--- ## **Chapter 1. Scalp Anatomy, Histology & Physiology** ### **[[1.1 Macroanatomy of the Scalp]]** 1.1.1 Five-layer structure of the scalp (SCALP mnemonic) 1.1.2 Regional anatomical variations (temple, vertex, occiput, hairline) 1.1.3 Vascular territories and watershed zones 1.1.4 Nerve distribution and pain mapping ### **[[1.2 Microscopic Anatomy Relevant to SMP]]** 1.2.1 Epidermal layers and cell turnover 1.2.2 Dermal matrix (papillary vs. reticular dermis) 1.2.3 Capillary plexus and lymphatic drainage 1.2.4 Follicular unit anatomy and SMP target correlation ### **1.3 Skin Physiology and Regeneration** 1.3.1 Skin barrier function and sebaceous activity 1.3.2 Transepidermal water loss and pigment clearance 1.3.3 Regional variation in scalp thickness 1.3.4 Hair cycle physiology and density zones --- ## **Chapter 2. Pigment Science and Biocompatibility** ### **2.1 Composition of SMP Pigments** 2.1.1 Carbon black: chemical structure, particle size, reactivity 2.1.2 Iron oxides and synthetic pigments: pros and cons 2.1.3 Suspension media: glycerin, water, alcohol, surfactants ### **2.2 Pharmacokinetics of Pigment in Human Skin** 2.2.1 Diffusion, lymphatic clearance, and macrophage uptake 2.2.2 Pigment stability vs. degradation (oxidation, photobleaching) 2.2.3 Pigment migration mechanisms and histological findings ### **2.3 Color Theory and Optical Properties** 2.3.1 Optical scattering and dot perception in different skin tones 2.3.2 Subdermal reflection and melanin interaction 2.3.3 Color shift over time: chromophore behavior in vivo ### **2.4 Safety and Regulation** 2.4.1 Allergenicity and heavy metal contamination 2.4.2 MRI compatibility and ink safety studies 2.4.3 Sterilization, batch control, and labeling compliance --- ## **Chapter 3. Wound Healing and Inflammatory Kinetics** ### **3.1 Phases of Healing Post-SMP** 3.1.1 Inflammatory phase: cytokines, edema, and platelet signaling 3.1.2 Proliferative phase: fibroblast activation, collagen synthesis 3.1.3 Maturation phase: melanocyte activity, scar remodeling ### **3.2 Factors Influencing Pigment Retention** 3.2.1 Role of immune clearance (macrophages and lymphatics) 3.2.2 Influence of scalp circulation and skin hydration 3.2.3 Sebum, sweat, and pigment washout rates ### **3.3 Healing Variations by Skin Type** 3.3.1 Fitzpatrick I–VI: thickness, PIH risk, and response 3.3.2 Aging scalp vs. young scalp: collagen content, elasticity 3.3.3 Pathologic healing: keloid tendency, hypertrophic scars --- ## **Chapter 4. SMP Instrumentation and Technical Science** ### **4.1 Micropigmentation Machines** 4.1.1 Motor design: torque, stroke, and oscillation patterns 4.1.2 Digital vs. rotary SMP pens: pros and clinical use cases 4.1.3 Voltage and RPM adjustment: scientific basis ### **4.2 Needle Engineering** 4.2.1 Needle types (1RL, 3RL, nano): dot size and tissue damage 4.2.2 Taper length, tip geometry, and fluid dynamics 4.2.3 Ideal needle-skin angle and penetration velocity ### **4.3 Pigment Delivery Physics** 4.3.1 Capillary action, ink flow, and backpressure 4.3.2 Viscosity effects on dot clarity and diffusion 4.3.3 Real-time depth control strategies --- ## **Chapter 5. Clinical SMP Technique** ### **5.1 Pre-Procedure Protocols** 5.1.1 Medical history and dermatologic assessment 5.1.2 Skin prep and antisepsis for follicle simulation 5.1.3 Pain management options: topical vs. injected anesthesia ### **5.2 Pigment Implantation Strategy** 5.2.1 Optimal epidermal-dermal junction targeting 5.2.2 Session planning: density building and layering 5.2.3 Frontal hairline, crown, temple-specific adjustments 5.2.4 SMP for donor and recipient scars (FUT, FUE) ### **5.3 Patient-Specific Technique Adjustments** 5.3.1 SMP on oily scalp vs. dry scalp 5.3.2 SMP on thin vs. thick skin zones 5.3.3 SMP for women vs. men: density illusion, hair preservation --- ## **Chapter 6. Complications, Pathology, and Management** ### **6.1 Pigment-Related Complications** 6.1.1 Blurring and migration: depth control errors 6.1.2 Color shift: chemical oxidation and photodegradation 6.1.3 Uneven fading: immune-mediated vs. technical ### **6.2 Dermatologic Complications** 6.2.1 Contact dermatitis and hypersensitivity reactions 6.2.2 Folliculitis, granulomas, and foreign-body responses 6.2.3 Keloid and hypertrophic risk management ### **6.3 Corrective Strategies** 6.3.1 SMP revision layering 6.3.2 Color camouflage techniques 6.3.3 Laser removal (Q-switched 1064nm) protocols --- ## **Chapter 7. SMP in the Context of Medical Hair Restoration** ### **7.1 Integration with Hair Transplantation** 7.1.1 SMP pre- and post-transplant (FUT/FUE timeline optimization) 7.1.2 SMP for donor depletion and density illusion 7.1.3 Scar coverage in graft failure and repair cases ### **7.2 SMP for Alopecia Patients** 7.2.1 SMP in alopecia areata and totalis 7.2.2 SMP in chemotherapy-induced alopecia 7.2.3 SMP for diffuse vs. patterned thinning in women --- ## **Chapter 8. Ethnic Skin, Aging, and Cosmetic Planning** ### **8.1 SMP Customization by Ethnicity** 8.1.1 Korean, East Asian, and Southeast Asian scalp physiology 8.1.2 SMP pigment matching for Asian undertones 8.1.3 Cultural aesthetics of hairline design in Korean men and women ### **8.2 SMP and Aging Scalp** 8.2.1 Age-related collagen loss and pigment stability 8.2.2 Adjusting needle depth and pigment density 8.2.3 Long-term follow-up and retouch scheduling --- ## **Chapter 9. Evidence-Based SMP Practice and Research** ### **9.1 Literature Review and Histologic Findings** 9.1.1 Key peer-reviewed studies on pigment placement 9.1.2 Histologic comparison of SMP vs. tattoos 9.1.3 Future directions in SMP pigment pharmacology ### **9.2 Clinical Protocols for Academic SMP Practice** 9.2.1 Consent, documentation, and medical photography 9.2.2 Pre- and post-treatment standardization 9.2.3 Data collection for case series and publication ---