TL:DR; Norwood 6 is an advanced stage of genetic hair loss where the “hair bridge” has completely collapsed, leaving a large unified bald area and a classic “horseshoe” pattern; however, full restoration is still possible at Medifue using 5,000 to 6,000+ grafts often split into two sessions by combining Sapphire FUE for maximum coverage, DHI for a natural hairline, and potentially Beard Hair Transplants (BHT) to supplement the donor area for a life-changing, dense result.
What Does Norwood Stage 6 Look Like?
At Stage 6, the hair loss has reached a point of “unification.” The scalp is no longer divided into balding zones; it is one continuous area of bare skin on top.
The Complete Loss of the Bridge
In previous stages, a band of hair (the bridge) provided a visual break between the receding hairline and the thinning crown. At Norwood 6:
- The Bridge is Gone: The hair in the middle of the scalp has completely fallen out or miniaturized to the point of invisibility.
- The “Island” Effect Disappears: The frontal hair and the vertex hair have merged into a single “bald plain.”
The Expanding “Horseshoe” Pattern
The remaining hair on the sides and back of the head is now the only “permanent” hair left.
- Lowering Side Walls: In Stage 6, even the hair on the sides of the head (above the ears) begins to recede downward.
- The Challenge: This means the total area of baldness is at its widest, while the “safe donor zone” (where we harvest grafts) is at its narrowest.
The Norwood 6 Challenge: Demand vs. Supply
The primary difficulty in treating Stage 6 is the math. The area that needs hair is massive, but the donor area is limited.
How Many Grafts Are Needed? (Estimate: 5,000 to 6,000+ Grafts)
To cover a Norwood 6 scalp with enough density to look “non-bald,” a very high number of grafts is required.
- Frontal & Mid-Scalp: Approx. 3,500 – 4,000 grafts.
- Crown (Vertex): Approx. 1,500 – 2,000+ grafts.
- Total: Often exceeding 5,500 grafts .
The Limitation of the Donor Area
Most men have about 6,000 to 8,000 grafts available in their lifetime donor supply. Taking 5,000+ in a single session can be risky.
- Over-harvesting Risk: At Medifue, we prioritize the health of your donor area. If we take too many grafts at once, the back of your head will look thin and patchy.
- The Solution: This is why we focus on efficiency —extracting only the strongest multi-hair follicular units to get the maximum “bang for your buck” from every graft.
Strategic Planning: The Medifue Approach for Stage 6
When dealing with Norwood 6, we do not just plant hair; we design a long-term architecture. Because the bald area is so vast, success depends on a “Prioritized Density” model.
Why We Recommend a Two-Session Journey
For many Norwood 6 patients, trying to transplant 6,000 grafts in a single day is not the best medical choice.
- Graft Survival: Beyond a certain point, the “out-of-body” time for grafts increases, and the scalp’s blood supply can struggle to nourish thousands of new implants at once.
- The Medifue Strategy: We often suggest splitting the procedure into two sessions, spaced 6 to 12 months apart.
- Session 1: Focuses on the Frontal Third and Mid-Scalp . This gives you an immediate transformation in the mirror.
- Session 2: Focuses on the Crown (Vertex) and adding density to the transitions. This ensures maximum survival rates for every follicle.
Prioritizing the “Aesthetic Zone” (Frontal Third)
At Stage 6, the surgeon must act like an artist with a limited amount of paint.
- The Framing Rule: We prioritize the frontal hairline and the “temple peaks.” Why? Because this is what defines your face and makes you look younger in social interactions.
- The Gradient Effect: We create high density at the front and slowly “feather” the density as we move toward the back. This mimics a natural aging pattern, where a man has a strong front even if the top is slightly thinner.
The Role of Body Hair Transplant (BHT): Beard as a Lifesaver
What if your scalp donor area (the horseshoe) is simply not enough to cover the massive bald area of Stage 6? This is where Medifue’s technical expertise shines.
- Beard Grafts: Beard hair is remarkably thick and has a high “coverage” value. We can harvest up to 1,000-1,500 grafts from under the chin and jawline.
- The Integration: We never use beard hair for the hairline (it’s too coarse). Instead, we mix it with scalp hair in the mid-scalp and crown to add incredible volume and “fill” the empty spaces without over-stressing the back of your head.
Realistic Expectations: Coverage vs. Density
A Norwood 6 patient must understand the difference between coverage (hiding the bald skin) and density (having thick, impenetrable hair). While we can achieve full coverage, the hair may not be as thick as it was in your teenage years.
Why You Might Need a “Shingling” Technique
Since the recipient area is massive and the donor supply is limited, Medifue surgeons often use a specialized method called Shingling .
- The Concept: Much like tiles on a roof, hairs are placed at a very specific, acute angle so that each hair shaft overlaps the one next to it.
- The Benefit: This creates a visual “wall of hair” that hides the scalp effectively even if the actual number of follicles per square centimeter is lower than natural density.
Managing the Crown: The Largest Area to Fill
The crown (vertex) in a Norwood 6 patient is usually a very large, circular “desert.”
- The Challenges: The crown requires a high number of grafts because of its whorl pattern, which naturally spreads the hair apart. Furthermore, the skin on the crown is tighter and has a slightly lower blood supply than the forehead.
- The Strategy: In some Stage 6 cases, we may recommend focusing on the Front and Mid-scalp with high density and accepting a lighter “conservative coverage” for the crown. This ensures you look great from the front and sides, where 90% of your social interactions occur.
Frequently Asked Questions (FAQ)
Can I get a “full head of hair” if I am Norwood 6?
Yes , but with a caveat. You will have a full head of hair that looks natural and covers your baldness. However, if you part the hair under a bright surgical light, the scalp will be more visible than that of a Norwood 2 patient. Our goal is to ensure you look restored in daily life, under sun, and in photos.
Is FUE or DHI better for Norwood 6?
At Medifue, we often recommend a Manual FUE or Sapphire FUE for the bulk of a Stage 6 procedure. Because we need to move 4,000+ grafts, FUE is the most efficient way to harvest and place large volumes. However, we can use DHI for the hairline to ensure the most natural transition and angle at the very front.
What happens if I don’t have enough donor hair?
If the scalp and beard donor areas are both exhausted, we have two professional solutions:
- Prioritization: We create a strong hairline and let the crown remain thin, which is a natural look for many men.
- SMP (Scalp Micropigmentation): We use medical-grade tattooing to create the illusion of hair follicles between the transplanted hairs, significantly increasing the “perceived” density.
