Now Age 40: 2nd hair transplant now or wait until mid-40s?

[Jejubumbee]

I had a 3,000 graft FUE in 2020 with really good results.  I stupidly stopped taking minoxidil after, and my hair is much thinner.  I read that hair loss stabilizes in mid-40's on average.  I could get a 2nd surgery now or wait until I am mid-forties.  

The issue I only have enough donor hair for 1 more transplant.  I'm on Minoxidil again, my brother was on finasteride and had terrible side effects, so I don't want to risk it.

I'm single and about to go back to university.  So I'm torn between getting it now and looking good for Uni and dating, or waiting until after and doing it then.

I don't know what to do and could really use some advice!

(Brother went bald in 30s, mother's father and that side of family extremely bald from 30s.  Father thinning and didn't stop from mid-40s.  My hair loss seems stable now, went back on minoxidil)   

2 pics current, 3rd pic was before and after 2020 FUE

Edited May 19 by Jejubumbee
Add pictures

[Shadman]

@Jejubumbee can you share some photos ?

[Jejubumbee]

@Shadmanupdated

[donpizmeov]

With a limited donor your biggest mistake IMHO is not to try finasteride, perhaps on a smaller dosing as your balding pattern is quite wide. And hairloss continues well into your 50 & 60s too…. 
 

On top or retaining what you already have, you also ensure your not loosing more hairs in your donor for future needs.

[Berba11]

So there’s serval things:

1. What’s the risk with finasteride? If you get bad sides you just stop taking it. You might as well try it. 
 

2. What is the basis for saying your donor only has one more surgery? And what size surgery? And FUE or FUT? Would be good to have more details about this statement. 
 

3. Your hair looks pretty good right now. What are you hoping another surgery achieves?

4. It won’t negatively impact your appearance if you did a HT whilst at Uni. You already have lots of hair so the recovery from a second surgery would be easy provided your adding density up top (any redness will be covered by your existing hair in those areas). I don’t really see that there’s any real argument one way or another as to when you might pull the trigger - only you can answer that. 

5. Who was your surgeon? Work looks quite nice so very keen to hear who did your HT!

[Jejubumbee]

47 minutes ago, Berba11 said:

So there’s serval things:

1. What’s the risk with finasteride? If you get bad sides you just stop taking it. You might as well try it. 
 

2. What is the basis for saying your donor only has one more surgery? And what size surgery? And FUE or FUT? Would be good to have more details about this statement. 
 

3. Your hair looks pretty good right now. What are you hoping another surgery achieves?

4. It won’t negatively impact your appearance if you did a HT whilst at Uni. You already have lots of hair so the recovery from a second surgery would be easy provided your adding density up top (any redness will be covered by your existing hair in those areas). I don’t really see that there’s any real argument one way or another as to when you might pull the trigger - only you can answer that. 

5. Who was your surgeon? Work looks quite nice so very keen to hear who did your HT!

Hey,

So my brother took it, gave him serious depression killed his sex drive. Even after he stopped it took months to normalize. 

Dr. Bicer in turkey did my surgery in 2020, it was really great until I stopped minoxidil. I was just looking to increase density in the hairline/ front because I'm tall. I saw 3 doctors, they told me I don't have much donor area left, 1500-2000 grafts.

I would like to return to uni with a dense hairline, but was worried about if it would be patchy come mid-40s.

[Berba11]

3 hours ago, Jejubumbee said:

So my brother took it, gave him serious depression killed his sex drive. Even after he stopped it took months to normalize.

I can only assume he was taking it for while, having the sides but ploughing on anyway for as long as possible. Obviously that’s ill-advised. You’ll know pretty quickly if you’re getting sides, but I’m not here to advocate medication - it’s really your choice and for you to decide for yourself without influence or pressure. 
 

Which three doctors told you that your donor is limited, and what reasons did they give? Unless you’ve got a particularly bad donor naturally (doubtful!) or Dr Bicer did a terrible job with your donor (unlikely as she’s a very good surgeon), then I’d be surprised if you were limited to only 4,500-5,000 total scalp grafts available across your first and a potential second session. 

Your hairline/frontal third looks pretty decent to me, and a further touch up shouldn’t require many grafts at all. You’ll probably find something small like 500 grafts will go a long way to giving it a boost and won’t be particularly intrusive or hard to manage during those initial few months. 

[Melvin- Admin]

You should consider topical dutasteride. It’s been a game changer for me, and no side effects. You can get it relatively easy in the US and Europe. Definitely give that a try. Stabilizing hair loss is essential. 

[Jejubumbee]

55 minutes ago, Berba11 said:

I can only assume he was taking it for while, having the sides but ploughing on anyway for as long as possible. Obviously that’s ill-advised. You’ll know pretty quickly if you’re getting sides, but I’m not here to advocate medication - it’s really your choice and for you to decide for yourself without influence or pressure. 
 

Which three doctors told you that your donor is limited, and what reasons did they give? Unless you’ve got a particularly bad donor naturally (doubtful!) or Dr Bicer did a terrible job with your donor (unlikely as she’s a very good surgeon), then I’d be surprised if you were limited to only 4,500-5,000 total scalp grafts available across your first and a potential second session. 

Your hairline/frontal third looks pretty decent to me, and a further touch up shouldn’t require many grafts at all. You’ll probably find something small like 500 grafts will go a long way to giving it a boost and won’t be particularly intrusive or hard to manage during those initial few months. 

Thank you. I visited a friend in Colombia, so I stopped by  Dr.Camacho in Bogota since he is well known, and I visited 2 other doctors on the ishrs list. They said because my hair is so fine and thin, they could only do 1500-2000 grafts without the donor area looking patchy and messed up. 

[sekiro109]

1 hour ago, Melvin- Admin said:

You should consider topical dutasteride. It’s been a game changer for me, and no side effects. You can get it relatively easy in the US and Europe. Definitely give that a try. Stabilizing hair loss is essential. 

I've switched to topical dutasteride and honestly, have seen better results, which to me is quite surprising. 

[Gatsby]

8 hours ago, Jejubumbee said:

I stupidly stopped taking minoxidil after, and my hair is much thinner.  I read that hair loss stabilizes in mid-40's on average. 

Your hair will continue to thin in the donor (ever so slightly) over the years even if you feel that your hair MPB loss stabilizes naturally. You might want to consider topical finasteride from a dermatologist. Still, staying on minoxidil now will help if you have had a good response before but it will never equal blocking hair loss at the root cause (pardon the pun). All the best.

[Gatsby]

I should add also that I cannot take finasteride (after numerous attempts) due to sexual side effects. However I do take 5mg a day of oral minoxidil and it has definitely helped. All the best.

[Berba11]

9 hours ago, Jejubumbee said:

Thank you. I visited a friend in Colombia, so I stopped by  Dr.Camacho in Bogota since he is well known, and I visited 2 other doctors on the ishrs list. They said because my hair is so fine and thin, they could only do 1500-2000 grafts without the donor area looking patchy and messed up. 

I'd want to seek the opinions of some surgeons who deal with bigger graft harvesting sessions if I were you. Pittella, Sethi, Zarev, Hattingen, H&W are the really big names in that area... My sense is you'd get quite a different evaluation from some of these guys versus other surgeons who may be more conservative in terms of what they're willing to take from a donor area.

[Al - Moderator]

If minoxidil was working then get back on that. If you were using topical min then you can try oral min which should work better. Whether you wait to do another transplant or do it now is up to you, but if it's bothering you now then why wait a few more years. You're already 40. It's not like your 25 and worried about using all your donor at a young age.

 

 

[Jejubumbee]

Does anyone have doctors they recommend in Latin America?