what really causes ridging / tenting?

[wouldLikeMoreHair]

hi all,

from what I've read, apparently ridging can occur when the excess tissue isn't properly shaved off from the hair grafts, i.e. when the graft is too big for the recipient site. So you'd think this could only stem from surgical errors.. 

 

(sources:

https://www.bernsteinmedical.com/research/art-of-repair-in-surgical-hair-restoration-part-ii-the-tactics-of-repair/#:~:text=As discussed in the section,body's reaction to that tissue.

https://www.hairtransplantmentor.com/what-is-hair-transplant-ridging/) 

 

But the many doctors I've spoken to (and watched videos of) have told me that sometimes it just happens. Not from fault of the surgeon / techs, but just dependent on the patient's skin. And not only for patients that are prone to hypertrophic / keloid scarring, but it can happen to anyone. 

 

What could really be the cause of it? Can maybe adding too much density to the hairline area cause ridging / tenting? 

 

Also, I've found a lot more Asian patients with ridging issues than Caucasians. I wonder if Asians are just naturally more prone to ridging? (I've read that Asians scar more easily than Caucasians) 

 

If there is anyone that experienced ridging/tenting post-op:

• were you prone to scarring? 
• has it improved at all? either naturally or through medical procedures? 

 

thank you! 

 

example of ridging I found from a patient review:

 

 

[mxnprettynice]

This is a very rare and extreme case of ridging. Most ridging is not even detectable by eyes and can be only felt by touch