ACell, a Current Review of Applications in Hair Transplant Surgery

[Jerry Cooley, MD]

Again, Dr Hitzig and Dr Cooley, thanks for all the advances you have developed and are in the process of developing for the HT industry.

1)In regards to the autoplucking, would it work behind the hairline?

2)What if one has a thinning crown, would you recommend the ACell + PRP or would you suggest a small session of autoplucking there as well?

3)What is your view in regards of trying to fill in a donnor area depleted by FUE with autoplucking?

Thanks Dr Hitzig and Dr Cooley

Silver Surfer

These are good questions. I hope to have more information to present to the public by October. Like standard FUT or FUE, it takes 9-12 months to form impressions so the timeline is unfortunately frustratingly slow. Most of our work is behind the hairline, at the top and crown of the scalp. I want to see how that works before I do alot of hairline work.

Dr Hitzig and I are completely independent of each other. He is currently interested in the PRP angle and I have very little experience with this. Regarding inquiries about PRP+ACell, please contact him. For a thinning crown, I typically advise my patients to use finasteride and minoxidil. The plucked grafts may be considered in the situation where FUT or FUE are not recommended or desired. I would think that the plucking technique would be a consideration for someone whose donor had been depleted by FUE. It would depend on the situation of course.

We do not recommend the plucked grafting as a replacement for FUT or FUE at this time, if a patient is otherwise a good candidate. These have the track record and predictability to be the treatments of choice. So when do we do the plucked grafts? We do them for what I call the "desparate" or the "adventurous".

By 'desparate', I mean repair cases in which the patient may have had numerous prior surgeries, minimal donor reserves, and we are up against the wall in search of options. I am seeing more and more of these patients and this is a main driving force for my work. By 'adventurous' I mean those patients who never would have had FUT or FUE because they are opposed to the idea of surgical harvesting. They are intrigued by the science of ACell and plucking and are willing to take the gamble in regards to the uncertainty of this technique (success and long term viability). This will be a small niche of patients. I repeat, those who are good candidates for FUT or FUE should proceed in that direction.

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.

It has been an interesting time for me, with widespread interest, as well as criticism and even threats of lawsuits. Nevertheless I am pushing forward because I believe in the ACell technology and plucked technique to genuinely help those with hairloss. It will certainly be refined over time as more knowledge is gained of stem cells and ECM, and methods to jumpstart the follicle regeneration process are discovered. It is an exciting time in our field.

Dr Cooley

[RichardDawkins]

Wonder who is responsible for the lawsuit threat? I dont wanna know the answer cause we all know who is responsable, one of his shills is lurking here. This is so disgusting even to consider a lawsuit or to find this kind of thing funny (like one user does)

Btw thank you Dr Cooley for pushing into the Acell/Plucking thing. I have some questions here.

1) To me it seems that you guys got more and more serious and als confident in Acell+Plucking equals in fact unlimited Donor. Am i wrong with this impression or not?

2) So lets assume for one second, that hairs in combination with Acell are permanent (i personally think its permanent) will this mean that we finally got a cure not for hairloss but for the results of hairloss?

3) When you got more information and good results, will you consider to put in Plucking as a standard procedure besides FUT and FUE?

4) Is it possible to gain more density with plucking then with FUT or FUE? I am wondering about this because when it comes to FUT and FUE there has to be tissue transplanted as well

5) Are you also aiming to get infinite or regenerating donor hair when you use FUE in combination with Acell?

6) As mentioned before, there was a two year timeline till it comes to the conclusion IF we have a cure or not. Did you guys mean the idea about "infinite donor"?

My personal opinion here is, that the plucking technique is THE game changer in the field because everyone has been thinking about " Well what if i could just pluck my hair and insert it in the blank spots" and now this at some point in our life "stupid idea" seems to be legit.

7) Are you plucking the transplanted hairs right now, to see if they cycle? If so could you give a sneak peak, what we can expect. In the case if you witnessed something.

And another thing, and dont get me wrong here, but i think you guys know more, in a positive way, because otherwise you wouldnt transplant more agressive hairlines as stated and also wouldnt go for the "adventurous" kind of patient but maybe iam just a dreamer regarding this.

[Bakez]

I think that when they pluck the hairs they are just 'reawakening' the defective stem cells. So essentially I think both Hitzig's PRP/ACell and Cooley's plucking are doing the same thing - the plucked hair is just a carrier for the right cells for it to work (providing they arent lying about their results). Maybe you dont even need to pluck the hair, we just need a way of getting these the same cells from the plucked hair, then 'wounding' the scalp as if we were going to implant a graft, but instead injecting the cells+ACell. Perhaps this also explains why sometimes more hairs grew around the implanted plucked hair (I think Cooley said this happened a few times with beard hair)?

