NicH0le007

If you look through my photos I give a patient history at the beginning. Many of my patients have had transplants. Actually, the great majority. You are correct, ht and smp are a great combination. If you don't feel like combing through the threads you can msg me and I can send some.

Depends on the color, texture, and width of the scar. If the scar is flat and light you should be able to get 90%ish. If it is indented or raised expect 50%. If the scar is very wide it is important to note that you will have to keep it at a shaved look because you can't camouflage the gap. If you let the hair grow around the scar it then looks like a scar with dots...

It should not be a problem. We have many patients who are laser removing smp and are between transplants. I have seen it cause shock loss - but, the hair all back in like normal!

That sounds like my line

Permanent Pigmentation is a great procedure but it is not in fact for everyone. Depending on the circumstance it is much safer to move forward with a semi-permanent procedure vs a permanent change. For example, if a patient wants to do a density effect and they are not willing to take meds the hair loss is not stable. What's it going to look like in a few years. If you go with a permanent route those bald spots will stand out even more because the hair to skin ratio will cause a contrast vs if they had done semi -permanent they would be fading and we could adjust our technique and color to be strategic with the increased loss.

Permanent pigment is not designed to fade. It's designed with large particles that cannot escape the cell they are trapped in. When permanent pigment appears to be fading often its tissue damage above the dermis that obscures the image (its easiest to think of this image if you think of someone you know who has tattoos and tans too much in a tanning bed or in the sun - the image is blurry because of the skin damage in the epidural layer) Or, it was placed too deeply and migrated into the subcutaneous layer where the cells are not as compact and able to hold the pigment together tight with the cells next to it (think being in a closet with 40 people vs 2) and it can spread around a little making the image look lighter. The body attempts to rid itself of pigment as if it were an infection when it is implanted. What is dispelled does so via the lymph node, liver, gall bladder, then ultimately urine or feces. Every pigment manufacturer is different. Some do and some don't. Depends on the pigment company your provider uses.

Maybe Dr. Blake can answer this better. But, the post was on another site I do believe. And, he was still getting the smp procedures at the time. He had been diagnosed with cancer after 1st treatment but before the 2nd. The thing is..cancer does not work that way. It takes years for those cells to mutate. And, he was posting a year after the fact. he was about to be getting another treatment. If it were another acute form a year later he would have been very, very, very ill and or not posting.

