Hair Tattooing - Scalp Micropigmentation

[hairthere]

I think he meant it was "good" of you to check in.

[Davis91]

Hi Dr. Rassman,

 

Yes, did not mean to put you in deity status! "Good" of you to check in. I fully agree that a great way to check outcomes is to see patients in person. However, as you can imagine for the majority of people outside of your area, making a specific trip may be difficult. All I and others who share a similar position ask for is a little more transparency. I am specifically referring to taking videos of SMP scar repair. The few videos that are out there seem to avoid more than a few seconds of showing a SMP type scar repair (per earlier posts in this section), and they are of dubious quality. While potentially promising, we need more information. Quality video is a way to help us. The same with FUE into scar results. While this is not a post on that subject, I believe that the doctors/companies that find a way to capture the market for HT scar repair will have a very steady business line for awhile. But these are early days for SMP and to an extent FUE's into HT scars. Time To Do Something's search echoes many other similar ones here, and probably countless others who sit quietly trying to figure out how to undo a mistake, or enhance a partial outcome. WHen that one company or doctor sets the gold standard for transparency on results, we will know it.

[Dr. William Rassman1530037930]

I spoke to Dr. Pak about videos and will focus on the few patients that will permit the filming. I have a face mask that might help them sign our consent for video. The suggestion is good. At our next Open House, I will ask the SMP patients if they will participate in a video and will be prepared to 'shoot it'.

 

A patient with FUE scars came in after he tried to shave his head and found visible scars. He kept his hair longer than he would have liked. See pictures here: Picture 9999 « Album 3 « Gallery 26 « Gallery – SMP for Scalp Scar | Scalp MicroPigment SMPScalp MicroPigment SMP. The doctor who did his FUE must have used a larger punch (possibly 1.25 or 1.5mm). What this photo shows is that the FUE does have scars associated with it (FUE is not without scars). The smaller the punch, the smaller the scars. Notice the before and after SMP pictures. It looked much better and he was able to walk around with his head shaved after the first session of the SMP. The scars that remained, can be seen if you look carefully. Another session would be a good idea for him to close up the remaining 'white' areas.

[gillenator]

In my own experience of observing tatooing in the scalp for "any purpose", repair or cosmetic, you want to see the results "in person". :rolleyes:

[Dr. William Rassman1530037930]

I agree that in-person viewing is the best way to understand the process. Today's patient was asked if he would do a video with us and speak about the experience. He has had two FUE procedures in the past, some incomplete as he lost additional hair. He had SMP to treat the FUE scars in the back of his head (the initial results looked great and I could not see the FUE scars when I was leaving today. Dr. Pak just started on his front, top and crown. The patient promised to come to our next Open House for those who want to see his results.

 

For those of you that can not or are not willing to come to Los Angeles, maybe the video we will do and telephone can help even more (skype call). Will that be a reasonable substitute. Thoughts?

 

As an aside, if I were going to do it and the only person doing it as in Texas, Florida or NY, I would fly there to see for my self what I would be getting into. I always tell patients that much of what we do (hair transplants and SMP) is not practically reversible. The cost of a trip is far less than making the wrong decision. Recognizing this, we offer a travel reimbursement program to rebate you up to 5% of the total fee paid to us for travel expenses. That would reduce your costs and it would even apply for a consult visit.

[Davis91]

Hi Again,

 

Sorry to be a frequent commentator on this one. I also agree that there is no better way than in-person consultations/viewing and the cost are justified for the reasons stated above by Dr. Rassman. Telephone consults are also helpful. I think the key here Dr. Rassman is that there are a limited number of options for SMP--basically the names like NHI, Good Look Inc., and HIS get floated with a few others. The issue is if a reader had to pick just one to visit or they could only afford to visit one, what information is being presented to them in a transparent, honest way? The ultimate test (for me anyway) is how they present pictures and videos, and whether it seems like too much of a sales pitch.

 

The original poster to this subject got a bad impression from GLI due to their agressive marketing pitch and inability to answer some questions. On the other hand, you and your team are medical professionals who can probably answer these questions more easily. However, GLI tries (it seems) to take photos in a consistent lighting and with a consitent angle-sometimes not a NHI strength. Here we have a very new part of the transplant-repair game and very few players. Someone needs to step up and become the gold standard here, and no one has done this yet.

