Can I avoid finasteride/propecia by having multiple hair transplants using my robust donor area? I'm 48.

You do not need to take Propecia as it is an optional drug.You can have surgery without being on Propecia.Strip surgery does produce better results in general than FUE as there are transections with FUE.Each case and each patient have different needs with different goals.If you don't want to be on Propecia and you want the FUE procedure then that is your prerogative. FUE is just a harvesting technique. It does not relate to the final results of surgery.You can cook with olive oil or butter but if you're not a good cook nothing you use will taste good.

Finasteride is completely voluntary, but it does slow continued hair loss. Side-effects can be mitigated, even completely eliminated, with dose and frequency adjustments.FUE does NOT have a higher transection rate, as some others have posted. The procedure is definitely very technician/operator-dependent, though. Multiple FUE procedures are certainly possible, and preferable, should you continue to maintain your 'healthy' donor site, and do NOT leave you with any scars. Multiple procedures with the strip method will eventually decrease your scalp volume itself, lowering your vertex hairline, by pulling it down, and/or raising your occipital hairline, by pulling it up. The scar can be unseemly, alter your choice of hair styles, and/or leave you with in-grown hair problems, among other potential issues.FUE is the state-of-the-art, anyone still claiming that strip method is the best is delusional.I would suggest FUE for your hair transplant, Finasteride to slow hair loss with modified dosage/frequency. Should you not like the side-effects of finasteride, then stop it, use Rogaine, and should you continue with hairless, understand that you may need it again.

Hair transplant and the concept of what to expect in long term has to do with the relationship of your supply (donor hair) and demand (bald area that needs to be restored).  If you have significnat number of hair on your donor area (high density and good quality of hiar) with not too much of a large balding area, you may never need to take finasteride.  You could be able to restore your entire balding area with the reserve you have without the need to keep taking finasteride for the rest of your life. Of course finasteride minimizes shock loss in addition to what it does for maintain the rest of yoru hair.  If you are concerned with its sides effects there are other options avaialble that I am sure your doctor can discuss with you.

If you have the right kind of donor area and hair loss pattern, you may be able to get away with just a hair transplant and no pills.  This is not the most conservative approach, but it tends to be popular.

Your question is a  great one but more complex than first appears. You don't state your age so it makes answering this quite the bit more difficult.One can ONLY conclude they have a "robust donor area" at around age 45 and beyond.From age 35-45, one can conclude that "it sure seems like I have a robust donor area."From age 18-35, one can't conclude a whole lot except "I sure hope based on my family history and age and progression so far that I have a robust donor area. Once never 'needs' to take finasteride although it helps a lot. Yes, side effects are possible. Five hair transplants may be possible for you if you have a robust donor area. However, if you don't have a robust donor area, you may only have a 1-2 transplants available to you. There are a lot of factors that go into these decisions.