ACell, a Current Review of Applications in Hair Transplant Surgery

And one more Question:
Dr. Hitzig, what do you think about FUE Hairmultiplication by regenerating the donor with Acell PRP after a FUE procedure? Are you or Dr. Cooley working on this?

And thanks a lot for answering questions here.

Dr. Hitzig, I hope you understand my scepticism, but now you say you hit 5 consecutive jackpots back in 2003, and then no luck?
You tested the technique in 5 individuals, and reported a 80-85% average yield. This was beard plucking without Acell.

Now you say that it was just 5 consecutive jackpots, and then the good luck disappeared. Sorry but I can't believe it.
Furthermore, you maintained the 5-patient success story in your website until recently and I think you never reported that it was just a "jackpot" and the technique was really a failure.

Now, regarding the strip healing with Acell (the 3 photos we have been discussing in the last few days) you have not addressed our doubts.
1. Why did you shave the hair only under the scar? The supposed fine scar on the left can't be seen properly because you parted the hair upwards, and the partline coincides with the position of the supposed scar.
The fine line seen on the left could be just an illusion created by the hair parting. I can't see any significant "whitish remnant" you are talking about.
If you were so excited about the result, why didn't you shave it properly to properly expose the beautiful tiny scar?
2. Could you post the photos "just after surgery" on this patient?

thanks

Quote:

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Originally Posted by Gary Hitzig MD

Yes as was pointed out and I had discussed on the Bald Truth Program several times, my initial pluckings in 5 patients did have an incredibly high yield. If you remember, I also stated that it was like walking into a casino and putting a dollar in the slot machine and winning-you generalize too quickly that it will always happen-it did not!
If that was universal I would never had sought out adjunct treatments (especially ACell) to improve my success rate. The results were preliminary yet exciting with the hope of future expansion on the technique to make it more viable. I have always had my limits on where I applied it and never intended to use it to replace traditional donor, but instead to help those with limited or no donor or for those with very small areas of hair loss.
ACell allowed us to start plucking scalp hair and develop a successful transference to other scalp areas-only beard hairs had worked in the past.
We are proceeding carefully so as not to generalize our early results-we hope to sustain them and have others reproduce or improve on the technique which is tedious. Let me say that despite what some have said, the plucked hairs DO grow back.

As far as the donor picture with ACell, this was a medical student who had a large transplant and agreed to have his donor area closed with ACell plus simple loose sutures on the left, and simple sutures alone loosely applied on the right. He was of course rewarded for his volunteering (reduced fee) but also knew he would never be shaving his head. He also knew, as a Student Doctor the point of the trial. If you magnify the pictures you will see the whitish remnant of the scar on the left although hairs grow through it. The right side speaks for itself. This was a case who came for re-evaluation very recently and it was exciting to see the result. Will this be every result-I hope so but can't and won't predict but if you look at the slide show from my talk, you will see it to be very dependable.
Sorry not to have posted in a bit but I have been quite busy with my paper and with some exciting new stuff.
Best to all of you
GH

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If Dr Hitzig is writing a paper, then we should wait for this, there is no point in hear say now. What journal will it be published in?

Dr. Hitzig, Do you have an update on the results for the enhanced PRP? What about the HIP Stem Cell extraction procedure you were going to learn? Did you finally get in contact with Cotsarelis? Hopefully you have some good news on all of this. Thanks DOC.

Montrose,
How much did they tell you the PRP+ACell injections were at Dr Hitzig's office??($$$$$)
I am curious since I might get the treatment myself.
Please let me know in order to evaluate if I should procede with Dr Hitzig or Dr Greco.
Thanks

When I contacted the office I was told it would cost $3000.

Quote:

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Originally Posted by montrose

When I contacted the office I was told it would cost $3000.

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I think trialists should be paid money, not charged. :)

Ah, Dr. Hitzig, something else.

It seems that your colleage Dr. Cooley is having difficulties planting plucked hairs on scar tissue. First he said that yield was 40-50% but now it seems that it was just a "jackpot".

You, however, seem to be quite sucessful doing autoplucking on scars, because, in your Acell presentation, you claimed that you planted 55 plucked hairs on a scar, and not only they grew, but amazingly they multiplied to 150 hairs!! :)

So, I think dr. Cooley needs your help. Would you help him to achieve good results with autocloning in scar tissue?

http://www.iahrs.org/news/acell-matr...inary-results/
Part I, Minute 7:40.
Hitzig plants 55 plucked temple hairs on a "long standing refractory scar".
At 4 months, early growth can be seen, according to him.
At 8 months, there are 150 hairs growing on the scar.