 

As you say Dr. Rassman, what happens here is an easy thing to reverse--indeed SMP may be more difficult to reverse from a cosmetic standpoint than a bad transplant. To help add to our information, you have offered to make videos which is great. May I please suggest that the FUE fill in videos are helpful, but the strip scar SMP videos will be equally if not even more important! Let me give you an example of what I think most viewers would react to negatively--see this link and fast forward to 1:04, when exactly 3.5 seconds worth of the strip repair is shown and then some funny camera shaking goes on. Its like a magician waving their left hand to distract the audience to what is going on with the right hand! Go to the testimonial section in the middle and open the video on the lower (viewer's) right title hair transplant scar repair:

 

Video Gallery | Good Look Ink

 

3 seconds out of a 3:50 second video showing the final product. It all looked so promising until we are forced to ask, "why will they not show the strip scar on video in a reasonable way??!"

 

Sorry to carry on. I tell you Dr. Rassman, if you produce some quality videos of strip scar SMP repair, I will be on the next flight to L.A.!

[Davis91]

Sorry, meant to say what happens here is NOT an easy thing to reverse.

[scar5]

Dr. Rassman,

 

I agree with Davis here. We need clear videos or pictures of strip scars which have been treated.

 

Fixing FUE scars from old 1mm or larger punches is obviously a great thing, but the part that speaks to improving (and I wont say "fixing", because I think that might be impossible) strip scars is where many of us are dwelling and hoping.

 

And to all readers.

I wonder if the companies that are 'early runners', AC, GLI, HIS etc., are going to improve in the their marketing approach. So far, I suspect, some of them are doing everything we don't want, including,

 

1) Going on national TV or local TV programs and telling everyone about tattooing heads. The consequences for guys, (duh..we live in a competitive world) is...? Guys are not gonna say, "wow, how sweet, he tattooed his head, now I wont tell anyone" they are gonna say, 'thanks very much, i got you boy"

2) One of them, at least, with dirty web search engine tactics that make all of them look bad.

3) Posting videos supposedly about strip scar repairs, that as has been suggested, are an insult to anyone who has to live with a strip scar and is looking for realistic solution. If anything, arousing our suspicions.

4) Being vague where it really counts. i.e., when we need to see what happens with hair

5) One, of them, we can reasonably suspect, coming onto boards like these in disguise.

 

 

 

And all the while, it maybe that what they have to offer could really be helpful to us, if they learn to present and compete with better manners.

 

I hope this thread and threads like it help 'raise the bar' and we must remember guys, it is fantastic that Dr. Rassman has added to the value of the thread, I wonder what the other companies can do about it, given that they, as non-medical companies, have no hope of being part of the coalition and being represented here.Unfortunately, I suspect, we have only seen some shoddy attempts to break in so far.

 

I guess the HTN heads have wondered about what the appropriate way would be for these companies to participate, being that so far, I suspect we've only seen the 'rough side', and if there is a 'sweet side' then how be it they can show it?

 

I am wary and loathe to promote the concept of tattooing, but I have already tried a bit of it, and I want to get 'fixed'. So take all my comments in that light.

Edited March 10, 2012 by scar5

[Dr. William Rassman1530037930]

We are indeed the only medical group that offers SMP. As a doctor, we have the best interest of the patient at heart, not how much money we can get out of everyone who comes our way. I think that you would find that we (Drs. Pak, Bernstein, Shapiro and some others) take the view that the patient is king and our job is to serve the patient. I know that our group and Dr. Bernstein reject many patients for surgery (including SMP for us) because they are too young, have unrealistic expectations or frankly are not willing to educate themselves in the preparation for such procedures). One day I will tell some interesting stories from the patients we reject for surgery or SMP (for the above reasons). We will try to produce better videos and other visual aids to help you understand the process better.

 

William Rassman, M.D.

