SMP, the most important questions I have (experts needed)

[paleocapa89]

Hi all,

 

I am thinking proactively about the future, and how SMP could be used to camouflage FUE donor scars. However if there is one thing I have learned is that I will never ever again jump into something without the proper research beforehand.

 

We know that there have been tattooing for thousands of years and they are considered to be pretty safe. However, to my understanding SMP is different in two important ways. It is injected into the upper layer of the skin and not the deeper layer where regular tattoos go and the ink used has a smaller molecular structure (although I am not sure about this)

 

Whether it is temporary or permanent, I have questions regarding their safety and their effectiveness and cosmetic value

 

Safety:

Permanent SMP:

 

1: The first and most important: can we be sure that the substance that is injected into the upper layer of the skin will in fact stay there and will not travel anywhere else in the body entering the lymphatic system for example and or can we be sure if it is get's carried away, it will not cause problems down the road like cancer etc?

2: What exactly happens when the ink fades? I would assume it fades because the molecules brake up and some of the molecules get carried away by our system.

3: What happens when we try to remove SMP? I would assume again that the laser breaks down the molecules and the small particles get carried away by our system.

 

 

Temporary SMP:

 

1: what happens when the ink fades, how does it get excreted by our body exactly? Does it enter our lymphatic system? Can we be sure that it will not cause problems like cancer down the road?

2: I have read that temporary ink particles are coated in silicone. To my knowledge, silicone can't be excreted from the body. What happens to the silicone when the ink fades, where does it go? What happens when we are repeating the temporary SMP? Are we accumulating silicone in our body without the knowledge of it's long term effect?

 

 

Effectiveness and cosmetic value:

 

1:How does temporary and permanent SMP work in scar tissue, will it fade or will the ink flow everywhere in the scar tissue creating a smudgy look? Where can we see the photos of stellar results?

2: If an SMP fades and needs a touch up doesn't that mean that you will only get a new layer of ink on top of the faded layer of ink ultimately creating a big splodge on your head?

 

 

I would really like if some experts in the field could share his/her knowledge.

 

Thanks.

[Buzz2]

Exactly the info I am after, after Doganays techs ruined my donor!

[hairthere]

Hi paleo,

Firstly, the only true temporary pigment that I am aware of is manufactured by Beauty Medical. It is the product my clinic uses exclusively. Milena Lardi developed this product specifically to be used for scalp micro pigmentation and to disappear completely from your system over time.

 

This product is temporary for a few reasons. One, we only inject it at .5mm. Second, the particles in our pigment are 15 microns in size, and all perfectly round. This allows the bodies' cell defense system to "eat" the particles. The pigment is absorbed by the macrophages of our immune system and is naturally excreted, like all materials the body doesn’t need, through urine for example.

 

The particles are not encapsulated by silicone, but by a simil-siliconic bio-compatible material that can be excreted from the body the way I said before. All the particles and substances are developed to be excreted from the body without causing any side effect.

 

Regarding the effectiveness in scar tissue: This varies from person to person and depends on the level of scarring. We usually recommend doing a test patch first to see how the pigment holds up over a few weeks and then procede based on that. The great aspect of temporary is that you don't have to be concerned about the product turning color or migrating.

 

Hope this helps and feel free to contact me with any further questions.

[pkipling]

Very interesting questions. I've thought about this a lot recently as I've seen quite a few posters lately considering FUE in the hopes that that they could then opt for SMP into the FUE scars as a backup plan should they ever have to shave their heads in the future. Hopefully this is something we can see actual results as SMP continues to advance and improve, as I believe that would add even further appeal to FUE in the FUE/Strip debate.

[paleocapa89]

Hi hairthere

 

Thank you for the detailed answer! Is there any chance you can share the full ingredient list of the ink you are using? I'd think if it is regulated by the authorities then one needs to disclose it anyway right?

[hairthere]

Hi Paleo,

The pigments that Beauty Medical produces have to meet European standards which are very strict unlike those in the U.S.. I've seen the actual guidelines and they are quite extensive. But the actual ingredients are proprietary so it's information that even I'm not privy to.

 

I know there was one study done on the effects of tattoo ink on the lymphatic system. Our product, however, is not tattoo ink. In fact it is very different from tattoo ink and as I stated earlier was specifically designed to be safely expelled from your body.

