Dr. Ron Shapiro FUE 2194grafts/3754hairs After SMP

[Janna]

[aaron1234]

Janna, I can't remember ever seeing a post with SMP followed by SMG!

 

This is a great case for us to see. I like the color/shade of the SMP though I think the FUE in the hairline will help soften the front up a bit.

 

Where did he have the inking done? GLI?

 

Very interesting case. Looking forward to following it!

[BadBeat]

What's amazing to me is just how clean Shapiro's FUE procedures are. You can barely even tell anything was done 3 days post op.

[Janna]

Hey Aaron,

 

Yes, he had SMP done at GLI. The planning and design of the hairline and where to have the SMP were all discussed with Dr. Ron prior to any work.

 

It is an interesting case and since he's local, he'll stop by Shapiro Medical on a regular basis to update everyone.

[aaron1234]

Sounds good Janna! Pardon more questions... Was is different or difficult to work on an inked up scalp? I always assumed that SMP would have been better post-transplant rather than pre-transplant. Also, if you are moving grafts from the donor region do you feel that the uninked skin tissue on the grafts would stick out at all? Little white dots on a black surface perhaps? THANKS!

 

Love the temple points. I'm a little surprised that GLI didn't address at all. Should I be?

[Janna]

No problem answering your questions Aaron.

 

No, there are no differences working with the inked up scalp nor does it make it more difficult to work with it. Since the transplanted tissue basically dries up and falls off, it's a non-issue.

 

As for the temple points, Doc did not want the SMP in that area but felt real hairs would be best.

 

We put together couple pics of the SMP close up to show the dots and counted the number of dots. The hairline shows less dots, which would be appropriate.

 

[Spanker]

I wonder if this could be the future for high contrast patients to be able to level the playing field.

[Sean]

I am excited to see this on here. It shows how FUE with SMP can work together successfully. It looks very natural. I really think SMP (if done properly) along with a successful hair restoration procedure can certainly give a denser look. Might really change the way we see illusion of density. This is great case Janna and a very valuable thread. Thank you for being the first to showcase this. I can't wait to see the updates.

[Janna]

Hi Spanker and Sean,

 

I agree that when done appropriately and on appropriate patients, SMP can be a good adjunct to FUE or Strip procedures. This patient is local to Shapiro Medical so hopefully he'll check in on a regular basis.

[TakingThePlunge]

Janna,

 

Thank you for this! I have also been waiting to see an example of hair transplantation where SMP was actually a part of the plan from the start. This is fascinating and I'm very happy to hear he is local. I hope we'll see a lot more of him as his results progress.

[StaggerLee123]

For guys that absolutely feel like they have to shave their heads this is the way to go...

[aaron1234]

True, though I feel guys with longer hair could possibly benefit from this as well.

[azazelgs]

I can't believe it's the first time I have seen this thread , I was dying to get an info like that!

 

Janna, if you don't mind I'd like to ask few questions;

 

1- Is there any specific reason why the hairline designed so high and conservative?

 

2- Do you and Dr. Shapiro recommend this type of combinations for a patients who prefers buzz cut?

 

3- Can a patient trust SMP with FUT/SMP combo? I mean if someone to plan more grafts with FUT and count on SMP to cover the scar, would that be a wise choice?

 

4- Are there any more examples of Shapiro Medical Group that done HT/ SMP cases?

[Janna]

I can't believe it's the first time I have seen this thread , I was dying to get an info like that!

 

Janna, if you don't mind I'd like to ask few questions;

 

1- Is there any specific reason why the hairline designed so high and conservative?

 

2- Do you and Dr. Shapiro recommend this type of combinations for a patients who prefers buzz cut?

 

3- Can a patient trust SMP with FUT/SMP combo? I mean if someone to plan more grafts with FUT and count on SMP to cover the scar, would that be a wise choice?

 

4- Are there any more examples of Shapiro Medical Group that done HT/ SMP cases?

 

Q1 - This patient is 30 yrs old and he is already a NW4 with hairloss still progressing. He himself wanted to do the SMP conservatively since there are questions still unanswered. We felt this was a wise move as you can always add in the future depending on the rate of his hairloss. If he's able to slow it down with ht medication, then he may be able to bring the hair line down. I recall he was very pleased with the outcome right after his fue session.

