Senior Member Time to do something Posted July 3, 2010 Senior Member Share Posted July 3, 2010 I have noticed something for a while but never said anything because either I thought it was my imagination or it was something that was already there before my procedure or would eventually go away if it were a product of the procedure. I have what appears to be pits all over the recipient site. This was a result of my first two procedures. When I look at my crown which is slick bald and never been touched it is completely smooth. When I part my hair on the sides and look there the scalp is completely smooth there. However, the recipient site looks pitted. I have only let a couple of people see my real hair under the hair piece. One person I have allowed to see it for monitoring purposes said the recipient area was pitted so that confirmed my fears. So it appears on top of extremely poor growth from my first two procedures I am now scared for life. I was going to post a photo but for some reason as clear as it is in person it doesn’t photograph. That may just be my lack of photography skills. I’m no expert but I knew something was not right. I went to another coalition doctor after my first procedure and he said he saw evidence of cobble stoning. Is cobble stoning and pitting the same thing? This just goes from bad to worse and all of this from a highly rated doctor by this site. I know of others complaining of the same issue with this doctor. NW5 Dr. Epstein July 4, 2007 2520 grafts 471 one hair grafts 1540 two hair grafts 505 three hair grafts 5070 Total hair count Dr. Epstein August 4, 2008 2384 grafts 870 one hair grafts 1150 two hair grafts 364 three and four hair grafts 4262 Total hair count Dr. Ron Shapiro November 18, 2009 1896 grafts 760 one hair grafts 852 two hair grafts 288 three hair grafts 46 four hair grafts 3362 total hair count Dr. Ron Shapiro July 1, 2011 1191 grafts 447 one hair grafts 580 two hair grafts 150 three hair grafts 14 four hair grafts 2113 total hair count Link to comment Share on other sites More sharing options...
Senior Member Danielkiwi Posted July 3, 2010 Senior Member Share Posted July 3, 2010 That is just insane....i have posed this question a couple of times on this forum and have not received nore than 2 or 3 replies which concerns me even more...This is one of the fears that i have of HT which has longer repurcussions than inapproprate growth... TTDS, are you sure you had cobblestoning only from dr. epsteins procedures and nothing fron Dr. shapiros procedure. If yes, how can you be so sure...I am worried this might be the case with any HT... I know Bill showed me his pictures that had no evidence of cobblesting or pitting (i dont know what the difference is but i am sure niether looks good)..but when i asked him how it looks to the naked eye, he did not answer...so, i am not sure about looking at this on camera as you mentioned.. As far as ur question is concerned regarding a coalition doctor having these results, i think this community does a decent job in recommending good doctors. but that does not substitute ones research...i have seen ordinary results from the top doctors as well.. which can be best described as combovers...it really is a gamble.... As far as solutions are concerned, i am not sure what you are going to achieve by bringing this out now as Epstein is no longer recommended on this community...however, i have seen some people reduce the scarring by laser and maybe you can look into that... Really unfortunate and i feel for you a lot.....i think it will be good karma if you can educate newbies on this forum!!! Link to comment Share on other sites More sharing options...
Senior Member Time to do something Posted July 3, 2010 Author Senior Member Share Posted July 3, 2010 Danielkiwi, The issue I’m addressing appeared before my third procedure. I did a massive amount of research and at the time the doctor I selected appeared to have among the best qualifications and recommendations. However, that all abruptly changed shortly after I had my first procedure. I did not go into this blindly with no research. I asked many questions well before I had the procedure on this forum and with the doctor as well. This a forum for people to express their experiences. I still see people on this forum considering work by this doctor and I think they should be aware of my experience. I feel like I paid a huge amount of money not only to obtain cosmetically unacceptable results but be scared as well. You seem to have done extensive research. Which doctors are you considering and why? NW5 Dr. Epstein July 4, 2007 2520 grafts 471 one hair grafts 1540 two hair grafts 505 three hair grafts 5070 Total hair count Dr. Epstein August 4, 2008 2384 grafts 870 one hair grafts 1150 two hair grafts 364 three and four hair grafts 4262 Total hair count Dr. Ron Shapiro November 18, 2009 1896 grafts 760 one hair grafts 852 two hair grafts 288 three hair grafts 46 four hair grafts 3362 total hair count Dr. Ron Shapiro July 1, 2011 1191 grafts 447 one hair grafts 580 two hair grafts 150 three hair grafts 14 four hair grafts 2113 total hair count Link to comment Share on other sites More sharing options...