[paleocapa89]

It is good to know that you are 100% sure that the used ink is safe and safely excreted from the body. However as I understand there is very limited research done that is why I am very cautious as I have been burned once.

 

I don't see why the ingredients can not be disclosed. We know that the recipe of Coca Cola is one of the most guarded secret of all time, however they still have to list all the ingredients on the bottle. If we require that from a beverage I don't see why we can't demand the same from an ink that is injected into our skin.

[Petchski]

Probably a trade secret or something, but should be disclosed really.

 

I'm thinking of getting this done in to my old strip scar, but the Uk clinics don't look as good as these ones based in NY, The Vinci clinc in the UK seems a bit of a mill, offers up hair transplants outsourced and that's kind of put me off possibly using them for SMP, plus i read that the ink drops out with the scab material, and works better for some than others...i was getting the impression from what i read that some of these SMP clinic are dodgy with poorly trained staff. Is there any Milena Lardi trained places in the UK?

[wibbles180]

I too would love to know if there are any milena lardi trained clinics based in the uk ? I've tried contacting beauty medical on several occasions but no reply so far . I wonder if I could get a test patch done on a scar on the back of my head from years ago ? It's not a fue or strip scar but would it still give me an idea of what could be achieved for when I have my first fue if the scarring is bad ? Cheers

[NicH0le007]

Hey guys, sorry this is a late response.

 

1. Beauty Medical Pigment is made of : Isopropyl alcohol, water, glycerin, titanium oxide, yellow color iron oxide, black iron oxide, and red iron oxide.

 

2. In the UK for trico I would go see Debbie Clifford. She is an outstanding tech who has been in the industry for many years.

 

3.

The Question: Will TricoPigmentation Fade?

The Answer: YES.

Why? Two reasons. The first = because the pigment is injected so superficially into the upper layers of the dermis much of it is exfoliated during the cell renewal process. The second = TricoPigmentation pigment is designed to fade completely over the course of 6-18 months because the particles it is made of are small enough for your cell defense system to “eat” and eliminate.

Before we go any further into this discussion it is important to make the distinctions between the different types of fading you will experience:

1. The portion of pigment that washes away at your first hair wash reflects the pigment that was left only on the surface of the scalp that was superficially sitting in your pores, hair follicles, etc.

2. Short term fading (fading between sessions): After each session every patient is generally sent home, and asked to return to the clinic about six weeks later for their next session. The reason for this is for two fold– to give the scalp a chance to heal, and to enable the pigments to settle down and fade. Once the pigment is in the scalp, the amount of pigment that remains over the first 28-45 days generally reflects the depth of the pigment placement.

Let’s discuss the science. To understand short term fading we will discuss: anatomy of the skin, the cell renewal process, and placement of the pigment. Let’s start from the beginning: Remembering that the SMP process begins by inserting a micro drop of pigment through the skin and into the upper dermis (second layer of skin) by perforating the skin with a needle. To get to the upper dermis it must first perforate the epidermis, which is the most outer layer of the skin.

First, let’s discuss the purpose and function of the Anatomy of the skin because it plays a very important role in short term fading and the cell renewal process.

The epidermis: is the outer layer of your skin and includes the part of your skin you see every day – the surface. However, the epidermis is comprised of more than just the skin's surface. It consists of a number of levels, each with their own distinct role

1. stratum corneum – surface,

2. stratum lucidum,

3. stratum granulosum,

4. stratum spinosum,

5. stratum basale-deepest layer

Cells in the deepest level of your epidermis are extremely active and divide constantly to make more and more new cells. Once generated in the stratum basale, these new cells are pushed upward through the other levels of the epidermis and toward the surface of your skin. Along the way, they die and eventually become filled with keratin, a very strong protein. These dead, keratin-filled cells make up the outer parts of the epidermis and provide your body with the tough, protective overcoat it needs to survive. The dead cells on the outer parts of your skin are constantly shed and replaced by new ones. As a result, every 20-30 days, your body has an entirely new surface of skin.

