I'm Norwood 6 - is it foolish to go for HT if I may one day be Norwood 7?

[tedwuji]

It was an analogy finasteride can only cause birth defects if cut or broken pills are handled by a pregnant woman, PFS does exist even if it's a 0.1% chance you may get it, think about how someone who's already completely bald would feel getting PFS for trying to save a few hairs like I said high risk low payout, at best you maintain what you have and keep from turning Norwood 7, at worst you get PFS impotent for life still bald and still may become Norwood 7.

Yeah, and a lot of those guys that progress as far a full-blown nor 7 earlier in life also get some donor area thinning down the road. So the transplanted hair, in those cases may still benefit from the finasteride making the option of forgoing to take it still perilous. Its such a terrible struggle for high Norwoods, particularly early age ones. Then throw in choosing not to optimize the mathematical fact FUT provides more "sweet spot" safe zone hair and it's a potential recipe for disaster. Could be okay if planned right i guess, but seems risks are super high and effort required is too. FUE is also more expensive than FUT which in larger procedures moving maybe 6 or 7 thousand grafts could be detrimental to some depending on individual finances. And u get less hair in the end lol.

To me seems a Norwood 7 who is choosing no finasteride and choosing FUE over FUT could be asking for high risk.

[HTsoon]

I dunno about birth defects, but maybe a temporary risk for lower libido.

It was an analogy finasteride can only cause birth defects if cut or broken pills are handled by a pregnant woman, PFS does exist even if it's a 0.1% chance you may get it, think about how someone who's already completely bald would feel getting PFS for trying to save a few hairs like I said high risk low payout, at best you maintain what you have and keep from turning Norwood 7, at worst you get PFS impotent for life still bald and still may become Norwood 7.

[tedwuji]

FUT first then FUE without a doubt maximizes the donor hair, i can only speak for myself being a Norwood 6 and already have done two FUE transplants, I knew going in that one day I may have to shave my head if they lateral humps drop, the scars are noticeable at a zero guard but only to the trained eye.

With that being said, it's going to be hard for anyone not a Norwood 6 to fully comprehend why one would want to have surgery starting with such disadvantages, for me personally, I'm under the belief that some hair is better than no hair and of course the framing of the face is without a doubt the single most important aspect, I disagree with needing finasteride for life, if you're Norwood 6 it's ill advised to take finasteride, it's like using fertilizer that can cause birth defects on a dirt crop high risk low payout my 0.2 cents.

I dunno about birth defects, but maybe a temporary risk for lower libido.

[HTsoon]

Traditionally higher norwoods have been suggested to go FUT by docs, because it maximizes precious donor hair in an unbalanced supply & demand scenario. I also maintain any SMP into scar tissue is a precarious scenario at best.

This is all without mentioning the fact norwood 6/7 will be investing considerable time, resources, and emotion into such an endeavor. Particularly if they require more than one or even two procedures spaced narly a full year apart at a minimum. Norwoods of this magnitude typically do require two or more surgeries given the number of grafts needed to cover the lost ground. Then add in taking propecia for life and risking sides.

It seems to me the situation is not without "costs" both literally and figuratively when it comes to higher norwoods specifically.

FUT first then FUE without a doubt maximizes the donor hair, i can only speak for myself being a Norwood 6 and already have done two FUE transplants, I knew going in that one day I may have to shave my head if they lateral humps drop, the scars are noticeable at a zero guard but only to the trained eye.

With that being said, it's going to be hard for anyone not a Norwood 6 to fully comprehend why one would want to have surgery starting with such disadvantages, for me personally, I'm under the belief that some hair is better than no hair and of course the framing of the face is without a doubt the single most important aspect, I disagree with needing finasteride for life, if you're Norwood 6 it's ill advised to take finasteride, it's like using fertilizer that can cause birth defects on a dirt crop high risk low payout my 0.2 cents.