Unfortunately I think that if this is the case - that both these methods are simply reactivating the stem cells - then the hairs will be permanent but sensitive to the same things that caused them to become defective in the first place, be that DHT or whatever.

[Jerry Cooley, MD]

Wonder who is responsible for the lawsuit threat? I dont wanna know the answer cause we all know who is responsable, one of his shills is lurking here. This is so disgusting even to consider a lawsuit or to find this kind of thing funny (like one user does)

Btw thank you Dr Cooley for pushing into the Acell/Plucking thing. I have some questions here.

1) To me it seems that you guys got more and more serious and als confident in Acell+Plucking equals in fact unlimited Donor. Am i wrong with this impression or not?

2) So lets assume for one second, that hairs in combination with Acell are permanent (i personally think its permanent) will this mean that we finally got a cure not for hairloss but for the results of hairloss?

3) When you got more information and good results, will you consider to put in Plucking as a standard procedure besides FUT and FUE?

4) Is it possible to gain more density with plucking then with FUT or FUE? I am wondering about this because when it comes to FUT and FUE there has to be tissue transplanted as well

5) Are you also aiming to get infinite or regenerating donor hair when you use FUE in combination with Acell?

6) As mentioned before, there was a two year timeline till it comes to the conclusion IF we have a cure or not. Did you guys mean the idea about "infinite donor"?

My personal opinion here is, that the plucking technique is THE game changer in the field because everyone has been thinking about " Well what if i could just pluck my hair and insert it in the blank spots" and now this at some point in our life "stupid idea" seems to be legit.

7) Are you plucking the transplanted hairs right now, to see if they cycle? If so could you give a sneak peak, what we can expect. In the case if you witnessed something.

And another thing, and dont get me wrong here, but i think you guys know more, in a positive way, because otherwise you wouldnt transplant more agressive hairlines as stated and also wouldnt go for the "adventurous" kind of patient but maybe iam just a dreamer regarding this.

1. I have never said "unlimited donor", but rather "expanded donor". Everyone knows that hair grows back after plucking but we also know from the long term observation of patients with trichotillomania, hair can be plucked to the point of failure, although this takes repeated cycles of plucking.
2. Way too early to be making statements like this.
3. Yes
4. Potentially. Requires study to make this claim.
5. I am also looking at this but like Dr. Cole, I am seeing hair regrowth after FUE without plucked grafts so its not cleat that we need this added step.
6. These treatments will always be evolving and getting more refined. I would not conceive of it as "two years to know if its a cure". We are seeing the practical applications of regenerative medicine in the field of hair restoration. It will only get better and better.
7. Yes, but will probably not have information to share about this till later this year.
Dr Cooley

[Jerry Cooley, MD]

I think that when they pluck the hairs they are just 'reawakening' the defective stem cells. So essentially I think both Hitzig's PRP/ACell and Cooley's plucking are doing the same thing - the plucked hair is just a carrier for the right cells for it to work (providing they arent lying about their results). Maybe you dont even need to pluck the hair, we just need a way of getting these the same cells from the plucked hair, then 'wounding' the scalp as if we were going to implant a graft, but instead injecting the cells+ACell. Perhaps this also explains why sometimes more hairs grew around the implanted plucked hair (I think Cooley said this happened a few times with beard hair)?

Unfortunately I think that if this is the case - that both these methods are simply reactivating the stem cells - then the hairs will be permanent but sensitive to the same things that caused them to become defective in the first place, be that DHT or whatever.

This may be happening in some cases but clearly not all. By observing the results of plucked beard in the scalp, and performing biopsies, we saw new follicles clearly separate from the surrounding follicles. We were not simply 'waking up' miniaturized follicles, but creating entirely new ones. The occasional success in scar tissue also supports this.
Dr Cooley

[KeepHoping]

Dr. Cooley

With the successful plucking cases coming in would it be too much to ask to get some pictures of at least a few of these cases just to get an idea of the progress being made?

[topcat]

Hurry, hurry step right up and have a seat in the chair. Who needs pictures when the ht industry has a long history of honesty and integrity? In my own repair journey I was able to take weekly pictures for the first 4 weeks, then monthly pictures for the next 11 months. I have now begun taking weekly pictures again after my second procedure and will move on to monthly pictures for the next 11 months. But I have been blessed with having the opportunity to own an exotic piece of equipment called a camera. So I am in an advantageous position and not everyone is as lucky. And after all, you are getting a discount so why would you need pictures.

Seriously though I hope it all works out. I guess I am just too cautious.

[RichardDawkins]

I think we are on a good way here.

Well btw i say Thank You to all people who actually put themselves in the position to be the "guinea pig" for us other hairloss sufferers here.

Thank you very much

[topcat]

Richard, I agree with you again. There is nothing wrong with being a pioneer but be intelligent, minimize your risk. If that 4000 figure I have read is true, then that is complete foolishness.

But sometimes you lose a few trailblazers along the way, that's the price of reaching the promised land.

