NORWOOD 6 members who have had HT surgery

[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.

[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.