revlipo

I am a surgeon who has practiced cosmetic surgery for over twenty years, my practice never included HT. For the last 13 years I have performed permanent make-up tattooing, in the last 5 years I have done this exclusively. I have thoroughly researched the use of tattooing in the setting of thinning or balding hair patients. I came across this discussion and thought I could probably learn something as well as contribute my own experience and knowledge. To understand the rationale for Pigment Substitution Hair Replacement Treatment "PSHRT" you must understand two basics, pixelation and illusion. I am sure most of you have seen the street art of the person who develops a chalk drawing on concrete that appears to be 3-dimensional. This is the illusion portion, proper shading, dimension and positioning will tell your brain that the image is real - no matter that you see it on a two dimensional surface, this works and is not disputed. The second component is pixels. If you have a good television, you are completely unaware of the millions of "dots" which comprise your picture - yet that is all it is, a group of dots making your brain see an image as a whole - thus the illusion again. In cosmetic tattooing there are several considerations. First, the colors must match the subject and appear realistic and true to the canvas upon which they are placed. Second, the dots ( or pixels ) must be of the appropriate size and spacing to create the desired image, in this case a head of hair. Of course the tattoo dots cannot be made three dimensional, but they can be given the appearance of a 3 dimensional hair - the more talented the artist, the more "length they can create from pigment." There is definitely a limit to how much appearance of length can be created. Certainly a #1 shave can easily be matched, a #2 or #3 is much more difficult. The pigments used today can withstand sun and other insults while maintaining their true color much longer than in the past, also touch-ups can be performed to restore the color intensity. As to what the tattooing is good for, I have seen and done completely bald individuals who were given a completely masculine hair line, they had to maintain any remaining hair very short, but they were happy with the outer perimeter change. Anyone with thinning or a harvest scar can have extremely good results without having to always maintain a shaved head. Color matching is critical and should not be rushed. Women are exceptionally good candidates because the tattooer is simply darkening the canvas to match the remaining hair, there is usually enough hair to make the color the important correction - no need to shorten the hair when there are only patches of thinning or hair loss. The advantages of "PSHRT" are 1. Minimal risk, no incision, local anaesthetic, 2. Healing time of 2-4 days, most patients able to return to normal activities by 2 days. 3. Cost is less, generally about 1/3 that of surgical HT. 4. It can be simply updated, color restored , not dependent upon donor tissue, color can be altered as chosen by the client. 5. No waiting for the grafts to "mature" or grow-in. 6. Far less risk of infection. 7. No need for ongoing medication with their concomitant side-effects. 8. Excellent option for thinning or patchy baldness. The disadvantages of ""PSHRT" are 1. Not real hair. 2. Not real hair. 3. Cannot create significant length appearance. 4. Must maintain close shaved appearance for total baldness. 5. Requires great skill on the part of the tattoo artist. 6. Color and pattern creation are a highly developed art and most tattooers have no understanding of the skill which must be maintained in order to create truly remarkable hair appearance. 7. As one of you pointed out, if you later decide to undergo surgical transplant, the donor area would transfer any pigment placed in that area to the recipient area, causing an noticeable color difference. I am certain that I am forgetting to mention several things, but perhaps this will help to begin the discussion on a much more objective level. Best of luck to all of us seeking to address this problem of not enough hair on our heads and too much hair elsewhere on our bodies.