Two months post-op: is this cobblestoning?

[FinasterideOverdose]

Hello HRN community,

I am now two months post-op, after a 3000 graft FUE procedure to lower my hairline. My donor area is already fine/looks back to normal, but I'm somewhat concerned about my recipient area.

The recipient area is still rather pink/red, with rough and bumpy skin. I obviously can't judge the yield/growth yet, but am worried about the bumps. Has anyone else had this issue? Does the skin gradually smooth out over time? I'm concerned that this is the scarring phenomenon known as "cobblestoning."

I already have some early growth, which is somewhat visible in the photos (I'm carefully trimming it with scissors, until it all starts to all grow in). I suppose if the yield is good, I don't really mind the bumpy skin as long as it's covered with hair lol

My clinic, which is being helpful and responsive, says things are looking on track. But I wanted to see what the veteran patient community had to say. I'm not gonna panic yet and will maintain a positive attitude. Thanks for your time to read my post, and let me know if you have any advice!

Medication: I'm taking 1mg Finasteride daily, as well as applying topical minoxidil to the recipient area and rest of my scalp daily.

[John1991]

Might it be possible that the bumps could be inflammation in response to minoxidil applied to the recipient area before it calmed down?  I'm not a veteran as many on here are, but that may be something worth considering.

Edited July 30, 2022 by John1991

[FinasterideOverdose]

6 hours ago, John1991 said:

Might it be possible that the bumps could be inflammation in response to minoxidil applied to the recipient area before it calmed down?  I'm not a veteran as many on here are, but that may be something worth considering.

Thanks so much for your reply. I think the topical minoxidil may be prolonging the redness. But the bumps just feel like skin; there is no pain or tenderness and I think they may just be scarring.

With skin cell turnover/shedding, I think the bumps may gradually get less noticeable with time. Again, even if it is scarring/permanent I'm not gonna cry as long as the hair grows in and remains there haha

I was just wondering if anyone else here had similar experiences.

Also I should note that I have somewhat sensitive/fair skin, and this was a dense pack/megasession on an area with zero hair previously. Apparently such procedures on virgin scalp tend to leave redness and roughness for a longer period of time. So that's something to consider...

[kumardarshan]

5 hours ago, FinasterideOverdose said:

Thanks so much for your reply. I think the topical minoxidil may be prolonging the redness. But the bumps just feel like skin; there is no pain or tenderness and I think they may just be scarring.

With skin cell turnover/shedding, I think the bumps may gradually get less noticeable with time. Again, even if it is scarring/permanent I'm not gonna cry as long as the hair grows in and remains there haha

I was just wondering if anyone else here had similar experiences.

Also I should note that I have somewhat sensitive/fair skin, and this was a dense pack/megasession on an area with zero hair previously. Apparently such procedures on virgin scalp tend to leave redness and roughness for a longer period of time. So that's something to consider...

Does the redness fade away when you press on the skin? Like does it have a Blanche effect and skin return to its normal colour? Or the redness stays even after pressing?

[FinasterideOverdose]

4 hours ago, kumardarshan said:

Does the redness fade away when you press on the skin? Like does it have a Blanche effect and skin return to its normal colour? Or the redness stays even after pressing?

Yes, I just tried it and blanching occurs when I do that. It looks just like the untouched skin below, but rough textured.

Why do you ask? I'm curious what it means, one way or another.

[kumardarshan]

3 hours ago, FinasterideOverdose said:

Yes, I just tried it and blanching occurs when I do that. It looks just like the untouched skin below, but rough textured.

Why do you ask? I'm curious what it means, one way or another.

Hey, I am not too sure. But I feel blanching would be a good thing. I think discolouration would be temporary if it blanche

[A Fue Good Men]

This might be your skins normal reaction to all the trauma and inflammation. The only thing you can do is wait.

 

Which clinic?

[FinasterideOverdose]

On 8/1/2022 at 2:47 AM, kumardarshan said:

Hey, I am not too sure. But I feel blanching would be a good thing. I think discolouration would be temporary if it blanche

Interesting, I see. I think the redness is starting to fade, very gradually though. I'll post updates every few weeks or so.

Early growth has also begun at just two months, which is a good sign. The hairs are very small and clear though.

[FinasterideOverdose]

On 8/1/2022 at 4:16 AM, 5BetaReductase said:

This might be your skins normal reaction to all the trauma and inflammation. The only thing you can do is wait.

 

True, I guess I'll hang on and see how the next few months play out.

For personal reasons, I don't feel comfortable naming the clinic here. For the record, they have been super helpful, and after my surgery they offered to do further work for free in case a patch doesn't grow in or something.

[Rahal Hair Transplant]

John1991,

in my opinion, what you are seeing is likely inflammation of the scalp and possibly mild folliculitis either from the minoxidil or just your overall healing characteristics.

Cobblestoning is a phenomenon that’s hardly seen today especially if you’ve selected a reputable surgeon. Also, I would think you would have noticed the phenomenon of cobblestoning long before two months postop.

I know I experienced something very similar to this during the healing stages of my 2nd hair transplant around two months post-op.  I was prescribed what’s called TendSkin” which is a solution that helps with folliculitis and inflammation.  You could look into something like that or even use aloe vera or vitamin E oil which might help with these phenomenon.

But first, I do suggest consulting your surgeon and garnering their input since you are already two months postop and your scalp looks pretty red.

