20 days post op and noticing small bumps where grafts are. Is this cobblestoning or pitting? (photos)

20 days post op 1218grafts for fixing hairline just noticed bumps around the grafts and was wondering if they were placed properly or is the work okay. Here are detailed pictures up close please let me know how you think the transplant work looks.

Doctor Answers 7

Is this cobblestoning and pitting in my recipient area? Yes it is.

Dear euroboss,

Thank you for writing in with your question. The short answer is yes, that appears to be both cobblestoning and pitting. I’m just looking at these pictures, however, and I may have different comments if I saw you in person.  A visit with your hair restoration surgeon is indicated to investigate further.

If indeed it is cobblestoning and pitting, it is most commonly caused by a failure of the hair restoration surgery technicians to remove the cuff of skin that comes out with all FUE grafts extracted with any device. That cuff of skin, if not removed using a blade and a dissection microscope, then heals into the new location, and many do not heal in completely level with the surrounding skin. It’s a well-known and elementary part of any hair restoration procedure to remove this cuff of skin no matter how you’re going to perform a hair restoration. The cause, of course, is inexperienced technicians, an inexperienced doctor, or both. Any doctor of any background, surgeons and non-surgeons alike, may purchase an ARTAS system and the very next day claim they are hair restoration experts without having performed a single procedure in their careers. The use of any particular machine or device absolutely does not guarantee good or even acceptable results. It is the experience, dedication and talent of the physician and his team that will determine the results. Every time. Clearly It pays to do a lot of research into your choice of provider.

That being said, the silver lining here is that it you’re only 20 days post-op. The skin will continue to change and remodel over the next 12 months or so. The redness will fade, and the cobblestoning and pitting should be minimized. You’ll be about 80% there in 6 months, with the final 20% of re-modelling occurring in the final 6 months.

I hope this information is helpful to you.

Atlanta Hair Restoration Surgeon
5.0 out of 5 stars 153 reviews

Pitting post operative FUE

It does appear there is some pitting.  However, I'd be patient as there will be a lot of changes that take place over the next few months.  If you are really concerned, I recommend you visit with a physician in person for an evaluation. 

Justin Misko, MD
Lincoln Hair Restoration Surgeon
4.9 out of 5 stars 16 reviews

Small bumps at graft sites 20 days post-op


Some of the grafts look a little depressed. This may not represent anything significant. It is far too early to start worrying. Would recommend that you follow up with your doctor. The tincture of time may bring the growth and results that you are looking for.

Bernardino Arocha, MD, FISHRS
Houston Hair Restoration Surgeon
5.0 out of 5 stars 10 reviews

Post-op bumps

It does appear that there is some pitting or depressed grafts,however it is very early in the process and tough to comment on whether or not this will have any effect on final growth.It is also difficult to fully evaluate based on a photo as opposed to a face to face evaluation by your surgeon.More than likely with time this appearance will lessen.

David Deutsch, MD
Beverly Hills Hair Restoration Surgeon
5.0 out of 5 stars 43 reviews

Yes it looks like it

Yes that looks like cobble stoning and pitting based on the photos.  Of course the best thing to do is to followup with your hair transplant surgeon.

Amir Yazdan, MD
Irvine Hair Restoration Surgeon
5.0 out of 5 stars 24 reviews

You should see your doctor for a recheck and exam. The bumps can be scarring but you really need an exam to confirm this.

You should see your doctor for a recheck and exam. The bumps can be scarring but you really need an exam to confirm this.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 99 reviews

20 days have pitting of your recipient area

You need to speak with your doctor about what you are seeing. There should be no pitting on the recipient area at 20 days or in fact, anytime after a hair transplant. 

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.