Norwood 3 Vertex patients can expect significant visual improvement from hair restoration. With 2,000 to 2,800 grafts addressing both temple recession and crown thinning, most patients see full density results by 12 to 18 months post-procedure.
What Norwood 3 Vertex Looks Like Before Treatment
Norwood 3 Vertex (3V) is a distinct classification that combines two areas of loss. The frontal hairline shows the same deep temple recession and M-shaped pattern seen in standard Norwood 3. In addition, the vertex (crown) displays noticeable thinning or the beginnings of a bald spot.
This dual-zone pattern creates unique challenges for restoration. Unlike standard Norwood 3, where a surgeon can focus graft placement entirely on the frontal zone, Norwood 3V requires strategic allocation between two separate recipient areas. The visual impact is also different: thinning at the crown is often more noticeable to others (who see you from behind or above) while temple recession is what you notice most in the mirror.
Before treatment, common characteristics include:
- Temple recession creating an M-shape with the central forelock still present
- A widening part or visible scalp through the crown area
- The vertex thinning zone is typically 3 to 5 cm in diameter
- The area between the frontal hairline and crown (the mid-scalp) may still have reasonable density
For a complete breakdown of where 3V fits relative to other stages, see our Norwood scale complete guide.
Typical Before and After Timeline
Understanding the progression of results is critical for setting realistic expectations. Hair transplant results do not appear overnight. Here is what the typical Norwood 3V patient experiences at each stage.
Weeks 1 to 4: Initial Healing
Immediately after surgery, the transplanted grafts are visible as tiny crusts across the recipient areas. Redness and minor swelling are normal. By the end of week two, most crusts have fallen away. The transplanted hairs are still present but have not yet entered a growth phase. Both the frontal zone and crown area will look somewhat pink, and the transplanted hairs sit close to the scalp surface.
During this period, many patients feel cautiously optimistic but also anxious. The treated areas look thin because the transplanted hairs have not grown yet.
Months 1 to 3: Shock Loss Phase
Around weeks 3 to 6, most transplanted hairs shed. This is called shock loss, and it is completely normal. The follicles remain embedded in the scalp and are simply cycling into a resting phase before new growth begins. At this stage, many patients feel like the procedure has not worked. The crown area may look almost the same as it did before surgery, and the temples may appear only marginally different.
Existing native hairs near the transplanted zones may also temporarily thin (sympathetic shock loss). This resolves on its own in nearly all cases.
Months 4 to 6: Early Growth
New growth typically begins around month 3 to 4. The initial hairs are often fine and wispy, gradually thickening over time. By month 6, most patients see approximately 50 to 60% of their final result. The frontal hairline usually shows visible improvement first because hair in the temporal zone tends to emerge slightly earlier than crown grafts.
At the crown, early growth may appear patchy. This is normal. Vertex grafts often lag behind frontal grafts by several weeks.
Months 8 to 12: Substantial Results
By month 8, roughly 80% of transplanted grafts have emerged. The hairline is visibly improved, and the crown shows meaningful coverage. Hair caliber continues to thicken, adding density and visual fullness. Most patients report a significant boost in confidence at this stage.
The contrast between before and after becomes clear. Temple recession has been filled, recreating a more continuous hairline. The crown spot has filled in, reducing or eliminating visible scalp.
Months 12 to 18: Final Result
Full maturation occurs between 12 and 18 months. At this point, graft survival rates of 90 to 95% mean that the vast majority of transplanted follicles are producing healthy terminal hair. The final result should look natural, with appropriate density in both the frontal and vertex zones.
Patients who combined their transplant with finasteride (1mg daily) often see additional improvement in native hair surrounding the transplanted areas, as the medication halts further loss in 80-90% of men and produces regrowth in roughly 65%.
What Determines Your Before and After Outcome
Graft Count and Distribution
Norwood 3V typically requires 2,000 to 2,800 grafts total. How those grafts are divided between the frontal zone and the crown significantly affects the visual outcome. Most surgeons prioritize the hairline (which has the most face-framing impact) and allocate a portion to the crown.