Senior Member Danielkiwi Posted July 3, 2010 Senior Member Share Posted July 3, 2010 (edited) Yes..i have done extensive research and still i havent found 100% of the answers and will not book a procedure until that..i have had consultations with some doctors including epstein. Epstein never gave me a good feeling and and hence i removed him from my consideration...I have shortlisted Dr. hasson & wong, Feller, Shapiro medical group, Dr. rahal and Dr. bernstein..the reason i have shortlisted them is due to consistent results from patients and negligible negative reviews...I know Dr. Feller has had some miscommunication feedback but all in all he seems to be a quality doctor... but i need to gain control over a couple of issues before i take the plunge..firstly i need find see atleast 3 patients that are not referred by the clinics to get an honest review..then i would like to meet them personally and see their scars both in the recipient area and the donor area.. Secondly, i need to decide my comfort level with propecia in the long run...i am yet not sure if i want to take this 100% and all the doctors strongly recommend to have propecia in your regimen..to me, MPB will progress and i dont know how much patience i will have when i have kids and a family to chase this all my life!!! and even then i would not have a full head of hair with constant fear of how it looks in sunlight etc... Hence, i was trying to convince my mind that if my first HT does not work, i will completely shave of my recipient area and get on with my life with lil hair covering the scar in the donor area...but your post ( i have seen a few others as well) leaves me more worried about this approach...sorry for venting but i am sure you can understand..I am also looking into couple of other forums to get unbiased opinions since this is a membership forum in the first place where these doctors are responsible for maintaining the forum in the first place and from time to time there will be somebody like Epstein come in to the picture.. I think your post can do a great job by letting people know that just because one selected a coalition doctor, the job is not over..i am sure there are other quality physicans out there as well!!! Edited July 3, 2010 by Danielkiwi Link to comment Share on other sites More sharing options...
Senior Member Time to do something Posted July 3, 2010 Author Senior Member Share Posted July 3, 2010 Be VERY careful of Propecia. It did not agree with me and once you study the mechanism of how it works it makes sense that it can have very negative effects on some. Aging isn’t fun. Most men will lose at least some of their hair as they age. If you don't get a transplant you've got the option of a hair piece. They can look natural but high maintenance and always wondering if it looks ok. I will say my donor scar seems to be ok by both doctors. I don't have an issue there. As far as the pitting at the recipient area is concerned, I believe that even with a dusting of hair covering the affected area it would hide the pits. I'm guessing one wouldn't notice it in everyday encounters. When I was considering my third procedure I had it narrowed down to Shapiro, Hasson & Wong, and Rahal. I had several people look at the examples of their work on their websites and they all picked Shapiro. They said the other two also had very impressive results but Shapiro just went over the top a little more. I believe any of the ones on your list would do a great job. NW5 Dr. Epstein July 4, 2007 2520 grafts 471 one hair grafts 1540 two hair grafts 505 three hair grafts 5070 Total hair count Dr. Epstein August 4, 2008 2384 grafts 870 one hair grafts 1150 two hair grafts 364 three and four hair grafts 4262 Total hair count Dr. Ron Shapiro November 18, 2009 1896 grafts 760 one hair grafts 852 two hair grafts 288 three hair grafts 46 four hair grafts 3362 total hair count Dr. Ron Shapiro July 1, 2011 1191 grafts 447 one hair grafts 580 two hair grafts 150 three hair grafts 14 four hair grafts 2113 total hair count Link to comment Share on other sites More sharing options...
Senior Member Danielkiwi Posted July 3, 2010 Senior Member Share Posted July 3, 2010 Yes TTDS...i am aware of propecis and am gonna give it six months before i make the final decision..i am also leaning towards Dr. Ron shapiro coz he has given the most consistent results without being overly agressive....h&W give great results but they have known to take high scars recently and i am not a big fan of that..Dr. Feller has had some miscommunication issues and Dr. Bernstein is super expensive... Inspite of all this, Dr. Shapiro will also not be able to help me if i stop propecia and loose more hair..infact they have been really honest about this and told me the same..i am not a big fan of toupees either so that is out of question.... I know i will not have a full head of hair with transplants...you take a look at Bill for example...it took him 4 surgeries to look anything decent but is still thin in the crown area..infact, after 3 of his procedures, he was still very thin and pluggy....and he has had 9000 grafts and should be lucky for that.. Hence, the big question is should i let nature take its course and go naturally bald or should i try to fight it and end up with half a head of hair and lifetime worth of stress...how is your growth coming along at this time with Dr. Shapiro. Link to comment Share on other sites More sharing options...
