Transitions

Multitrepannic Collagen Actuation, Percutaneous Collagen Induction, Collagen Induction Therapy, Dry Needling, Dry Tattooing, Needle Dermabrasion all apply to a tattoo procedure where the effect of the healing process results in scar remodeling. Typically, they all can help but there are significant variations in the service and tools that really make a difference.

So, who came up with this concept, what is the history of the players, what tools are used and the differences in technique. 

So lets start with the first known Dr. involved with the needling technique and some of this statements.  To my best knowledge, Dr. Camirand made his observations in the late 80's and published in '92.

Dr. Camirand Says:

"This gave us the idea that the puncturing or trepanation ( same as Trepannic?? ) of the scar was responsible for the great improvement and repigmentation of the scar. From this idea, we began tattooing without pigment hypochromic scars following face lifts, with improvement of the scar and improvement of the pigment. The technique had been described at the Xth Congress of the International Confederation for Plastic and Reconstructive Surgery in Madrid, Spain in June 1992 and at the XIIth Congress of the International Society of Aesthetic Plastic Surgery in Paris, France in September 1993...."We use 9 or 12 needles and at high speed, we perforate the wound until it bleeds. The needles must penetrate the epidermis and part of the dermis. We can feel spontaneously a softening and stretching of the scar. By puncturing with needles, we leave some islands of intact tissue that will assure the regeneration of our tissue"...Extracted from a publication of Dr. Camirand

trepanation    Synonym: trephination.                                   

trephination  Removal of a circular piece ("button") of cranium by a trephine.

Synonym: trepanation.

trephining:  The removal of a circular disk of the cranium. It is performed with a trephine, a small circular saw with a centre pin mounted on a hollow metal shaft to which is attached a transverse handle.

After Dr. Camirand came Dr. Des Fernandes.  Dr. Fernandes read Dr. Camirand's observations then coined the phrase ""Skin Needling" and then used the more impressive categorization of Percutanous Collagen Induction. Dr. Fernandes published his findings in '96

Dr. Des Fernandes Says: "I was impressed by the publication of Camirand to make scars less obvious by using a tattoo gun to "needle abrade" the scars" ..."Skin needling is the name I use for a special treatment that I have introduced and pioneered. It is based on the old technique of tattooing, but of course, no pigments are used"...  "I use a tattoo-artist's gun with 4/5 needles in a straight row. The skin must be held tightly and the excursion should be sufficient to penetrate skin. It is usually easier to work in the Langer's line but I also work in a contrary direction as well" ... "But the tattoo gun could be cumbersome", so Des designed a medical device known as the Medical Roll-Cit",  Extracted from a publication of Dr. Fernandes

Main Entry: per·cu·ta·ne·ous
Pronunciation: "p&r-kyu-'tA-nE-&s
Function: adjective
Date: 1887
: effected or performed through the skin
- per·cu·ta·ne·ous·ly adverb

Dr. Des Fernandes Wrote:

Dear Frank,

Sorry that I have taken so long to reply. I have been to Japan, Singapore, Poland and Germany since your wrote this letter talking about needling.

Thanks for telling me what you know about trepination. I have seen patients who have been treated with the needles rupturing right through the dermis. This causes a lot of scarring and delayed healing. I prefer to penetrate only to about 3mm at maximum and if one does it that deeply then you cannot have the density of holes that is usual with the tattoo machine. That is the essential difference between trepination and percutaneous collagen induction. PCI should not do any more damage to the skin than a simple tattoo. However, we have to realize that if one did the deeper needling at the density of a tattoo, then the skin would be scarified, and sure one would get a lot of collagen (in the form of scar tissue) and not a restoration of the complex elastin and collagen network which we aim to achieve with needling. Yes, the important point is that very many people can be helped by their tattoo artists and get better results than from expensive lasers. However, deeper scars need greater penetration with the needle. Even if the extra needling is done by hand with a single needle, this is well worthwhile doing.

Use the cross weave pattern in the same way.
No doubt you have the expertise and experience

Kind wishes, Des

This was a letter we received by Dr. Fernandes

Then came  "Multi-Trepannic Latrology "

"Multi-Trepannic Latrology Recently the use of a laser of micro-entomology needles to stimulate collagen and melanin re-pigmentation has been under current research with the American Institute of Permanent Color Technology...This process is designated as Multitrepannic Actuation (MCA), derived from the Greek word, trypanon--to bore." also "In 1993, I introduced a technique permanent makeup industry that I called "Multrepannic Collagen Actuation"  

Wait a second, didn't Camirand use the trepannic word in his documentation?  And isn't this MCA actually the same service as Dr.Des Fernandes and  Dr. Camirand's.  And didn't Susan Church publish an article regarding Skin Needling with the Society of Permanent Cosmetic Professionals in '91. Ok, what is really important is that this tattoo procedure really, absolutely and positively can help with scarring.

Still to date, I haven't heard of a "laser of micro-entomology needle."  But it sounds cool.

Transitions Advanced Multitrepannic Collagen Actuation (or Dry Needling)

Our system is based on research of alternate remodeling techniques and with the assistance of Doctors, Nurses and generous input from Dr. Des Fernandes. We believe that the tattoo machine has potential to help but it should not be regarded as "The best" tattooing method for scar remodeling.  Remember that the tattoo machine has a reputation of causing damage to the skin and with that comes many warnings.  Ever see raised tattoos?  It's macerated skin resulting from machine work. Even a single pass with a tattoo machine can change the texture of the skin.

So these are our views: We call it Dry Tattooing. We leave it to others to think of these impressive names for the same type service.  We and others including Dr. Des Fernandes consider this service a tattoo procedure.  We have specialized hand tools and coil needles to provide the best penetration, with minimal resistance. This means no bruising, macerating or hyper pigmentation. And no long recovery period.  Moreover, the hand tools allow us to be more precise and accommodating to rolling hypertrophic scars.  Acne scars can be treated individually. 

So to Summarize:

Dr. Camirand- Used Tattoo Machine and Conventional Tattoo Needles             We didn't find that "we leave some islands of intact tissue"  a positive approach. Remember macerate. 

Dr. Des Fernandes - Used Tattoo Machine and Conventional Tattoo Needles  Eventually developed the Roll-Cit  "if one did the deeper needling at the density of a tattoo, then the skin would be scarified, and sure one would get a lot of collagen (in the form of scar tissue)" Remember macerate. 

 "Multi-Trepannic Latrology"  Used Tattoo Machine and a "laser of micro-entomology needle."  This is sure better than using conventional needles, however it is typical that these needles still maintain a tight configuration and will have resistance when penetrating the skin. This procedure still maintains a moderate level of risk but is still an improvement over the previous techniques because the use of fine needles. Still, it's just tattoo needles.

Transitions  We use tattoo machines tuned specifically for Dry Tattooing. We have also developed Uniquely Designed Entomology Dry Tattoo Needles and Hand Tools.  On our tools, the individual needles are spaced further apart than conventional tattoo needles.  This spacing minimizes penetration resistance allowing greater access to deeper scarring. Using the hand tool properly minimizes any risk of overworking the skin.

As you can see, there are really only two ways to perform "Dry Tattooing".  The old way using only a tattoo machine with tattoo needles (MCA & PCI) or the better way. Using Transitions Uniquely Designed Entomology Dry Tattoo Needles and Hand Tools. Both ways help, it's just our way helps better.