ACell, a Current Review of Applications in Hair Transplant Surgery

[Gary Hitzig MD]

It seems that we are getting multiple hair growth from single transplanted hairs and need to adjust how far forward we inject the ACell. The good news is that in person one does not see the closeness that magnification shows. The patients look very natural, but the hair is thicker than one would expect from any single session.
In areas where there are still viable (alive) original but weakening hairs, we are seeing new multiple hairs sprout, but not yet in completely previously bald areas. I still believe that there is a point of no return for hair regrowth in vellus hairs and that's why the hairline needs single folliclar units with no ACell.
I don't type well enough to explain all the differences between Venous and Arterial PRP and you are welcome to call me to discuss but suffice it to say Arterial Blood delivers the necessary nutrients etc. to tissues- the venous blood is the waste collector; it removes the tissue waste for disposal---so which blood source would you think is better?

[bellerofonte]

PRP vs APRP

@Dr Hitzig:

Dear Dr Hitzig, I just have one question, probabily you already answered about this but I still didn't have time enought to read all the topic.

What's the difference between simple PRP ( obtained from venous blood) and APRP ( obtained from arterial blood) ?
I read that you use arterial blood from the surgical donor area: should you explain the procedure in detail?

Thanks a lot.

[wolvie1985]

Hi Dr. Hitzig, just to clarify, have you seen multi-folicular units sprout from single hair plucking or have you just seen multiple single hairs sprout?

And re: acell/prp: have you seen multi-units grow? If acell/prp just reawakens the progenitor cells, and those cells along the hairline are for single units, why would there be a risk of a multi-unit growing?

[RichardDawkins]

Wow it seems Acell is working "Too Good" at least in the hairline.

Dr Hitzig, do you think that a combination of FUE for a full frontal restauration of the hairline with autocloned hairs behind it would be a good idea.

To me it seems like this because it doesnt matter if on a big area like the vertex some 4 hair follicles are spreading.

And another question : It seems that those beard hairs could esily been used as kickstart. You dont even have to pluck scalp hair. This is also promising.

Anyway good job so far Dr Hitzig

[Gary Hitzig MD]

Plucking in Hairline

You're absolutely right. Plucked beard hairs also may grow coarse and unruly and are best hidden behind the hairline.
The temple plucked hair, however, is another story. It is soft and works fine in most cases.
To answer your question directly, I do not put ACell/PRP in the hairline region for just that reason. We can always get a small sample of natural hairs (a few FUE or FUT to start the soft look of the hairline.
I am posting some beard plucking transplant picture follow-ups in the next few days-you will see I stay behind the hairline but have great multiplication and recycling of hairs (1 Year F/U)
Best
GH

[wolvie1985]

Dr. Cooley or Dr. Hitzig

Drs., is it a good idea to do autocloned plucking for the hairline since there's a chance that, with Acell, multiple follicular units can result from a single hair, which would make the hairline look unnatural?

Thanks for your response.

[RichardDawkins]

No i have to thank you.

I really hope you do some experiments with this "FUE Multiplication" also.

Even if this plucking right now is tedious, it is worth to be examined further because the result and the working scale is actually proved. But the way to get a good yield is the key.

Its not satisfying if you pluck 1000 hairs and only 700 are usable because this will slow down the progress.

But Dr Hitzig i hope you wont abandon plucking as a useful hairtransplant technique, this would be sad. Cause it could also be the case that you and your collegues will get better and better due to training.

