2nd Transplant or Not?

[Rossybop]

I had a 2,040 FUE transplant with Saifi in December 2020. Results were great for about 18 months then I started noticing my hair was not looking as good. I used finasteride and minoxidil for 3 years until July 2023 but then jumped on dutasteride in July 2023 - October 2023. I quit the meds because of awful sides. Now I take no medication.

Should I get another HT or would I be as well off shaving my hair? How many grafts would I need? I've thought about hair systems, maybe they'd be good, but the maintenance is a bummer.

Thanks.

[HappyMan2021]

2 hours ago, Rossybop said:

I quit the meds because of awful sides. Now I take no medication.

ah this may be a reason to not getting any more HTs unfortunately

That being said, this potential 2nd HT has been at the forefront of your mind for years and years now, so feel like you have to do something regardless

[Rossybop]

19 minutes ago, HappyMan2021 said:

ah this may be a reason to not getting any more HTs unfortunately

That being said, this potential 2nd HT has been at the forefront of your mind for years and years now, so feel like you have to do something regardless

Yes you're right, it might be a good reason to avoid getting more HTs. I think some hair systems that I've seen online look very good but the maintenance costs and commitment are immense. Cost is like €3,000 a year.

[Berba11]

3 hours ago, Rossybop said:

I had a 2,040 FUE transplant with Saifi in December 2020. Results were great for about 18 months then I started noticing my hair was not looking as good. I used finasteride and minoxidil for 3 years until July 2023 but then jumped on dutasteride in July 2023 - October 2023. I quit the meds because of awful sides. Now I take no medication.

Should I get another HT or would I be as well off shaving my hair? How many grafts would I need? I've thought about hair systems, maybe they'd be good, but the maintenance is a bummer.

Thanks.

Your current situation is still very, very good from these photos and I’m not seeing any need to get another HT yet. 
 

Personally I would give it plenty more to time see how things develop. If you lose hair quickly, then another HT will at least be worthwhile. If you lose hair very slowly then you know things are stabilised somewhat and can proceed on that basis. 
 

What you don’t really want to do is get a small HT now and then lose more hair quickly and need another one. Chasing down hair loss with constant surgeries isn’t ideal if you can help it. 
 

As it stands, no one would know you’re losing hair (unless you deliberately try to expose the weaker areas as in these photos) and it seems there’s no reason to make any hasty decision in terms of shaving it or getting another HT. 

[Rossybop]

4 minutes ago, Berba11 said:

Your current situation is still very, very good from these photos and I’m not seeing any need to get another HT yet. 
 

Personally I would give it plenty more to time see how things develop. If you lose hair quickly, then another HT will at least be worthwhile. If you lose hair very slowly then you know things are stabilised somewhat and can proceed on that basis. 
 

What you don’t really want to do is get a small HT now and then lose more hair quickly and need another one. Chasing down hair loss with constant surgeries isn’t ideal if you can help it. 
 

As it stands, no one would know you’re losing hair (unless you deliberately try to expose the weaker areas as in these photos) and it seems there’s no reason to make any hasty decision in terms of shaving it or getting another HT. 

To me its noticeable and its really bugging me a lot. Its definitely a lot worse off than it was 2.5 years ago.

It feels thin and sparse too. I would be much happier to buff it up and make it thick and full. If I could get a good result with 1500 grafts and get another 4 - 5 years out of it before needing my next top up I'll go for it.

[Gatsby]

Have you tried oral minoxidil? IMHO I would not get another transplant at this stage. Going by your pics I think it just needs to be styled more. How old are you can I ask?

[Al - Moderator]

Just to be clear. You are losing hair around and behind the transplanted hair but not the transplanted hair itself. Is that right? 

[Willforhair84]

It’s been on your mind for nearly 2 years , just do it. Looks like will require only 1000 grafts 

[mr_peanutbutter]

could you post your hairstatus before and directly after ht?

[Berba11]

8 hours ago, Rossybop said:

To me its noticeable and its really bugging me a lot. Its definitely a lot worse off than it was 2.5 years ago.

It feels thin and sparse too. I would be much happier to buff it up and make it thick and full. If I could get a good result with 1500 grafts and get another 4 - 5 years out of it before needing my next top up I'll go for it.

The issue though is that you don’t know if you’ll get a good 4-5 years out of it. You’ve been off the meds for less than a year, which isn’t very long. You don’t know if your hair loss will suddenly pick up speed. 
 

Of course it’s noticeable to you, just as my own areas of ongoing hair loss and weakness are noticeable to me (even if less so to others). The question is whether it makes best sense to pull the trigger now or to exercise a little more patience in order to better plan for the longer term. To me it’s a total no brainer - better to wait for a bit and see where your hair loss is heading now that you’re off the meds. I’m saying wait for 5 years, but giving things an extra 12 months to see where you’re at and try and get a handle on where you might be heading would be wise. In the meantime you can look into various surgeons & take consultations etc and make good use of that time. 

[Duke1984]

I went to Saifi a few years ago I remember chatting to you. I’ve been on finasteride for about ten years and rogain foam now and after chatting to a doctor he has suggested changing medication to dutasteride and oral monoxidil. What sort of side effects did you get when you changed medication ? 

[Rossybop]

17 hours ago, Berba11 said:

Your current situation is still very, very good from these photos and I’m not seeing any need to get another HT yet. 
 

