I underwent two hair transplant procedures. The first was in June of 2006 and the second one was in June 2007. Both were performed to lower my hairline and no remaining natural hair existed. Now, almost two years after the second procedure I am noticing thinning hair again in the same area. Is it possible for transplanted hair to thin two years after the procedure? If so, is this permanent?
All hair goes through shedding cycles, but always at different times. Hair can sometimes appear thinner due to more hairs being in the telogen (shedding) phase at various times of the year. This is referred to as “seasonal shedding”. But it is not normal for you to permanently lose your transplanted hair.
Transplanted hair is as permanent as the hair from which it was taken. Because the majority of your hair on the sides and back of your head are resistant to DHT (the hormone responsible for genetic female hair loss and male pattern baldness), it's considered safe for transplanting. This is referred to as the "safe zone". As long as hair was harvested from the safe zone, your transplanted hair should return as each hair in telogen re-enters anagen - the hair growth phase of the natural hair cycle.
In some hair loss sufferers, hair on the sides and back of the head is diffuse, which means there is no permanent safe zone. In the event you are losing hair on the sides and back of your head, transplanted hair too may fall out.
Another possibility is excessive pulling of the hair. If you wear a tight headband or do anything that puts a strain on the follicles, it could result in temporary or permanent hair loss of the area. Certain medications amongst other things can also cause hair loss.
If you are concerned about permanent transplanted hair loss, I encourage you to speak to your hair restoration physician.