Hi everyone, First of all, I would like to apologize for not getting back to you all yesterday like I said I would. Dr. Shapiro and I decided that before we responded we wanted to do some research and find the studies, etc. that Dr. Rasmussen and/or Dr. Pak were citing from. Second, I would like to note that Dr. Shapiro and Dr. Rasmussen have a long working relationship and friendship. We hold both Dr. Rasmussen and Dr. Pak in very high respects. We believe that Dr. Rasmussen is a brilliant doctor and extremely ethical MD. We would like to invite them to please forward us the studies and medical reports in which they found this information because we have done a ton of research and cannot find any document in which anything like this has been reported. The link they provided just brings me to their website. Now, I think they are incredible but we can't claim something as medical fact because we say so...Without the supporting documentation there is no actual scientific proof that this claim in fact occurs. It is nothing more than a personal theory of theirs. I would like to tell you what is proven and absolute about these pigments: 1. The EU has the strictest protocol in the world for the manufacturing, labeling, packaging, and distribution of pigments. Their standard far exceed that of every other country in the world. The EU law ban 1,328 chemicals from the manufacture of cosmetics that are known or suspected to cause cancer, genetic mutation, reproductive harm or birth defects. In comparison, the US FDA has only banned or restricted 11 chemicals from cosmetics. Unlike the US, EU law requires pre-market safety assessments of cosmetics, mandatory registration of cosmetic products, government authorization for the use of nanomaterials and prohibits animal testing for cosmetic purposes .With all these restrictions in place that would make trico pigment one of the safest on the market. It feels like they are comparing their pigment against this pigment but what are they using? Where is it from? And, what are the ingredients? How do we know that their pigment is in fact safe? We invite them to share this information. 2. Dr. Rasmussen loosely made a reference implying that the reason that the pigment is fading is because the silicone makes it easier to slip through the cell walls and are entering the bloodstream and then to the brain. The silicone that he is referring to is actually a semi-silconic membrane and the reason they are using it for the manufacturing of this pigment is actually to protect patients from infections, allergies, or any accelerated inflammation. No known reports or documentation of an allergic reaction have never been made with trico pigment. The fading of tricopigmentaton is caused by the shallow penetration of the pigment implant and by the particle size of the pigment. The particles are small enough to to slip through cell walls and to be eaten by macrophages and then descreted. That's what separates pigments in general from permanent vs. semi permanent. Permanent Pigment are designed with larger particle sizes so they cannot slip out. As long as the particle of trico pigment are small enough to be eaten and dispelled the body can rid itself of silicone. Rapid cell turnover and the slow healing of the basement membrane (epidermal-dermal layer) allowing pigment to be expelled through the dermis to the epidermis for at least 90 days is what makes the shallow poke important. The studies on silicone that people have been quoting saying that it cannot be dispelled are of macro Silicone conglomerates like aka: breast implant. The body has two different reactions to Macro vs Micro amounts of any particle or substance that we put into the body. As far as the claim that silicone is problematic - those claims were thrown out many years ago when the silicone industry won a reversed judgement in court and the medical community was forced to retract their claims that silicone caused cancer, or any inflammatory diseases, etc. It is widely used today. And, preferred in many situations. 3. Iron and Zinc are not dangerous in small doses. They are natural element that are found in the body and responsible for proper function. It should be noted that women who are pregnant are not candidates for SMP because the body will absorb the minerals as if they were a supplement or vitamin. It uses it for what it needs to function at it's maximum potential not because it is damaging anything. The result of this absorption will cause pre-mature fading. When I was practicing permanent pigmentation and or/ am working with permanent cosmetics any patient experiences this pronomina outside of pregnancy I always have them get their iron level tested. We all have and make assumptions about other procedures. The problem with discussing them publicly without fact is that it induces unnecessary panic and distrust. Seems like a biased move made by physicians who have not only publicly stated their dislikes of this procedure but whom also perform the directly competing procedure. Do we know everything about pigments - No. Are their risks - Yes. Any and all medical procedures come with risks. But, the only real medical fact is that is known here is that there are zero reports of any medical consequence that have been made against beauty medical or golden eye. I would like to respond the question above about the person who posted concern about another patient having cancer after getting smp treatments at hasson and wong. If you read the post carefully you will notice he learned of his cancer during the process. Cancer doesn't form quickly it takes years for the cells to mutate and to start presenting problems. Unless, in fact it was an acute form BUT in that case he not have been posting about a year or so later or he would have been deathly ill. That im afraid was a very scary coincidence. SMP is a fairly new procedure medically speaking. We have learned a lot in the last 10 years and i suspect in 10 more years we will have better answers because we will have had time to do studies of the long term results/effect/consequences. Over the past 10 years all of us have made mistakes and struggled to find solutions to common consequences of smp gone wrong. That's what we have been busy researching the last 10 years - it hasn't made sense to research long term consequences because we didn’t have a stabilize the process yet. We were busy trying to keep people safe walking out of the clinic and in the first year. Their group included has struggled with discoloration, migration, and all the other common problems that we talk about. Now that the majority of us have crossed over that hump we are ready focus on long term effects in order to keep perfecting the process. We invite Dr. Rasmussen and Dr.Pak to please keep sharing their medical findings on the permanent procedure as they have been fundamental in the knowledge and growth we have of that procedure today. We will do the same with ours.

Hey everyone, no need to panic! This is not a secret I have personally discussed it many times in the forums just not on its own thread. Both, dr.ron and I are in procedures right now but I will give you the scientific breakdown, etc by the end of the day. The pigment particles are encapseled in a semisiliconic membrane. Long story short the amount of silicone that is in the membrane can in fact be broken down by the body. It begins to be scary thinking about a collection of silicone that could become the size of a breast implant in your brain. I will give all the technicals by the end of the day, today! But, I didn't want anyone to think I didnt see this. I'll be back as soon as my patient is complete!

Great Job, Erik! I love that it's edgy but still looks soft and natural!