[TakingThePlunge]

Dr. Rassman,

 

Thank you for taking the time to address the concerns of this community regarding scalp micropigmentation. Like many others here, I am intrigued by the possibilities SMP offers but have been left unsatisfied by the lack of unbiased documentation currently available.

 

I am most interested in the procedure as a permanent concealer and adjunct to hair transplantation. If you wouldn't mind addressing one more question. For someone considering SMP to add density to a hair transplant, do you recommend that patients wait until they have undergone their last hair transplant before having SMP? In other words, is it advisable to have a hair transplant over a scalp that has been tattooed?

 

As it's only a short hop to LA from my home in Arizona, I may try to attend one of our open houses at some point in order to meet some patients and perhaps get to view a procedure in person.

 

Thank you again.

[aaron1234]

Plunge,

 

That would great if you did that - and even better if you did some video documentation of your visit! Going above and beyond your duties as moderator of this forum!

[Dr. William Rassman1530037930]

The question, 'which comes first' is a good one. The answer to this is not an easy one. From our experience, I think that seeing the problem will allow us to recommend the path. There is no difficulty performing FUE after the Scalp Micropigmentation (SMP). What I have been doing is to do a test area and then see if the problem is solved in the test area to your satisfaction. The SMP solution is often less expensive than the transplant solution to the 'to thin' problem often experienced by transplant patients.

 

In my earlier communications here, I discussed realistic expectations. If you compare SMP to the well known concealer Toppik, there is no real comparison as it is an 'apples to oranges comparison'. Toppik is superior for blanketing the scalp with color so in many ways, it reduces the contrast between hair and scalp better at the expense of giving the SMP client a painted look. SMP, on the other hand, are micro-dots at or slightly larger than the cut end of a hair and these 'dots' are placed close to each other. There is white space (assuming a fair complexion Caucasian) between the dots as seen in: Picture 9999 « Album 2 « Gallery 9 « Gallery – SMP for Thinning Hair | Scalp MicroPigment SMPScalp MicroPigment SMP (expand the photo). This is not a solid color application. Some of our prospects wants more of a blanket of color, but that is not what I recommend, not at all. In fact I often have to push on this very point, something that our Toppik users do not want to hear. If the patient in the photo used Toppik, then there would be a 'black' scalp. For African Americans, this is not a problem but for those individuals where the contrast between hair and skin is high (the woman shown had black hair), so realistic expectations are very important. If the applications of pigment have many repeat sessions, there is a bleeding effect as the color may spread to the skin producing a situation far less satisfactory.

 

For many patients who are out of donor hair (we have done a few of these) the SMP process may work out well. I know you are all worried about scars, but if you review the scar section of the above website, you will see some bad scars where the scars have almost disappeared. If the patient wishes to keep the hair long, the scars are well hidden below the hair. I would encourage you to make the trip from Arizona to our next Open House. Schedules are at: Upcoming Events - NHI.

[scar5]

Picture 9999 « Album 3 « Gallery 4 « Gallery – SMP for Scalp Scar | Scalp MicroPigment SMPScalp MicroPigment SMP

 

Scroll through picture 1,2 by hitting, next>next> to Picture 3 in this series.

And look at the hairline! That is the good as far as I am concerned.

 

The hairline is graduated and soft. Even Rassman's opening SMP page shows a result far worse than this IMO, because the hairline is too bold, as are most of the hairlines and temple points on SMP/ (MHT (or whatever HIS call it)) seem to be at least as far as I've seen on white or high-contrast guys' heads.

 

Why/how could they achieve it here, and 'not there' and would/could they do that for me. Now I am thinking.

[Dr. William Rassman1530037930]

Most clents request a natural hairline regardless of whether it is Scalp Micropigmentation (SMP) or a hair transplant. But there are others patients who think that a flat, low and solid line is what they want, but this is just not normal. I always discourage flat, solid and abnormally low hairlines and try to educate the patient on this very issue. Unfortunately, inexperienced hair transplant surgeons or SMP tattooists, don’t really understand what constitutes a natural hairline. A natural hairline should reflect a transition from a bare forehead to the thick hair that we normally have on the top of our head. A transition zone must be built and it is eased from no hair on the forehead to thick hair on the top of the head. If you look at the normal non-balding man or woman, there is no hairline, but there is a transitional zone in the front. Creating the zone is an art form that took me years to perfect. The pictures in cited by 'scar5' above, shows the zone reasonably well.