$3000??? Why so much for something that does not guarantee you anything excellent??

Can we see results of the transplants with robust growth? Why haven't more pictures come out? If you are seeing much higher hair counts the recipients should look incredible. These donor pics are impressive but I'd like to see both sides.

Quote:

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Originally Posted by CVAZBAR

$3000??? Why so much for something that does not guarantee you anything excellent??

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I agree with you. PRP injections by themselves cost $1000, so an extra $2000 seems crazy. If the price came down a bit i would definitely give it a shot.

Thanks Montrose. I agree way to expensive for an alternative with unproven or definite results yet.

With the use of ACell in the donnor area, what would you say the percentage of regenerated donnor sites comes out to be?
In other words say you use 1000 grafts, how many of those sites would you say regenerates follicles?

Quote:

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Originally Posted by montrose

I agree with you. PRP injections by themselves cost $1000, so an extra $2000 seems crazy. If the price came down a bit i would definitely give it a shot.

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Even $1000 is too much. Remember every person is different and until they prove that it will guarantee good results for everyone, its definitely not worth it. This is truly unfair knowing people will desperately try it and probably wont get anything out of it. Not everyone is rich to be throwing away thousands of dollars for some shit that cant guarantee you anything. After you pay $3000 for the treatment, what next? You will have to go back a month later to get another shot? HAHA. What if you need it constantly to maintain what you have? How the hell do you afford that? I thought this was to HELP people from suffering, not to milk the shit out of them.

Quote:

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Originally Posted by Gary Hitzig MD

The results are what they are to date. It's still early but very promising. I have always felt that it's easier to save the hair than to grow it back and I do believe there is a point of no return when the miniaturazation is irreversible.
As I keep telling multiple patient inquiries, please prove me wrong.
I think time will tell us whether we need multiple injections or if not, how long between them. I look as the ACell/PRP injections like a flu shot--it may not work 100% but it certainly is helpful.
Sorry you haven't been blown away by the results, but the results are the results to date.
Hope to blow you away in time.
GH

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Than you for your response Dr. Hitzig.

If anything, I would definitely do the ACell/PRP injection over any hair transplant, i'd take my chances with growing/strengthening my native hair and maybe regrowing some of the peechfuzz I have around my forehead, rather than get a transplant. I am only 22 years old, seeing the pictures in your page, made me happy that I have more hair than those guys' "after" pictures. It made me happy because maybe it can work twice as better for me. It didn't have me jumping around in my seat but I believe it shouldn't have, at least not yet? If i'm not mistaken, you said this is just early experimental stuff? As an experimental treatment, yes it is great results. But maybe my wording was wrong and I should have said as some kind of a "cure" it didn't blow me away. But i'm definitely excited about what's ahead with ACell and to tell you the truth, if I can afford it right now i'd have called you right now and taken the ACell+PRP injection tomorrow :cool:

Definitely, down the line, your PRP+ACell injection is my number 1 option. It's very convenient too since I live in New York. For now i'm stuck with Minoxidil+Finasteride. I'll keep my fingers crossed that everything goes well with ACell, because I may very well take the plunge soon.

Quote:

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Originally Posted by drcole

I have been doing non-shaven FUE for many years. i strongly feel this is the future in FUE for all patients. It requires more preparation time, but it does allow the patient to return to work the next day without shaving. There still are many physicians who are unaware that patients do not need to shave their donor area. i've done well over 3500 grafts on a patient in one day without shaving the donor area of my patient. i think a good mark is about 2000 to 2500 grafts in one procedure non-shaven, however.

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How do you perform F.U.E. without shaving the patient? How would you gain access to the follicles?

Quote:

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Originally Posted by drcole

i honestly think that Dr. Hitzig and Dr. Cooley need to inject the donor area with Acell, in addition to the plucked follicles. i'm really worried about what will grow in the donor area if they do not do this. I'm sure they will keep us posted on their results.

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Are you saying you're suspicious there would be loss in the donor area when using the plucking method? If not, I'm unclear to what you mean; if so, I'm as unclear, though in a different way (as far as I know, plucked hair grows back — it's why beauty parlors continue to exist...).

Quote:

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Originally Posted by Jerry Cooley, MD

We charge for the plucking procedure the way we charge for FUT. In other words, the fee for 2,000 plucked grafts is the same whether it is FUT or plucked, even though it takes us twice the amount of work to do a plucked case. The reason for the reduced fee is that we don't have the same track record with plucked grafts and in exchange for the uncertainty, patients recieve a discounted fee. When the procedure is more firmly established, we will charge in accord with the time, effort, and expense on our part. We have no plans to price gouge, only to charge fairly.