Senior Member Time to do something Posted July 3, 2010 Author Senior Member Share Posted July 3, 2010 Danielkiwi, I think most people understand that a hair transplant is not a one time procedure and that is it. You could get a couple of transplants and plan for the worst case scenario that you will become a full blown NW7 which is unlikely. In the event that happens you would still have a light density of hair. In my opinion not every guy can pull the totally bald look off and studies have shown that bald men are looked upon negatively compared to their hirsute counterparts. That is unfair but true. I believe even if you lose more hair you could achieve at least a light density of covering on your head which may be better than a total bald head. What I am doing is concentrating my grafts in the front 2/3 of my scalp and not addressing the crown. This will allow me to increase the density in the crucial area. I plan to wear a lace hairpiece between the size of a silver dollar and baseball on my crown. My stylist has several guys who have done this with amazing results. I’ve even talked with people on here doing the same thing with great results. Being that I’ve worn a regular hairpiece for years a crown piece should be a piece of cake. These are just some things for you to think about. Hair from the safe zone should be safe from DHT so Propecia shouldn’t be needed for that but only to save hair you already have on top of your hair that you want to keep. Even if all of that falls out, with the transplanted hair safe from the effects of DHT you should have enough to give a light covering vs. being totally bald. I am at the seven month point so I’m in the frustrating limbo stage. I have hair where I didn’t before so that is good. I also think I’m a slow grower so it may take a bit longer for me. I’ve also seen many times on here and other places that the biggest change/improvement comes between months eight and ten. I have also been keeping the hair buzzed down short so it is hard to tell. However, this month I am no longer going to buzz it and start letting it grow for the planned unveiling in November. Remember one day cloning will be reality as well but this could provide some results until then. NW5 Dr. Epstein July 4, 2007 2520 grafts 471 one hair grafts 1540 two hair grafts 505 three hair grafts 5070 Total hair count Dr. Epstein August 4, 2008 2384 grafts 870 one hair grafts 1150 two hair grafts 364 three and four hair grafts 4262 Total hair count Dr. Ron Shapiro November 18, 2009 1896 grafts 760 one hair grafts 852 two hair grafts 288 three hair grafts 46 four hair grafts 3362 total hair count Dr. Ron Shapiro July 1, 2011 1191 grafts 447 one hair grafts 580 two hair grafts 150 three hair grafts 14 four hair grafts 2113 total hair count Link to comment Share on other sites More sharing options...
Senior Member Danielkiwi Posted July 3, 2010 Senior Member Share Posted July 3, 2010 HI TTDS..i see your point...that lace hair peice in the crown seems to be a good idea...what cos. are you looking into for this? i might do some research on this as well...have you seen anybody wearing it.....does it look natural? it looks like you have a plan and you have chosen an excellent doctor....addressing frontal 2/3 of the head seems to be a good idea...and yes hopefully cloning can come in our life time!!! PS - i did not mean to turn your thread in to a personal discussion between you and me but i appreciate your thoughts..I will send you a PM later on and hopefully we can stay in touch long term as well.. good luck and we all sincerely hope to see you as a new man in thanksgiving!!! Link to comment Share on other sites More sharing options...
Tsakalos Posted July 3, 2010 Share Posted July 3, 2010 what exactly is pitting ? is that when u see the recipient site under the light it looks like it has some short of appearance like the surface of the moon ? i hope it makes clear how i am describing it.. Link to comment Share on other sites More sharing options...
Senior Member Sparky Posted July 3, 2010 Senior Member Share Posted July 3, 2010 cobblestoning is the opposite of pitting. My Hairloss Website http://www.hairtransplantnetwork.com/blog/home-page.asp?WebID=2198 Link to comment Share on other sites More sharing options...
Senior Member Time to do something Posted July 3, 2010 Author Senior Member Share Posted July 3, 2010 I'm not 100% sure which is why I posted this but in my case I see some areas which appear to be raised slightly and other areas that are indented, sort of like what someone looks like who has acne scars. NW5 Dr. Epstein July 4, 2007 2520 grafts 471 one hair grafts 1540 two hair grafts 505 three hair grafts 5070 Total hair count Dr. Epstein August 4, 2008 2384 grafts 870 one hair grafts 1150 two hair grafts 364 three and four hair grafts 4262 Total hair count Dr. Ron Shapiro November 18, 2009 1896 grafts 760 one hair grafts 852 two hair grafts 288 three hair grafts 46 four hair grafts 3362 total hair count Dr. Ron Shapiro July 1, 2011 1191 grafts 447 one hair grafts 580 two hair grafts 150 three hair grafts 14 four hair grafts 2113 total hair count Link to comment Share on other sites More sharing options...
