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

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

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.