A common split might be 1,400 to 1,800 grafts to the frontal/temporal zone and 600 to 1,000 grafts to the vertex. However, this varies based on patient goals. Some patients prioritize crown coverage (especially if their career involves people viewing them from behind), while others focus entirely on the hairline.
Hair Characteristics
Your natural hair properties directly affect how full the result appears:
- Hair caliber: Thicker individual hairs provide more coverage per graft. A patient with coarse hair may achieve the appearance of full density with fewer grafts than someone with fine hair.
- Hair color vs. scalp contrast: Low contrast (blond hair on light skin, or dark hair on dark skin) makes the result look denser at any given graft count.
- Curl or wave pattern: Curly or wavy hair covers more scalp surface area per strand, creating better visual density.
- Follicular unit composition: Multi-hair follicular units (2 to 4 hairs per graft) provide more coverage than single-hair units.
Surgical Technique
The method used affects the final look:
- FUE (0.7 to 1.0mm punch): No linear scar, 7 to 10 day recovery, up to 5,000 grafts per session. The scattered extraction pattern minimizes visible donor thinning.
- FUT (strip method): Linear scar in donor area, 10 to 14 day recovery, up to 4,000 grafts per session. Often yields a high percentage of intact follicular units.
- DHI (Choi implanter pen): 7 to 10 day recovery, up to 3,500 grafts per session. Precise angle control is valuable for natural-looking crown whorls.
For detailed pricing at this stage, see our Norwood 3V transplant costs breakdown.
Factors That Can Compromise Results
Even with proper graft counts, several factors can diminish the before-to-after improvement:
- Skipping medication: Without finasteride or minoxidil, native hair surrounding the transplant may continue thinning, creating an "island" effect. This is particularly relevant at the vertex, where medical therapy can be highly effective on its own.
- Smoking during recovery: Nicotine constricts blood vessels, potentially reducing graft survival below the standard 90-95% rate.
- Sun exposure: UV radiation on newly transplanted grafts can damage follicles during the first 3 months.
- Unrealistic expectations: Expecting pre-hair-loss density at age 20 from 2,000 grafts is not realistic. The goal is natural-looking improvement that frames the face well.
How to Evaluate Your Own Before and After Potential
The single best predictor of outcome is a thorough consultation with a board-certified hair restoration surgeon. However, you can begin evaluating your potential right now.
Consider your donor area density, your hair characteristics, and how much coverage you want in each zone. If you are unsure about your classification or want a preliminary evaluation before booking a surgical consultation, the free AI assessment at myhairline.ai can analyze your hair loss pattern and provide guidance on graft estimates and treatment options.
Documenting your current state with clear, well-lit photographs (front, temples, top-down crown view) gives you an honest baseline to compare against future results.
Frequently Asked Questions
What does Norwood 3 Vertex look like?
Norwood 3 Vertex features temple recession similar to standard Norwood 3 (deep M-shape at the temples) combined with thinning or a bald spot at the crown. This dual-zone pattern distinguishes it from standard Norwood 3, which only involves frontal recession. The vertex thinning area is usually 3 to 5 cm in diameter and is most visible from above or behind.
How many grafts at 3V?
Norwood 3 Vertex typically requires 2,000 to 2,800 grafts to address both the receding temples and the vertex thinning. The allocation between frontal and crown zones depends on individual priorities and hair characteristics. A common split is roughly 60-70% of grafts to the frontal zone and 30-40% to the crown, though this varies by patient.
Best treatments at 3V?
A combination approach works best at Norwood 3V. Hair transplant surgery (2,000 to 2,800 grafts) restores lost coverage, while finasteride 1mg daily halts further loss in 80-90% of men and produces regrowth in about 65%. Minoxidil 5% applied twice daily adds 40-60% moderate regrowth and is particularly effective on vertex thinning. Medical therapy alone may significantly improve the crown area, making it possible to allocate more surgical grafts to the hairline.