Am I a good candidate for a hair transplant? Do I exhibit any signs of problematic recession such as retrograde? (photo)

Question

Please see the attached photos. I’m aware that I’m a tough case. Wondering where I fall on the Norwood scale? How successful a transplant would be (including using beard hair)? Do I exhibit any signs of problematic recession such as retrograde? Thank you!

Mehmet Erdogan, MD · Answer

Based on photos, you're currently at approximately Norwood level 6, which means full restoration would typically require 8,000–9,000 grafts over 2–3 sessions. However, your donor capacity appears limited, and we estimate that around 3,000 grafts could be safely harvested in the first session.
With that number, we could focus on reconstructing your hairline and frontal zone. Future surgeries (sessions 2 and 3) would depend entirely on how your donor area looks one year later, but realistically, coverage of the midscalp and crown would remain difficult due to your donor limitations.
Beard or chest hair could potentially be used as supplemental sources in the future, but they don’t offer the same quality or yield as scalp grafts, and the cosmetic result is generally less predictable.Generally, patients with Norwood 6 hair loss and a weak donor area are usually not ideal candidates for full restoration. But &mdash; if your expectations are realistic, and you’re not aiming for ultra-dense coverage or a full head of hair &mdash; we can still create a natural-looking frontal hairline and rebuild the "hair frame" of the face. It’s not about perfection, but it can absolutely be about strategic improvement.

Chet Mays, MD · Answer

Thank you for your inquiry! It looks like by your photo, you would be a great candidate for Neograft, a hair transplant procedure. We would love to meet with you virtually or in person to discuss your goals and create a plan for you!

Anna Chacon, MD, FAAD · Answer

Determining candidacy for a hair transplant involves several factors, including the pattern and extent of hair loss, donor hair availability, and overall scalp health. Here’s a general guide to help assess your situation, although a personal consultation with a hair restoration specialist is essential for a definitive evaluation:

Norwood Scale: The Norwood Scale is used to classify the stages of male pattern baldness. Without seeing the photos, it’s challenging to accurately place you on this scale, but assessing the frontal hairline, crown, and overall thinning can help determine your stage. A specialist can provide a precise evaluation.

Signs of Retrograde Alopecia: Retrograde alopecia refers to thinning or recession at the nape of the neck and sides of the scalp. This can impact the availability of donor hair. A thorough examination by a dermatologist or hair restoration expert can identify if this is present.

Donor Hair Availability: Successful hair transplants rely on having a sufficient supply of healthy donor hair. If scalp donor hair is limited, some specialists may consider using beard or body hair, although these have different characteristics and may not always yield the same results.

Success of Hair Transplant: The success of a hair transplant can depend on factors such as the skill of the surgeon, the characteristics of your hair, and adherence to post-operative care. Using beard hair can be an option, but it should be discussed with your surgeon to understand potential outcomes and limitations.

Consultation: Meeting with a board-certified dermatologist or a hair transplant surgeon is crucial. They can assess your scalp, hair characteristics, and discuss your goals to provide personalized recommendations.

By consulting with a specialist, you can gain a comprehensive understanding of your hair loss pattern and explore the best treatment options tailored to your needs.

Didem Alev, MD · Answer

Thank you for sharing your photos and being upfront about understanding this is a challenging case. I appreciate patients who have realistic expectations from the start.
Your Classification
Based on your photos, you fall into Norwood Grade 7, which represents the most advanced pattern of male pattern baldness. You're correct that this makes you a "tough case," but that doesn't mean we can't achieve meaningful improvement.Regarding Retrograde AlopeciaI don't see significant signs of retrograde alopecia (hair loss behind the ears) in your photos, which is actually positive news. This means your side donor areas should remain stable long-term.
Realistic Assessment for Hair Transplantation
The Challenge:
Extensive hair loss area requiring significant graft numbersLimited scalp donor hair availabilityNeed to balance coverage with natural density
The Opportunity:
Your hair quality appears good from the photosHealthy-looking donor areasBeard hair can supplement scalp grafts effectively
My Recommended Approach
Phase 1: Strategic Foundation (Primary Surgery)Focus Areas: Hairline and mid-scalp regionEstimated Grafts: ~4,000 grafts total
Scalp donor: Maximum safe extractionBeard hair: Supplement for increased graft count
Why This Strategy:
Creates the most visual impactEstablishes a natural hairline frameProvides coverage for the most noticeable areasPreserves some donor hair for potential future procedures
Phase 2: Evaluation and Possible Crown TreatmentTimeline: 6+ months post-surgeryApproach: Comprehensive consultation to assess:
Healing and growth from first surgeryRemaining donor hair availabilityPatient satisfaction and goalsFeasibility of crown/vertex coverage
About Using Beard Hair
Advantages:
Significantly increases total graft availabilityGood texture match for crown areasAllows more comprehensive coverage
Considerations:
Slightly different growth characteristicsRequires specialized extraction techniquePart of my DIT® approach for optimal results
DIT® Technique Benefits for Your CaseFor complex cases like yours, my DIT® (Dermo-needle Incision Technique) offers several advantages:
Precise placement crucial for maximizing limited graftsMinimal trauma important for extensive proceduresBetter graft survival ratesFaster healing between potential sessions
Setting Realistic Expectations
What You Can Expect:
Significant improvement in overall appearanceNatural-looking hairline restorationGood coverage in priority areasAbility to style hair in multiple ways
What to Understand:
Complete restoration to original density isn't possibleStrategic coverage rather than full densityMay require 2 sessions for optimal resultsMaintenance of realistic expectations is crucial
Next Steps
I'd recommend a detailed consultation to:
Assess your specific hair characteristicsMeasure exact donor availabilityCreate a personalized surgical planDiscuss realistic outcomes and timelineReview the DIT® technique in detail
Final Thoughts
While Norwood 7 is indeed challenging, I've successfully treated many similar cases with very satisfied patients. The key is strategic planning, realistic expectations, and executing a well-thought-out approach.Your case would benefit from an experienced surgeon who understands how to maximize limited donor resources while creating natural, aesthetically pleasing results.I hope this helps.
Dr. Didem Alev

Ilhan Serdaroglu, MD · Answer

Although my  aim as a  plastic  surgeon is to restore all bald areas of the scalp  in  one session of  operation , when I look to your donor site that is poor and has a limited area that we may not able to get enough number of follicles to cover all bald spot and restore preexisting hair.

We may also plan to do a body FUE and harvesting grafts as much as possible in order to get high number of follicles to try to cover all bald spot and restore almost  whole preexisting hair. 
We can harvest between 1800-2900 grafts from beard and 1000-1500 grafts from chest with  body  FUE technique. But you  should know that those  number  of follicles depends on the  density and area  of  your  beard and  chest donor areas.ugh number of follicles to cover all bald spot and restore preexisting hair.

Am I a good candidate for a hair transplant? Do I exhibit any signs of problematic recession such as retrograde? (photo)

Answers (5)

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