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Dr. Cooley, in what way does the plucking technique require "twice the amount of work"? I would think, as you don't need the careful labor of a physician extracting follicular units (F.U.E.), or of technicians creating such units under a microscope (F.U.T./strip-harvesting), the procedure would be far less costly.

Also, simply owing to the still-very-experimental nature of the work, I'm surprised to read it's being charged at the same rate as is the strip-procedure.

Quote:

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Originally Posted by tbtadmin

Patient had transplant approximately 1 year ago. The right half of the donor was sutured normally, the left half was sutured normally and injected with ACell suspension (Spun down Arterial Blood)

NOTE THE EXTREMELY FINE LINE ON THE LEFT WITH HAIR GROWING THROUGH IT.

Attachment 8604
Attachment 8605
Attachment 8606

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Whose work is this?

Quote:

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Originally Posted by blueheel

Donor @ 3 weeks
Recipient 17 days

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Is this with plucking+ACell?

Quote:

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Originally Posted by HairTalk

Whose work is this?

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That is Dr.Hitzig

Quote:

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Originally Posted by Spanish Dude

Ah, Dr. Hitzig, something else.

It seems that your colleage Dr. Cooley is having difficulties planting plucked hairs on scar tissue. First he said that yield was 40-50% but now it seems that it was just a "jackpot".

You, however, seem to be quite sucessful doing autoplucking on scars, because, in your Acell presentation, you claimed that you planted 55 plucked hairs on a scar, and not only they grew, but amazingly they multiplied to 150 hairs!! :)

So, I think dr. Cooley needs your help. Would you help him to achieve good results with autocloning in scar tissue?

http://www.iahrs.org/news/acell-matr...inary-results/
Part I, Minute 7:40.
Hitzig plants 55 plucked temple hairs on a "long standing refractory scar".
At 4 months, early growth can be seen, according to him.
At 8 months, there are 150 hairs growing on the scar.

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PVTPoint2000 might argue this point
http://www.************.com/forums/m...VIEWTMP=Single

/forums/messageview.cfm?catid=5&threadid=93401&messid=7918 75&parentid=791520&FTVAR_FORUMVIEWTMP=Single

************(dot)com

************ ... god damn

i give up .. sorry pvtpoint2000 for not getting permission to post your comment on another board

here it is
I had a small test area done back in Sept Last year.......I had about 60 or so ACELL treated plucked hairs placed into the center of my strip scar with ok results thus far .....many grew....I also had several small white FUE spots removed via punch and treated the small wound with ACELL but as of now they look the same.........Cooley said to give it a few more months.........I will revisit him mid this rear for a total eval....

Found this forum and read the whole thread. It is rational but in some way its good to read a story from a repair patient who benefits at least in a small way from plucking.

If if RIGHT now there might be problems to create the density of a whole Graft (i think someone will fix this anyway) it seems more then promising.

And also it seems that the hairs did grow like your normal donor hair in the scar area.

I hope this guy keeps people informed but i wont register myself there because this forum is really depressing to me in some strange way (very bad vibrations)

PVTPoint posted in this forum, but now he prefers to remain silent:

http://www.baldtruthtalk.com/showthr...0879#post20879

Quote:

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Originally Posted by Spanish Dude

PVTPoint posted in this forum, but now he prefers to remain silent:

http://www.baldtruthtalk.com/showthr...0879#post20879

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maybe he doesnt post in every forum

i found this on hair loss help site, so maybe you can ask him on that forum

he was active at hlh a few days ago.

But SPanish Dude has i t occured to you that it could maybe that pvt is quiet for a reason? For a good reason, because lets face it here. If someone gets hair transplanted with a new promising technique and the result would be "non existing".

We all know that in this case the person would be all over the forums and would say negative things about this.

But why is pvt not doing so even if he had bad hair transplants in the past? Has it ever come to mind that he could be satiesfied and is going for more.

At HLH he also said that many plucked hairs grow in the scar. And also nobody from here would be that calm if it wouldnt work, and this guy is someone who doesnt speak through flowers here.

Just my 2 cents here

with due respect to pvt his reason to post or not to post could be personal. it might not have anything to do with the outcome of his procedure but conspiracy theorists will quickly assume that the procedure didnt work out because he did not report back. he owes the community nothing and probably has more important things to do in his life.

i regret copying his post on this board, have sent him a private message to appologise for dragging him into this discussion.

I also dont think that his outcome was negative because 7 days ago he said "Many grow" but the rest of his posting was short.

Maybe he is used as one of the test patients for major plucking sessions.

