FUT (strip method) surgery may be the best surgical option at Norwood 6, where the large bald area requires 4,000 to 6,000 grafts and maximizing donor yield becomes the top priority. At this advanced stage on the Norwood scale complete guide, the frontal and crown zones have fully merged into one large bald area, and treatment planning must balance ambitious coverage goals against a finite donor supply.
Understanding Norwood 6
Norwood 6 presents a fully connected bald area across the top of the scalp. The frontal hairline, midscalp, and crown are all involved, with only a narrow bridge of thin hair possibly remaining at the sides. The donor band around the back and sides is intact but represents a limited resource that must be managed strategically.
The Scale of the Challenge
The jump from Norwood 5 to Norwood 6 is significant in terms of surface area. The bald zone is roughly 30 to 40 percent larger than at Norwood 5, which is why the graft requirement increases from 3,000-4,500 to 4,000-6,000. Covering this area with natural-looking density requires precise surgical planning and often multiple sessions.
Why Donor Management Is Critical
Most men have 6,000 to 8,000 total extractable grafts. Using 4,000 to 6,000 of those for Norwood 6 restoration leaves a thin margin for future procedures. Every graft counts, and the extraction method directly impacts how many grafts are available over a lifetime.
Why FUT May Be the Better Choice
Higher Graft Yield Per Session
FUE and FUT are both viable at Norwood 6, but FUT offers specific advantages at higher graft counts. The strip method removes a linear section of donor tissue that is dissected under microscopes into individual follicular units. This process tends to yield more grafts per session than FUE because there is no transection from punch extraction.
A single FUT session can provide 3,000 to 4,000 grafts with graft survival rates above 95 percent. This allows a surgeon to accomplish more coverage in one sitting, reducing the total number of sessions needed.
Preserving the Donor for Future FUE
A strategic advantage of starting with FUT is that it preserves the surrounding donor area for future FUE extraction. The linear scar from FUT is confined to a narrow band, leaving the rest of the donor zone untouched. If additional grafts are needed later, FUE can harvest from the areas above and below the FUT scar. This combined approach maximizes the total lifetime graft count.
When FUE Is Still Preferred
FUE remains the better choice for men who wear their hair very short (under 5mm) around the sides and back, since it avoids a visible linear scar. At Norwood 6, this is a personal decision that should be discussed thoroughly with your surgeon.
The Multi-Session Surgical Plan
Session 1: Hairline and Frontal Zone
The first session dedicates 2,500 to 3,000 grafts to rebuilding the frontal hairline and filling the midscalp. This produces the most dramatic visual change because the front of the scalp frames the face. Hairline placement at Norwood 6 must be conservative to keep the density natural-looking across a large area.
Session 2: Crown and Fill-In Work
The second session, scheduled 8 to 12 months later, uses 1,500 to 3,000 grafts for crown coverage and midscalp density enhancement. Crown work at Norwood 6 focuses on creating soft coverage rather than achieving full native density, which would require more grafts than most donor areas can supply.
Optional Session 3: Refinement
Some patients opt for a smaller third session (500 to 1,000 grafts) to refine density in specific areas after the first two sessions have fully matured at the 18-month mark.
Medication and Non-Surgical Support
Finasteride at Norwood 6
Finasteride cannot reverse the extensive hair loss at Norwood 6. Its role is purely protective: maintaining donor area density and preserving any remaining native hair. It is less effective at halting progression than at Norwood 2 or 3, where it works in 80 to 90 percent of men, but it remains an important part of the treatment plan.
SMP as a Density Multiplier
Scalp micropigmentation can be used after transplant surgery to create the appearance of greater density between transplanted follicles. At Norwood 6, where the graft-per-square-centimeter ratio is lower than at earlier stages, SMP fills in the visual gaps and makes the transplanted hair appear thicker.
Realistic Expectations
Norwood 6 treatment can produce a visible hairline, moderate frontal density, and soft crown coverage. It will not replicate the density of a full head of hair. The goal is a natural appearance that represents a major improvement over the untreated state.
Upload a photo at myhairline.ai/analyze to get an accurate Norwood assessment and learn exactly how many grafts your specific pattern requires.