most get to norwood 6 eventually with or without propecia. I know Jotronic stills takes it as he is concerned that the lateral humps may drop over time.
> 
> I know that Jason Gardiner does not use meds as he has lost all the hair across the top and Dr. Ziering must feel the lateral humps are not miniturising.
> 
> It really is a case by case basis. Everyone is different. There's actually a really interesting case that Dr. Feller posted here a number of years ago about a 24 year old norwood 3 that began the restoration process. His hair continued to thin over the years and his norwood 6 pattern eventuallly stabilised. Dr. Feller I believe did 3 transplants in total over the years and the patient always looked better than he did before the first session. He also has more in the tank in case of any further unforeseen loss. I don't recall the exact number of grafts he had transplanted but I think he had 7300-7500 with more than 2500 left in the tank by strip.
> 
> In other words you can sweep against the tide but you need:
> ...


 That case is absolutely unreal. It looks to me like that is real density, rather than just a combover allusion.

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## Alpine

> What I cannot do is debate the pros and cons of FUE with a physician who predominately does strip surgery.  Those of us who do FUE daily already know the benefits of FUE over strip surgery.  Today we debate other factors such as how to approach a donor area.  The debate of strip Vs. FUE is over.  Now more than 50% of all hair restoration surgery procedures are FUE.


 My surgeon only does FUT and he is the best in the world. He teaches the best doctors in the world. He is the one who is usually sitting on your oral board exams when you are trying to get membership into an elite organization like IAHRS or ISHRS (member of both and founding member of the latter). He is one of the very few who actually did their residency in hair transplant surgery and he was Chief Resident at that. He is Clinical Professor at USC Medical School, is the main hair consultant for Merk (maker of Propecia), the main hair consultant for Pfizer (maker of Rogaine), and is either the president or senior member of just about every hair organization there is. So he is wrong when saying that FUE is not good compared to FUT because in FUE you lose so much donor supply? And btw the scar from my first FUT was almost non-existent and I can't even feel the scar from my second FUT done 8 days ago (can't even feel a thin line), so the whole scar thing is mute if you are talking about competent surgeons.

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## fred970

> My surgeon only does FUT and he is the best in the world. He teaches the best doctors in the world. He is the one who is usually sitting on your oral board exams when you are trying to get membership into an elite organization like IAHRS or ISHRS (member of both and founding member of the latter). He is one of the very few who actually did their residency in hair transplant surgery and he was Chief Resident at that. He is Clinical Professor at USC Medical School, is the main hair consultant for Merk (maker of Propecia), the main hair consultant for Pfizer (maker of Rogaine), and is either the president or senior member of just about every hair organization there is. So he is wrong when saying that FUE is not good compared to FUT because in FUE you lose so much donor supply? And btw the scar from my first FUT was almost non-existent and I can't even feel the scar from my second FUT done 8 days ago (can't even feel a thin line), so the whole scar thing is mute if you are talking about competent surgeons.


 This is complete BS.

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## Alpine

How can any of this be BS? All this stuff is easily verifiable by merely looking it up. The only thing I said that you can't look up yourself is what I said about my scar. And yes like it or not my scar was virtually invisible with hair growing out of it from my first surgery, and after my second surgery the same scar is developing the same way. So what exactly is BS?

I'm starting to believe that many of you deserve these horrible HT's you get.

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## fred970

> How can any of this be BS? All this stuff is easily verifiable by merely looking it up. The only thing I said that you can't look up yourself is what I said about my scar. And yes like it or not my scar was virtually invisible with hair growing out of it from my first surgery, and after my second surgery the same scar is developing the same way. So what exactly is BS?
> 
> I'm starting to believe that many of you deserve these horrible HT's you get.


 I'm quite happy with my (scar-free) HT, thank you.

I'll just repeat what someone else intelligently said on this forum:

Anyone who gets FUT in 2015 is a certified bozo.