[RichardDawkins]

Yes you are right, but if it doesnt fail, all i can say to the 4000 hair guy is " Son of a Bitc* you got really lucky" :-)

And i know one thing for sure, when his turned out good, i will punch my face ten times a day for beeing just a "too" cautious moron

I know and absolutely respect your arguments because of your back story. But if it works you can also benefit and this it whats so amazing in plucking hairs, everyone can benefit.

My calculations, i know they may seen stupid as anything but just to crunch a few numbers.

You have around 100.000 single hairs. A NW7 person has well around 20.000 visible hairs in his horseshoe area (i set this numbers really low to mark a real worst case).

And its said as a (stupid) rule of thumb that you need around 1000 Grafts per NW scale marker. NW 3 = 3000 Grafts and so on.

1 Graft consists of 2 hairs ( i wont count in 3 hair grafts because lets stick to the worst case).

So a NW7 would at least need 7000 Grafts or 14.000 hairs.

And now we assume that the plucking technique works as she is hoped to be. Then we have to harvest those 20.000 (its just a number here) and plant them. Lets say we loose around 4000 hairs (also just an extremely high number) then we would have 16.000 hairs transplanted (equals around 8000 Grafts).

After some time your horseshoe has getting back, your hair count will be around 20.000 from horseshoe and 16.000 transplanted. This would be 36.000 hairs from your 100.000.

I know its a stupid calculation but it shows at least what the possible benefits could be. And i also know that you need more procedures to get back to full density on your whole head. But with a fully working plucking technique, i would go for it.

Those numbers will get better of course when the autocloned hairs will be permanent. So i say we keep our fingers crossed that this thing will work so perfectly, that the next time someone mentions "mega session" , only tweezers are needed for this.

And another question iam asking myself is : If those plucked hairs in the reciepient area could also be seen as potential donor hair. So that we can see hair transplantation as donor area creating instead of illusion making.

Maybe these are really stupid ideas or thoughts, but i have the gut feeing that there is something to it.

topcat iam very thankful for your input because stuff like that keeps me personally thinking about those advances.

[Gary Hitzig MD]

Appreciate your Calculations
Remember results are measured by appearance, not numbers.
If you can get proximity and naturalness of distribution your result will trump the same number of singlely distributed hairs,
Duplicating recipient hairs without "clumping" accomplishes this.
Can't do this with single hairs alone.
Hope the "Vaccination" against hair loss or further hair loss is on the way
Of course, time will tell-Just trying and hoping guys-I've lived this nightmare!

Best,
GH

[SilverSurfer]

Dr Cooley

Thanks for taking the time to answer these questions. I am very excited with all the new developments and hopefully in the near future I will have some work done by you with the Autoplucking technique. I am still waiting for an estimate of how many growth cycles the new hairs will develop and if their growth cycle will be that of a normal hair. Good luck with everything and please don't let external factors (like the lawsuit) discourage you from the work you are doing.

All the best.

[Gary Hitzig MD]

I don't Have any lawsuits.
14 years ago I caught staff "moonlighting" in my office on video camera thinking the cleaning service was stealing supplies. Those I caught tried to exhtort money from me or else they would claim I was a party to the plot (WHEN I THREATENED TO PROSECUTE). I went to court (growing up in Brooklyn I don't give into false threats) and proved all was false.
The lawyer dropped the case and was cited by the Bar Association.
EVERYTHING WAS DISMISSED or dropped.
Not sure who is trying again to malign me again but now you understand why I keep far away from some of these jealous people.
Jerry Cooley has always been a supporter and knew the facts.
So does Spencer.

Thank You for the kind words.
It would be easy and tempting after 35 years to simply disappear again.

[Jerry Cooley, MD]

Thanks for taking the time to answer these questions. I am very excited with all the new developments and hopefully in the near future I will have some work done by you with the Autoplucking technique. I am still waiting for an estimate of how many growth cycles the new hairs will develop and if their growth cycle will be that of a normal hair. Good luck with everything and please don't let external factors (like the lawsuit) discourage you from the work you are doing.

All the best.

I wish I knew the answer about cycling....this will take time and makes me frustrated too.

I don't have any lawsuits either!

[SpencerKobren]

Thanks for taking the time to answer these questions. I am very excited with all the new developments and hopefully in the near future I will have some work done by you with the Autoplucking technique. I am still waiting for an estimate of how many growth cycles the new hairs will develop and if their growth cycle will be that of a normal hair. Good luck with everything and please don't let external factors (like the lawsuit) discourage you from the work you are doing.

All the best.

I for one would prefer to focus on the positive aspects of Dr. Hitzig’s career, and truly hope that his groundbreaking work with Acell’s MartiStem pans out for all of us. We support both his and Dr. Cooley's efforts to perfect this treatment and appreciate their participation in our forum.