Postcards From Birmingham

by Andrea Darby - Master Medical Tattooist & Industry Educator
Saint Vincent's Hospital in Birmingham

We often receive requests for training in medical tattoo services from people with a diverse range of educational backgrounds including those with no previous cosmetic tattoo or health service experience right up to and including highly skilled health practitioners.
When I was first contacted by Dr. Michael Beckenstein back in 2013 what struck me the most about his inquiry was how humble his correspondence was particularly once had we performed our usual due diligence and I read more details about his background and experience; a highly respected Plastic and Reconstructive Surgeon based in Birmingham Alabama USA with numerous accolades for his standards in patient care. Media commentators sometimes say that communication via email and other online platforms lacks the sense of personality that can be gleaned from face to face conversation but right from the outset we knew that Dr. Michael Beckenstein or 'Mike' as he introduced himself was much more than a skilled surgeon he was someone we really wanted to work with.

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Over the next few months we juggled dates, planned itineraries and the training syllabuses and Dr. Beckenstein and his staff got stuck into our preparatory theory in preparation for practical training in a range of cosmetic and medical tattoo techniques with training to be conducted in his rooms within the Saint Vincent's Hospital in Birmingham. We knew that Dr. Beckenstein and his staff Genger Ferrell - SFA (surgical first assistant) and Savannah Yocum - CST (certified surgical technologist) had all had prior training in cosmetic and medical tattooing and they were looking to expand their skills in Scalp Hair Follicle Simulation Tattooing™/Scalp Micropigmentation, 3D Areola Tattooing and contemporary hair-stroke eyebrow techniques and it was an honour that they recognized the quality of our training courses and identified me as their preferred trainer.

Some of the constructive comments that are sometimes made about cosmetic and medical tattoo training providers by highly qualified health professionals is that equipment, pigments, procedural techniques, and course content being offered were not always of a standard that they felt was adequate for their patients. With this in mind our approach is carefully structured to ensure that we meet and hopefully exceed expectations of health professionals in those key areas and we encourage all our course students to aspire to the same standards regardless of their backgrounds or locations that they are working from.

In other words the health professionals set the standards that the cosmetic & medical tattoo industry should be aspiring too achieve.

Andrea Darby - Master Medical Tattooist

Birmingham is Alabama's largest city with a population of close to quarter of a million people and the greater metropolitan area has a population of over 1 million, during the late 1800 and early 1900's Birmingham was originally known for steel, railroad and manufacturing industries but during the later part of the twentieth century Birmingham also became well known for banking, telecommunications, transportation, electrical power transmission and high standards of medical care and college education.

Nearly three quarters of the population of Birmingham are African American people many of whom have deep ancestral routes in the region dating back to the late 1800's. The climate is humid and sub tropical with mild winters and hot summers and the close proximity to Atlanta and Nashville make it a great central location for historical, cultural and music adventures.

Saint Vincents Birmingham Hospital Alabama

Dr. Michael Beckenstein rooms are located in Saint Vincent's Birmingham (SVB) which was founded in 1898 and is Birmingham's oldest hospital, in July 2007 St. Vincent's Hospital merged with Eastern Health System to become St. Vincent's Health System which employs over 4,700 people throughout its five facilities; SVB is a general medical and surgical hospital with 409 beds and their reported survey data for the 12 months to June 2014 showed that 48,565 patients visited the hospital's emergency room, the hospital had a total of 20,258 admissions and its physicians performed 27,318 inpatient and 37,174 outpatient surgeries, quite impressive for a hospital of its size.

The Hospital has a reputation for a high standard of patient care and excellent physicians, during the time we spent in Dr. Beckenstein's rooms we had the pleasure of talking with several hospital staff and patients and its was obvious from all of our interactions that the hospital has a strong culture of friendliness and respect, those core principles lay the foundations for patient satisfaction yet unfortunately they can sometimes be absent from culture of large health care institutions.

One of the first things that impressed us about Birmingham was the friendliness and politeness off the people, I am not accustomed to being called Ma'am but in Birmingham its commonplace for people to use the words Sir and Ma'am during ordinary conversation and strangers will open a door for each other, those southern genteel manners are still taught to children in Birmingham which makes them seem quite remarkable compared to children and adolescents in other cities.