No changes have been made with the ink itself since inception. We have better needles and a better machine now. This makes a big difference because it implants the pigment in such a way that causes less trauma to the tissue which should create a bit of extended longevity. The best thing to come out of the time between inception and today is that we are better able to predict what it will do exactly and have tailored our protocols in a way that it should get our patients some more time between maintenance visits. I don't think there will ever be a time that a pigment that doesn't fade will exist without changing color. The law of color won't allow that. With time the body is always going to be able to break down implanted pigment in some way. When that happens instead of it disappearing it starts fading to the most dominant primary color that created it. For instance, black is made of many levels of the color blue and brown is made with more red and yellow. That is why when permanent black smp fades you see blueish tones and when permanent brown fades you see orange. I'm talking permanent like tattoo pigments and permanent make-up pigments. Those are designed to be life long. We really know today that special pigments designed only for the scalp are what's best for smp because the skin on the scalp is so different than skin on other parts of the body and it really requires different properties. The reason I think we see color change with scalp pigments would be because the wrong color was chosen by the technician right off. I've seen technicians choose to put really dark pigment on really light skin and it definitely has a blue hue. This is because the undertone of the skin caused a color change not because of fading. Good technicians are important. We really want pigments that are made with smaller particle sizes so that our body can remove them vs seeing these color changes. They may require some maintenance but at least not repair.

Just so there is no confusion, I have been practicing SMP for 7 years. My first years as a permanent technician and now trico for the last 4. We are the only clinic in North America trained and who will soon be practicing in both tricopigmentaiton and permanent SMP techniques. Currently, we are only offering tricopigmentaiton at SMG. But, after completing an intense advanced training partnering with HIS we will begin offering an alternative permanent procedure hopefully by the end of the summer. This procedure will be also be "semi-permanent" but it will last closer to 2-5 years vs. 6 months to 24 months. We will be offering both the tricopigmentation and the HIS technique based on patient needs and qualifications. Piggy backing on what I said above, as far as using smp to get you through the ugly duckling syndrome. I would only recommend using the trico technique to do this. The reason being is that when your body is healing from the surgery it will affect the SMP in the exact same way as if it were healing naturally on it's own after a fresh SMP procedure. The cells will attempt to break down the pigment as if they were causing an infection. Because the pigment particles are so small they can slip through the cell walls and the body will just rid itself of them. Because the pigment is designed to fade via this exact process it will lighten it and make it disappear worse case scenario. Since, with the more permanent versions the pigment has bigger particle sizes designed to withstand these attacks by being to big to escape the cell walls it might cause a discoloration with pre-mature or forced fading (Particularly, if they use the color black) or because it may migrate lower into the dermis or sub-cutaneous tissue with the incision it might not even form an impression it will just migrate and look like a stain on the skin. Bill, SMP is great tool to augment the surgery afterwards so that the practitioners can use very exact specific patterns to maximize what the surgery could or did not do. But, with trico, since everything is changeable because of the fading it provides more freedom with a beginning point in this type of a scenario. Often if they do it before an FUE, by the time the hair really starts to grow at a year (if they haven't done any touch-ups) it allows for that exact game planning that you are speaking of because realistically over 50% will be faded. The other thing I wanted to mention was that Dr. Blake made a good point above by mentioning that you would not want to do anything in a same day procedure because the pigment would in fact also fill in the incisions during the wiping process. Creating very large and odd shaped impressions that resemble blobs. Also, because the transplant incisions are much deeper they more than likely will be discolored immediately or create that migration stain I mentioned above. (Think touching a marker to a white sheet and the ring of pigment bleeding that causes) It should be noted that even if trico pigment is used if placed too deep it is still susceptible to migration and color change and the guarantee on fading then becomes a wild card. It's very important that you have a completed SMP procedure before you start the FUE. If they cut through a healed SMP (trico) impression it will just fade.

Hi Newbie, This is not a new concept and I'm glad you brought it up. We have been successfully doing many combinations of SMP (Trico) and FUE very regularly at Shapiro Medical Group since 2012. Many patients are opting to do exactly what you are thinking of. They use the trico to get them through the "ugly duckling" stage and/or camouflage a strip scar before shaving their head prior to FUE. Feel free to email me and I can give you all the details. Basically, as long as you wait 4-6 weeks until your smp is completely healed you will be fine. I have all my patients complete a successful start (meaning I have them do three rounds each one month apart) then just schedule the FUE 30 days after the SMP is completed. That way I can plan for the fading that will occur during the surgery. It will not cause any type of bleeding or smudging like mentioned above. Nor does it make the surgery any more complicated for the physicians if they are using surgical loops. We all use very powerful loops that basicly gives us 6x normal vision or "super vision" as I like to call it. Many other clinics are actually doing same days procedures although from an infection standpoint that seems a little risky to me, unless they were working on separate areas of the scalp. Feel free to msg me and I can go through all the details and protocols that you should be looking for. And, I can refer you to some clinics other than us who have been successfully doing this already. Like I said before, you don't have to be too worried this is not a foreign concept and it has been successfully been being done for awhile now at most of the top clinics by top doctors.

