Unusual complcation after hair transplant

This patient had a hair transplant. As I don’t have pre-operative photos, I am stumped in understanding how this developed. I suspect he had this before surgery, but without photos, it is impossible to know. Dr. Robert Bernstein defined the two permaters that must be evaluated here: https://journals.lww.com/dermatologicsurgery/citation/2017/04000/commentary_on_association_between_scalp_laxity,.15.aspx

I suspect that this patient had a problem that was not detected prior to his surgery.  A corrective procedure may be necessary. This condition, known as Cutis Verticis Gyrata, can be seen clearly with an excellent photos in the article here : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008067/