Norwood I   Normal head of hair with no visible hair loss.

Norwood II The hair is receding in a wedge-shaped pattern.

Norwood III Same receding pattern as Norwood II, except the hairline has receded deeper into the frontal area and the temporal area.

Norwood IV Hairline has receded more dramatically in the frontal region and temporal area than Norwood II and there is the beginning of a bald spot at the back of the head.

Norwood V Same pattern as Norwood IV but much reduced hair density.

Norwood VI The strip of hair connecting the two sides of the head that existed in Norwood IV and V no longer exists in Norwood VI.

Norwood VII Shows the hair receding all the way back to the base of the head and the sides just above the ears.

Guidelines for the Number of Follicular Unit Grafts Needed in First Hair Transplant Procedure Based on the Norwood Classification System

Minimal Number of Hair Grafts in FIRST Hair Transplant Session

Norwood Class

Follicular Unit Grafts

With Crown

IIa

800

III

1200

III Vertex, IIIa

1600

2000

IV

2000

2400

IVa

2200

V

2400

2600

Va

2600

VI

3000

3500

Norwood Scale and Graft Number

Our philosophy to hair restoration is one of continued care. For men this may be a novel idea. Much like exercise and diet, as well as women’s facial care, it doesn’t keep going if you stop. Our goal is to preserve as much of your natural hair as possible. Sometimes transplants are necessary, but that is not our first goal. Also, men must realize that once a transplant is done there is still continued care. Over the counter Minoxidil as well as compounded preparations including finasteride (Propecia) are a good starting point as well as home LED “red light” or infrared therapy.  Turning on your own stem cells to grow hair follicles will probably be a reality in the not too distant future, so even if the graft site is sparse now, there still is more hair on the horizon. There may be some good growth simulators that can be mixed with laser or micro-needling in the near future as well. Healthy follicles also need healthy dermal structures and collagen too, so platelet treatment using your own “stem cells” promotes this as well. Our hair products, PRFM, laser and LED phototherapy are things you can start now to prepare for transplant day if needed.

The first transplant session is usually designed as a stand-alone procedure. A second session could be considered for additional density, or if your hair loss progresses, so it is important to have a long term plan to maintain your hair. Ideally, the larger the graft the better, but the reality is we are limited by the number of hairs on our body.

A special note on the crown, covering the crown should not be the primary goal in the first follicular hair transplant procedure unless there is a great donor supply and if limited hair loss is anticipated or controlled. If crown restoration is attempted prematurely, the future options will be more limited and the chances for a more natural look could be hampered.

So, at Landmark Aesthetic the primary goal or objectives will include:

  • creating, or reinforcing, the frontal hairline in order to establish a permanent frame to ones face
  • providing coverage to the thinning areas of the scalp with the hair transplant up to the vertex transition point
  • a sufficient density in the first hair transplant session, to give a natural looking result
  • as much coverage as possible over the entire transplanted area, so that the surgical hair restoration may be completed as quickly as possible. Your full hair growth may not be realized for two years!
  • There is no guarantee of all follicles surviving, so we use the NeoGraft 2 for extraction and up to three transplant techs to reduce trauma and establish rapid implantation of your new hair.

Occasionally, some of the hair implanted just starts growing, and doesn’t seem to go into telogen phase, but most hair will fall out leaving the follicle bulb that will grow new hair. Additional sessions may be desired in the future, to add more fullness or to replace future hair loss, but larger rather than smaller for the initial session is better. The nice thing about the FUE method is small procedures can be done with out much loss for future treatments. Most patients are best candidates for FUE rather than the strip method.

 

norwood 7

3500 FUE Graft

Norwood Class V or Greater is more dependent on the donor site, as to how much can actually be done. Pretreatment with PRFM and laser therapy with our novel erbium laser to stimulate growth is also recommended. See the link below for more details about the treatment and package deal.
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norwood 6

2500 Follicular Unit Graft

More advanced stages of loss in the Norwood IVa to V classification. See the link below for more details about the treatment and package deal.
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Norwood III 0CD7DF87-749C-4F00-974A-BBE079ACD7F0

1500 Follicular Unit Extraction

Norwood III or III vertex pattern allows for a good doner area and good treatment results in one session. See the link below for more details about the treatment and package deal
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Platelet Rich Plasma

At Landmark Aesthetics we use PRP, or more correctly PRFM, to stimulate growth in collagen in places like the face, but it has been shown to stimulate hair growth as well, probably by similar mechanisms. It can be used alone or in treatment with transplants.
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Not sure which treatment is right for you?