Breakfast Southern Style

Cuisine in Birmingham is a delicious excursion into spicy Cajun, BBQ ribs and hearty soul food; the grits biscuits and gravy accompanied by omelettes and home made jellies that we had at the Big Bad Breakfast were among the tastiest breakfasts that we have had anywhere. In addition to its unique southern dishes Birmingham also boasts a wide variety of international cuisines each with a slightly different interpretation to what we have had elsewhere and always served with a smile and southern manners.

Dinner at Crazy Cajuns'

During our visit with Dr. Beckenstein we shared many meals with Michael, his wife Colleen and his staff members which provided us some closer insights into the unique people beneath the health professionals, what we discovered was some truly warm, caring and hospitable people with strong interpersonal relationships, professionals who genuinely enjoy doing what they do. During our travels we have discovered that a sizable percentage of successful business owners practices are built upon those same foundations of strong relationships.


Dr. Beckenstein's Waiting Room

Dr. Beckenstein's waiting room is quite unique, a relaxed room with stylish furnishings and subdued lighting it is actually a room that you feel that you want to spend some time in rather than the cold and sterile waiting rooms that you will find in many traditional settings, a lot of thought has gone into creating the right mood and feel for patients to set them at ease before they enter the consulting rooms. There is good science behind this approach because calm relaxed patients are less likely to feel discomfort during treatments and more likely to have an overall positive experience from their interaction with the health service provider.

Each day prior to our cosmetic and medical tattoo training sessions Dr. Beckenstein and his team had already completed a challenging early morning surgery list and yet they arrived with energy and enthusiasm eager to add new techniques to their extensive range of patient services already on offer. We noted that they had an excellent rapport with their patients with good hearted mischievous banter sometimes resulting in broad smiles and laughter from the patients perhaps at times when they needed it most.

Genger Ferrell SFA & Michael Beckenstein M.D.

Genger Ferrell is Dr. Beckenstein's right hand and an important part of the equation for the smooth progression of their surgical list each day, a highly organised surgical first assistant with inexhaustible energy simply getting the job done with the minimum of fuss.

One of the aspects that medical tattoo trainers sometimes fail to recognize is that you cannot have the same approach to training sessions with highly skilled health professionals that you would with those with other types of educational/occupational backgrounds, our role is to communicate at their level and to adapt to their work environment and skill set not the other way around.

During the training sessions we adapted the approach to meet the needs of a skilled surgical team that were used to working in close association with each other during highly complex procedures, two experts functioning as a single unit with hand eye coordination occurring in tandem with an intuitive understanding of the needs and movements of the each other.

Genger Ferrell SFA, Michael Beckenstein M.D. & Andrea Darby MMT

Scalp Tattooing
is referred to by a plethora of names such as scalp stippling, scalp micropigmentation (SMP), Scalp Camouflage Tattooing, Scalp Trico Pigmentation and numerous other trademarked terms and the standards vary widely from provider to provider. Our course in Scalp Hair Follicle Simulation Tattooing™ (SHFST™) is the first course that was designed in conjunction with a health professional and specifically intended for health professionals and medical tattooists.

As time progresses we believe that an increasing number of hair transplant surgeons will follow the path of the early adopters such as Dr. Beckenstein and incorporate Scalp Tattooing into their range of patient services. Dr. Beckenstein and Genger Ferrell are also early pioneers of the Neograft form of follicular unit extraction which automates the harvesting of individual follicular units for transplant into balding regions of the scalp. Scalp tattooing is an excellent accompaniment to hair transplantation services as it can help camouflage scars from older forms of strip surgery and add the appearance off hair density in thinner regions.

Scalp Tattooing Immediately After First Treatment

The photograph above was taken immediately after first treatment during our training session for a patient with Hamilton Norwood VI hair loss and the one below shortly thereafter, skin redness quickly subsides and is almost completely gone within a few hours and density of pointillism's (pigment dots) will be increased on follow up treatments in a few weeks time, the goal is to gradually layer pigment until the target density is achieved. We find that skilled surgeons and their surgical assistants such as Dr. Beckenstein and Genger Ferrell quickly acquire the techniques required as they are already performing far more complex dexterous tasks on a daily basis.