 

Q2 - Dr. Shapiro feels SMP can be an option worth researching for those who want to keep their hair buzzed and are high NW levels. And, these patients would normally use concealers. We inform our patient of the different options available to them but have them research and decide for themselves if SMP, surgical, or medical therapies, or a combination is right for them. It's really a case by case basis on what's best for that individual.

 

Q3 - That's a tough question to answer because we don't know the answer to that yet. While the SMP helps the donor scar, we don't know how long it'll last. We do not know if it'll change color or fade too fast since scar tissue is different than normal skin tissue.

 

Q4 - Yes, we have several more patients but I've been able to locate just one of them. It's the best one to post anyway as we have pics with his head shaved. The other patients have long hairs so it's difficult to tell and we do not have before SMP anyway. I'll post pictures here next week when I get a chance to put them together for posting.

[Sean]

Thanks for such a great explanation Janna. Will this patient be coming in sometime soon for a follow up? I really hope to see/hear about his progress and how everything looks.

 

I also am unsure about FUT scars and having smp in that area. My uncle wants to get rid of his 3.5 bosely scars ,but he doesn't know if SMP would be a good alternative. Some people have mentioned that since the scar is not like the surrounding skin and is a highly sensitive area, that you have to pigment it at the right depth or the ink itself may bleed since it's scar tissue. So, there is a possibility depending on the type of scar, whether hypertrophic, atrophic, keloid, or contracted, that it may affect SMP and its benefit. The other thing that I think about is if the scar repaired with SMP will be permanent and if it will be visible with a different colored outline as we age. Grey hairs all around the scalp, but then there is a distinct line of discoloration showing in the scar area. That's another concern I had.

 

It's great to hear that Dr. Shapiro sees SMP as an option worth researching for buzzed hair and higher norwood levels. You mentioned you had several patients that had SMP but you didn't have shaved pics of them and couldn't locate them. Do you recall any of those patients having longer hair and if it looked promising with their hair restoration procedures as a combo? I wonder if SMP+hair restoration for someone who keeps their hairstyle/hair length similar to the way I do, can get a natural looking effect.

[Blake Bloxham]

Like a few others, I didn't see this case until now, and I truly think the combination of FUE and SMP is innovative and very interesting! I feel like this type of combination is an excellent application of both treatments, and I hope to see some more cases like this in the future!

 

Many people complain about the inability to "graduate" the hairline with SMP, and I think an SMP session followed by FUE with an emphasis on the hairline really solves this problem.

 

Great work!

[Janna]

Sean,

 

Regarding your uncle's scars, the concerns you two have are same as ours.

 

"So, there is a possibility depending on the type of scar, whether hypertrophic, atrophic, keloid, or contracted, that it may affect SMP and its benefit."

 

We know that the traditional tattooing to scars, for the most part, did not work. The SMP clinics are claiming that it now works because they use the correct depth of the needle and revolutionary new ink, among other top secret techniques. We have to see it over long term for ourselves. As for concerns about distinct darker ink on scar as native hair color changes with age, I believe the ink fades somewhat quickly. Quicker than what the SMP clinics may claim. So, its important to know and understand all the limitations and benefit, just as you would when researching ht surgeries.

 

I have seen two patients who wear their hair half an inch to more than an inch long on top (so not the buzz cut). They both had diffused thinning and were used to using concealers. They were about 6 months out from a SMP treatment. It looked to me that while there was a benefit to SMP, I was surprised by how quickly the ink had faded. At six months they were both happy with their SMP treatment but wanted more natural thickening up with a ht. Both these patients had brown to light brown hair color. The color of the scalp in the treated areas were light brown/grayish. At least it wasn't blue, which is a concern for many people. I believe one of these patients had purchased a "touch up" SMP session if the ink faded too much with a certain period of time. Dr. Shapiro likes the fact that the ink fades so that you are not bound to the ink forever since your skin and hair changes with time.

 

There are SMP clinics that are more open to making sure they address every concern while some are more secretive. My advice is stick to the ones that provide answers.

 

We'll try to update this patient's progress soon.

[Janna]

Many people complain about the inability to "graduate" the hairline with SMP, and I think an SMP session followed by FUE with an emphasis on the hairline really solves this problem.

 

Great work!

 

You really have to have real hair at the hairline. Just the SMP alone on a bald hairline would end up with a two dimensional look for it to look natural. I think the combo of ht and smp can be effective for a denser look behind the hairline. If you don't plan to buzz your hair, strip surgery is an option. I don't think you have to limit yourself to just the FUE and SMP combo.