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## Intoodepp

Hi, I'm new to all of this. I decided to join after just googling random hair questions and bald truth always coming up. I decided to join when I realized I have a rare but horrible situation. So imheading for a Norwood 6 and I've already had like 5 procedures. Um, all strip, didn't know there was anything else. Jeez not quite there but soon will need roconstuction work for the strip surgery. Didn't know due existed til resently. Was on tour and was so worried about hair loss I stayed away from facts

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## Intoodepp

Hi, I'm new to all of this. I decided to join after just googling random hair questions and bald truth always coming up. I decided to join when I realized I have a rare but horrible situation. So imheading for a Norwood 6 and I've already had like 5 procedures. Um, all strip, didn't know there was anything else. Jeez not quite there but soon will need roconstuction work for the strip surgery. Didn't know due existed til resently. Was on tour and was so worried about hair loss I stayed away from facts😒

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## Artista

*Intoodepp--HELLO THERE my friend !!*
Yes, the *BaldTruthTalk forum*(created by Spencer Kobren)  is the *BEST forum* to be at if you want to learn more about hairloss treatments/plans and realistic expectations!! 
Stick around here bro!! There are a good portion of members like myself that are here to HELP.....
By the way, What country are you from/living at? 
Also what age are you now?  That is important info as well. 

I saw your thread this morning on my smartphones email.
Now I am on my computer but
I must get ready for work right now, *lets have a CONVERSATION soon.*
*I want to try and give you good commonsense advice if I can!!*
*Ive got some cool info' to talk with you ,and others,  about*.

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## Intoodepp

Thank you for replying artistas. I've read a lot of your posts. You are always positive and helpful. I'm 29 and from the u.s. I started balding at age 17 and freaked out like the normal cliche thing to do at that age. I fell for the  Bosleycommercials as a desperate teen and now am stuck with minoxidil and concealers. Like I said, was on tour and was just in denial longer than I should have been. I have thick dense and curly characteristics, so I've been getting away with balding longer than expected. I read that's what you've been looking for so even though I made wrong decisions I added myself here just to help with my poor decisions. Plz be patient with me working up to post pics. To be honest, I'm still a bit superficial about it all and it doesn't even look that bad now. Just when you know it's heading there soon. I understand the views of yeahyeahyeah but do not want to sound like that and understand realistic expectations.

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## Intoodepp

Plz reply people's. Support is needed

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## Artista

Hello Intoodepp!!
Sorry by I'm at work right now. I WILL respond tomorrow morning. Cheers

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## Driver

First, great thread. Second, I think NW6 can certainly have good outcomes but, as I have said elsewhere, it is all about expectations. If you are NW5 or NW6, full coverage is extremely tough to achieve unless you have ideal hair characteristics, which most people do not have. If you have advanced hair loss, a mature hairline in the front and top coverage are very reasonable expectations, with little to no work done in the crown in many/most cases. Will you look like you are 18 again? No. Will you have a good cosmetic outcome that is better than slick baldness? Yes.

Also, I noted that a few pages back this conversation veered into the argument about FUT vs FUE. It makes me nuts to see this "debate" raging endlessly on this and other boards. People have so many motivations in this debate it clouds their judgment. Patients want to defend what they had done to validate their decision making and doctors want to defend what they do as it is their reputation and income on the line. IMHO, both are good techniques and have pros and cons. I really think that some people are better candidates for one surgery or the other. No reason not to have FUT in 2015 if you are a better FUT candidate. No reason not to have FUE in 2015 if it works better for you. Both operations leave scars and have pros and cons.

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## HTsoon

I will have to agree that both procedures have their place, I am a norwood 6 and have had two transplants very happy with the outcome, managing expectations is just as important as managing your donor supply, in the beginning there seemed to be some discussion about illusion of coverage and illusion of density, coverage is coverage which means any area void of any hair that has grafts placed in to it will have coverage, now the illusion of density is created when those follicles overlap each other and this gives visual density, however if the hair were to be shaved the density would be diminished elimination the "illusion".

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## blohan

> I will have to agree that both procedures have their place, I am a norwood 6 and have had two transplants very happy with the outcome, managing expectations is just as important as managing your donor supply, in the beginning there seemed to be some discussion about illusion of coverage and illusion of density, coverage is coverage which means any area void of any hair that has grafts placed in to it will have coverage, now the illusion of density is created when those follicles overlap each other and this gives visual density, however if the hair were to be shaved the density would be diminished elimination the "illusion".


 do you have to take pills to keep the hair?? how do i know if my donor hair is resistant or not?