[Gary Hitzig MD]

Try not to argue--we all have the same goal

I think transecting the hairs in an FUE procedure would help simplify regrowth (using ACell) but it might affect the hair result being transplanted. I need to give it some thought.
As far as plucking goes, I have tried every type of scenario to increase my useable yield. What I found was that you want the beard hairs to be at least 10 days growth so the girth of the hairs will support the plucking and not fracture. Fracturing occurs more easily than you might imagine so twisting has not worked although I have tried it.
The key to successful plucking as I see it is using the correct plucking instrument (sanded down cross-cut needle driver and snapping the hairs in their growth direction with the corrct force to overcome resistance-much easier said than done.
I am always open to new ideas as many come from patients.
Try not to argue--we all have the same goal
As always, thank you for your input!
GH

[RichardDawkins]

Knock yourself out, my criticism towards is more of the nature

"Fresh registered, not interested in thinking about something to improve some other thing but instead attack other peoples ideas"

An maybe "strange" idea is better then no idea, i called it MacGyverisms

Oh but to answer another of your questions, i personally highly doubt that Histogen can regrow hair on scar tissue or if it could, i think its cosmetically NOT significant.

For scar revision you will always need hair transplants to get a cosmetically significant result.

But as always, i hope iam just wrong and it will work on scar tissue as well, but right now with my "strange and stupid garbage" ideas i doubt it

PS: There is no such thing as a dumb question, but thats a common mistake at message boards

[HairTalk]

So if you think you are not involved in research, why do you keep posting here

That's a dumb question: I'm posting because I'm interested in this subject. Neither this thread nor this forum is reserved for researchers; thus both my presence and yours (unless you actually are involved with the work being done in this area, beyond spinning a few "suggestions" on the Internet).

I believe this particular conversation has run its course, thus I'll remove myself from it, here. If you say something of interest to me, and I wish to, I of course shall respond; in the interim, good-bye.

[RichardDawkins]

So if you think you are not involved in research, why do you keep posting here

Utter Garbage is IMHO a little bit over the top when it comes to serious discussions, with such approaches you keep disqualifying yourself from any discussion.

Its funny , you refuse to think about things to improve a technique because in your iwn words "iam not involved in the research" but on the other hand you say everything is utter garbage. Dont you think you contradict yourself here

I didnt say the whole field of medicine is based on luck or coincidences but there are remarkable things which happen due to accidents. You know Propecia is such an example, i think it wasnt considered as a hairloss helping drug in the first place.

Acell is another example its purpose is not hair regeneration.

Iam not talking about FUE iam talking about plucking and there could be serious differences in between length or hair.

Well but in this case we obviously have the goal right in front of our face "Expanded to infinite Donor" but now we have to go from the Finish line to the start to see what works best and what doesnt work.

Doing something related to hair plucking is always better then just look at this and do nothing. So you say :

"Dont do anything out of the box or even think about it" But what should be done then? The more information one thing has (it doesnt matter if they may seem stupid or not) the better it is for others.

Oh and that some things can make a huge difference, just look at the situation if you would have a tick bite.

There is a huge difference if you pull this thing out clockwise or counterclockwise.

[HairTalk]

Hello Iron.Man2

The lenght can in fact alter the experience. if you pluck long hairs, sometimes they just BREAK or there is not enough force to pluck it correctly.

As I said, this makes sense only if you are grasping the shaft of the hair near its terminus.

I think with your expose to sunlight you actually meant to get this scalp in a warm area that those pores gets wider.

I'm unsure whether you're being sarcastic, but, if you aren't, clearly that statement was rhetorical (to illustrate the frivolity of trying random things) and not a suggested point on which to experiment.

Science is of course based on accidents, just look at Penicilin, this was an accident, like many other inventions.

Garbage. Utter garbage. The overwhelming majority of science and research are based on people's experimenting with things they know in relation to those they wish to find out. The fortuity of someone's making a mistake and discovering a bacterial colony a weekend later, which happens to be of remarkable clinical relevance, does not stand as testament that medicine more or less is a very long serious of dumb-luck findings.

If my ideas are like shooting in a vacuum well then thats your opinion, i say some people have to give it a try.

Of course, it is my opinion.

Trimming the hairs is to get a better force point of grabbing them, if you would have take a closer look at the pictures where the technique is shown, you would have seen that the tweezer is very close to the scalp to get a better force.