It really depends on how short you plan to wear your hair.

[Blake Bloxham]

You really have to have real hair at the hairline. Just the SMP alone on a bald hairline would end up with a two dimensional look for it to look natural. I think the combo of ht and smp can be effective for a denser look behind the hairline. If you don't plan to buzz your hair, strip surgery is an option. I don't think you have to limit yourself to just the FUE and SMP combo.

It really depends on how short you plan to wear your hair.

 

Agreed. Great analysis!

[azazelgs]

Janna,

 

I agree with you about this companies being so secretive about their methods, techniques, inks etc.. I mean the idea of tattooing your head always seems a bit "brave " move for someones life and instead of being more transparent about their work , all those companies are really a black box. When we look at the great ht docs like Shapiro , Hasson or Rahal , everything is %100 transparent from what needle they use to how they extract the hairs. The choice of patients is down to their preference after knowing all of these facts. Those SMP companies on the other hand makes this as "we have a super secret super new ink that is great!" and the other one says " no ours are more super and more secret!". Thats what I don't like.

 

However, I still believe that SMP is a good option for a buzz cutters like me and Dr. Shapiros opinions on supporting it with FUE always encourages me. So , here are my questions .

 

1- What would be the plan of FUE+SMP in high norwood levels(5, 5a,6) ?

I have posted a picture that what I think. Create a hairline with 1-1.5 cm wide with a good density to have the 3d illusion and rest is SMP. What does Dr. Shapiro think about this?

 

2-Also , in my daily life I see some diffuse thinnes that really lost neary all of their hair in nw 6 level but when they buzz it to lowest clipper with no guard, it looks like as if they have a good hair and chooses to buzz. After 3-4 days the density difference becomes obvious. So , I've always thought this; If you apply the SMP with "less dense" than the sides, it will look ok and that can give a freedom to not to shave it every single day. What do you/Dr. Shapiro think about that??

 

3-As a clinic , what do you think about the major SMP companies like HIS, GLI or NHI ? I know GLI is local but maybe the other results look more impressive to you?

 

 

This is what I wanted to explain with first question;

[Janna]

1- What would be the plan of FUE+SMP in high norwood levels(5, 5a,6) ?

I have posted a picture that what I think. Create a hairline with 1-1.5 cm wide with a good density to have the 3d illusion and rest is SMP. What does Dr. Shapiro think about this?

 

On a high nw level you are referring to - Dr. Ron would recommend a conservative hair line with FUE even if you plan for SMP. SMP is not permanent as far as we can see at this point. The color fades fairly quickly so you have to do touch ups multiple times. We feel you shouldn't get "caught" having to do something to maintain a look forever. So plan SMP for enhancing but not make it absolute necessity.

 

2-Also , in my daily life I see some diffuse thinnes that really lost neary all of their hair in nw 6 level but when they buzz it to lowest clipper with no guard, it looks like as if they have a good hair and chooses to buzz. After 3-4 days the density difference becomes obvious. So , I've always thought this; If you apply the SMP with "less dense" than the sides, it will look ok and that can give a freedom to not to shave it every single day. What do you/Dr. Shapiro think about that??

 

I think you may be classifying NW 6's incorrectly. If they have hairs to buzz, they are closer to a NW 4. NW 6's don't have hairs to buzz except for few strands of hair here and there on top and the hairs below the bottom of crown to the sides. A buzz cut hair length varies from guard #3 to #7. If you go any lower, you achieve a shaved look. For the buzzed look, you have to have some real hairs grafted then add SMP to get a denser look.

 

3-As a clinic , what do you think about the major SMP companies like HIS, GLI or NHI ? I know GLI is local but maybe the other results look more impressive to you?

 

I haven't seen any results in person from other SMP clinics and frankly, I haven't seen that many from GLI to say if one is better than the other. I can say that when Dr. Shapiro visited NHI, Dr. Rassman was a lot more forthcoming about their technique than GLI. With HIS clinic being in London, it's hard to see any of their patients in person.

