Getting at least two consultations before committing to a Norwood 5 hair transplant is strongly recommended. At this stage, surgical decisions about graft count, hairline placement, and technique have long-term consequences that are difficult to reverse, and the variation between surgeon recommendations can be significant.
Why Second Opinions Matter More at Norwood 5
At earlier Norwood stages (2 or 3), the surgical planning is relatively straightforward: the area is small, graft counts are modest, and most competent surgeons will arrive at similar plans. At Norwood 5, the complexity increases substantially:
- The bald area is large (120-180 cm2), requiring careful graft distribution across multiple zones
- The 3,000 to 4,500 graft range means the surgeon must make strategic trade-offs (front vs. crown, density vs. coverage area)
- Hairline design at this stage has a profound impact on the final appearance
- The donor area is under more pressure, approaching the 45% safe extraction limit in some patients
These factors mean that two qualified surgeons may propose meaningfully different plans for the same patient. Understanding why they differ helps you make an informed decision.
How to Structure Your Consultation Process
Phase 1: Online Consultations (2-3 clinics)
Most reputable clinics offer free or low-cost virtual consultations based on photos. Submit the same set of standardized photos to each clinic:
- Front-facing, hair pulled back
- Both temporal views
- Top-down vertex view
- Posterior view of the donor area
- Close-up of the donor area under good lighting
Providing identical photos ensures each surgeon evaluates the same baseline. Record or take notes on each consultation.
Phase 2: In-Person Consultation (1-2 clinics)
After narrowing to your top choices, schedule in-person evaluations. These should include:
- Trichoscopy examination: Magnified assessment of donor density, hair caliber, and miniaturization. This cannot be done remotely
- Scalp laxity test: Important for FUT candidates to determine how much strip can be harvested
- Hairline drawing: The surgeon should draw the proposed hairline on your scalp with a marker so you can evaluate placement and shape
- Detailed plan review: Zone-by-zone graft allocation, session count, and timeline
What to Compare Between Consultations
1. Graft Count Estimate
At Norwood 5, the expected range is 3,000 to 4,500 grafts. If one clinic proposes 2,000 and another proposes 5,500, investigate why:
| Discrepancy | Possible Explanation |
|---|---|
| Significantly lower count (below 2,500) | May be under-treating the area, or planning multiple smaller sessions |
| Within expected range (3,000-4,500) | Normal variation based on the surgeon's density targets and zone priorities |
| Significantly higher count (above 5,000) | May be exceeding safe donor limits, or counting individual hairs instead of grafts |
A difference of 500 or fewer grafts between consultations is normal and reflects different density preferences. Differences of 1,000+ grafts should be questioned directly.
2. Hairline Placement
Ask each surgeon to describe or draw the proposed hairline. Compare:
- Height above the glabella (should be 7-9 cm at Norwood 5)
- Shape (rounded, peaked, or flat across the front)
- Lateral extent (how far toward the temples)
- Whether temporal points are included
If one surgeon proposes a significantly lower hairline, ask how they plan to distribute grafts across the remaining area. A low hairline with thin mid-scalp coverage is generally a worse outcome than a moderate hairline with consistent density.
3. Technique Recommendation
| Technique | Max Grafts/Session | Recovery | Scar Type | Best For |
|---|---|---|---|---|
| FUE | Up to 5,000 | 7-10 days | Tiny dot scars | Patients wanting short hair option |
| FUT | Up to 4,000 | 10-14 days | Linear scar | Patients prioritizing max grafts with medium+ hair |
| DHI | Up to 3,500 | 7-10 days | Tiny dot scars | Patients wanting precise hairline work |
All three techniques achieve 90-95% graft survival with experienced surgeons. If a clinic pushes one technique exclusively without explaining the trade-offs, that is a concern.
4. Pricing Transparency
Request itemized pricing that includes:
- Per-graft cost
- Total surgical fee
- Anesthesia fees
- Post-operative care and medications
- Follow-up appointment costs
- Any additional charges for PRP or medications
Compare total costs, not just per-graft prices. Some clinics quote low per-graft rates but add significant fees for other components.
5. Norwood 5 Portfolio
Ask to see 10+ before-and-after cases specifically at Norwood 5. Evaluate:
- Consistency of results across cases
- Natural-looking hairlines
- Photos at 12+ months post-surgery
- Multiple angles for each case
- Patients with similar hair characteristics to yours
Red Flags During Consultations
Be cautious if a surgeon or clinic:
- Guarantees specific density outcomes: No surgeon can guarantee exact results. Graft survival rates are 90-95%, not 100%
- Proposes a very low hairline for your age: This suggests prioritizing short-term wow factor over long-term natural appearance
- Discourages post-surgical medication: Finasteride and minoxidil are standard of care after a Norwood 5 transplant. A surgeon who does not discuss them may lack interest in your long-term results
- Pressures you to book immediately: High-pressure sales tactics (limited-time discounts, "slots filling up") are not consistent with thoughtful surgical planning
- Has no Norwood 5 cases in their portfolio: Advanced cases require specific experience. A surgeon who primarily does Norwood 2-3 work may not have the expertise for optimal Norwood 5 results
- Quotes well below market rates without explanation: Extremely cheap procedures may rely on undertrained technicians performing most of the work
Questions to Ask Every Surgeon
Use this checklist during each consultation:
- How many Norwood 5 cases have you personally performed in the last 12 months?
- What is your graft survival rate, and how do you measure it?
- Who performs the extraction and implantation (surgeon personally, or technicians)?
- What is your plan if I need a second session?
- How do you handle complications or unsatisfactory results?
- Can I speak with previous Norwood 5 patients?
- What post-operative medication protocol do you recommend?
- What is the total cost, including all fees?
Documenting Your Consultations
Create a simple comparison spreadsheet with each clinic's answers to these questions plus the five comparison elements above. Seeing the data side by side makes patterns and outliers immediately visible.
Starting with a Preliminary Assessment
Before scheduling consultations, you can get an initial estimate of your Norwood stage, graft requirements, and treatment options. Upload a photo at myhairline.ai/analyze for a free AI-powered analysis. This gives you a baseline to compare against surgeon recommendations and helps you ask more informed questions during consultations.