I feel you're going in a circle and trying to drag me along: One would grasp the hair-shaft at (or close to) its base; thus, the length above that point would be irrelevant. Sure, it might be easier for a person to navigate a shorter hair, but that doesn't imply the result of plucking out a short hair would be better than that achieved by taking out a long one. With F.U.E., one is cutting follicles out of the scalp. Many surgeous prefer to shave the donor area, to make life easier for themselves; others go ahead and make extractions from an unshaved area. The length the hair extends beyond the scalp remains inconsequential to what occurs beneath, as it isn't a portion of the shaft with which the doctor interacts.

If you dont have any proposals, you should begin to think of some.

Why? I'm not involved with this research.

Something is always better then nothing. A small scar reduction is way better for a repair patient then nothing.

We're talking about two completely different things. I'm unsure whether this is a matter of your misinterpreting what I said, or simply manipulating it into something on which you can make the comment you wish to. I'm not suggesting small positive results are not better than no positive results; I'm saying simply "doing something" is not better than doing nothing at all. When you act, you must do so from deliberation and with direction. Else, you may be wasting time, energy, and money; worse, you may inflict harm (and, no, I don't think plucking trimmed hairs will inflict harm...).

[RichardDawkins]

Hello Iron.Man2

The lenght can in fact alter the experience. if you pluck long hairs, sometimes they just BREAK or there is not enough force to pluck it correctly.

As i said before everything plausible which alters hair charateristics should be tried, wet hair can easily be plucked in large groups.

I think with your expose to sunlight you actually meant to get this scalp in a warm area that those pores gets wider. This idea occured to me but then i realised that after plucking f your to slow the programmed cell death starts to act and a warm surrounding aways enhanced this. But it was a good idea

You see thats its all about to discuss things in relation to their plausible methods which could actually work.

As i said before not all follicles grew in the same direction so clockwise and counter clockwise could make a difference from case to case.

Science is of course based on accidents, just look at Penicilin, this was an accident, like many other inventions.

If my ideas are like shooting in a vacuum well then thats your opinion, i say some people have to give it a try.

Trimming the hairs is to get a better force point of grabbing them, if you would have take a closer look at the pictures where the technique is shown, you would have seen that the tweezer is very close to the scalp to get a better force.

If thats a laundry list for you, well knock yourself out buddy

Your answer or idea " I dont think its a good idea to pluck the whole follicle" shows me that you didnt really understand what hair plucking is about. The hair in the donor area just grew back normaly after some time without "waste" of donor material.

You dont pluck out a WHOLE follicle. you pluck a hair with all the genetic material in the surrounding tissue, thats the differende. A FUE just stances out the whole "Follicle" but the plucking not.

Wrong, even FUE under some cicumstances can lead to donor regrow, when the follicle or the information is still intact or semi intact o a certain degree.

If you dont have any proposals, you should begin to think of some. I dont feel important its the other way around, iam only interested in a solution, everything else i couldnt care less.

Something is always better then nothing. A small scar reduction is way better for a repair patient then nothing.

Also, a few years ago nobody would have considered plucked hairs to work like a normal hair transplant (people like you?) but then some people just went one step beyond and thats the most important thing.

Is my ego fragile? Depends on situation but not under normal circumstances, and yes iam pissed off when some people register themselve in a forum this month and their first postings are a mouth full

I dont ask for an apology i ask for some thinking to solve the problem.

[HairTalk]

You didnt understand my posting right? The yield rate right now when it comes to usable plucked hairs is maybe 60% and this number has to increase you know to make it more time efficient.

And so its highly obvious that you have to search for different approaches to get to the point where you can say "Thats working better then the rest"

I see you are not a researcher right. If you would consider just a little time to think about hairs you would know that not all hairs grow the same way and therefore you have to find a Semi-working technique.

