Pitting? Too early to tell?

[jim_hair]

Hello, I am worried I may have pitting from my FUE procedure that was done 26 days ago.  In many locations where the grafts were placed it appears to have a pitting appearance in the right lighting.  I am worried that these will be permanent and that healing will not get rid of them.  However, I can NOT tell if it is actually pitting or just the incisions finishing their healing/closing, or just the appearance of pitting that will even out with more healing..  The surgeon used 1.5mm scalpel to make the recipient incisions, which are pretty large.  They also used 1.25mm & 1mm hole punches for donor area.  

I hear the appearance of pitting is somewhat normal in the first months, but eventually subsides (3-5 months)..  Anyone have experience with this?  Any idea how long it takes for the recipient area to go back to normal and for the surface to become flush again? I theorize that with such large recipient incisions it could just be taking longer to close up and level out, but I am uncertain and worried that the worst case scenario has already manifested.  My surgeons technician said to give it a few weeks, but that seems like the perpetual answer to any concern "just give it more time".  Not much of a choice on that one, but if anyone has any knowledge on this topic or opinion on my situation, I'd appreciate the comment.  Please, let me know your thoughts, good or bad.

Sorry, photos aren't best but you can see that the angle plays a huge difference in them showing up, due to elevation differences of skin?

Edited August 18, 2021 by jim_hair

[Melvin- Admin]

It’s still healing. Too early to saybits pitting. 

[jim_hair]

On 8/18/2021 at 11:39 AM, Melvin- Moderator said:

It’s still healing. Too early to saybits pitting. 

Melvin,

Thank you sir!  I'm going to wait it out for a few months and see how things progress.  Will keep you and the community updated!

[Britanium]

It should definitely improve over the next few months, this is early days ! 👌

[gillenator]

Not pitting IMHO...it looks like needles were used to create some of your recipient sites.

[jim_hair]

@JohnAC71 & @gillenator Thank you both.  Surgery was on 7/22 so at the one month mark right now. All incisions for recipient site were done with a 1.5mm scalpel, so they are large and could be taking longer to finish healing.. It seems like it is almost every incisions/recipient site giving off the pit appearance.. So, I'm hoping it is just all of the incision sites finishing their healing process and will finish closing / smooth out in the months to come.  

[gillenator]

IMHO, it's surprising to me that all of the recipient sites were done with a 1.5 mm instrument.

When the sites are larger than some of the peripheral sizes of the grafts, there can potentially be some pitting or dipping occurring. Sometimes acutely and sometimes very minor as in your case....still, I do not see your situation as being a problem as long as the sites heal nicely.

The reverse happens when the sites are too small for the size of the grafts and potential cobble-stoning can occur as a result.

[jim_hair]

59 minutes ago, gillenator said:

IMHO, it's surprising to me that all of the recipient sites were done with a 1.5 mm instrument.

When the sites are larger than some of the peripheral sizes of the grafts, there can potentially be some pitting or dipping occurring. Sometimes acutely and sometimes very minor as in your case....still, I do not see your situation as being a problem as long as the sites heal nicely.

The reverse happens when the sites are too small for the size of the grafts and potential cobble-stoning can occur as a result.

I thought it was odd they didn't use smaller incisions on the hairline and surrounding area, but that is what they deemed appropriate I guess.  FYI: they used 1.25mm and 1.0mm hole punches to harvest the grafts, so hopefully those sizes line up in a manner that's not too prone to pitting.  Honestly just hoping it is the incisions finishing their healing and that the remodeling phase will even this out for me.  It doesn't appear I have any cobblestoning appearances.  It just worries me so much that it won't ever go away.. I've seen a few threads where they thought it was pitting but it resolved itself over time, but there's not much out there that I can find to reassure myself.. The ugly duckling phase is much more stressful than I anticipated..

I will be seeing the Shapiro Medical Group (not who did this operation) on September 14 to discuss their opinions on if it is pitting and to see what my options are for a second Hair Transplant.  Will update this thread with their conclusion (hopefully a favorable one)!

