Second Hair Transplant

[FinallyHT]

I've been losing my hair since 2006.  I've been on oral fin and topical minox for the last 17 years.  I had my first transplant in 2019 where they dense packed 3400 grafts. Unfortunately, after a few years, the hairs have thinned out again. (I am 40.)

I had an in person consultation with a very good doctor, who said the following.  I have plenty of donor hair, he measured 70cm2 with mostly multiples in back still. (My dad at age 74 still has tons of jet black hair on his sides, despite being bald on top.) 

The doctor had some concern about shock loss and suggested I take oral minox for 3-4 months before having surgery. He said I have a lot miniaturized hairs. 

I want to go back to him and say, no to oral minox as I don't want to take this medication for the long term.  And I want to suggest I take oral dustasteride instead, which I don't have concerns taking.  Does this make sense?  And/or can I say we dense pack grafts to offset any hairs lost to shock loss? The previous doctor did this in the first surgery in 2019, so why not now?

Can I get people's thoughts? Attached in this post are my pre-surgery hair, where they added grafts during my first surgery, and post surgery photos.

 

  In the second post, I am uploading photos of my hair as it is currently. 

 

Thank you.

[FinallyHT]

A few pictures of trouble areas I noticed the year after surgery on 2020. 
 

and a photo showing how my vertex hairs thinned out in 2022.  Basically, the area where the surgeon did transplant grafts down the vertex, and area on the left temple that perhaps grafts didn't take have thinned out. 

 

Edited July 29, 2023 by FinallyHT

[Berba11]

You don't need another HT at all. The photos you've posted show no additional hairloss, or at least nothing to be concerned about or that would justify a 2nd HT at this stage.

Also, I'm confused by the advice to take minoxidil in the months *before* surgery? Most Dr's advise the exact opposite with minox.

Jumping on dutasteride or finasteride and seeing how you get on with that would be a good idea as it might reduce future hairloss.

[Gatsby]

2 hours ago, Berba11 said:

You don't need another HT at all. The photos you've posted show no additional hairloss, or at least nothing to be concerned about or that would justify a 2nd HT at this stage.

Also, I'm confused by the advice to take minoxidil in the months *before* surgery? Most Dr's advise the exact opposite with minox.

Jumping on dutasteride or finasteride and seeing how you get on with that would be a good idea as it might reduce future hairloss.

This ^ There are always weak spots in every hair transplant. Dr Pradeep Sethi did an excellent video on hair transplants are not perfect. The goal of meds as @Berba11 rightly described is to halt MPB or at the least slow it down. A few people like @Viney have even reversed their loss. All the best!

[A_4_Archan]

You don't need a ht imo...from your pics it seems you have enough density and there can be a chance that a surgery may harm your native hairs ..who was the surgeon who adviced you for surgery ?

[Bhumik Shah MD]

I agree with some of the above posters. Based on your photos, I don't see any evidence of significant thinning justifying a change in medical regiment or another major hair transplant. 

[FinallyHT]

Here is the area I want addressed.