OF Course the main point is the material at the end of the hair BUT you have to get this material in the first place and for this you have to find THE WORKING technique.

Instead of making fun of my ideas you can come up with some of your own, where you think they will suit better.

My ideas are ONLY opinions and ideas. You know when it comes to plucking you can actually think outside the box because no precious donor is destroyed here.

Trimming the hair as a test is very simple law of PHYSICS you know, the longer something the harder it gets to concentrate your force on one single area. And its highly likely that if you have long hair, the plucking force will end before the critical point and therefore you only got a plucked hair without material

To be honest your posting did really made me angry because you spill out only empty phrases but dont give some ideas out yourself. Just think for one second what you can do with hairs and that there are different ways to pluck hairs.

I try to give away any food for progresion, nothing more. this is better then just keep sitting here and do nothing

Take a breath, Punky Brewster — you have as little idea to who I am or what I do as I do to your position. No one made fun of you: you were asked to explain why you feel your propositions could improve yield, and you've yet to do so. Science and research aren't based upon people's trying out random things because what they're doing isn't working very well; one experiments based on one's knowledge, reasoning how a particular application may lead to improvement.

You suggested several techniques for how to harvest plucked hairs, but they all seem to me to be blindly shooting into a vacuum. Do you have a theory for why wetting hair could help increase yield? For why clockwise or counter-clockwise pulling might do so? For why trimming might? How about we have people sit out in the sun for fourteen minutes before pulling out the hairs? It might sound absurd, but, hey, we're trying stuff out, right? One does what one feels might make sense; one doesn't engage in an inexhaustible laundry-list of ideas enthusiastically supposing, "You never know."

To trimming, you mention the difficulty of concentration of force, but this holds only if one is plucking out a hair by grasping it at the terminus of the shaft. Regardless of the hair's length, this would be a foolish approach, and one instead would grasp the piece closer to its base; thus, the overall length of the hair should not have an effect on the success of its being pulled with plenty of the follicle still stuck (by the way, I don't think it would be a good idea to remove actually every bit of said follicle — a method for doing so already exists: it's called F.U.E., and it typically doesn't lead to re-growth in the donor area).

No, I haven't any proposals of how to approach this situation. I'm also not eager to say things just for the sakes of hearing them leave my mouth and of feeling important. "Something" is not necessarily better than "nothing" — I lament the ridiculous fallacy that it is; something we feel, based on what we know, might work, and that won't be harmful to try out, is.

Your post has yet to anger me. If mine upset you, I'll refrain from apologizing, as I did nothing wrong, so shouldn't bend to coax your too-fragile ego. You want to make "contributions" to science? Step one: don't be so damned delicate as to take umbrage if a person does something other than fawn over your generosity of suggestions.

[RichardDawkins]

You didnt understand my posting right? The yield rate right now when it comes to usable plucked hairs is maybe 60% and this number has to increase you know to make it more time efficient.

And so its highly obvious that you have to search for different approaches to get to the point where you can say "Thats working better then the rest"

I see you are not a researcher right. If you would consider just a little time to think about hairs you would know that not all hairs grow the same way and therefore you have to find a Semi-working technique.

OF Course the main point is the material at the end of the hair BUT you have to get this material in the first place and for this you have to find THE WORKING technique.

Instead of making fun of my ideas you can come up with some of your own, where you think they will suit better.

My ideas are ONLY opinions and ideas. You know when it comes to plucking you can actually think outside the box because no precious donor is destroyed here.

Trimming the hair as a test is very simple law of PHYSICS you know, the longer something the harder it gets to concentrate your force on one single area. And its highly likely that if you have long hair, the plucking force will end before the critical point and therefore you only got a plucked hair without material

To be honest your posting did really made me angry because you spill out only empty phrases but dont give some ideas out yourself. Just think for one second what you can do with hairs and that there are different ways to pluck hairs.

I try to give away any food for progresion, nothing more. this is better then just keep sitting here and do nothing