Tsakalos Posted July 3, 2010 Share Posted July 3, 2010 can someone post 1 pic of pitting and another one of cobblestoning so i can have an idea of what do u mean by those terms ? Link to comment Share on other sites More sharing options...
Senior Member RCWest Posted July 4, 2010 Senior Member Share Posted July 4, 2010 Cobblestoning is when the grafts heal with the tops above the surface. Pitting is when they heal below the surface. The hair usually grows fine in cobblestoning, but when pitting occurs it may not grow. Hard to believe this happened from two of the best doctors in the country! Maybe your donor area skin is thinner than the top skin? Finasteride 1.25 mg. daily Avodart 0.5 mg. daily Spironolactone 50 mg twice daily 5 mg. oral Minoxidil twice daily Biotin 1000 mcg daily Multi Vitamin daily Damn, with all the stuff you put in your hair are you like a negative NW1? Link to comment Share on other sites More sharing options...
Senior Member Time to do something Posted July 4, 2010 Author Senior Member Share Posted July 4, 2010 Cobblestoning is when the grafts heal with the tops above the surface. Pitting is when they heal below the surface. The hair usually grows fine in cobblestoning, but when pitting occurs it may not grow. Hard to believe this happened from two of the best doctors in the country! Maybe your donor area skin is thinner than the top skin? NO! As stated in my post this issue occurred with my first one or two procedures NOT with my third. I had already observed the pitting and cobble stoning with the first procedure. I agree that Dr. Shapiro is one of the finest doctors in the country for hair transplants if not the world. Can you share with us why you are calling Dr. Epstein one of the best hair transplant doctors in the country? I have not scalp conditions. As I said in a previous post, I was examined by several top dermatologist and they all said I had a perfectly normal healthy scalp and there should be no reason I would have any complications from a hair transplant performed correctly. But who knows, maybe I have a thick head. NW5 Dr. Epstein July 4, 2007 2520 grafts 471 one hair grafts 1540 two hair grafts 505 three hair grafts 5070 Total hair count Dr. Epstein August 4, 2008 2384 grafts 870 one hair grafts 1150 two hair grafts 364 three and four hair grafts 4262 Total hair count Dr. Ron Shapiro November 18, 2009 1896 grafts 760 one hair grafts 852 two hair grafts 288 three hair grafts 46 four hair grafts 3362 total hair count Dr. Ron Shapiro July 1, 2011 1191 grafts 447 one hair grafts 580 two hair grafts 150 three hair grafts 14 four hair grafts 2113 total hair count Link to comment Share on other sites More sharing options...
Senior Member RCWest Posted July 4, 2010 Senior Member Share Posted July 4, 2010 That's what I get for not paying more attention. I didn't mean Epstein was one of the best. Anybody affiliated with Bosley is questionable. Finasteride 1.25 mg. daily Avodart 0.5 mg. daily Spironolactone 50 mg twice daily 5 mg. oral Minoxidil twice daily Biotin 1000 mcg daily Multi Vitamin daily Damn, with all the stuff you put in your hair are you like a negative NW1? Link to comment Share on other sites More sharing options...
Senior Member Time to do something Posted July 4, 2010 Author Senior Member Share Posted July 4, 2010 That's what I get for not paying more attention. I didn't mean Epstein was one of the best. Anybody affiliated with Bosley is questionable. LOL Got ya! I just wanted to make sure you weren't aware of some new information I wasn't. NW5 Dr. Epstein July 4, 2007 2520 grafts 471 one hair grafts 1540 two hair grafts 505 three hair grafts 5070 Total hair count Dr. Epstein August 4, 2008 2384 grafts 870 one hair grafts 1150 two hair grafts 364 three and four hair grafts 4262 Total hair count Dr. Ron Shapiro November 18, 2009 1896 grafts 760 one hair grafts 852 two hair grafts 288 three hair grafts 46 four hair grafts 3362 total hair count Dr. Ron Shapiro July 1, 2011 1191 grafts 447 one hair grafts 580 two hair grafts 150 three hair grafts 14 four hair grafts 2113 total hair count Link to comment Share on other sites More sharing options...
Senior Member TheEmperor Posted July 5, 2010 Senior Member Share Posted July 5, 2010 Before any hair grew in from my first procedure with Dr. Wong, I saw all these tiny pits and was concerned that my skin would have a pitted look. Over the following 6 months as hair grew in, I found that the skin smoothed out. It stands to reason that the smaller the incisions, the smaller the grafts, the less noticable will be any pitting. If you are concerned about pitting, you should seek a doctor that uses the finest grafts. However, larger grafts will provide more density and an ability to completely cover the scalp. I suppose it is a trade off: density vs naturalness. My Hair Loss Web Site - Hair Transplant with Dr. Wong Link to comment Share on other sites More sharing options...