I've asked the question before but I'll ask again. With the reports of "Robust Growth" and seeing cloned hairs appear after transplanting why would they not show the pictures of the recipient areas? In theory, if the growth is robust and they are actually getting more hairs then transplanted by a huge margin why would they not be all over the place?

There a few pics of what they call "robust growth"

http://www.***************/hair-loss...ell-matristem/

substitute regrowhair

I've seen those, I mean pictures of all the people with good results that have been reported by these doctors. I don't mean to sound rude, I just don't understand why we aren't seeing more before and afters, makes no sense to me, would only boost their profits with the amount of patients it would bring in.

Ok some people here doubt that plucked hairs actually survive and are dht resistant. We all know that the most important thing is the follicle right.

Then just look at this picture and search where exactly the "follicle" is and you got your answer if you compare the fotos of plucked hairs with this picture :-)

http://en.wikipedia.org/wiki/File:Skin.jpg

Enjoy ^^

I hope that's right

What is hard to understand is why all of the sudden the docs are not giving anymore feedback on their findings and are trying to build some sort of mystery around the subject.

Yes I get it, the business perspective; but if it is working, why aren't succesfully treated patients with the autoplucking coming forward?

the problem is simply and sad : Yes its working and could solve our problems but the how to be efficient side is another story

Quote:

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Originally Posted by RichardDawkins

Ok some people here doubt that plucked hairs actually survive and are dht resistant. We all know that the most important thing is the follicle right.

Then just look at this picture and search where exactly the "follicle" is and you got your answer if you compare the fotos of plucked hairs with this picture :-)

http://en.wikipedia.org/wiki/File:Skin.jpg

Enjoy ^^

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Nice one Rich ;)

One thing that bothers me though in terms of dht resistance is that the dermal papilla, which is waht actually controls hair growth (as is my understanding), is derived from the recipient. The plucked hair - correct me if I'm wrong - only contain the root sheath (i.e. epithelial cells). I'm no MPB expert, but it seems to me that the dermal papilla if anything should be the DHT sensitive part of the follicle.

Nevertheless, even if dht resistance turns out to be a problem, I think autoplucking can find its way as a repair procedure (let's just hope the scar issue gets resolved..)

When your plucked hair grows, it grows from the FULL material of the dht resitant here itself. The hair itself creates its surrounding as you know the cells are formed then.

Cause even if this hair actually connects to a DP, the DP will take this genetic material especially when its dormant. The DP is actually capable of stimulate other cells to develop hair follicles. Thats why sometimes autocloned hairs come up.

But the key is the material from the hair which connects to the dp. The material around the hair itself has to be sufficiant enough to create another follicle, thats why thie technique right now is tedious.

And those autocloning hairs are nothing other the somethings direct copies of the follicles where the hair was plucked.

You see how strong the genetic material around the hair is it also contains the information " Is my origin a single hair follicle or a multi hair follicle"

Have I understood it right if you say that the dp in the recipient is an exact replica of those in the donor? Any sources? Cooley has shown pics before demonstrating a certain degree of recipient dominance, so I'm not sure that's entirely true.

Do you refer to the 2007 fact sheet? Well i can almost clearly say, that those autocloned hairs are an indicator for the new born follicle from donor material. Because if you see like this

"How possible is it, that one single plucked hair could create or animate other follicles or cells to create other hairs in an area where DHT is "deadly" for hairs"

Another possible aspect could be, when you lance the skin in the recipient are, you cause damage and at this point when tissue gets repaired it "accidentally" uses cell material from the donor area.

Both explainations could show why the hairs Dr Hitzig plucked years ago, are still cycling.

Also its high likely that the moment you pluck the hair, different cell material is still present also DP material and this is transplanted in the recipient area.

And thanks to acell as an enhancement its pretty quick "multiplying"

But all this doesnt change the fact that a lot of efficancy has to be done to make this technique faster and les labor intensive.

Remember guys that Dr. Kim showed well before me that if you cut out a complete hair (FU) then transect it below the bulb, and then transplant both "pieces" to the same person (in his case his arm), he grew 2 hairs.
This is what started me on the road to "Autocloning". Other studies showed that rat whisker hair would do the same whereas body hair (on rodents) would not. When you try laser hair removal of body hair it is not a problem; however beard laser hair removal just doesn't work well at all. I postulated that beard hair is like weeds- they are stonger than body hair. This proved itself to be true in the early trials. Despite this, there was something missing to help stabilize the "take" in autocloning. ACell seems to be that missing puzzle piece.
Richard has really got it in terms of understanding that we are nearing the answer but need to improve the method. Your suggestions help fuel our ideas.