Yes, while a hair transplant is permanent in almost all cases, some individuals may experience hair loss even after the procedure. In the short term, this is usually due to shock hair loss. Your scalp reacts to the trauma of hair transplant surgery, typically within a month of the procedure, causing hair transplant shedding. Despite the appearance of hair loss, most of the hair grafts will have been safely implanted. You just need to wait for them to regrow.

It's very uncommon for your transplanted hairs to fall out after a year. Most patients who have undergone a high-quality hair transplant operation see excellent results within 12 months of surgery. If your hair transplant is falling out after a year, here's what could be happening:

1-   Your hair loss hasn't stopped. A hair transplant replaces lost hair, but it won't prevent ongoing hair loss. Supplementary medications like Finasteride and Minoxidil are designed for this purpose. However, if you haven't been taking any hair loss medications, your hair may continue to fall out, even after the hair transplant. In this case, the hair that falls out isn't usually your transplanted hair grafts. Instead, the native hairs around your new grafts (which are also vulnerable to the hormones and androgen receptors that lead to male pattern baldness) may start falling out.

2-   You're stressed. A healthy person sheds 50-100 hairs every day. However, if you suddenly notice more extensive hair shedding, you may be experiencing telogen effluvium. Telogen effluvium is a type of temporary hair loss that occurs when you're stressed, anxious, or depressed. The hair follicle prematurely enters the shedding stage of the hair growth cycle, causing more hair to fall out than usual.

3-   You have another hair loss condition. In rare cases, you may develop an unrelated hair loss condition like alopecia areata. This autoimmune condition causes small round bald patches to develop at random areas on the scalp. It can affect both transplanted and non-transplanted existing hair.

4-   You have temporary hair loss. If you've just started using Minoxidil or Finasteride to manage your ongoing hair loss, you may experience temporary hair shedding.

5-   Your hair is damaged. Just like regular hair, hair that has been transplanted can become brittle and break off if not properly cared for. Dyeing, bleaching, and heat styling your hair can result in breakage and hair thinning, which may resemble hair loss.