Dr(s),
Regarding the use of SMP for creating a thicker look in those with existing, thin transplants and limited remaining donor hair….are you still creating simulated follicle “dots” or are you “painting” the whole scalp. If the latter is required for reasonable cosmetic difference, it seems like a really poor choice in terms of any unavoidable future hair loss (say, chemotherapy induced, etc).
The way we do SMP (scalp micropigmentation) is by creating individual “dots” that mimic a shaved scalp and an end view of the follicles. We don’t “paint” the scalp.
If you should lose your hair from chemotherapy or further hair loss should develop, it should not matter because SMP can be performed over the entire scalp. In some men, shaving the head is a good option and allows you to exploit the shaved look that SMP offers. If a man lost his crown hair, we do not just put the pigment over the bald crown, because that would look strange (it would look like a person shaved the crown and left the rest of the hair long). For women who keep their hair longer, if they go through chemotherapy but the recovery only has a partial return of their hair leaving it thin, then we may consider doing SMP to make it appear thicker in the areas where thinning is a problem.
Since there is definitely a limitation of SMP (mainly the life-long shaving of your scalp in men who want that look) we are highly selective on the clients we choose for this. There must be maturity and a clear understanding of the limitations of the process. For those who have had chemotherapy, SMP may be an option to make the hair appear thicker, but the decision to undertake this process must be clearly understood. There are more details on the SMP process: here.
The start of hair loss is mainly genetic (according to our general understanding), but recent studies suggest that diet, lifestyle and other factors such as stress, will also impact the start and rate of balding. It is believed that our final pattern is predetermined. That means if it is meant to be a Class 4A (see image at right), then the variable will be the rate of achieving that final pattern. A Class 7 will not evolve out of a Class 4A genetic pattern if the genes are not lined up that way.