 

I can not answer this question without showing you one of the baldest men I have ever transplanted: Full Face Photos - Patient - NHI. He wore a wig for most of his life and had no idea where his natural hairline belonged. The challenge here was to create a natural looking hairline. This is an artistic process that takes years to perfect.. and it is in the hands of the surgeon or the SMP operator. I would recommend that everyone investigating hairlines, to (1) meet patients up front who had SMP or transplants done, or (2) look carefully at the pictures offered on the websites. We often repair the unnatural hairlines that other SMP operators have created. We recently had one such patient and we removed the frontal hairline because it was not natural and could not be repaired by SMP alone. Then we rebuilt it. If the hairline is not graduated and soft, the person doing the work may not be the artist for you.

[Jholcollege11]

Hey everyone, thanks for all of your posts. I have been reading and learning. Im a 30 year old man, almost 31, and I have fought MPB for 7 years. Also have been on finasteride and rogaine for 7 years. I have done alot of researching on three companies- HIS, Good look Ink, and Artistry Concepts. HIS just seems too fake looking to me, Good Look Ink looks pretty good and have alot more professionalism, and Artistry Concepts seems to be good but when I called I got one of their techs or artists, and he was not helpful or professional at all. Also their pics look doctored and I've read some other posts and they had similar experiences. I really want to have this done and alleviate my number one concern. Im looking at booking good look ink appointment in Minnesota but I still am not 100 percent. Also all I seem to be finding on these forums are undercover people from each of these places talking crap about each other and as for the horror story experiences that I keep finding about each of these businesses, for all I know they are BS as well. Anyway, thanks in advance to anyone who has feedback for me.:confused:

[Davis91]

J--11,

 

YOu seem pretty set on one clinic--but what makes you less than 100% at this point?

[Jholcollege11]

Well I guess it is just the permanence of the procedure, the newness of it and not having an example of anyone who has had it done 6-10 years ago, as well as different posts I've read that say negative things about each of these places. I also have this fear that I will spend 4k and be more self-conscious than I already am with thoughts like "I wonder if anyone is staring at my head and noticing these dots." That is the reason I want it, to silence those kind of thoughts and concerns so I can worry about whats important. IDK, maybe that is an immature way of looking at it, but I just want to feel confident again (and I know thats what everyone says lol).

[Dr. William Rassman1530037930]

The best way to determine what you are going to look like after Scalp Micropigmentation (SMP), is to meet (one on one) with people who had it done. The New Hair Institute makes this opportunity happen once a month where people have have had procedures (hair transplants or SMP) come to talk about their experience and allow prospective patients the opportunity to look at them up-close (Upcoming Events - NHI). Some times we will actually be performing SMP at these events. Would it be worth a visit to Los Angeles to see what I am talking about? Well, if you declined to do this diligence and things went wrong with the choice of who does it, you will have the results of a poor decision for the rest of your life (it is permanent). If you elect to take me up on my suggestion, please call in advance to make sure that at least one SMP patient was scheduled to be at the next open house event.

[Jholcollege11]

Thanks Dr. I appreciate your feedback. My biggest concern at this point is that it will change effect in say, 10 years or less. I would hate to see these tiny dots merge together and create a large ink mess. I have been told by Darren at GLI that if I come to Minnesota he will show me plenty of people in person who have had this procedure- my concern with that is that they will probably all be employees who have the benefit of having touchups at any time, and I will not know when the last time they actually had any work done. Artistry Concepts in FLA seems to have a good system- and are very up front about needle size and pigment- but that is all. They are very guarded and not willing to offer much info over the phone. Also the tech who had his head done has a big horse shoe bald spot, and that is a red flag and also probably the reason they have zero pics of the back or crown of the head in any of their image gallery. As a physician, in your med opinion, could this type of procedure-scalp micropigmentation, ACHM2, CTHR or whatever they choose to call it- possibly do damage to the scalp that could prevent either of the new biotech companies' future solutions like Replicel or Histogen?

