There is an autoimmune disease called Lichen planopilaris (LLP) which appears to be a rare inflammatory condition that results in patchy progressive permanent hair loss mainly on the scalp. From time-to-time this disease, which may be present when we perform a hair transplant and is not evident with any of the modalities available, can reactivate and could then kick out the hair that was transplanted. Some patients might have signs that LLP participated in their frontal balding, possibly overlying the genetic component of the hair loss.