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Hair Transplant Surgery And SMP - Just A Money Grab Or A Viable Option?

SMP (Scalp Micro Pigmentation) is one of the latest and most heavily marketed hair loss “solutions” being offered in the hair loss industry today, Essentially a permanent or semi-permanat cosmetic scalp tattoo, SMP is offered as both an alternative to hair transplant surgery as well as an adjunct to surgery. The key to researching this procedure is to remember that all SMP is not created equal and not every hair loss sufferer makes a good candidate for this cosmetic tattooing processes.

Spencer: Hey, you're on the air. Who's this and where you calling from?

Jason: Jason, from California.

Spencer: Jason from California, what's happening man?

Jason: Hey also known as "Poet", Joe knows me.

Joe: He is old school from the early 2000's on the forums.

Spencer: I think I even recognize Poet from HLH, right?

Jason: That's right, I've been out of the game for a while but here I am again.

Spencer: You're better off for it I'm sure.

Jason: I think so, regrettably I'm back.

Spencer: Alright well what's happening man?

Jason: I just recently came across this I guess they call it SMP, Scalp Micro Pigmentation, maybe not that new to you guys but I just came across it, and I was actually thinking about it.

Spencer: So I mean you were a heavy user of these forums, and so you just essentially disappeared, stopped going online, stopped reading about it, stopped worrying about it.

Joe: I think Jason needs to maybe give a little bit of his background, a little bit of his history, cause it's actually pretty incredible.

Jason: Yeah, I'll try to a bridge version. I could go on about it. So when I was 14, I had a pretty serious head injury. I won't get into that but that left me with a significant scar.

Spencer: Right.

Jason: That kinda ran vertically down my head. I started losing my hair, scar started getting exposed, and I was you know all the normal reasons someone doesn't like their hair loss but then that compounded by that fact. I was really very eager to take care of it, at this time I'm not gonna name any doctors but, I got one strip scar. It seemed to go pretty well, it kinda covered the front a little bit.

Spencer: When are you gonna name the doctors?

Jason: Maybe another time.

Joe: Just to say if you do name the doctors, there's nothing wrong with it, and it's actually fascinating if you did but, I mean you know your comfort level, I get it.

Jason: Alright, so I had that kind of a light dusting of hair, it wasn't anything magnificent. Then I waited a couple years and I just, I wanted more, but my elasticity, I know all these terms now, and concepts, I didn't at the time, there was no internet, forums or anything. So I went back again, and I got another strip scar, and...

Spencer: What year was this?

Jason: This was the late '90s, I was young too, I was like 19 or 20, I pretty much was bald when I was 16, I got all the luck. But I got a second one, somehow that left me with a new wide scar, somehow seemed to erase the hair I had gained and my effort to get rid of one scar ended up leaving me with two scars, and less hair. So I was quite unhappy, very vocal about that, and then they offered me even some money to not be so vocal, and I declined that. And one other interesting thing is I went to this place and it was when FUE, which I'm sure your listeners know, was really new and they had this test, it was called the Fox Test. Maybe you start to know who I'm talking about now.

Spencer: I do. You went to the old NHI.

Jason: Right. They're like, "You're not a candidate. Too wavy. Too curly. Not going to work." So then I was really desperate, really unhappy and then, I will say this doctor because it worked out pretty well, Dr. Woods in Australia. I came in contact with him and kind of serendipitously inherited a little bit of money at that time and then I went to Australia and he did a really good job I've got to say. I don't have a whole lot of hair but it gave me more comfort and cut my hair shorter, much shorter now. And then later I went to Dr. Wong, and he pro bono, fixed that kind of vertical scar. Not to get to graphic but people used to call me Frankenstein actually because I had a couple of crazy crooked scars. He helped fixed the scar, put a little bit of it in the scar.

Spencer: He actually recycled some previously transplanted body hairs into the scars. Is that right?

Jason: Right, yep. The vertical scar he was able to get a little bit of graphs. He put that in there and then I had to keep my hair, I mean up to now, I guess 3/8 inch on the clippers. And so, I don't have a lot at the top so I still kind of have that afro situation on the sides. But I met a wonderful lady and I kind of just went on with my life and I just kind of stopped thinking about it. Like it's just other peoples' problems, not mine.
I just would love to cut my hair shorter, but I have these kind of gaps in it still from remaining strip scars. Started researching that and actually just contacted Joe recently. Just trying to learn more about that, and I've been talking to a couple of people and for now I just want to get it in the scar area, but I know some people put it on the top of their head. I don't know how well that works out because I have some light dusting of hair, so I don't know if it will create an illusion that looks right or looks weird. I don't know how much you might know about that.

Spencer: I have a very strong opinion when it comes to any type of scalp tattooing, scalp SMP, whatever term people are using. I definitely think it has its place. I am more of a fan of temporary tri-co pigmentation because at least you know, when it fades, and I will say that they all fade, but when it fades, it's going to fade naturally. From what I've seen, it doesn't really turn a bluish tinge as it fades, it just kind of fades away. Joe has a lot of experience with this. I have seen it work well in scars, but when it comes to scar tissue, you never really know how any ink takes and you have to kind of have a, in my view, any responsible practitioner would do a test patch. A couple of dots in a scar area. See how it takes in your particular tissue.