[azazelgs]

Janna,

 

Regarding to your answers;

 

"On a high nw level you are referring to - Dr. Ron would recommend a conservative hair line with FUE even if you plan for SMP. SMP is not permanent as far as we can see at this point. The color fades fairly quickly so you have to do touch ups multiple times. We feel you shouldn't get "caught" having to do something to maintain a look forever. So plan SMP for enhancing but not make it absolute necessity. "

 

I don't get the relation between the duration of the ink and the conservativeness of the hairline. About this case, yes it is good that we see a good approach of SMP+FUE but what I don't like about it is the very very conservative hairline.

 

"I think you may be classifying NW 6's incorrectly. If they have hairs to buzz, they are closer to a NW 4. NW 6's don't have hairs to buzz except for few strands of hair here and there on top and the hairs below the bottom of crown to the sides. A buzz cut hair length varies from guard #3 to #7. If you go any lower, you achieve a shaved look. For the buzzed look, you have to have some real hairs grafted then add SMP to get a denser look."

 

 

I think I am not. There are some people who have a diffuse thinning all the way in their nw6 area. You can clearly see the difference between the hair in sides and on top. However, when they buzz it with the lowest clipper, (what I mean by buzz is to use a clipper with no guard, check out Philips 180* rotating clipper) it looks like they have a full head of hair.

 

"I haven't seen any results in person from other SMP clinics and frankly, I haven't seen that many from GLI to say if one is better than the other. I can say that when Dr. Shapiro visited NHI, Dr. Rassman was a lot more forthcoming about their technique than GLI. With HIS clinic being in London, it's hard to see any of their patients in person."

 

Janna, what does Dr. Shapiro think about the future of this treatment? Can anything be improved in order to achieve more three dimensional look? Are there more cases that you can share??

[Janna]

Janna,

 

Regarding to your answers;

 

"On a high nw level you are referring to - Dr. Ron would recommend a conservative hair line with FUE even if you plan for SMP. SMP is not permanent as far as we can see at this point. The color fades fairly quickly so you have to do touch ups multiple times. We feel you shouldn't get "caught" having to do something to maintain a look forever. So plan SMP for enhancing but not make it absolute necessity. "

 

I don't get the relation between the duration of the ink and the conservativeness of the hairline. About this case, yes it is good that we see a good approach of SMP+FUE but what I don't like about it is the very very conservative hairline.

 

The relation is that because we don't know how often you have to do touch-ups of smp, it's difficult to recommend an aggressive, low hairline approach. What if the patient gets tired of repeatedly applying the ink for a denser look. Or, they decide the shaved look is no longer the look they want. The more you bring down the hairline, the more cm2 of coverage you will need with scalp or body hairs to get a similar look density if you decide smp is no longer an option. Who knows, maybe the smp holds for many, many years and your diffused hair loss does not progress any further for many, many years but we cannot count on that.

[Janna]

Janna,

 

Regarding to your answers;

 

 

"I think you may be classifying NW 6's incorrectly. If they have hairs to buzz, they are closer to a NW 4. NW 6's don't have hairs to buzz except for few strands of hair here and there on top and the hairs below the bottom of crown to the sides. A buzz cut hair length varies from guard #3 to #7. If you go any lower, you achieve a shaved look. For the buzzed look, you have to have some real hairs grafted then add SMP to get a denser look."

 

 

I think I am not. There are some people who have a diffuse thinning all the way in their nw6 area. You can clearly see the difference between the hair in sides and on top. However, when they buzz it with the lowest clipper, (what I mean by buzz is to use a clipper with no guard, check out Philips 180* rotating clipper) it looks like they have a full head of hair.

 

 

With diffused thinning, you have to approach them like the traditional NW 6's by assuming those hairs are going to go as well. If you look at older men in their 60's or higher, they become as I stated in my previous post last week, the head of hairs are far and few and somewhat wispy. And by our experience, they do not look like they have a full head of hair when shaven. And, most older men do not want to shave their heads.

Edited June 13, 2012 by Janna

[Janna]

Janna,

 

Regarding to your answers;

 

what does Dr. Shapiro think about the future of this treatment? Can anything be improved in order to achieve more three dimensional look? Are there more cases that you can share??

 

Dr. Shapiro thinks there is a promising future with this treatment. He recently attended the Italian Hair Conference in Rome. I believe Joe Tillman mentioned a temporary SMP approach not too long ago. Dr. Shapiro visited the same SMP clinic and was also very impressed. The ink lasts about 2 years with more color options than what we've seen available so far. I believe he said the brown colors looked really good.

 

I will try to share any pics that come up.