I am NW VII at 57years, i have had just one strip procedure as usual it was insufficient and I would like to FUE only from my nape to my bald area i am not concerned about my crown and I believe that the total amount should be 6500 FUE to get a conservative nw3. I would like to ask you is this possible?
A NW VII typically looses 70% or more of their original scalp hair. This means that they maintain 30% of their original hair or less. In my opinion, this makes them a poor candidate for hair restoration surgery. The best you can hope for is what some call a frontal forelock that is isolated from the sides of your scalp. In other words, it is hair that sits on top of your head with a bald rim on the sides above the ears before you see hair again.
It does occur in nature, but it is quite uncommon. It can help to frame your face, but you must recognize that it can also look a little unusual to have hair on the top of your head, a bald fringe, and then hair again above the ears.
A typical donor area will have a maximum of 16000 follicular units. I think that a NW VII will have less. Of this donor area, you can expect to remove 50% or a little more in those with outstanding donor area characteristics such as a high density and coarse caliber hair.
In your instance, you can probably expect to remove no more than 5000 grafts in total. Of course, you may be able to move slightly more, but 5000 is a safe number to anticipate. This may leave you looking a little thin on the sides between the top of the head and the fringe of hair that normally remains in the NW VII.
We have added body hair in select NW VII cases, but body hair in general is a hit or miss. Some do well with it and some do poorly. Therefore, I always tell patients to try a little to see how they respond, but don”t bank on your body hair until you actually see how you respond to it. Many are quite happy with body hair, but some are quite disappointed with the results so try a little and see how you respond prior to expecting too much from this.
In summary, a NW VII is a poor candidate for hair restoration surgery. It is questionable whether you have enough donor hair to create an acceptable result. I would be surprised if you were able to get a total of 6500 grafts from your donor area and not make your donor strip scar visible, but it is possible. Therefore, I would proceed cautiously with any further treatment and don”t expect a miracle because it is impossible to expand the capacity of your scalp donor area.
One final note is that with your initial procedure you became 100% better because you added hair to a bald scalp. Assume that you next add 1000 more grafts to the original 1000 grafts from your strip procedure. With the second procedure, you increased from 1000 grafts to 2000 grafts in total, but you are only 50% better. You get the most dramatic result from the initial procedure and each procedure subsequent to this leaves you a with a less impressive result.