The upper dermis (papillary layer): the second layer of skin, a connective tissue made up of collagen and networks of elastic fibers which give skin its resiliency, is the layer in which smp pigment is deposited. The majority cell type in the dermis is fibrocyte (or fibroblast) other cells that are important in relation to pigment placement are resident immune cells – dendritic cells, macrophages, and mast cells.

The lower dermis (reticular layer): is made up of dense connective tissue and contains blood vessels, hair follicles, sweat glands, lyphatics, nerves, and sebaceous glands. If pigment in injected any lower than the upper dermis into the reticular or further into the hypodermis you will see migration and discoloration.

Hypodermis: a loose connective tissue containing mostly adipose (fat) tissue.

Epidermal-Dermal Junction (Basement Membrane): the area of tissue that joins the epidermal and the dermal layers of the skin.

Second, Lets Discuss the placement of pigment and the cell renewal process.

The SMP process causes damage to the epidermis, epidermal-dermal junction (basement membrane), and the topmost layer of the dermis. The pigment itself is initially dispersed as fine granules in the upper dermis, but collects into more concentrated areas at 7-13 days. The largest layer of the epidermis is the stratum spinosum, and this area will fill with pigment in the track created by the needle. The deepest layer of the epidermis is the stratum basale, a row of cells that resign on the basement membrane separating the epidermis from the dermis. Significant amounts of pigment may be found in the basel cell layer immediately after the process is done. Pigment particles are found within the cytoplasm of keratinocytes and phagocytic cells, including fibroblasts, macrophages, and mast cells. Also important to note and understand is that at one month, the epidermal-dermal junction (basement membrane) is reforming, and collections of pigment particles that are present within the basale are starting to disappear, as these cells migrate upward toward the surface. Eventually, all of the pigment found in the epidermis will be pushed upward with the exfoliation of the stratum corneum and the only pigment that will remain at this point will be the pigment that was placed into the upper dermis. Because those once damaged epidermal cells were shed and replaced by new, pigment free cells the color may look less deep as when all the cells were carrying the pigment in the initial wound.

3. Long Term Fading: The fading that takes place 3 months-2 year s after the treatment is complete: This is the period after the pigments are fully settled creating the appearance they will ultimately maintain over the long term should you maintain your SMP.

Let’s Discuss the Science:

A. First, At 3 months the basement membrane of the epidermis (epidermal-dermal junction) is fully reformed, preventing any further loss of ink through the dermis into epidermis via the basel layer.

B. Second, pigment stays in place for years by tricking the body’s immune response. Think of the needle and pigment as a military operation. The immune system leaps to defend the body against a wound and pigment invasion, thinking a bad infection is about to occur. The body is functioning properly by responding this way. Phagocytes are like pac-men. When pigment is deposited in the dermis , the body mounts an immune response with macrophages, phagocytes and mast cells. Macrophages and phagocytes are the rough equivalent of microbiological pac-men, and literally eat and envelop the tattoo ink in an effort to contain the invasion of foreign material. As the damaged epidermis and dermis heal, granulation tissue and specifically dermal fibroblasts interlock the ink-containing phagocytes in a collagen network just beneath the dermis/epidermis junction. That’s how permanent pigment stays put for years. Permanent cosmetic pigments have 20+ microns of various shapes and traditional tattoo Ink 30+ also variously shaped. These particles are too big to be carried off my macrophages. Tricopigmentation (temporary SMP) are different from the pigments or inks used in both permanent makeup and traditional tattooing. The difference in the pigments are mainly seen by difference in particle sizes. Tricopigmentation pigment particles are 15 microns and are all perfectly round in shape. These particles are small enough that they can be eaten and dispelled by the macrophages making it’s result therefore “temporary”.

[NicH0le007]

The Jargon:

Phagocytosis – think of it as the cell eating or swallowing an item ie: a particle of pigment

Phagocytic- cells that are capable of phagocytosis; some cells can become phagocytic during an inflammatory response (ie:keratinocytes), whereas others are phagocytic all the time (ie: immune cells).

Extracellular-outside the cell.

Intracellular-inside the cell.

Dendritic Cell- an immune cell type that continually samples its environment for changes, and will migrate to lymph nodes to trigger an immune response if necessary.

Mast Cell – an immune cell that plays a crucial role in allergic reactions and is present in connective tissues.

