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 (8)

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 Facial Plastic Surgeon
5.0 out of 5 stars 14 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.

Omeed Memar, MD, PhD
Chicago Dermatologist
5.0 out of 5 stars 15 reviews

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 50 reviews

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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
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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
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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.

E. Ronald Finger, MD
Savannah Plastic Surgeon
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Hair Falling Out After Transplant


Hair which has been transplanted from the correct area should not fall out after a hair transplant procedure due to androgenic alopecia. There are several options for this loss. Medical conditions such as thyroid disorders, physical stress, and autoimmune conditions should be evaluated. It may also be possible that your hair was not harvested from an area which is immune to androgenic alopecia. I would certainly suggest visiting a hair restoration specialist or dermatologist for further evaluation.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
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Hair loss years after a transplant


There are many factors to consider. One possibility  could be that the donor grafts were taken from areas that are becoming bald with age. See a hair transplant specialist. 

Sheldon S. Kabaker, MD
Oakland Facial Plastic Surgeon
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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.