:eek::eek::eek: That is the worst idea I have ever heard of or seen. It was strictly made up by people who thought the procedure was too long to perform. And, they were looking for a shortcut so they could attempt to do more patients in one day. Derma Roller + SMP = RUN

It's important to note that to use SMP as a form of permanent concealer that you have to have enough hair for it to look natural. Remember SMP is a 2d procedure (skin, follicle replication). If you add hair into the mix it becomes 3d. Now, that can look great if the hair is distributed evenly. But, if you put hair into a bald crown that has hair around it (for instance) it will be very obvious and unnatural looking. Also, with this technique you need to keep your future hair loss in mind. What happens if you lose more hair? You need to have a future plan in place.

Without a doubt I would go to Brandwood Clinic! Simon Lane and Paul Clark are some of the best in the world.

I would be happy to evaluate your photos if you would like to email me directly. I did post some photos of the back of his head. Are you looking for a different angle? He has 4000 graphs currently and we are hoping for another 2000 at his next fue. It is hard to say at this point how often he will need touch-ups because the FUE will cause some fading. And, although we will start re-touching at 6 months post op he will still be healing. My instinct says we will retouch at 6months and i will re-check at 9months and i'm sure retouch again at 12 months. I anticipate after that he will need touch-ups roughly every 10 months knowing how he likes to keep it looking. But again, that is not in stone. And, due to the nature of his repair we will also move very slow and cautious watching the healing very closely before ever adding more pigment.

Nice, Nice, and Nice! Great work, Eric!

Thank you Arrie!

Thank you for your kind words. No, I do not make my thickening patients shave down. I have them cut it to the shortest lengh they are ever going to wear it at that time. But with the understanding that if they ever do plan to shave down they will need to make an appointment for blending.

Hi! No, this pt has had 4 FUT. The last one was in 2004.

Tricopigmentation

Hi Lorenzo, Have you discussed this with Dr. Hasson or Dr. Wong? I'd be very curious to see what their thoughts are. I am going to pass this on to Dr. Shapiro to get his thoughts as well. Off the top of my head, I'm guessing the pigment that you had stay for longer than 3 years is due to the fact that in 2012 both the ladies from H&W (and us) were very new to learning tricopigmentation. And, we were using a different machine and different needles then. I'm thinking (I know) perhaps that machine was more aggressive than we realized (due to lack of experience) and the pigment was placed deeper than .05mm. Since 2012, we have a new machine with a much slower speed, a new needle and much stricter protocols. The old needle that was used in 2012 would make an incision and the pigment would sit and pool at the bottom of the site. Now, the needle is a bit jagged on the sides and pigment does not collect at the bottom but sticks to the sides of the incision. The reason this is better is that the pooling pigment is much more prone to migration. All the pigment is still the same as 2012. You know, the pigment we use is manufactured in Europe and according to EU regulation they are not allowed to manufacture any pigments with any material that has been proven to be a carcinogen. Their standards are much higher than the US FDA (or, anywhere in the world) and the industry is regulated. But, I always like to remind us that no procedure comes without risks. Yes, pigment is ultimately filtered through the lymphatic system. But, does this mean it collects in the lymph node - NO. The thing to remember is that our pigment is manufactured with microns below 15 so they can still slip through cell walls and the body rids them by process of phagocytosis. The study that many people are quoting was a FDA case study done with tattoo pigments - which are very different in chemical makeup than our medical grade pigments. It's the heavy metals used in tattoo pigment that sat in the lymph nodes and caused problems. Also, remembering that tattoo pigment has a micron size above 20 so the pigment cannot escape the cell wall. And again, pigments +ink manufactured in the US are not regulated. Again, I'm going to run all this by Dr. Shapiro and get his opinion because I'm not a MD. I hope you will keep in touch with us (me in particular) and let us know what the MD's at H&W think. And, keep us updated on how you are doing.