Tenting (cobblestoning) and pitting in recipient area 12 months post FUE

[Dickie]

Hi, 

I’m 51 and was Norwood 4. I’m now 12 months post 2,200 grafts FUE and having some pretty substantial tenting at each follicle in the recipient area that is noticeable under direct light. 

My donor area is salt and pepper and sides of my scalp are white. My donor hairs are course. The transplant was mostly in the front 1/4 of my scalp and “fades” into the crown.  I have plenty of hair in the donor area for a second procedure but am very concerned that further scars would happen. 

At 6 months I was told the tenting would smooth out. At 12 months I returned to the clinic that performed the FUE and was told that the tenting was not noticeable and that my hair looks great. That’s it. Just move along. I don’t feel they care or accept responsibility for the tenting. The clinic is in the Atlanta area. 

I have not done any pre or post transplant minox or finast. I do take a “hair skin and nails”supplement that has tons of biotin. 

Went to another clinic and was told a second transplant was my only option. 

Looking to have a smooth scalp. Does anyone have any success with 1450 diode lasers or co2 fraxel lasers.  How about micro-needling (derma stamp) with radio frequency?

I’ve seen other posts on here that have said they were going to have a try at laser and or micro-needling  and unfortunately most of the posts end with no follow up on how the procedure turned out. 

Any recommendations or advice on how to smooth these bumps and pits would be greatly appreciated. I feel very uncomfortable the way my scalp looks and hopefully someone has some input on what has helped their situation or knows of solutions. 

Please help!

 

First photo below is pre FUE. 

 

and tenting after FUE. 

Edited June 10, 2022 by Dickie
Typos

[Melvin- Admin]

Let me tag @DrTBarghouthi

[shiba1985]

That is 2200 FUE grafts? What clinic in Atlanta?

[DrTBarghouthi]

Thanks @Melvin- Moderator

@Dickie Do you have immediate post surgery photos you can share? It may well be a skin type of thing or a graft placement technique. I’d like to see. 

[RTC]

Can you post some closer photos please

[Dickie]

@ Dr. T Barghouthi, No immediate post photos. Do you have any solutions or recommendations? 
thanks

[RTC]

Hi Dickie, could you name the clinic? Even by private message

[Gatsby]

Yes who was the surgeon?

[gillenator]

Does his last name rhyme with “Pole?”

[Melvin- Admin]

It may be best to have the grafts removed and re-done. Based on what Dr. Mwamba said last week on our podcast. 

 

[Dickie]

Hey, not looking to drag the clinics name down.
     I’m really hopeful that someone can lead me to getting these bumps smoothed out.  I’d like to have my old self back even if I have no hair. These tenting follicles really do look noticeable under direct light and when my hair is wet. 
 

[Kerma M]

I think it’s fair to mention the clinic! just so people can be aware, especially that you mentioned they didn’t seem to care or take responsibility?

[harryforreal]

The issue, Dickie, isn't just skin texture. It looks like you've got quite a few doubles and triples and not enough singles. This creates a pluggy look. Thus the reason Melvin is suggesting removing the grafts and re-doing it - by someone with considerably more skill I'd suggest.

[Gatsby]

17 hours ago, Gatsby said:

Yes who was the surgeon?

The reason I have asked this is so that you can help in preventing another person having to go through what you are experiencing now. Also you can be helping others who have this problem by this surgeon on how it can be fixed. All the best!

[DrTBarghouthi]

Those irregularities are most likely grafts placed flushed with the skin so that when skin heals, it contracts and gets pushed in further. That’s only one assumption. Skin type and even incision technique can cause it. 
I think a proper repair is what’s needed. Removing unsightly ones and adding density. Part of what you see is due to it being “see-through” and that’s what makes any skin irregularities obvious. 

[Mike10]

Who was the Dr?

[BaldReaper]

1 hour ago, DrTBarghouthi said:

Those irregularities are most likely grafts placed flushed with the skin so that when skin heals, it contracts and gets pushed in further. That’s only one assumption. Skin type and even incision technique can cause it. 
I think a proper repair is what’s needed. Removing unsightly ones and adding density. Part of what you see is due to it being “see-through” and that’s what makes any skin irregularities obvious. 

Removing the graft removes the ridging?

[DrTBarghouthi]

If they are scattered these can be removed and re implanted. Also adding density might disguise some of these and make it all hidden. 

[gillenator]

It appears that needles we used to create the recipient sites that were smaller in size than the circumference of the grafts…and when the sites heal, they contract and push the tips of the grafts upward causing the bumps…the reverse is true when the sites are larger than the peripheral size of the grafts and when healing occurs, pitting takes place.

[Bee9]

Has it gotten better?