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 15

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 25 reviews

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

I believe all hair deteriorates in quality with time and as you age. In most cases this does not become cosmetically evident until much later in life but on occasion it may happen earlier. So even if everything is done correctly, it is possible that say 10, 20 or 30 years later, the transplant may not quite be the same quality it once was
Your scalp needs to be examined throughout to see if the same is happening to your donor area where the original hair transplant came from.
There is a study I have been part of that shows that apart from male pattern baldness, the hair can also genetically deteriorate due to the ageing process

Bessam Farjo, MBChB
Manchester Hair Restoration Surgeon
5.0 out of 5 stars 1 review

Lost of hair transplant hair

This is highly unusual. after over 15,000 surgeries, I have seen this maybe 4 times. In the times I saw this, I examined the donor hair to see if the donor area had miniaturization. as senile alopecia could be a cause, but this was not the case in the 4 patients examined. A doctors in the community. a member of an email group that I belong to, asked that question to over 40 hair transplant surgeons about this phenomenon seen in one of his patients and this is what I said about it:
1- It could be senile alopecia, examine the donor area and see if the donor hairs are all healthy
2- It could be an autoimmune disease, so consider a biopsy of the recipient area
3- Count the donor density and see its comparison to your hair transplant density measurements. 

One experienced hair surgeon from Australia who wrote one of the classic text books on hair transplantation, said that he saw this rarely (just as I said) and further stated that he believed that some of the hairs had a shortened hair cycle after a number of years and that might be the cause of it. But in reality, assuming that #1,2 and 3 are not identified, then no one really knows the answer to this. 

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 13 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
4.5 out of 5 stars 19 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 6 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 13 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 76 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 4 reviews

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.