[jim_hair]

On 8/25/2021 at 3:33 PM, jim_hair said:

I thought it was odd they didn't use smaller incisions on the hairline and surrounding area, but that is what they deemed appropriate I guess.  FYI: they used 1.25mm and 1.0mm hole punches to harvest the grafts, so hopefully those sizes line up in a manner that's not too prone to pitting.  Honestly just hoping it is the incisions finishing their healing and that the remodeling phase will even this out for me.  It doesn't appear I have any cobblestoning appearances.  It just worries me so much that it won't ever go away.. I've seen a few threads where they thought it was pitting but it resolved itself over time, but there's not much out there that I can find to reassure myself.. The ugly duckling phase is much more stressful than I anticipated..

I will be seeing the Shapiro Medical Group (not who did this operation) on September 14 to discuss their opinions on if it is pitting and to see what my options are for a second Hair Transplant.  Will update this thread with their conclusion (hopefully a favorable one)!

So, I went and met with Shapiro and they didn't seem willing to tell me their opinion on whether or not they believe I have pitting.  Told me to wait it out and see how things heal and that they "don't tell clients at consults things that may distress them"... 

I'll keep the thread posted as I continue to heal (hopefully). If anyone knows of any similar story, where the healing looked similar and it all worked out (or didn't), it would be great to check out.

Thanks for all your comments and help!

[Britanium]

11 minutes ago, jim_hair said:

So, I went and met with Shapiro and they didn't seem willing to tell me their opinion on whether or not they believe I have pitting.  Told me to wait it out and see how things heal and that they "don't tell clients at consults things that may distress them"... 

I'll keep the thread posted as I continue to heal (hopefully). If anyone knows of any similar story, where the healing looked similar and it all worked out (or didn't), it would be great to check out.

Thanks for all your comments and help!

Thanks for the update. I find the response of the clinic a little odd ? Is it improving ? 

[jim_hair]

41 minutes ago, JohnAC71 said:

Thanks for the update. I find the response of the clinic a little odd ? Is it improving ? 

I haven't seen much improvement at this point..  Here's a picture of my head right now.  These pics appear a little better when held side by side I suppose.

 

Edited September 14, 2021 by jim_hair

[Britanium]

When I look at the pics you last posted it does seem like it’s improved. Comparing them next to each other.

[jim_hair]

31 minutes ago, JohnAC71 said:

When I look at the pics you last posted it does seem like it’s improved. Comparing them next to each other.

@JohnAC71 After taking a closer look at side by sides, it does seem to be a little less noticeable..  I'm 7 weeks post-op right now so hopefully the next 2-4 months does the trick.  Many people have told me it's normal and it takes 4-6 months to heal but having a hard time finding similar stories or any reassurance on that.  I got the impression from my consult with Shapiro Group that this is not normal however, but wouldn't tell me that directly.

Thanks for the help and staying with the thread John!

Edited September 14, 2021 by jim_hair

[Al - Moderator]

It should smooth out more over time. If you see some improvement since last month then it's on the right track even if it's only been minor improvement so far. Check again in another month. In any event, once the hair grows in, any minor bumps or indents probably won't be noticed anyway because your hair will be covering it. The only issue at that point is if you have bumps or indents right along the hairline because those may be noticeable, so that's the only area I'd be concerned about. If they aren't on the front row of hairs then it shouldn't really be an issue in the long run.

I'm actually more concerned about the donor area. 1.25mm seems like a rather large punch size for these days. How is the donor looking?

 

Edited September 16, 2021 by BeHappy

[gillenator]

I agree that the size of the punches were LARGE and almost sounds like someone in the initial learning phase of extracting.

[InTheSix]

On 9/14/2021 at 2:13 PM, jim_hair said:

@JohnAC71 After taking a closer look at side by sides, it does seem to be a little less noticeable..  I'm 7 weeks post-op right now so hopefully the next 2-4 months does the trick.  Many people have told me it's normal and it takes 4-6 months to heal but having a hard time finding similar stories or any reassurance on that.  I got the impression from my consult with Shapiro Group that this is not normal however, but wouldn't tell me that directly.

Thanks for the help and staying with the thread John!

