What Makes a Norwood Class 7 Not a Good Transplant Candidate?

I have heard many people say that Norwood 7s are not good hair transplant candidates. However, two of the most successful hair transplants (Bobman and Jotronic) from another medical group were both Norwood 6’s heading towards level 7. What stops them from progressing further after their transplants? If you get a transplant as a 6, is it really that noticeable if you slowly progress to a 7? Is there something I’m missing altogether?

I have many Class 6 and 7 patients with great results from a hair transplant, so yes, it can be done well, but this is an issue of supply and demand with regard to donor hair. In other words, is there enough supply in the back of the head to meet the demands of the bald top? Take a look at Patient ZU from a past blog post (photos below) — now he has 9900 grafts and yet still has plenty of donor hair for more transplant procedures (which he does not need now) and that is because of two reasons:

1. His scalp had a great laxity to it.
2. He had a donor density which reflected an original hair population of 175,000 hairs on his head (normal is about 100,000 hairs).

Not everyone is a candidate and the issues that the doctor and the patient must face are one of realistic expectations and an excellent doctor/patient relationship.

Patient ZU – Before:

Patient ZU – After:

Update: More photos! Click to enlarge.