NORWOOD 6 members who have had HT surgery

[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.

[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.

[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.

[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.

[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.

[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.

[3rd time]

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

[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.

[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.

[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

[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.

[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.

[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

[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.

[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!