But I have seen some guys who have pretty significant scarring, have this performed and they're able to then cut their hair to a much shorter length and live their lives in fashion where they feel more comfortable in their own skin. However, there is upkeep, there is ongoing costs, and it's something you have to be prepared for. Now Joe is somebody who actually had it done, so I'm going to let him talk about it.

Joe: Multiple times and we did talk about it on the phone the other night. Just to get back into that, I mean the, what Spencer says is absolutely correct. That you can't just go and get it done. You've got to find a responsible technician that can say, "Let's just take this slowly. Let's do a test patch to see how your scar tissue reacts." I think I was telling you the other night that scar tissue is different than skin tissue and so that's why you need to do these test patches. Especially on scar tissue because I have seen it disappear in a matter of days inside scar tissue because the lattice work, the mesh, that holds the tissue together, is different. Sometimes it's very porous underneath and so you do these applications and it just disappears completely. I've seen it splotch. I've seen little tiny dots turn into a smear over the course of a few weeks. It's just something you've really got to be careful of.

Jason: That makes sense and I'm fortunately in a place where I'm much more comfortable. Every time in the past that I was so desperate to come up with a cure and there's that voice that tells you to be careful but then there's that other voice that wants it to work.

Spencer: Well, here's the good news. You're comfortable now and you have someone in your life who has obviously enhanced your life to the point where you were able to get off the fucking forums, which is incredible. I'm really happy for you. However, there's still an issue that you want to try to resolve. How tight, can you cut your hair, how close, before it really starts to show?

Jason: I mentioned that I use the 3/8 of the clippers. I don't know if you're familiar, there's the different sizes.

Spencer: Sure.

Jason: So it's short but even that, on one side of my head it's actually a whole inch wide with the terrible stretching so I kind of have to cut it in such a way that if I want to camouflage it, that it kind of covers it. So I guess to Joe's point, the scar tissue is a great unknown. Different people scar differently, whatever caused the scar is a whole bunch of different scenarios. It is a mysterious realm of the head that you've got to approach cautiously. That makes complete sense to me.

Spencer: But also if it's actually an inch. That's a lot of coverage for, in my view, for SMP to blend in with your natural hair. So even in the best hands, if it's tri-co pigmentation, temporary stuff, perfect color match. It's possible if it's that large of a gap, it's going to look like you have dots on your head, even done by the best practitioner, even if it works perfectly with your scar tissue. That's a possibility that you have to be aware of.

If you're talking about a 2 or 3 millimeter scar then it's much easier to blend and the eye doesn't really go to that. But if it's a big scar like that, it's possible it's not going to work. Even with the best circumstances.
Jason: I agree with. I figure it's low risk because I can just keep doing and cover it up. It's not like the top of my head. Kind of to your other point, the forums are great.

Spencer: No they're not.

Jason: I don't know. Misery loves company too.

Spencer: Yeah.

Jason: I never thought the day would come when I didn't need that support network and constantly looking at other peoples' situation. It's very liberating and I'm grateful for those forums but I'm grateful to not need them also.

Spencer: Yeah, well that's the thing. Listen, I have a forum. A forum is part of what we do. I like to be able to provide people with that platform, but I'm the first to say, maybe it's not a smart business more, but I'm the first to say, if you can, stay off the forums. Go there once a month. Whatever it is. It doesn't help me. What helps me is the consistent traffic, which we get, which is great. The bottom line is I want people to be able to move on with their lives if that's possible.

And you're right, it's great to have a support system. It's great to have a place, where it's cathartic to be able to voice your concerns, see others going through what you're going through, but there's also a lot of ugliness on the forums. There's a lot of nastiness and a lot of just, in my view, people who aren't really supporting each other. People who are just fighting with each other and bashing each other. Everything is so politicized. It can be a very ugly place. If you're smart, probably like you are, then you realize what you can glean from it and what you can take away from it and not get too involved in the drama and the politics of it all.

Jason: Yeah, I guess people are coming from a place of pain and that can spiral into a lot of negative outcomes. There's good people, compassionate people, some good information, but you really have to dig through it to find the nuggets.

Spencer: That's right.

Jason: I want to say one other thing. People told me this all my I life, I guess it's the confidence goes a long way and if you saw me, my hair is far from perfect and I have a bit of scarring, but I hardly care. I mean I obviously care enough I've been listening. I'm considering SMP, but if you don't care, other people care less. That's just really a key thing in the way you look and the way people approach you and what you're going to be in life.

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The International Alliance of Hair Restoration Surgeons is a consumer organization that selectively screens skilled and ethical hair transplant surgeons. The IAHRS does not offer an open membership policy to doctors practicing hair transplatation, and is the only group that recognizes that all surgeons are not equal in their skill and technique. Its elite membership seeks to represent the best in the discipline, the true leaders in the field of surgical hair restoration.