Best wishes,

Rahal Hair Transplant 

[FinasterideOverdose]

Hello guys, I’m just dropping an update now that I’m at 3 months, 2 weeks post-op

I have some growth coming in, which is nice…but 1. The density is not something I’d be happy with if it doesn’t increase 2. The redness is still there 3. The recipient area bumps are still there…These three issues are somewhat concerning me.

How does this look to you veterans, considering the time post-op?

Relevant info: I’m applying topical minoxidil to the recipient and donor areas once per day, and taking 1mg oral finasteride. Also this was 3,000 grafts FUE.

[Rahal Hair Transplant]

@FinasterideOverdose,

I hope you understand that you are only 3 months and 1 week post op.  Therefore, the hair growth you are experiencing is not even close to what you’re going to see several months from now.

In other words, don’t worry about density or fullness at this time. You will see a lot more come in over the next couple of months and by the time you are 1 year to 18 months out from surgery, you will see your final result.

Best wishes,

Rahal Hair Transplant

[Al - Moderator]

It's a little more than a month later. How is the redness and the bumps at this point?

 

[FinasterideOverdose]

On 10/12/2022 at 7:13 PM, BeHappy said:

It's a little more than a month later. How is the redness and the bumps at this point?

 

Hey man, thanks for checking back in. Now that I'm at about 4.5 months, it seems that the follicles are starting to look decent/presentable.

The redness and bumps are still there, but they seem less noticeable. It's hard to tell whether the bumps are smoothing out, or maybe just being covered by growing hair.

The density is looking fine, but there are still some spots where hair isn't growing. I hope those follicles begin to sprout soon.

[JohnCasper]

Hang in there and be patient.  I'm sure you will be pleased in a few more months.

[Balding Bad]

Fascinating thread...looks like you're improving quite nicely. Any updates?

[Melvin- Admin]

Would also love to see how this progressed. 

[FinasterideOverdose]

On 1/6/2023 at 11:34 AM, Balding Bad said:

Fascinating thread...looks like you're improving quite nicely. Any updates?

 

On 1/12/2023 at 9:11 AM, Melvin- Moderator said:

Would also love to see how this progressed. 

Hey guys, sorry for the late reply here. I was feeling pretty satisfied around the 5 month mark and stopped checking on this site. Now that I'm at 9 months post-op, I'll give a thorough update. I'm also including some pics here, 4 under harsh lighting (bathroom lamps directly over my head and in front of my face) and 3 under normal room lighting.

The density seems okay, and even under very harsh bathroom lighting (with the lamp right in front of my face) it doesn't have much of the "see-through" effect that I was worried about. Under ordinary lighting, and especially not super close-up, I think it looks quite good.

Overall, I would give my result an 8 out of 10:

-The pros: yield seems pretty good, around the 90-95% that my clinic promised. I was lucky to also have thick individual hairs, and a high proportion of multiple hair grafts. They also followed my hairline's natural slight cowlick (I didn't want a perfectly straight/aligned, artificial looking hairline) and I have always styled my hair to my left side anyway.

-The cons: the skin is still rough, and slightly raised, in the recipient area...so I would guess that this is probably gonna be permanent, or maybe it will fade over the years...who knows. Is it what people consider cobblestoning? I don't know...but unless it's viewed under harsh overhead lighting, this isn't super visible. I can mostly just feel it when I run my fingers over my recipient area. Was this due to my physiology, or the clinic placing grafts too shallow and/or not properly trimming excess tissue? I don't know...maybe both, maybe one or the other...I'm not gonna brood over it too much. Another con is that there are a few multiple hair grafts that were placed at the front of my hairline. However, this isn't super visible unless viewed quite closely, so I'm not super upset by that. The redness is also ever so slightly there...but seems to gradually be fading. All things considered, the cons mentioned aren't too bad.

This was an ambitious surgery, with 3000 FUE grafts to completely lower my hairline (all of the recipient area skin had zero hair beforehand; there was no bolstering of thinning areas etc. I didn't even really have much recession; I just had a big forehead with ever so slight "maturing" in the temples). With the surgery, my hairline was lowered by about half an inch in the middle, and over an inch on the sides. All things considered, I'm fairly happy with the result and would do it again if I could go back.

I'll be checking this site from time to time in the future, maybe to look for tips on long-term care, medication etc. But will stop being a regular, since my mission is accomplished. I am taking 1.25mg of Finasteride daily (I use a pill cutter, and cut a 5mg pill into four equal quarters). And I apply topical finasteride once per day, after I shower. I don't have any bald guys in my family, just big ol' foreheads, so maybe I don't need to medicate...I will keep it up for now but might just do it forever in the long term, since everyone does thin out at least a bit sooner or later.

All of you guys, thanks so much for your positivity, and sharing your valuable experiences. This site is truly precious; in a world full of clinics and shills marketing sweet promises to you, it's nice to have a page with real clients sharing their real results and recommendations...without an ulterior motive.

This entire experience of having a slightly-too-large forehead, undergoing surgery, and looking like I was balding for 3 months afterwards has been quite difficult. It made me reflect on a lot. While looks, sadly, do matter...it's important to look past superficial things like hair and see who someone really is.

Thanks again everyone!

[Al - Moderator]

This looks pretty good. You say you are at 9 months, so there's a very good possibility that any bumps or redness will continue to fade over the next several months or more.

 

[Balding Bad]

Thanks for coming back to provide that final update! The results are looking fantastic! Best of luck!