[tedwuji]

I didn't mean permanent smp I meant trico pigmentation that fades, also I would never recommend treating Norwood 6/7 for FUT, the chances are you're going to need a huge strip, if your skin is not elastic your scar will stretch causing a bad scar, additionally, if the lateral humps drop and you become full blown Norwood 7 camouflaging the scar is going to be extremely difficult, it's much easier to camouflage FUE scars than a bad FUT scar, of course combining both procedures maximizes the donor capacity, I just don't like the fact that the scar might stretch and you may one day have to shave your head.

Traditionally higher norwoods have been suggested to go FUT by docs, because it maximizes precious donor hair in an unbalanced supply & demand scenario. I also maintain any SMP into scar tissue is a precarious scenario at best.

This is all without mentioning the fact norwood 6/7 will be investing considerable time, resources, and emotion into such an endeavor. Particularly if they require more than one or even two procedures spaced nearly a full year apart at a minimum. Norwoods of this magnitude typically do require two or more surgeries given the number of grafts (stacking price) needed to cover the lost ground. Then add in taking propecia for life and risking sides simply to maintain a few hairs as one poster above said.

It seems to me the situation is not without "costs" both literally and figuratively when it comes to higher norwoods specifically.

But who am I to tell what someone should or should not be willing to do? Its not my intention. As many have pointed out the potential patient needs to manage their own expectations and if they do, then there are some options available no matter how limited they may be compared to a norwood 4 or lower.

[HTsoon]

Yeah depending on skin tone and hair color contrasts i suppose but Spencer doesn't recommend SMP because it bleeds especially when applied to scar tissue.

In addition it fades and changes color over time in some cases. Again, to each their own but myself personally i would be very weary to get any permanent tattoo ink on my head
Especially into scar tissue, as i said.

Not sure how i feel about norwood 6 headed to 7 getting FUE over FUT, as well.

I didn't mean permanent smp I meant trico pigmentation that fades, also I would never recommend treating Norwood 6/7 for FUT, the chances are you're going to need a huge strip, if your skin is not elastic your scar will stretch causing a bad scar, additionally, if the lateral humps drop and you become full blown Norwood 7 camouflaging the scar is going to be extremely difficult, it's much easier to camouflage FUE scars than a bad FUT scar, of course combining both procedures maximizes the donor capacity, I just don't like the fact that the scar might stretch and you may one day have to shave your head.

[tedwuji]

Even a NW6 can get a transplant it is just the expectations that matter. Your discussion with the transplant doctor should be focused on long term outcomes and plans.

I agree!

[tedwuji]

Yes NW6 can totally have a good response, but you should concentrate on the front and top with a mature hairline. Do not worry about the back much as it will suck up grafts. Be realistic and you can look great.

This choice in treatment path would be reasonable assuming you are comfortable with the bald spot in the vertex with no option to buzz.

The intact hairline with isolated crown loss does occur in nature but is less common as the hairline is typically first to go, as depicted in the Norwood medical diagram.

[tedwuji]

I agree taking finasteride and or any 5AR inhibitor as a norwood 6 has higher risk with less reward, even if the chance of getting PFS is 0.2% would that be worth it to save a couple of miniaturized hairs on your bald head? absolutely not. However, I will say this everyones goals and expectations are different, your goal may be to have a teenage head of hair, whilst a norwood 6 simply wants to be less bald, also you mentioned shaving your head, if a norwood 6 were to get FUE and get a hairline done and SMP to the FUE scars and shave his head this would significantly improve his look then just shaving his head.

Yeah depending on skin tone and hair color contrasts i suppose but Spencer doesn't recommend SMP because it bleeds especially when applied to scar tissue.

In addition it fades and changes color over time in some cases. Again, to each their own but myself personally i would be very weary to get any permanent tattoo ink on my head
Especially into scar tissue, as i said.

Not sure how i feel about norwood 6 headed to 7 getting FUE over FUT, as well.