Personally I think its too early to say that there is an issue.. everyone heals at a different pace.. I too was concerned about this after my FUE (3 month post HT currently), but it certainly keeps subsiding after every month.... best of luck  

[jim_hair]

18 hours ago, BeHappy said:

It should smooth out more over time. If you see some improvement since last month then it's on the right track even if it's only been minor improvement so far. Check again in another month. In any event, once the hair grows in, any minor bumps or indents probably won't be noticed anyway because your hair will be covering it. The only issue at that point is if you have bumps or indents right along the hairline because those may be noticeable, so that's the only area I'd be concerned about. If they aren't on the front row of hairs then it shouldn't really be an issue in the long run.

I'm actually more concerned about the donor area. 1.25mm seems like a rather large punch size for these days. How is the donor looking?

 

@BeHappy Yes, it's hard to see any improvement when you view it every day and worry about it.  But I agree with John that there appears to be some minor improvement.  Some images and lighting seem to make it worse or better so it's hard to gauge with certainty... Some people on Reddit have said that theirs looked the the same and cleared up by 90-120 days, so hoping I follow suit.  Honestly this whole process is super distressing and depressing.  Really hoping it all works out in the next couple months.  

@gillenator @BeHappy The donor harvesting was an excessive punch size.  SMG says they only use 0.7mm & 0.8mm..  Fortunately, the donor area was undetectable after about 2 weeks, but did look a little thin on my right side the prior to hair growing out.  My hair is pretty long in this area so I don't really know how it looks under there.  SMG inspected the donor however, and said it looked good and they would suggest another FUE for my next procedure..  So, that sounds promising.  I have a wedding to go to on October 3rd so I don't want to buzz down to expose more of the recipient, but I will buzz afterward and share the pics.  Really wish that hats were acceptable at weddings!  Contemplating just wearing one lol.  

Edited September 16, 2021 by jim_hair

[jim_hair]

11 hours ago, InTheSix said:

Personally I think its too early to say that there is an issue.. everyone heals at a different pace.. I too was concerned about this after my FUE (3 month post HT currently), but it certainly keeps subsiding after every month.... best of luck  

@InTheSix Sorry to hear you went through a similar experience.  How is everything looking for you now?  Hoping that it's back to normal or very close for you!

Edited September 16, 2021 by jim_hair

[jim_hair]

16 hours ago, gillenator said:

I agree that the size of the punches were LARGE and almost sounds like someone in the initial learning phase of extracting.

Yes, the technician who did the harvesting had about 6 years of experience doing FUE.  Very green.  Donor turned out decent, but it could have been far better with a smaller punch size.  I'll buzz it down next month and share pics so you can see.  

[InTheSix]

8 hours ago, jim_hair said:

@InTheSix Sorry to hear you went through a similar experience.  How is everything looking for you now?  Hoping that it's back to normal or very close for you!

Yes..its mostly all back to normal. I wasnt too concerned as I have read beforehand that its quite common in the beginning. I am sure yours will be back to normal pretty soon. 

[jim_hair]

13 hours ago, InTheSix said:

Yes..its mostly all back to normal. I wasnt too concerned as I have read beforehand that its quite common in the beginning. I am sure yours will be back to normal pretty soon. 

@InTheSix That's awesome man I'm glad it's smoothing itself out for you , literally.  Thanks for taking the time to let me know that you were in a similar situation and that it's been moving in the right direction.. Eases my mind quite a bit and that's been much needed these past few weeks. I mean, I read about the ugly duckling stage and have seen different levels of that situation.  The examples I found were somewhat similar but none really resembled the hundreds of "pit appearances"..  My initial logic was that it was the incision marks taking a while to close and remodel due to the large (1.5mm) incisions they used.  As I read more and speak with people like you it appears that's the case..  I'll be doing monthly updates on here for my recipient site.  It'd be great to hear how things progress with you from time to time as well!  Thanks again!

[gillenator]

On 9/16/2021 at 11:47 AM, jim_hair said:

Yes, the technician who did the harvesting had about 6 years of experience doing FUE.  Very green.  Donor turned out decent, but it could have been far better with a smaller punch size.  I'll buzz it down next month and share pics so you can see.  

6 years is a long time to be doing extractions so possibly what you meant by "very green" was the total amount of cases worked on, meaning, not that many?

I cannot say this for your situation but some individuals use the large punches so they can work faster, not necessarily cleaner or safer....and obviously those who are initially learning the technique tend to use larger punches until they develop and refine their manual extraction technique.