Category: Pigments

How does SMP look like after 5 years? 10 years or 20 years down the road. I’ve seen some really bad SMP jobs on YouTube where the color looks smeared all over the scalp. Maybe these SMP jobs were done by novices or bad tattoo artists but if only a handful of Dr’s do it and do it well. How can there be a guarantee that a Dr with proficiency will be around in 20 years performing SMP when I need a touch up? I am interested in the procedure but worried that the color fades too easily or the dots expand to form a cloudy look. The bad SMP jobs on YouTube make the head look like there is a permanent giant bruise on the entire head. Looks like some sort of disfigurement.

Has any of your SMP patients been unhappy with the results after so many years?

We have been performing Scalp Micropigmentation (SMP) now for two years, so I can not address a longer time frame. I have seen one patient who had scalp tattoos done elsewhere about 9 years ago and he touched it up often (possibly too often). His scalp took on the appearance of smeared color. The black ink turned green and when it covered the entire scalp, the scalp appeared green. Certainly, it was not a good end result. He was experimented on, so his result probably reflected the many techniques that evolved and possibly many different pigments.

With regard to our practice, yes, we have had dissatisfied patients. In analyzing the reason for the dissatisfaction, we concluded that: (a) they really did not understand what they were getting, (b) they were expecting Toppik level concealers which produces better camouflage and are much darker, (c) they noticed irregularities in the ‘dots’ where some of them were larger than others, (d) the pigments faded irregularly, (e) they came from long distances and needed touch-ups that required them to make another trip to California and (f) the color changes in the black to a green or blue tint was more than they expected to see.

A few patients tried to push us to repeat the process more times than we wanted to do, and early in our experience we wanted to make them happy, so we were swayed by their desire far more than we should have been. Now, we stick to our guns and keep to what we believe is in the best long-term interest of the patient. Even though we still want to make the accommodations that will make the patients happy, we will not do anything that will lead to a complication or poor result.

We have addressed these complaints by spending a huge amount of time with each prospective patient, explaining every detail of the process and expectations. The patients seemed to be more satisfied with the end results.

Who performs the scalp-micro pigmentation procedure, the same doctors performing the hair transplants or tattoo artists?

Scalp micropigmentation (SMP) is performed by Dr. Pak who creates the hairline and adjusts the individual pigment. His assistants also help in the process. We are not tattoo artists.

Hello Doctor Rassman, thanks firstly for you great blog.

My question relates to SMP. I know you have mentioned about use of pigment colours depending on hair colour.

But what about someone like me who is gray on the sides and balding on the top…and who wants to conceal not just the balding but also the graying on the sides. Can I completely shave off my head and have black pigments on the sides where there is gray hair growing currently?

Will that hide the graying?

You can certainly shave your head and not worry about the gray hair. While having Scalp Micropigmentation (SMP) done on a shaved head is a common approach for many men who wish to maintain the closely cropped look, having this done to the sides of your head just to offset the graying is not a reasonable approach.

I came across your writing on SMP. I am a Norwood 5 – 6. Caucasian, fair skin blue eyes 63 years old. I decided against a hair transplant but would consider SMP. Can you tell me what the costs would be?

Are you planning of shaving your entire head? If so, the Scalp Micropigmentation (SMP) procedure will cost $7,000 and will include up to 2 touch-ups in the first year. The process often takes one or two touch-ups, as early as 5 days after the first, and then a month or two for a second. The pigment can fade and become patchy, so touch-ups are important. For less than the entire head, costs can be about half that. For very small areas, even less.

The first procedure often takes 6 hours and the second procedure can take 3-4 hours, depending upon the fading. Anesthesia to minimize or obliterate the pain is recommended and included in the professional fee.

Dr Rassman

In order to perform SMP between existing hair ( in order to create an illusion of fulness by lowering the contrast ) is it necessary to shave the area ?

It is not necessary to shave the area, but it is distinctly more difficult and time consuming to do Scalp MicroPigmentation (SMP) with the hair long.

Dear Dr,
Like many readers of your blog, I cannot thank you enough for your contribution and this blog. I stumbled across the site for HIS hair clinic.

Seems like they like to promote SMP as their invention (specifically noting promotion of HIS hair clinic over NHI). Any thoughts?

They did actually develop the technique and used it before we did. The biggest difference is that their work with clients does not have a medical focus. When they do the process, they can not use anesthesia and have little experience with treating hair problems since they are not doctors. As a medical group specializing in hair restoration, we focus on the Master Plan that may include SMP as well as hair transplant (FUE) and even medications. We have more than Scalp MicroPigmentation (SMP) in our arsenal for treating hair loss and we know the hair loss field far better than they do. This does not mean that HIS Hair Clinic is not good at what they do. They are just different with a different focus.

For the young man who has no medical problem or interest in a medical / hair evaluation, then HIS clinic works well if the client is in their area. It should be noted that they have licensed many individuals throughout the world, so quality control of the process may be an issue. Finally, the hairline creation and achieving a proper frame to the face is also something NHI has been doing for the last 21 years.