Not every man at Norwood 6 is a good candidate for hair transplant surgery. Candidacy depends on donor area quality, overall health, age, progression stability, and whether your expectations align with what 4,000 to 6,000 grafts can realistically achieve. This guide walks through each factor surgeons evaluate during a Norwood 6 consultation.
Factor 1: Donor Area Density and Quality
The donor area is the single most important variable in Norwood 6 candidacy. Without adequate donor supply, surgery cannot produce meaningful coverage across the large bald zone (200 to 250 cm2).
Donor density thresholds:
| Density (FU/cm2) | Candidacy Assessment |
|---|---|
| Above 80 | Excellent candidate. Ample supply for 5,000+ grafts across sessions. |
| 70-80 | Good candidate. Sufficient for 4,000 to 5,000 grafts with careful planning. |
| 55-70 | Marginal candidate. Limited to frontal-only coverage (2,500 to 3,500 grafts). |
| Below 55 | Poor candidate. Risk of visible donor depletion outweighs benefit. |
Surgeons measure density using a dermoscope or trichoscope, counting follicular units per cm2 at multiple points in the donor zone. They also assess the safe zone boundaries, the area where follicles are statistically resistant to DHT miniaturization.
The safe extraction limit is approximately 45% of available follicular units. A patient with 75 FU/cm2 across a 100 cm2 safe zone has 7,500 total units, of which roughly 3,375 can be safely harvested via FUE. FUT (strip) may yield more per session (up to 4,000 grafts).
For a detailed breakdown of the assessment process, see our Norwood 6 donor area assessment guide.
Factor 2: Hair Characteristics
Hair caliber, texture, and color relative to skin tone all influence how much visual coverage each graft provides.
Favorable characteristics: Coarse hair (above 70 microns), wavy or curly texture, low contrast between hair color and skin tone. These patients achieve more coverage per graft, meaning fewer grafts are needed for equivalent visual density.
Challenging characteristics: Fine hair (below 50 microns), straight texture, high contrast (dark hair on pale skin). These patients need more grafts per cm2 to achieve the same visual result, which strains the already limited donor supply at Norwood 6.
Surgeons evaluate these characteristics during the consultation and adjust their graft estimates and density targets accordingly.
Factor 3: Age and Progression Stability
Young patients (under 30): Norwood 6 before age 30 signals aggressive, rapid progression. Most surgeons are cautious with these patients because further loss to Norwood 7 is probable. Conservative hairline placement and reserved donor supply are essential. Some surgeons recommend waiting until at least 30 and demonstrating stability on finasteride before operating.
Mid-age patients (30-55): This is the typical candidacy window. The hair loss pattern is usually established or near its final state, making surgical planning more predictable.
Older patients (55+): Generally stable patterns. Surgery is safe and effective in healthy older patients. The main considerations are healing capacity and the aesthetic goals (a 65-year-old may prioritize a natural, mature look over maximum density).
Regardless of age, surgeons prefer to see at least 6 to 12 months of stability (no significant further loss) before operating. Men actively losing hair are operating on a moving target, which risks poor outcomes as native hair continues to thin around transplanted areas.
Factor 4: General Health
Hair transplant surgery is performed under local anesthesia and carries low medical risk, but certain health factors affect candidacy.
Conditions that may affect candidacy:
- Uncontrolled diabetes (impairs wound healing and graft survival)
- Blood clotting disorders (increases bleeding risk during extraction)
- Active autoimmune conditions (may trigger immune rejection of grafts)
- Active scalp conditions (psoriasis, severe dermatitis, or infections must be controlled first)
- Immunosuppressive medications (may reduce graft survival rates)
Most otherwise healthy men at Norwood 6 are medically cleared for surgery without issues. A pre-operative blood panel and medical history review are standard.
Factor 5: Realistic Expectations
This is arguably the most important candidacy factor at Norwood 6. The donor area cannot restore a full head of hair at natural density. Patients who understand and accept this produce better satisfaction outcomes.
Realistic expectations include:
- Understanding that 4,000 to 6,000 grafts produce 35 to 50% of natural density
- Accepting that the crown may have thinner coverage than the front
- Knowing that two sessions are typically needed
- Recognizing that ongoing medication (finasteride, minoxidil) is necessary to maintain the result
- Accepting that the final result takes 12 to 24 months to fully develop
Red flag expectations:
- Wanting to look like you did at age 20
- Expecting a low, dense hairline that matches pre-loss thickness
- Refusing medication after surgery
- Wanting full, uniform density across the entire bald zone
A surgeon who refuses to operate on a patient with unrealistic expectations is acting in that patient's best interest. For a full breakdown of achievable outcomes, see our Norwood 6 realistic expectations guide.
The Candidacy Consultation Checklist
A thorough consultation for Norwood 6 candidacy should include:
- Trichoscopy or dermoscopy of the donor area at multiple points
- Donor density count in FU/cm2 with a clear number communicated
- Safe zone mapping with an explanation of how boundaries were determined
- Hair caliber assessment with a discussion of how it affects coverage
- Family history review to predict potential further progression
- Medical history review including current medications
- Expectations discussion with honest assessment of what is achievable
- Multi-session plan outlining grafts per session, timeline, and total cost
- Alternative options discussed if the patient is a marginal candidate
If a consultation skips any of these steps, consider seeking a second opinion.
Upload a photo at myhairline.ai/analyze for a free AI assessment of your Norwood stage before your consultation. Arriving with a baseline understanding of your stage helps you ask better questions and evaluate the surgeon's recommendations.
FAQ
Who is a good candidate for hair transplant at Norwood 6?
Good candidates for Norwood 6 hair transplant surgery have donor density above 70 FU/cm2, are at least 30 years old (ideally older), have realistic expectations about achieving strategic coverage rather than full restoration, are in good general health, and have stable hair loss (not actively progressing). Candidates with coarse or wavy hair and low hair-to-skin contrast tend to achieve the most visually impressive results.
Who should NOT get a hair transplant at Norwood 6?
Poor candidates include men with low donor density (below 55 FU/cm2), active or rapidly progressing hair loss, unrealistic expectations of full restoration, diffuse thinning in the donor zone (indicating the donor hair may also be susceptible to loss), uncontrolled medical conditions that impair healing, and those under 25 whose final hair loss pattern is not yet established.
Is there an age limit for hair transplant at Norwood 6?
There is no strict upper age limit. Healthy men in their 60s and 70s undergo successful transplants. However, younger men (under 30) at Norwood 6 face more complex planning because their hair loss may continue progressing, requiring conservative donor management. The ideal candidacy window for Norwood 6 is typically 35 to 60 years old, when the pattern is relatively stable and health is generally good.
Can I get a transplant if my donor area is thin?
If donor density is between 55 and 70 FU/cm2, surgery is possible but graft yield is reduced, meaning coverage will be limited to the most critical zones (typically the frontal hairline only). Below 55 FU/cm2, the risk of visible donor depletion is high, and most surgeons will recommend against surgery or suggest non-surgical alternatives like scalp micropigmentation.
Do I need to stop hair loss medications before surgery?
No. In fact, most surgeons recommend continuing finasteride and minoxidil before and after surgery. Finasteride protects remaining native hair during recovery, and minoxidil may support graft survival and regrowth in the surrounding area. Blood thinners and certain supplements (vitamin E, fish oil) may need to be paused 1 to 2 weeks before surgery to reduce bleeding risk.