NORWOOD 6 members who have had HT surgery

[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.

[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.

[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Yes these guys look like they have hair on the top of their head, but the hairstyle looks outdated and as a result doesn't look good.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.

[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.

[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]

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]

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]

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.

[gillenator]

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

[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?

[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

[Artista]

Dr Cole, great advice given to Fred !

[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.

[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.

[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.

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?

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.