Extracellular matrix – a generic name for the scaffold of proteins both structural and “glue”types) that cells attach to and are supported by. Major components include basement membrane (one type of collagen network), elastic fibers, structural glycoproteins (eg: fibronectin), proteoglycans (“glue”) and collagen.

Fibrocyte – a cell type that makes up most of the cells in connective tissue. They secrete collegen as well as other proteins that make up the extracellular matrix when activated. Thaey are normally phagocytic, but become so when inflammation occurs.

Fibroblast – a fibrocyte that is actively secreting proteins (an active fibrocyte).

Granulation tissue – tissue that fills in gaps formed from debris or necrotic tissue removal. It consists of newly formed small blood vessels embedded in a loose structure of fibroblasts and immune cells. As the tissue matures, immune cells decrease in number, fibroblasts form collagen networks and blood flow resumes to the area.

Hope this all is helpful. Nicole

[Yaz89]

The above information is excellent Nicole! What do you think of permanent SMP? Do you think it is safe? Any problems or issues one should be aware of. I have an consultation with Paul Clarke at Brandwood Clinic in the UK, near Birmingham. I have heard things about Paul. That he was one of the best at HIS Clinic. I am looking into SMP for my FUE scars

[wibbles180]

Thanks for all your info and help but Isn't the idea to work within the hairline if the client is wanting to keep his existing hair with a little bit of length on it ??? Also how well do you know Debbie to be able to recommend her so highly ?

 

As much as I'd love to find a decent uk smp provider I don't think this is the answer we were seeking looking at the 3 examples on her website

[NicH0le007]

Debbie is an internationally known permanent cosmetic make-up artist and she is now currently teaching tricopigmentation for Milena. I have seen her work in person and taken many classes with her.

 

I would like to have her explain motivation and thought for that hairline. If I were doing a hairline on pt whom was not doing a transplant to strengthen those corners - yes, personally I would have stayed within the existing hairline because I never like to lock anyone into 1 look.

 

FYI - Milena does work out of a clinic in UK once a month, I believe.

[NicH0le007]

Also, a few threads down nocureforbaldness is doing a monthly update of his results from a beauty medical company out of UK. Maybe PM him for his experience.

[wibbles180]

Hi, yes it seems she is more accustom to female smp treatments such as eyebrows etc , I'm just trying to get some densification work done to fill in the thinning areas of my scalp and keep my hair long , fed up of using concealers

 

In your experience is this possible or would it be possible to see the difference from 3D to 2d ?

 

Thanks again

[NicH0le007]

Hi, yes it seems she is more accustom to female smp treatments such as eyebrows etc , I'm just trying to get some densification work done to fill in the thinning areas of my scalp and keep my hair long , fed up of using concealers

 

In your experience is this possible or would it be possible to see the difference from 3D to 2d ?

 

Thanks again

I can look for some photos for you! Feel free to email me at Nicole@shapiromedical . com anytime, I'm happy to help you find someone. But, I will say this -- the only 3d SMP I recommend is scalp (1d) + hair follicle replication (2d) + real hair (3d). The companies that promote that they can do hair strokes with pigment make me very nervous. I have never seen a hair stroke hold its integrity throughout the healing process in the scalp. They turn into big blobs.

[pkipling]

Hey Nicole - Thanks for that SMP crash course. It was extremely informative.

[wibbles180]

Hi Nicole , I have emailed you some pictures for your opinion of densifying my vertex and mid scalp whilst keeping my hair long . If it's not possible id rather save my cash towards a ht .

[lorenzo]

Temporary SMP:

 

1: what happens when the ink fades, how does it get excreted by our body exactly? Does it enter our lymphatic system? Can we be sure that it will not cause problems like cancer down the road?

2: I have read that temporary ink particles are coated in silicone. To my knowledge, silicone can't be excreted from the body. What happens to the silicone when the ink fades, where does it go? What happens when we are repeating the temporary SMP? Are we accumulating silicone in our body without the knowledge of it's long term effect?

 

I never though about that. After I had SMP for the first time I was diagnosed with cancer. During my chemo I had another session all over my head because I was bald. Was cancer free and had another session Feb 2015. Oct 2015 my was once again diagnosed with cancer. I don't know if this has anything to do with it but I am going to research it. My back and sides of head SMP have not faded in 3 years. I have enclosed a picture to see the SMP on the side and back that was only done once in Oct. 2012. I am not saying this has anything to do with my cancer but I have to share my experience.

