Norwood 6 typically requires 4,000 to 6,000 grafts to restore meaningful coverage across the frontal, mid-scalp, and crown zones. This is near the upper limit of what a single donor area can safely provide over a lifetime, making careful planning essential.
This article is for informational purposes only and does not constitute medical advice. Consult a qualified hair loss specialist before making any treatment decisions.
What Is Norwood Stage 6?
The Norwood-Hamilton scale classifies male pattern baldness from Stage 1 (no visible loss) through Stage 7 (maximum baldness). Norwood 6 represents the second-most advanced stage.
At Norwood 6, the frontal and crown bald zones have merged into one continuous area of loss. The bridge of hair that persists at Norwood 5 between the front and crown has been lost. What remains is a horseshoe-shaped band of hair around the sides and back of the head, the permanent donor zone.
The total bald surface area at Norwood 6 is approximately 200 to 250 cm2. Covering this area at even modest transplant density (25 to 30 grafts per cm2, compared to natural density of 60 to 80 FU/cm2) requires thousands of grafts.
Graft Calculation at Norwood 6
Graft requirements are calculated by multiplying the recipient area size by the target density per cm2. At Norwood 6, each graft contains an average of 2.2 hairs.
Norwood 6 graft breakdown by zone:
| Zone | Area (cm2) | Target Density (grafts/cm2) | Grafts Needed |
|---|---|---|---|
| Frontal hairline | 30-40 | 35-40 | 1,050-1,600 |
| Mid-scalp | 60-80 | 25-30 | 1,500-2,400 |
| Crown | 50-70 | 20-25 | 1,000-1,750 |
| Total | 140-190 | -- | 3,550-5,750 |
The frontal zone receives higher density because it is the most visible area and anchors the perception of a full head of hair. The crown and mid-scalp are planted at lower density to distribute limited donor supply across a larger area.
Most surgeons round this to the 4,000 to 6,000 graft range when quoting Norwood 6 patients, depending on individual anatomy and goals.
Donor Area Limits at Norwood 6
The donor area, the permanent horseshoe band, contains a finite number of follicular units. The average man has approximately 6,000 to 8,000 extractable follicular units in the safe donor zone. The maximum safe extraction limit is roughly 45% of the donor area to avoid visible thinning.
This means:
- A patient with average donor density (75 FU/cm2) and a 100 cm2 safe zone has about 7,500 total units
- At 45% safe extraction, approximately 3,375 units are available via FUE
- FUT (strip) may yield more from a single procedure (up to 4,000 grafts per session) because it harvests a concentrated strip rather than distributed punches
For Norwood 6 patients needing 4,000 to 6,000 grafts, the math is tight. Many patients require a combination of FUE and FUT across multiple sessions, or must accept reduced density targets.
Single Session vs. Multiple Sessions
No single technique can reliably deliver 6,000 grafts in one session.
Session capacity by technique:
| Technique | Max Grafts Per Session | Punch/Method | Survival Rate |
|---|---|---|---|
| FUE | Up to 5,000 | 0.7-1.0mm punch | 90-95% |
| FUT | Up to 4,000 | Linear strip | 90-95% |
| DHI | Up to 3,500 | Choi implanter pen | 90-95% |
A typical Norwood 6 plan involves two sessions spaced 8 to 12 months apart. The first session addresses the frontal zone and mid-scalp (2,500 to 3,500 grafts), and the second session fills the crown and increases density in the mid-scalp (1,500 to 2,500 grafts).
Some clinics offer mega-sessions of 4,000 to 5,000 FUE grafts in a single day. These are technically demanding and require a large surgical team to keep grafts viable outside the body (grafts deteriorate after 4 to 6 hours).
Factors That Change Your Graft Count
Several personal variables shift the graft requirement up or down at Norwood 6.
Hair caliber: Coarse hair (above 70 microns shaft diameter) provides more coverage per graft, potentially reducing the count by 10 to 15%. Fine hair (below 50 microns) requires more grafts for the same visual result.
Hair-to-skin contrast: Low contrast (blonde hair on fair skin, dark hair on dark skin) is more forgiving at lower densities. High contrast (dark hair on pale skin) reveals gaps more easily and may push requirements toward the upper range.
Curl and wave: Curly hair provides significantly more coverage per graft than straight hair. Men with Afro-textured hair may achieve adequate results with 20 to 30% fewer grafts.
Desired density: Some patients accept a "strategic density" approach, concentrating grafts in the front 50% of the bald zone and using scalp micropigmentation or hair fibers for the crown. This reduces the graft requirement to 2,500 to 3,500.
Body hair grafting (BHT): When scalp donor supply is exhausted, some surgeons harvest grafts from the chest, beard, or body. These grafts have different growth characteristics (shorter anagen phase, different texture) and are typically used as supplementary fill, not primary coverage.
The Strategic Density Approach
At Norwood 6, full restoration to natural density across the entire bald zone is usually not achievable with available donor supply. A responsible surgeon will discuss this openly.
The strategic approach involves:
- Prioritizing the hairline and frontal third at 35 to 40 grafts/cm2 for maximum visual impact
- Filling the mid-scalp at 25 to 30 grafts/cm2 to create continuity
- Adding the crown last at 20 to 25 grafts/cm2, or deferring it to a second session
- Using medical therapy (finasteride and minoxidil) to support remaining native hairs
This creates the perception of significantly more hair while working within biological limits. The frontal zone does the heavy lifting because it frames the face and is visible in mirrors and conversation.
For a full breakdown of what each zone costs to treat, see our Norwood 6 cost breakdown.
Graft Requirements Across Norwood Stages
For context, here is how Norwood 6 compares to other stages.
| Norwood Stage | Typical Graft Range | Areas Treated |
|---|---|---|
| Stage 2 | 500-1,500 | Minor temple recession |
| Stage 3 | 1,500-2,500 | Temples and early hairline |
| Stage 4 | 2,500-3,500 | Hairline and crown |
| Stage 5 | 3,500-5,000 | Extensive hairline and crown |
| Stage 6 | 4,000-6,000 | Large combined loss area |
| Stage 7 | 5,000-8,000+ | Maximum coverage |
Norwood 6 sits in the range where donor supply becomes a limiting factor for most patients. This is why a thorough donor assessment is the single most important step before committing to surgery. See our complete Norwood scale guide for a full overview of all stages.
Upload your photo at myhairline.ai/analyze for a free AI-powered Norwood assessment. Knowing your exact stage is the first step toward an informed graft estimate.
FAQ
What does Norwood 6 look like?
Norwood 6 presents as a large, continuous bald area from the hairline through the mid-scalp to the crown. The bridge of hair that separates the frontal and crown zones at Norwood 5 has been lost. Only a horseshoe-shaped band of hair remains on the sides and back of the head.
How many grafts do I need at Norwood 6?
Norwood 6 typically requires 4,000 to 6,000 grafts to achieve meaningful coverage of the frontal, mid-scalp, and crown areas. The exact number depends on your desired density, hair caliber, donor supply, and whether coverage is prioritized in the front or distributed across the entire bald zone.
What are the best treatments at Norwood 6?
At Norwood 6, hair transplant surgery (FUE or FUT) is the primary restoration option, often requiring multiple sessions. Medical treatments like finasteride and minoxidil can help preserve remaining native hair and support transplanted grafts, but they cannot regrow hair in areas that have been bald for years. Scalp micropigmentation is a non-surgical alternative that creates the illusion of density.