Why multiple-session Scalp Micropigmentation Produces the Best Result.

Though some major clinics advertise single-day or even single session SMP procedures the consensus among SMP practitioners remains –multiple-session procedures (conventional SMP) produce the best result. After speaking with and reading numerous statements by leading SMP artists, I have summarized the general guiding principles of the conventional SMP method. Following the summary, is an overview of my experience with perhaps the largest provider of single day/session procedures in the country. Last, is short guide to finding the best SMP practitioner for you.

Scalp micropigmentation is most successful as a process, over time, because it provides the practitioner and client more control of the host of variables present in any permanent cosmetic procedure.

At the heart of conventional SMP is the acknowledgment by operators that their canvas is a living organ. As such, good operators understand each canvas has a host of unique variables to consider. Though many of the variables are observable to the operator prior to or during the procedure (of which they can make real time adjustments); some variables cannot be observed until after the client’s skin has healed. For example, a client’s immune response to the “operative trauma” of this minimally invasive procedure cannot be assessed ahead of time. Conventional SMP recognizes this reality, and consequently it values “healed” or “cured” results. Healed results reveal to the artist what cannot be initially observed, and provides vital feedback for the preceding applications.

The conventional SMP method is a byproduct of the necessity of receiving feedback from healed-results, and as a consequence it enhances the customization of the procedure. Conventional SMP allows the operator to observe any fading, bleeding, and change in coloration that has occurred during the healing process. In addition, allowing for healed results also gives the client an opportunity to adjust their expectations and desired look. For instance, a client who may have opted for a more conservative look may be pleasantly surprised by the realism of the healed results, and decide to add density or a more defined hairline.

The conservative approach of the conventional SMP method also reduces in-session errors. Without unnecessary time restraints, an operator can use a conservative approach to both the darkness of the ink and density of the impressions (dots), and adjust future sessions based on the healed results.
While the aforementioned ink migration, changes in coloration, and fading can be the result of unpredictable variables such as: immune response, sun exposure after treatment, and improper after care. They can also be the result of improper technique. Dr. William Rassman asserts, “Pigment bleeding will be minimized with a cautious, slow, and judicious approach in each session. This process is very stressful for the operator, both mentally and physically, and it is critical for the operators
to take frequent breaks during the process.” In summary, the conservative approach of the conventional multi-session method reduces the conflict of time vs. quality allowing for more concise real-time adjustments, and decreases the likelihood of operator error in a particular session. All while providing the client with more control, and decreasing the stress to the client and operator.

“There are many variables in performing Scalp Micropigmentation that makes this process more of an art form than a science.”
-William R. Rassman MD. et al., Scalp Micropigmentation a Useful Treatment for Hair Loss
Considering the many variables of working on a “living-canvas,” it goes without saying that SMP is a highly technical procedure. However, the artistic components of the procedure are often overlooked. This may be partially due to the devaluing of the artistic component of the procedure by single day/session SMP clinics (more on this later). However, when a medical doctor (quoted above) acknowledges the artistic role of the procedure, in a peer reviewed scientific journal, prospective clients should take note. So, in addition to the aforementioned benefits of conventional SMP, the multiple session process, by providing ample time for the operator to exercise their artistic judgment, also provides the highest level of aesthetic refinement to clients.
The feedback-process over-time philosophy of the conventional SMP method, is both a recognition of the limitations of working with a living canvas as well as understanding that good artistry takes time. It is the result of years of development, and it is the only smp method that has been subject to scientific scrutiny. It is also the only method that is transparent in its practices.

Avoiding Transparency With Sales and Marketing.

So how does the single day/session procedure compare to the consensus conventional method? The website of the largest provider of said procedure does not say, but I contacted the company (as was likely the intention of the design of the site) on several occasions via multiple mediums. I had conversations with multiple representatives via phone, online-messenger, and email. I approached the single-session/day clinic with the understanding that they are the outliers in terms of the industry consensus. Since I was unable to see any logical inconsistencies with the conventional multi-session method, I placed the burden of proof (that single-session is equal or better to the conventional method) on the single-day/session clinic.

After much back-and-forth with several representatives this is what I learned. Their representatives are expert sales people, and while generally kind and courteous they consistently pushed for a consultation. In regards to the specifics of their procedure, they are experts at deflecting questions about how it is performed, and substitute transparency with claims of proprietary training methods, needles and inks/dyes/pigments. In avoiding comparisons to the conventional method, representatives claimed to be unfamiliar with how other’s perform their procedures (an obvious falsehood for any competitive business), and they refused to address how their one day/session method took aspects such as “healed results” and providing time for artistic decisions into account. Consequently, my natural skepticism towards procedural claims breaking with convention was only heightened by their lack of transparency.

The dominant impression imparted by the clinics website and their representatives is a celebration of the experience the clinic provides, the unified method of their “technicians” (a term that deemphasizes the importance of the operator’s artistic eye), their proprietary “technologies,” and of course the speed of the procedure. Not a far cry from the presentation of the offerings of a Sport Cuts style barber shop. These elements are substituted for transparency of procedural methods, and evidence of the experience and artistry of the individual operator. Both are key features on conventional SMP websites.

My conclusion, in short, when clinics make procedural claims without substantive evidence supporting the validity of said claims, prospective clients should be weary (in the least). There is no evidence that any proprietary needle, ink, or method of application can eliminate the operative trauma resulting from inserting ink into the dermis layer of the skin. As a result, there is no logical reason (when it comes to producing the best results), for neglecting the aforementioned benefits of multiple seasons (healed results, control of client, time for artistic decisions). Additionally, single day/session procedures put unnecessary stress on both the operator and client. This increases the risk of operator error, and decreases the operator’s time for making artistic decisions (a primary factor in producing realistic results). So, while it is easy to see why single day/session SMP is so attractive to the consumer, the lack of transparency coupled with aggressive sales/marketing techniques should be considered for those interested in a provider who breaks from the conventional method.

An Abbreviated Guide for Prospective Clients: Finding the best Artist for You.

  • Ask to see the specific practitioners portfolio (not just before and after from the clinic in general) for whatever procedure you would like done. You should ask for a minimum of 25 examples, and the after photos should be of “healed” or “cured results”
  • Ask to see the results of a previous client in-person. Again, be sure you are seeing the work of the specific artist and not a representative of the work of the clinic in general.
  • Be sure your practitioner is transparent about their methods: How many sessions will the procedure entail, how long each session is, and how much time is in between sessions.
  • Be wary of clinics that use aggressive marketing and sales campaigns.
  • Be wary of clinics making claims about their procedure that contradict the consensus view of multiple sessions (as mentioned above).
  • Be wary of clinics/practitioners that are not transparent with their methods. Claims of proprietary training methods (without providing specific details about those methods), proprietary needless and inks/dyes/pigments, are often used to impress the client while avoiding specific details about their procedures.

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