Scalp Tattooing Side View Immediately After First Treatment

Those health professionals such as plastic surgeons or craniofacial surgeons and their staff who are accustomed to working with facial morphology and restoration of symmetry can sometimes intuitively understand the techniques that we use to design eyebrows or new lip contours when performing cosmetic tattooing on the face.

Andrea Darby MMT & Savannah Yocum CST

Savannah Yocum quickly adapted her technique to incorporate the use of a superfine needle to perform hair stroke eyebrows for clinic patients, this is particularly useful for those patients with no remaining eyebrow hair due to conditions such as alopecia areata, thyroid conditions and permanent hair loss subsequent to chemo / radio therapy or associated drug therapy (tamoxifen).

Breast Reconstruction & 3D Nipple Areola Complex Tattooing

In addition to those women who have mastectomies to treat diagnosed breast cancer there are an increasing number of women who once they are identified as having the BRCA1 and BRCA2 genes are opting to have prophylactic mastectomies in an attempt to reduce their risk of developing breast cancer later in life. Patients who have gone through a struggle with breast cancer or those who have made the tough decision to undergo prophylactic mastectomy and the trauma of reconstruction deserve to have all aspects of the reconstructive process provided at the highest possible standard and this includes Areola tattooing.

Breast Reconstruction Prior to Areola Tattooing

These photographs were taken before and immediately after 3 Dimensional Simulative Areola Tattooing (3D-SAT™) during our training session, Dr. Beckenstein's rooms are now offering 3D-SAT™ in complement to the exceptional surgical reconstructions being provided.

Breast Reconstruction After 3D Areola Tattooing

We have had the benefit of seeing some of the surgical outcomes in Australia, UK, USA and several other countries and we can say without hesitation that the standard of patient outcomes being achieved by Dr. Beckenstein and his team are extraordinary and in some cases ground breaking, the breast reconstructions being performed are superb and naturally they also wanted the very best medical tattooing to complement the quality of surgical outcomes that they provide.

I have no hesitation in saying that if you are a woman who is looking for a warm compassionate reconstructive surgeon who is working tirelessly with his team to achieve the best possible outcome for you then consider the merits of a trip to Birmingham Alabama, similarly if you are a man who is considering undergoing hair transplant surgery and you want a surgeon who is offering the full compliment of contemporary hair transplant and scalp tattooing services then I cant think of a better choice.

Presentation of Diplomas

Cosmetic & Medical Tattoo Training

We work hard to ensure that our cosmetic and medical tattoo courses are comprehensive and accessible to people with a diverse range of educational backgrounds and we view training sessions to be a shared learning environment with our colleagues, in many instances such as was the case in Birmingham I learn just much from the training days as those undergoing the training sessions and for that I am immensely grateful. Being education providers feedback is very important to us and I do not think that it gets much better than the feedback provided by Dr. Beckenstein on this link.

A Special Thank You

Prior to our arrival Dr. Beckenstein and his staff asked if there was anything that was on our must do list while in Birmingham, we said that we would really love to visit a gospel church as we had seen them on television but not previously in person, Genger Ferrell reached out to her friend and colleague Kim and they arranged for us to visit the New Rising Star Baptist Church in Eastlake. We could not finish this article without expressing our thanks to Pastor Thomas Beavers and his congregation for letting us visit their church, making us feel welcome, and enabling us to experience the musical joy of their gospel service.

Important Contact Information

Dr. Michael Beckenstein
Address: 800 Saint Vincents Drive #610, Birmingham, Alabama 35205 USA
Phone: (205) 933-9308

Roll Tide!


Our gratitude to all the staff and patients of Dr. Beckenstein rooms who contributed immensely to the success of our training sessions.

Date of most recent revision: 27/10/2014 (mutatis mutandis)
Original publication date: 25/10/2014

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The content of this article should be regarded as general information & is provided solely for the purpose of discussion & is not intended to replace cosmetic tattoo training or medical advice in any instance, always check with a cosmetic tattoo master trainer and or a qualified medical practitioner before acting on any information regarding cosmetic tattooing or in relation to any medical condition or medical circumstance.

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