Hair Falling off 4 Years After Hair Transplantation (FUE) Procedure

Hi, I had my FUE procedure done 4 years ago. But now my transplanted hair is falling off again. is it normal? what are my options now? thanks in advacne

Doctor Answers 12

Why Your Hair May Start to Fall Out After a Hair Transplant (F.U.E./Follicular Unit Extraction)

The most likely reason your transplanted hair is falling out is Telogen Effluvium.  This is a temporary condition caused by something stressing the follicles and should abate once you are relieved of the stress.  

The other possible cause of this hair loss would be unlikely, but perhaps the grafts were harvested from donor hair which was located too high in the back of the scalp, in an area which was prone to the effects of DHT or other permanent hair loss factors.  If the only hair you are losing is the transplanted hair, then this is possibly the cause, although it would be difficult to determine.


New York Hair Restoration Surgeon
5.0 out of 5 stars 22 reviews

FUE hair transplant is falling

Transplanted hair after either a strip or FUE should not fall a few years after your procedure.  When we perform a hair transplant we harvest the grafts from the areas that are known as permanent zones on the back, sides and beard areas.  Those hairs never go through the process of baldness so they don't have to fall after transplantation either.

If the grafts are selected and harvested out of the permanent zone, it is possible that transplanted hair go through miniaturization and balding process.

You need to go back to your doctor and be evaluated for the cause of your hair loss.

Parsa Mohebi, MD
Beverly Hills Hair Restoration Surgeon
5.0 out of 5 stars 13 reviews

Loss of transplanted hair

Hair restoration is going through very important evolution for improving both the naturalness and fullness that can be achieved from only one to two surgical procedures.  Each hair transplant procedure should be customized to the patients needs and concerns and explained throughly before hair transplant is performed. One of the set backs that I Have noticed happen when clients come to me from other clinics, is that many clinics perform FUE megasessions and the doctor transplants out side of the donor zone weather it be from the scalp or from the body. If the transplanted hair is taken from areas other than the donor zone, then thinning or hair loss could happen in the future. The patient may experience immediate satisfaction but in long term they will lose their transplanted hair.  Many doctors fail to explain this to their clients and end up with very unhappy clients later on.  You need to inquire about the harvesting areas from your doctor. 

Michael Meshkin, MD
Newport Beach Hair Restoration Surgeon
5.0 out of 5 stars 2 reviews

Hair loss after hair transplant

Thanks for question.  The hair harvested for hair transplant is from the area of the scalp where its follicles aren't susceptible to male pattern hair loss.  If the follicles were taken higher than the "safe" area, then it is possible that these follicles are susceptible and will die.  However, that is less likely than experiencing new hair loss from follicles that were not transplanted.  That is, it may be that the hair you are losing is your native hair - not hair that was transplanted.  Rogaine and finestaride (Propecia) can help reduce future loss.  A photo would be helpful to evaluate.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

Hair Loss a Couple of Years After a Hair Transplant

The most probable reason is diffuse male pattern baldness that is effecting the harvested donor hairs as well as the existing hairs at the recipient area. Using finasteride is effective in controlling this type of hair loss.

Other reasons could be metabolic, hormonal or dermatological deceases that cause diffuse hair loss. A thorough physical examination in combination with blood tests should be done if this kind of hair loss is to be suspected.

Ali Emre Karadeniz, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 2 reviews

Transplanted hair shedding after four years

It is not normal for transplanted hairs to shed this far after your surgery. I would recommend visiting a dermatologist specializing in hair loss. One reason hair could shed is telogen effluvium, for which you need a work up, including your thyroid hormone levels, iron levels, ferritin. Another cause can be alopecia areata, which is an autoimmune condition. Alopecia areata needs treatment with topical cortisone or injections of cortisone. Please seek out a dermatologist specializing in hair loss.

Hair Loss After Transplant

Likely the hair loss you have is due to diffuse thinning of the entire scalp, associated with male pattern hair loss.  Oftentimes, taking Propecia can help stop this, and perhaps even reverse some of the loss.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.5 out of 5 stars 71 reviews

Hair Falling out after Hair Transplant

Typically transplanted hair should be present independent of whatever technique is used.  If hair is falling out after four years, I assume you are also losing hair around your donor site and unfortunately there is little you can do about this.

Jack Fisher, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 3 reviews

FUE Hair Transplant Long-Term Growth

This is not normal, considering FUE hair transplant is a permanent procedure. Transplanted hair should be extracted from an area where it is not DHT-sensitive. (This typically includes the back and sides of the head or the body.) Thus, new growth should not be susceptible to the miniaturizing effects of DHT. Your current hair loss may be due to some other issue, such as an autoimmune disorder or stress. I suggest consulting your physician or a hair loss specialist.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 27 reviews

Hair Falling off 4 Years After Hair Transplantation (FUE) Procedure

There are many possibilities that may cause your hair to fall out after a hair transplant. One is the hair was taken from a donor area that was not immune to male pattern baldness. This is unlikely if an experienced surgeon/technician perfomed the procedure. Another consideration is that you are losing the hair around the grafted follicles. I always suggest that a patient use Rogain 5% plus finasteride to diminish this possiblility. You may have some metabolic imbalance, such as hypo or hyperthyroidism. Are you taking steroids? Steroids will increase your DHT which causes hair loss, or you may naturally have an elevated DHT. If so, there are medications that will prevent this transformation from testosterone to DHT.  Possibly you are under undue stress, which can also cause temporary hair loss, called telogen effluvium. Consider consulting a physician who specializes in hair loss who can run the proper blood work and evaluate your problem.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.