Personally I would give it plenty more to time see how things develop. If you lose hair quickly, then another HT will at least be worthwhile. If you lose hair very slowly then you know things are stabilised somewhat and can proceed on that basis. 
 

What you don’t really want to do is get a small HT now and then lose more hair quickly and need another one. Chasing down hair loss with constant surgeries isn’t ideal if you can help it. 
 

As it stands, no one would know you’re losing hair (unless you deliberately try to expose the weaker areas as in these photos) and it seems there’s no reason to make any hasty decision in terms of shaving it or getting another HT. 

Nah man, my hair generally looks bad and I can't really style it properly at all.

I'm thinking of trying hair systems for a couple of years instead.

[Rossybop]

15 hours ago, Gatsby said:

Have you tried oral minoxidil? IMHO I would not get another transplant at this stage. Going by your pics I think it just needs to be styled more. How old are you can I ask?

I have not tried oral minoxidil. Its hard to style it because its so thin, it just leaks weak and inconsistent and generally not great whichever way I style it. I'm actually thinking of trying hair systems instead. What do you think? I'm 33, ill be 34 in a few months.

[Rossybop]

14 hours ago, Al - Moderator said:

Just to be clear. You are losing hair around and behind the transplanted hair but not the transplanted hair itself. Is that right? 

I don't know. I'm sure I'm losing hair around and behind the transplanted areas but if I'm being honest I really feel like the transplanted areas have thinned and depleted more than any other part of my scalp.

[Rossybop]

12 hours ago, Willforhair84 said:

It’s been on your mind for nearly 2 years , just do it. Looks like will require only 1000 grafts 

It will either be another HT or a hair system at this stage.

[Rossybop]

10 hours ago, mr_peanutbutter said:

could you post your hairstatus before and directly after ht?

Its one one of my threads from December 2020 bro. Type in Saifi 2040 FUE or something like that. You'll see it there.

[Rossybop]

9 hours ago, Berba11 said:

The issue though is that you don’t know if you’ll get a good 4-5 years out of it. You’ve been off the meds for less than a year, which isn’t very long. You don’t know if your hair loss will suddenly pick up speed. 
 

Of course it’s noticeable to you, just as my own areas of ongoing hair loss and weakness are noticeable to me (even if less so to others). The question is whether it makes best sense to pull the trigger now or to exercise a little more patience in order to better plan for the longer term. To me it’s a total no brainer - better to wait for a bit and see where your hair loss is heading now that you’re off the meds. I’m saying wait for 5 years, but giving things an extra 12 months to see where you’re at and try and get a handle on where you might be heading would be wise. In the meantime you can look into various surgeons & take consultations etc and make good use of that time. 

I won't be able to wait 5 years without doing something about it. Its doing my head in and definitely thinning out. I'm thinking of going for hair systems instead.

[Rossybop]

6 hours ago, Duke1984 said:

I went to Saifi a few years ago I remember chatting to you. I’ve been on finasteride for about ten years and rogain foam now and after chatting to a doctor he has suggested changing medication to dutasteride and oral monoxidil. What sort of side effects did you get when you changed medication ? 

You can PM me. Any time I posted about side effects on fin or dut here, my post gets deleted. There's a degree of censorship on the public forums here. 

[Berba11]

55 minutes ago, Rossybop said:

I won't be able to wait 5 years without doing something about it. Its doing my head in and definitely thinning out. I'm thinking of going for hair systems instead.

I was supposed to write “I’m not saying wait 5 years…” (and then go on to say give it 12 months). 
 

I can’t really believe you can’t style your hair. The pictures clearly show enough hair for styling purposes and crucially you have enough hair - more than enough - to get the benefits of a nicely framed face. Your situation is pretty good overall as it stands, but there’s the question mark of what will happen now you’re not taking DHT inhibitors. 
 

The key point is that you’ve only been off the meds for a short period of time. I’m struggling to find fault in my suggestion: wait a year to assess the speed of your hair loss now that you’re med free and then make a decision. The idea that you’re even considering a hair system with that much hair on your head is pretty nuts I have to say. It’s just totally unnecessary, will be at least as much hassle as you’re finding your hair loss to be and, to be blunt, will look worse (because systems can often look a bit naff). 

[Willforhair84]

Btw you should post more pictures of your hairline up to show what areas are of concern 

[Gatsby]

7 hours ago, Rossybop said:

I have not tried oral minoxidil. Its hard to style it because its so thin, it just leaks weak and inconsistent and generally not great whichever way I style it. I'm actually thinking of trying hair systems instead. What do you think? I'm 33, ill be 34 in a few months.

I wore a hair system for 25 years. But with your amount of hair I personally can’t see why? All the best. 

[Rossybop]

5 minutes ago, Gatsby said:

I wore a hair system for 25 years. But with your amount of hair I personally can’t see why? All the best. 

Its looking and feeling worse as the days go by. How did you get on with the hair systems? I've been looking online, some of them seem to look wonderful, thick and full.

[Gatsby]

3 minutes ago, Rossybop said:

Its looking and feeling worse as the days go by. How did you get on with the hair systems? I've been looking online, some of them seem to look wonderful, thick and full.

Initially great. I owned it and threw a wig party. The last ten years was a drag and I would have loved to have just thrown them in the bin. I wore a hairpiece to hide a hairline scar (as well as my baldness). 
 

[Gatsby]

The scar I should add was the result of repairing two botched hair plug transplants from the late 80’s. 

[Willforhair84]

Why don’t you ever post pics with your hairline up