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 19

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
4.9 out of 5 stars 49 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

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.

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

Loss of hair is a natural process when it is between the limits that the body can restore them. When the capacity of the body to restore the hair loss is beaten by the excessive hair loss then we can name this situation something that should be treated. Women started to experience balding even more in the last 2 decades. It is getting more and more common also in women population. However it is also good to know that this problem is also treatable when it is present in women.

To obtain alive hair follicles implanted in higher rates, the latest technique being used is not the only manner, it is also affected by compliance of implantation area that we found a better way to improve as a result of our researches, The Organic Hair Transplantation. By this new and unique Organic Hair Transplantation Technique, before the extraction and implantation processes; we regenerate the implantation area with injection of stem cell enriched fat tissue. Regeneration of cells in target area before FUE transplantation with the support of stromal stem cells results in higher rate of alive thicker hair follicles.

Bulent Cihantimur, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 78 reviews

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

Hello, thank you for posting your question. Transplanted hair which are taken from the correct region of the donor region, should be resistant to DHT which is the majority cause of hairloss in men. Are there any stressors that may cause increase shedding? Stress can also cause increase shedding. Also, you may also see increase in shedding initially if you started Minoxidil for the first few weeks. Hope this helps. 

Matt Tahsini, MD
Pasadena Hair Restoration Surgeon
5.0 out of 5 stars 15 reviews

Hair Loss After Hair Transplant

It is highly unlikely that your transplanted hairs are falling out.  It is most likely, that you are currently noticing the loss of the hairs around those that were previously transplanted.  

The most common misconception with a hair transplant procedure is that once you have the procedure that you will not experience any more hair loss over time.  The hair that is harvested for a hair transplant are taken from a donor area of the back of the scalp where the follicles are not susceptible to male pattern baldness.  When these hair follicles are subsequently transplanted, they retain that same staying power as they had in the back of the scalp, so it is for the transplanted hairs that the above statement can be considered more valid.  What you are likely experiencing is hairloss from follicles that are native to that area and that were not transplanted.  

I would recommend that most males who are experiencing hair loss, with or without having undergone a hair transplant procedure, use Rogaine and Propecia (Finasteride) to help reduce future native hair loss.  I would also recommend following up with your doctor or consulting with a hair loss specialist to evaluate your hair loss and perform any blood work necessary.  It is possible that you could be experiencing telogen effluvium, or temporary hair loss from undue or excessive stress, but I would still recommend that you get evaluated by a hair loss specialist.

Hold on a second....

In just about every single case I've encountered, patient claiming their hair transplants are falling out are really suffering loss of the native hair in and around the hair transplants. Check your before photos to make sure this is happening. I had a patient claim ALL his transplants fell out ONE YEAR after his procedure. When he finally sent me a picture, all of my grafts grew beautifully and were still there. His hair around the transplants fell out. 
Dr. Feller

Alan S. Feller, DO
Great Neck Hair Restoration Surgeon
5.0 out of 5 stars 2 reviews

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 27 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 28 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 wether 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.  Another reason could be that you are losing your native hair and as a result you are seeing some thinning in the transplanted area. 

Michael Meshkin, MD
Newport Beach Hair Restoration Surgeon
4.8 out of 5 stars 27 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.