Senior Member EpilepticSceptic Posted July 5, 2010 Senior Member Share Posted July 5, 2010 (edited) Before any hair grew in from my first procedure with Dr. Wong, I saw all these tiny pits and was concerned that my skin would have a pitted look. Over the following 6 months as hair grew in, I found that the skin smoothed out. It stands to reason that the smaller the incisions, the smaller the grafts, the less noticable will be any pitting. If you are concerned about pitting, you should seek a doctor that uses the finest grafts. However, larger grafts will provide more density and an ability to completely cover the scalp. I suppose it is a trade off: density vs naturalness. I don't really notice anything like that from my recent surgery with Dr. Hasson, and this was after having 4496 grafts packed super densely into a relatively small area (NW4, small head & bridge intact, NW2 hairline, no temple point work). My head felt like a pin cushion during the HT, there were so many incisions being made! If I look really close with one hand mirror in another larger mirror (under bright light), I can only find 2 such very tiny areas up front where it seems indented inward in a circular like fashion. It looks like hairs are popping up there already, and maybe once that happens it will resolve itself. But other than this it looks like normal skin everywhere else; and it has looked that way (minus the pinkishness) from day #15 when alot of the grafts started to shed. I think people just have different skin with different healing characteristics. It would be nice if there was some reliable scientific method of discerning these particulars PRE-surgery! Edited July 5, 2010 by EpilepticSceptic Link to comment Share on other sites More sharing options...
Senior Member BigBill1234 Posted July 5, 2010 Senior Member Share Posted July 5, 2010 How is Epstein associated with Bosely? Link to comment Share on other sites More sharing options...
Senior Member RCWest Posted July 5, 2010 Senior Member Share Posted July 5, 2010 Are you thinking of this Epstein? (promotional link removed - feel free to mention the physician's first name instead of linking to a promotional website) Finasteride 1.25 mg. daily Avodart 0.5 mg. daily Spironolactone 50 mg twice daily 5 mg. oral Minoxidil twice daily Biotin 1000 mcg daily Multi Vitamin daily Damn, with all the stuff you put in your hair are you like a negative NW1? Link to comment Share on other sites More sharing options...
Senior Member Time to do something Posted July 5, 2010 Author Senior Member Share Posted July 5, 2010 My procedure was done by Epstein in Miami. NW5 Dr. Epstein July 4, 2007 2520 grafts 471 one hair grafts 1540 two hair grafts 505 three hair grafts 5070 Total hair count Dr. Epstein August 4, 2008 2384 grafts 870 one hair grafts 1150 two hair grafts 364 three and four hair grafts 4262 Total hair count Dr. Ron Shapiro November 18, 2009 1896 grafts 760 one hair grafts 852 two hair grafts 288 three hair grafts 46 four hair grafts 3362 total hair count Dr. Ron Shapiro July 1, 2011 1191 grafts 447 one hair grafts 580 two hair grafts 150 three hair grafts 14 four hair grafts 2113 total hair count Link to comment Share on other sites More sharing options...
Senior Member Balboa Posted July 5, 2010 Senior Member Share Posted July 5, 2010 pitting is dints and cobble-stoning is raised bumps. sparky is correct Dr A. Armani 2500 Fue Dec 2008 Proscar X1 Day Monixodil X2 Day Msm Daily Link to comment Share on other sites More sharing options...
Regular Member jim_hair Posted August 24, 2021 Regular Member Share Posted August 24, 2021 On 7/4/2010 at 7:43 PM, TheEmperor said: Before any hair grew in from my first procedure with Dr. Wong, I saw all these tiny pits and was concerned that my skin would have a pitted look. Over the following 6 months as hair grew in, I found that the skin smoothed out. It stands to reason that the smaller the incisions, the smaller the grafts, the less noticable will be any pitting. If you are concerned about pitting, you should seek a doctor that uses the finest grafts. However, larger grafts will provide more density and an ability to completely cover the scalp. I suppose it is a trade off: density vs naturalness. @TheEmperor I'm glad the appearance of tiny pits resolved itself for you over time with the skin remodeling process. I am 5 weeks post-op and am seeing a large amount of pit like appearances on my recipient area. I'm honestly worried, as you were, that it won't go away with time. Could you take a look at the thread I posted asking this question to see if mine looks similar to how yours looked? I'd really appreciate it! Link to comment Share on other sites More sharing options...
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