[Dr. William Rassman1530037930]

The depth of the needles is not deep (significantly under 1.5mm) while the hair follicles reside in the dermis which is well below the area where the ink resides.

 

This solution is not for everyone. Patients fall in two general categories (1) those who have had no surgeries or surgical treatments and (2) those who have had surgeries in one form or another and have problems that they perceive from these surgeries. These two patient types are very different. Those with problems following surgery may find that the solutions that they think are best solved with SMP, may find other solutions including another surgery like an FUE procedure might be an alternative. Of all of the groups offering some form of pigment treatment, we are the only medical group that specializes in medical and surgical hair restoration so the options in my command reflect 21 years of experience performing hair restoration and defining the FUT, the FUE and the megasessions in the medical literature. By our nature, Dr. Pak and I are creative thinkers and can think out of the box as we examine every candidate for SMP (for example) and first and foremost, we try to get into the head of the prospective patient like any good doctor would do. Turning someone down for SMP (or transplants for that matter) for unrealistic expectations reflect the judgments we make every time we meet a new patient and it is never a financial decision on our part.

[Jholcollege11]

Thank you for that info. I looked through my emails and I did receive a quote of 6k from Dr Pak and he explained the touchups and out of town 500$ one time credit. I like that you are Physicians and have extensive hairloss treatment exerience. The price is about 2 grand higher but that would be worth it if your clinic could produce better results and longevity. Could I email you my scalp pics and see if you think id be a good candidate? Thanks again

[jonny5]

Maybe I’m missing something here, as all I’ve seen mentioned on this thread is NHI and GLI. What about His Hair Clinic? As the pioneers of this kind of treatment they must have treated thousands of clients.

 

From what I can see they have been in business for 10 years where as everyone else around 2 years. I’ve read that Dr. Rassman went over to Birmingham to their clinic and then decided to offer a similar service, hence SMP was born. Is this true Dr?

 

I live in the UK so when I decide to get it done then it will be with the company that invented this kind of procedure, have been doing it the longest and that’s HIS. If that were a company overseas then I’d make the trip to get it done by the best.

 

So what’s everyone deciding factor? Location? Or the fact that some Dr with a medical background is offering it?

Edited March 26, 2012 by Future_HT_Doc
removed outside link.

[scar5]

Yeah, I'm with you on the 'experience counts' end of it, but going with the 'pioneer' is not always best. If we went with the pioneer of FUE we would all have to fly to Sydney, Australia. The Japanese invented hair transplantation and I don't see too many guys on their way to Japan for an HT around here. (maybe they should??)

 

In fact, HIS is not even the pioneer. People have been simulating hair on their heads for a long time. I had it 2003 and booked it in 2002 at my local cosmetic tattooist. (results were poor, (laugh now))

 

The 4 things that got me looking at Rassman as opposed to HIS is/were;

 

a) HIS exclusively do skin heads and I don't wanna skinhead.

b) Rassman can combine HTs and has HT know-how. I have had HTs

c) Local anesthetic can be given. SMP hurts. I know.

d) More likely I know who will do my procedure and his/her experience

 

The thing that makes me go for HIS is, as you point out,

a) They have 'miles-on-the-clock'

b) Despite Rassman and others doing hair+ink rather than just 'better shave it buddy' , I am getting increasingly confused about the merits and possibilities of combining hair and ink. I suspect a 'bait-and-switch' thing could easily develop - unintentionally perhaps. Bit like the old 'Come in we do FUE, wait, let's see, Mnn, we recommend strip', except in this case, 'Yep, our pictures show hair, it's great, mmnn, let's see, we recommend you shave for the full benefits of SMP." type BS

 

Anyway, here's a new kid on the block and

 

Hair pigmentation

 

a very interesting read, especially viz-a-viz, permanent ink, vs soluble inks.

