I have noticed that there are a lot of clinics now offering SMP and each day there seem to be more. I am looking into having it done. In reflection I like the competition but I don’t like it because it gets confusing. Can you help me here? What’s the difference between what you offer and what a tattoo shop can do?
There appear to be many clinics that are offering Scalp Micropigmentation (SMP), but the word “clinics” may be confusing. These clinics may not have any medical affiliation and many of them are tattoo parlors with a more “upper crust” office decor. First of all, tattooists can not administer anesthesia, as only an medical doctor (MD) is allowed to use anesthesia, so you would have to endure pain when SMP is done by a tattooist. When you see us,you get examined by an MD, interviewed by an MD, and evaluated by an MD. When the SMP process is done, the doctor is integrally involved in every part of the process, from giving the anesthesia to actually performing parts of the procedure.
These MDs are assisted by medical technicians who fully understand sterile techniques. We are careful about the pigments we use, for example, and although we purchase them in sterile bottles, we re-sterilize them to assure that there are no living bacteria in the bottles. When this is combined with sterile management, you are assured that your risk of infection is minimized. On the other hand, not uncommon risks and complications in the hands of those tattooists who were not trained in sterile techniques and may be sloppy in the delivery of SMP, include:
- infection, where reported outbreaks of non-tuberculous mycobacterial infections associated with contaminated tattoo inks have raised questions about the adequacy of packaging, sterilization, the use of dirty or reused needles, and faulty techniques at the tattoo-parlor level
- mycobacterium chelonae infection
- allergies to the component in the pigments producing scarring, granulomas from foreign body reactions
- MRI complications, such as swelling and pain from the metals in the pigments when exposed to the powerful MRI magnets
It has been reported that unsterile tattooing equipment and needles can transmit infectious diseases, such as HIV, hepatitis, and skin infections caused by staphylococcus aureus (“staph”) and other bacteria. This discussion alone should call attention to the need to have the process done by experienced MDs in this field.
For us in particular, we have taught this process at medical meetings to many doctor. At one of these meetings, we have given a course on the do’s and don’ts of the process. Although being a doctor delivering the service protects you from the infections discussed above, there is really no way a doctor can learn this process other than to get trained by another knowledgeable doctor. We have trained doctors in our office along with their technical staff. We have also published articles in medical journals on the subject. To say the least, we have the credentials to do it. Now we have five doctors involved in the process — three in Korea and two in Los Angeles.
It it generally thought that ACell will help the healing process deep in the wound and possibly reduce the superficial scarring, thereby making better wounds. There is circumstantial evidence for this in our practice, but this is more conjecture than science. I have not seen that ACell has helped the graft healing or made it grow better. 
As I’ve written in the past, I’m involved in an email group with some of the industry’s top surgeons. One of the topics that was recently brought up was a case where a patient was told, emphatically, not to take finasteride due to an increased cancer risk. Coincidentally, I received an email from a patient not too long ago with a similar concern… so I figured it was time to write about it again.