[NicH0le007]

The above information is excellent Nicole! What do you think of permanent SMP? Do you think it is safe? Any problems or issues one should be aware of. I have an consultation with Paul Clarke at Brandwood Clinic in the UK, near Birmingham. I have heard things about Paul. That he was one of the best at HIS Clinic. I am looking into SMP for my FUE scars

 

Hi Yaz,

 

I think the most consistently good permanent SMP work that I have seen done is by former techs from HIS, Vinci, and NHI. I refer to Matt Iulo at Scalp Micro in NYC most often (he is formally from HIS as well). I think if you want a great honest opinion of someone I'm sure he knows --ask him.

 

MY advice, find out if he is still using the same pigment as he was at HIS or is he learning a new pigment? Same equipment or new? How long has he been on his own and does he have examples of his work he can show you. And, lets say in worse case scenario you dislike your SMP -- How is he going to take care of you? Does he refund? Will he redo? Does he have access to a laser? HIS pigment does laser out pretty well in a few sessions but that's not the case for all permanent SMP. I have a pt I am correcting from another large organization (not represented on here) that has taken 11 laser sessions to remove his pigment. I started in this industry doing permanent SMP -- I believe in the right hands it is safe. Those hands are honest and transparent and they tell you everything. No sales gimmicks. Also, look at his hairlines. Does he have the ability to do soft natural hairlines? I know most guys think when they get SMP done that they are going to stay with that look but the reality is many itch for hair down the road. Don't get yourself locked into a situation that will be hard to get out of. Don't lower your hairline beyond your existing hair or go too low. If you are older than 30 get an age appropriate hairline, etc. Think about future planning.

 

Best of luck, I hope this was helpful

[NicH0le007]

Hey Nicole - Thanks for that SMP crash course. It was extremely informative.

 

Anytime

[NicH0le007]

I never though about that. After I had SMP for the first time I was diagnosed with cancer. During my chemo I had another session all over my head because I was bald. Was cancer free and had another session Feb 2015. Oct 2015 my was once again diagnosed with cancer. I don't know if this has anything to do with it but I am going to research it. My back and sides of head SMP have not faded in 3 years. I have enclosed a picture to see the SMP on the side and back that was only done once in Oct. 2012. I am not saying this has anything to do with my cancer but I have to share my experience.

 

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.

[LT]

Lorenzo,

 

Very sorry to hear about your problem. This is very concerning if SMP has anything to do with your cancer. I would like to hear what the experts think about this? Can SMP cause cancer??

[lorenzo]

Nicole and LT

I am not saying SMP caused my cancer. I am not accusing anyone or anything with my cancer. When you get cancer you are always looking for what caused this. I have a very rare and aggressive form of Lymphoma. I talked to my oncologist yesterday and mentioned it. He said there is really no way of knowing but it sounded like he is unfamiliar with tattooing causing any form of lymphoma. He went to the world lymphoma conference last month and lymphoma is on the rise all over the world. There is a lot of things out there that cause lymphoma and in the future I am sure there will be a definite answer for this.

I have a bone marrow transplant (non donor) April 2013 and when I was diagnosed Oct 2015 again I was told there was very little they can do. I am lucky that my cousin that is a lymphoma specialist at the mayo clinic was in town and her and the doctors discussed it. The last three months I have been on strong chemo that has completed destroyed me but I was able to shrink a very large tumor and get rid of the cancer around my brain. In three weeks I am getting another BMT (donor). So far I am going great.

Since I lost all my hair all that is left is my SMP. Everyone that sees me thinks its my own hair so it looks very natural. When I had my first SMP was when Milena was in the clinic and I didn't have cancer yet. Once I got cancer and lost my hair I had it once again all over my head. The SMP on the top of my head faded so I have more and was wasn't sure of the back since my hair grew back and it is a lot more thicker there. When I lost my hair this time I was surprised that the side and the back of my hair still had SMP. This is probably because as stated my hair is a lot thicker in the side and back.

All I care about is my health and could care less about my hair. I am quit sure SMP is safe and it normal to look for reason why I became sick.