[Time to do something]

Hey everyone, thanks for all of your posts. I have been reading and learning. Im a 30 year old man, almost 31, and I have fought MPB for 7 years. Also have been on finasteride and rogaine for 7 years. I have done alot of researching on three companies- HIS, Good look Ink, and Artistry Concepts. HIS just seems too fake looking to me, Good Look Ink looks pretty good and have alot more professionalism, and Artistry Concepts seems to be good but when I called I got one of their techs or artists, and he was not helpful or professional at all. Also their pics look doctored and I've read some other posts and they had similar experiences. I really want to have this done and alleviate my number one concern. Im looking at booking good look ink appointment in Minnesota but I still am not 100 percent. Also all I seem to be finding on these forums are undercover people from each of these places talking crap about each other and as for the horror story experiences that I keep finding about each of these businesses, for all I know they are BS as well. Anyway, thanks in advance to anyone who has feedback for me.:confused:

 

 

Ask them if for some reason you need to have the ink removed if that can be done with a laser without damaging the hair folicle. They refused to answer that question for me. If they say yes get it in writting. Let us know what they say. Good luck.

[Time to do something]

Thank you everyone for your great responses to my post. I am the original poster on this topic and just read through all of the responses which brings up a few questions and observations. I was initially quoted $1500, then $3000 now I see one member here was quoted $6000. This is getting as expensive as a hair transplant. I had the unfortunate experience of going to a highly recommended surgeon on this site who did a job that produced few results. He offered a second one free which I accepted and that produced few results as well. This doctor refused to offer a refund even though other doctors said I did not receive the benefit of the number of grafts placed. That not only destroyed about 5,000 irreplaceable grafts but also drained my bank account of $10,000. The doctor felt his work was adequate.

People on here were shocked at the photos I posted and shortly after that this doctor’s membership on the site was revoked. I’m told because of my results and results of other patients around the same time period. Dr. Shapiro followed my story and knew I had gotten the short end of the stick and performed two more procedures on me free. His work has been effective. I have another six months before I can say the last procedure is mature. I believe that I will be close to a cosmetically acceptable result but still need something to make the density appear thicker. Since my donor supply is exhausted SMP is my last hope with current technology. However, if the price is now $6000 I am priced out of the market. This five year journey has been very frustrating and now I feel so close but still so far due to the current cost of SMP.

One poster commented on the idea of a non-permanent ink solution. I like that idea. Would the color of the ink be different if I wanted to keep some length to my hair vs. keeping it shaved? I am so glad that Dr. Rassman contributed to this thread. If I have this done one day he is probably the one I would go to since it is medically supervised. He did seem to contradict himself and was wondering if he or someone could clarify a couple of statements? In one post Dr. Rassman says “tattoo removing with a laser works reasonably well”, then in another statement he says “, much of what his clinic does is not practically reversible”. Which is it? And if the tattooing can be removed with a laser is it the kind that will not damage the hair follicle? Remember one type of laser is used specifically for hair removal because it kills the follicle.

Dr. Rassman said two to three sessions will be needed. How far apart will those sessions be? There was another question concerning whether the SMP should be done before or after an hair transplant. I would say if one gets SMP done before a hair transplant they are going into the hair transplant with the notion that the finished result will not provide enough density to be cosmetically acceptable. I would get the hair transplant first, let it mature and see what the final results are. To me getting the SMP before the hair transplant is putting the cart before the horse. What if the hair transplant provided an acceptable density, then the SMP would have been an unnecessary procedure. I think a hair transplant and SMP can complement each other. I don’t think SMP alone without the texture of real hair is as convincing as SMP alone and a hair transplant without the illusion of adequate density is not as convincing as a hair transplant alone. In addition, even if one did want to get the SMP, I believe if it is done after a hair transplant the SMP artist will be in a better position to know what they are working with as far as final results of hair density and can better match the SMP with the available hair. This could all be argued the other way around too but this is just my opinion.

I noticed another contradiction here (it may have been between Dr. Rassman and another poster) that indicated for longer hair dots are not recommended but more of a blanket of ink. Then Dr. Rassman said he recommends dots not blanket color. I like that Dr. Rassman pointed out that a natural hairline has a transition and is not an abrupt thick wall of hair across the forehead. Natural hair is thinner at the hairline and gets thicker on top of the head. What to do oh what to do!