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## 2goingon3

Hi.  I was a 51 yr old Norwood 6 that buzzed my hair for 10+ yrs.  Started balding in early 20's and was at Norwood 5 by age 30 (basically no hair in front 1/3).
Had a 2000 graft FUE covering the front to mid area 2 years ago.  Coverage was at ~20 FU/cm2.  It did its job of framing my face, but looked "off" bc there was too much bald area to the top of my head.  I had the second HT 10 month later of 2000 graft FUE again at ~20 FU/cm2 up to top of head.  There were some extras (~200 FU) that I had the Dr implant to the front were it was the lightest densities.
Result is a framed face, but "see through" density at the front and top.  the crown still has a bald circular spot of ~64 cm2.
This looks OK and way better than being completely bald.  If I use Dermatch and sprinkle on a little Toppix it actually looks like I have pretty decent hair, very age appropriate.  But it is kind of a pain in the ass having to do this all the time.
I will have a third HT and have been told I have ~2000 grafts in my donor area. I plan on adding 10 FU/cm2 to the front up and the top to give a density of 30 FU/cm2.  This is ~150 cm2 so it will need 1500 FU's. I'm "on the fence" about using the other 500FU in the crown at ~10 FU/cm2 or just using them in the front for higher density up front.  I think putting them in the bald spot will help with holding the concealer and Toppix for when I want to use them to fool people into thinking I have more hair than I do. :Big Grin: 
I will post pics so Norwood 6's can know what to expect for results.  Like a previous poster said, you need 8000 for a decent result.  I only have 6000 on my head so I'm going to be lighter density or have the bald spot on my crown. Or use beard or body hair, which is $'s I may not want to spend.
FYI:  Cost was ~$7500 per HT, so $15k so far, soon to be $21.5k.

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## jconley

> Hi.  I was a 51 yr old Norwood 6 that buzzed my hair for 10+ yrs.  Started balding in early 20's and was at Norwood 5 by age 30 (basically no hair in front 1/3).
> Had a 2000 graft FUE covering the front to mid area 2 years ago.  Coverage was at ~20 FU/cm2.  It did its job of framing my face, but looked "off" bc there was too much bald area to the top of my head.  I had the second HT 10 month later of 2000 graft FUE again at ~20 FU/cm2 up to top of head.  There were some extras (~200 FU) that I had the Dr implant to the front were it was the lightest densities.
> Result is a framed face, but "see through" density at the front and top.  the crown still has a bald circular spot of ~64 cm2.
> This looks OK and way better than being completely bald.  If I use Dermatch and sprinkle on a little Toppix it actually looks like I have pretty decent hair, very age appropriate.  But it is kind of a pain in the ass having to do this all the time.
> I will have a third HT and have been told I have ~2000 grafts in my donor area. I plan on adding 10 FU/cm2 to the front up and the top to give a density of 30 FU/cm2.  This is ~150 cm2 so it will need 1500 FU's. I'm "on the fence" about using the other 500FU in the crown at ~10 FU/cm2 or just using them in the front for higher density up front.  I think putting them in the bald spot will help with holding the concealer and Toppix for when I want to use them to fool people into thinking I have more hair than I do.
> I will post pics so Norwood 6's can know what to expect for results.  Like a previous poster said, you need 8000 for a decent result.  I only have 6000 on my head so I'm going to be lighter density or have the bald spot on my crown. Or use beard or body hair, which is $'s I may not want to spend.
> FYI:  Cost was ~$7500 per HT, so $15k so far, soon to be $21.5k.


 Great, I look forward to seeing the pics! Thanks for sharing.

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## hmeg

Hi jconley, Congrats for the 2 successful HTs.
I'm 41 years old, NW5/6...interested about why didn't you go upfront for FUT as it yields more density and would, probably, leave you with more donor hair... also you could have put 4,000 grafts in just one procedure. Is it the scar?

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## jconley

> Hi jconley, Congrats for the 2 successful HTs.
> I'm 41 years old, NW5/6...interested about why didn't you go upfront for FUT as it yields more density and would, probably, leave you with more donor hair... also you could have put 4,000 grafts in just one procedure. Is it the scar?


 Oh that wasn't me, that's 2goingon3 up above. I've only had one HT and it was an FUT as you said  :Smile:

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