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Scalp Micro Pigmentation (SMP)


Almost 40% of new Forhair patients seek reparative work. New advancements in hair transplant techniques allow us to correct bad hair restoration results, scarring, and other mishaps from previous surgeries. Patients who select Forhair enjoy the results they sought in the first place.

Follicular Unit Transplantation (FUT) and other earlier procedures leave significant scarring. They also have other drawbacks -including a noticeable “plug” appearance. Still, other patients may be disappointed with FUE results from other clinics.


Sometimes a hair transplant procedure, for whatever reason, is out of reach. In such cases, Forhair recommends Scalp Micro Pigmentation (SMP). An all-natural pigment tattoo, SMP covers the scalp with little marks that convincingly look like hair growing follicles. This procedure brings several benefits to:

  • Those with hair thinning -SMP makes thinning spots look fuller
  • Those with hair loss -SMP on bald areas makes them appear to have real, growing hair
  • Those with scarring -SMP helps cover hair transplant and other types of scars

Ideal for several types of patients, SMP procedures essentially enables people to wear a buzz cut with uniform thickness and/or maximize the appearance of thick hair.


SMP has been around for decades, though it was often only for camouflaging scars. The advent of SMP becoming a common hair loss solution, though, is recent. Many specialists claim to be inventors of the method. The truth, though, is that they are merely adding new techniques to improve the method. To be fair, their results have also been improving since the early 2000s. Patients looking into SMP need only look at images of SMP results before and after 2010. Most SMP procedures before 2010 looked obvious, though thankfully most were using temporary pigments. Post-2010 SMP typically features more natural-appearing hairlines while follicle markings have more texture and dimensionality.


An established method, SMP is both an art and a science. Many clinics offer the procedure but are aware -applying SMP requires skill. Forhair SMP specialists are top caliber and expertly trained, one reason we are among the leading clinics to offer the procedure in the Southern U.S.

Specialists can create any type of hairline or can use any number of pigments. SMP remains on the scalp anywhere from 3 to 5 years, making the method one of the longest-lasting cosmetic procedures outside of hair transplants.

Patients may feel some mild discomfort during the initial part of the procedure. Recovery, though, happens in next to no time. A successful Forhair SMP procedure can also require up to 3 sessions. The number of sessions really depends on the amount of SMP your scalp requires. Reasons for multiple SMP sessions include available and scar coverage.


SMP marketing is now both commonplace and high profile. However, patients must be aware that there is a huge difference between an SMP specialist and an MD who specializes in hair transplantation and hair restoration. As one might guess, the former is proficient at applying SMP. Hair transplant specialists, meanwhile, are experts at actually restoring the patient’s hair. This includes hair transplant procedures, outpatient hair restoration treatments, and expert advice regarding take-home treatments, diet, and general hair care.

Though requiring a far less complex skillset, the world of SMP specialists is quite similar to that of hair restoration specialists in one way: variance of results. Not all SMP specialists are equal. In fact, many people offering SMP are downright charlatans. Always be careful! Modern SMP is not permanent but an obviously artificial hairline can be worse than a balding hairline. Laser treatments are possible in such a scenario but it really depends on the depth and pigment. Further, some lasers can damage the remaining follicles. Physically removing the SMP pigments is another option.

That mentioned, even the best SMP specialists lack one area of expertise that hair transplant surgeons often excel at: scar camouflage. Dr. Cole particularly excels at creative solutions that combine SMP with Cole Isolation Technique (CIT®) to correct other clinics’ disappointing or damaging transplants. Such reparative work is a specialty at Forhair. Around 40% of our patients request we correct other doctors’ work!


Most hair restoration procedures can leave scars. Their severity often depends on the procedure. Two are by far most common:

  • Follicular Unit Extraction (FUE) -Usually dependent on the physician’s skill, FUE scars are most often a mothball shape and can be noticeable with a buzz cut
  • Follicular Unit Transplant (FUT) -An older method than FUE, FUT always leaves a noticeable orbital scar that ranges in severity depending on the surgeon’s skill

SMP is ideal for covering both types of scars. FUE scarring typically requires fewer SMP treatments. FUT scars, on the other hand, require more treatments. The end result, for most patients, is being able to buzz the back and sides of their hair without noticeable scarring. SMP can also cover elevated scars from FUT, or marks that rise above the scalp.


This patient desired to add more density to his frontal area and crown. He opted for our shaven procedure and noticed some visible hypopigmented FUE donor scars from his previous surgery with another doctor. As you can see, his hair is dark and extends down into his scalp about 4mm. The undisturbed hair in his donor region has a natural “tinting” effect upon his skin, giving it a grayish flesh tone. This natural tone is disturbed by the white extraction site dotting is known as hypopigmentation. Correcting our patient’s skin tone in the hypopigmented areas via SMP has made a world of difference and helps to blend the scars in with our patient’s virgin scalp.

Our patient’s previous doctor placed his hairline way too low at about 5cm above his eyebrows. The hairline design is too straight and does not make efficient use of his limited scalp donor supply.


This patient began hair transplant surgery during the time where plug grafting was the norm and the results were disfiguring. They began by harvesting large plugs from the donor area and allowing them to heal without closure. This left wide “shotgun” scars in the donor area. The patient followed this up with a strip harvest and minigrafts. The result in both the donor area and recipient area was very unnatural. We used a procedure that Dr. Cole invented in 2003 called plug removal and redistribution to improve the recipient area. There was a wall of hair near the hairline, that needed to be “thinned out”. The donor area was another problem. We harvested individual follicular units within the donor area to add density and naturalness to the front. Plugs and mini-grafts leave islands of hair surrounded by bald skin. These islands needed to be thinned out and hair needed to be added in the oceans of bald skin surrounding the dense islands of hair. Next, we addressed the donor area with micro-pigmentation. This is an excellent choice to improve donor scarring. The results were night and day and immediate. Now, our patient can walk about with a shaved head and not be self conscious.


Forhair prides itself on leaving minimal scars. (CIT®) uses a minimally invasive technique for this very reason -patients heal faster and typically enjoy no noticeable scars. Such emphasis is contrary to most hair restoration clinics, where patients often walk away disappointed. As mentioned, around 40% of our clients come to us looking to repair work from another clinic.

Few hair transplants surgeons are as adamant about results as Forhair. A policy of offering SMP for free in the case of noticeable scars, in fact, would put many surgeons out of business -hair transplant scars are that prolific. Our policy both reflects our confidence in our skills and our belief that the patient always comes first.


While excellent for camouflaging scars and adding the appearance of thickness, hair restoration has many options. Hair transplants are increasingly viable. CIT®, for instance, overwhelmingly causes zero noticeable scarring due to its minimal invasiveness. The emphasis on minimal penetration also leaves stem cell remnants, enabling 30% to 40% of donor follicles to regenerate with the application of ACell. Put simply, such regeneration means 1300 to 1400 new strands of hair for every 1000 single implants. Cytokine Rich Plasma (CRP), an advanced version of Platelet Rich Plasma exclusive to Forhair, is also showing major promise, as are Follicular Stem Cell Infusions.

Of course, SMP is still an important cosmetic treatment. Many patients like the look it offers while other patients find it useful to give the appearance of denser hair. SMP is also proving indispensable for masking scars of all sorts. Learn more about SMP and other methods by scheduling a free consultation today!

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