[Driver]

Yes NW6 can totally have a good response, but you should concentrate on the front and top with a mature hairline. Do not worry about the back much as it will suck up grafts. Be realistic and you can look great.

[HTsoon]

People here are making semi-reasonable suggestions.

But for me (this is my own opinion, not professional advice) at a Norwood 6 contemplating a potential 7, I wouldnt even take an anti-angrogen pharmaceutical anymore.

I would just shave my head and go on. As a 40-year old man it would be age appropriate to be bald, which is worth noting.

I am 32 and 5-years stabilized with Finasteride at a Norwood 2.5 and if that were not the case id completely abandon ship instead of fighting an uphill battle.

Everyone will have their own opinion on this, and I believe they are entitled to it.

I agree taking finasteride and or any 5AR inhibitor as a norwood 6 has higher risk with less reward, even if the chance of getting PFS is 0.2% would that be worth it to save a couple of miniaturized hairs on your bald head? absolutely not. However, I will say this everyones goals and expectations are different, your goal may be to have a teenage head of hair, whilst a norwood 6 simply wants to be less bald, also you mentioned shaving your head, if a norwood 6 were to get FUE and get a hairline done and SMP to the FUE scars and shave his head this would significantly improve his look then just shaving his head.

[tedwuji]

Everyone is different regarding hair quality and family history. If an individual can work within their limitations and not set unrealistic goals or be sold pie in the sky, then who are we to say what they should or should not do.

I have seen a few guys who had outstanding donor characteristics like Prodigy and already in their 40s who were at NW6 and got an amazing transformation. Doubtful that Prodigy would progress to a full blown class7. But we never know for sure and that's part of the equation that must be prudently thought through beforehand.

But they are the exception and certainly not the rule and why each case must be evaluated on its own merits and not a pipe dream.

Amen.

[gillenator]

Everyone is different regarding hair quality and family history. If an individual can work within their limitations and not set unrealistic goals or be sold pie in the sky, then who are we to say what they should or should not do.

I have seen a few guys who had outstanding donor characteristics like Prodigy and already in their 40s who were at NW6 and got an amazing transformation. Doubtful that Prodigy would progress to a full blown class7. But we never know for sure and that's part of the equation that must be prudently thought through beforehand.

But they are the exception and certainly not the rule and why each case must be evaluated on its own merits and not a pipe dream.

[tedwuji]

I've been having a very interesting discussion with the fantastic Gillenator and I'm having a predicament that i'd like to open up to discussion. I'm a Norwood 6 and I really want HT but there is a chance i'll go to Norwood 7 which will means big gaps appearing between the HT and the dropping sides.

I'm in my early 40s and its not by any means certain my sides will drop any more. Both my brothers are Norwood 6, one is 4 years older than me. My father is a Norwood 7 but he went to that stage when he was 22 but both my grandfathers had good head of hair before they passed on.

i've been on the Minoxidil / Azelaic acid mix for over 6 years and on the Finasteride for about 2 and although i've lost hair since i started, i think its slowed down.

After discussions with Gillenator I'm thinking of around 3000 grafts up top and saving another 3000 for a later date - perhaps if I shift from Norwood 6 to 7. I'd really love to hear from anyone who may have been in a similar position though and have attached a picture.

many thanks

P[IMG][/IMG]

People here are making semi-reasonable suggestions.

But for me (this is my own opinion, not professional advice) at a Norwood 6 contemplating a potential 7, I wouldnt even take an anti-angrogen pharmaceutical anymore.

I would just shave my head and go on. As a 40-year old man it would be age appropriate to be bald, which is worth noting.

I am 32 and 5-years stabilized with Finasteride at a Norwood 2.5 and if that were not the case id completely abandon ship instead of fighting an uphill battle.

Everyone will have their own opinion on this, and I believe they are entitled to it.

[Dutch_Dude]

with the right doctor it may even be possible to get a full head of hair back, since your hair is very thick and your pattern is stable.