ACell, a Current Review of Applications in Hair Transplant Surgery

[SilverSurfer]

Dr Cooley

Assuming one would go to add density to a zone with the autoplucking, would there be any negative side effect to the already transplanted hairs growing there?
Also, what is the density you have been working with? What is the maximum beard or head hairs you have been able to pack as closely as possible per cm2?

Thanks

[KeepHoping]

Dr. Hitzig

Any news on when new pictures will be coming up on your website?

[KeepHoping]

Acell/PRP Injections along with transplantation

How many doctors are utilizing this on the entire scalp when performing transplants? Are those who are seeing thickening of native hair and faster growth when using Acell. I know Cooley and Hitzig have talked about robust growth and fast growth in the recipient but is this consistent with everyone?

Also, Dr. Cole, on your forum you had mentioned that looking through one of your recent CIT or FUE patients when you look through his donor you cannot even tell a transplant was done. Does this mean in that patient you saw regrowth in his donor or because it had prevented the hypopigmentation that sometimes comes along with a CIT/FUE procedure?

[bhoys]

Dr Cooley what is the max amount of plucked hairs do you think it is possible to use in one procedure?

[wolvie1985]

Hmm, if your hypothesis is correct, Dr. Cooley, and MSCs are grown from the local area as opposed to from the plucked hair itself, I suppose that means the plucked hair is more likely to be androgen sensitive.. Time will tell...

[Jerry Cooley, MD]

Many thanks for the update Dr. Cooley!

If your theory of the presence of mesenchymal cells is correct, what does this imply when autocloning to completely bald or otherwise hairless (but non-scarred) tissue? That is, will surrounding follicles have any impact on the concentration of mesenchymal stem cells in the area?

Also, to follow up on the pictures. When you have follicles forming around the plucked hair like that, do you still feel like you can control the direction that they grow in, or do they come off somewhat 'unruly' so to speak, since (I guess) they aren't growing from the basic follicular structure that was provided by the plucked hair?

Excellent questions. We know that mesenchymal stem cells (MSCs) can come from blood (marrow source), adipocytes (fat), or from surrounding follicles (dermal sheath). The new dermal sheath regenerated after plucked grafting arose from MSCs but from which source? We don't know. But I'm starting to think that local MSCs are important, which would be contributed by surrounding follicles. One of the many things to be sorted out.

I don't think hair direction is a problem. You have to keep in mind these are ultra-closeup photos created with a lens attachment that has a glass surface that you have to mash down on the skin to take the photo, so you don't get an accurate look at the way the hair lays down.

In answer to previous questions, we can create multihair grafts but I don't whether this as successful (I think so). Sometimes we'll see more than one hair sprouting from a single implanted hair. In this photo, you see two reddish brown beard whiskers implanted and two normal looking scalp hairs emerging from the implantation site. This suggests that local MSCs controlled the new hair characteristics. This would look very different if it was beard FUE.

Regarding our fees, see my previous post. NW7 to NW1? That's way down the road. One step at a time.

[RichardDawkins]

I can also say many thanks and i have some questions also, may seem a little bit to early but it would be interesting to hear.

Dr Cooley/Hitzig lets assume for one second that the plucking technique would work exactly like a normal hairtransplant.

What would be the price tag we should calculate then, i ask this question because some people throw around numbers like 10 dollar per single hair, which i think is a little bit over the top.

Second question, because we hear this argument a lot (almost in every discussion) is there a plan that you use lets say one patient as a patient zero and do a plucking transformation from NW5 to NW1? Of course with fotos documented.

I know that you guys must be really exhausted by now and those hard questions the people have, but in the long run i think its all worth it.

And i would really like to see a patent zero case where a NW5 has been transformed to a NW1 just by plucking, it would also make discussions at message boards way easier and it should nod people to rethink the idea about hairtransplants

[KeepHoping]

Dr. Cole

Is there anyway I could get in touch with you via phone when you have the time? Or maybe email you? I filled out the contact form through your website and sent it through but haven't gotten a response yet, I understand you're busy but I'd love to have the chance to chat for a bit. Thanks.

[plopp]

Many thanks for the update Dr. Cooley!

If your theory of the presence of mesenchymal cells is correct, what does this imply when autocloning to completely bald or otherwise hairless (but non-scarred) tissue? That is, will surrounding follicles have any impact on the concentration of mesenchymal stem cells in the area?

Also, to follow up on the pictures. When you have follicles forming around the plucked hair like that, do you still feel like you can control the direction that they grow in, or do they come off somewhat 'unruly' so to speak, since (I guess) they aren't growing from the basic follicular structure that was provided by the plucked hair?

[Gubter_87]

Dr Cooley; Thank you for your reply. In at least one of the pictures it also looks like you have gotten two hairs from one transplanted.
Is this correct and if so is it common?

[wolvie1985]

Dr. Cooley, how is your success rate with respect to implanting two or three plucked hairs in one incision to create a multi-haired follicular unit? Is it the same success rate as implanting a single hair - which I believe to be 75-80%?

[Jerry Cooley, MD]

Dr Cooley; In these pictures it seems that the actual transplanted plucked hair does not grow, but new hair starts growing where it has been implanted.

Is this what happens in your experience? Will that plucked hair always be there at the same length or will it fall off or start growing?

Also the new hair looks quite thin. Do you believe it will grow in thicker in time?

Sometimes the implanted hair seems to grow and sometimes new hair is seen branching out from the implanted hair, in which case the 'stub' is eventually shed or can be plucked out.

These are 6 month photos so the hair may be thin because of that or because plucked hair growing in scar tissue is thinner. I don't have enough data to anwer that yet. I predict they will be thinner because they are probably made up of fewer mesenchymal cells. Plucked hair that grows in non-scarred scalp looks normal, and is usually indistinguishable from surrounding hair.

[Gubter_87]

Dr Cooley; In these pictures it seems that the actual transplanted plucked hair does not grow, but new hair starts growing where it has been implanted.

Is this what happens in your experience? Will that plucked hair always be there at the same length or will it fall off or start growing?

Also the new hair looks quite thin. Do you believe it will grow in thicker in time?

[Jerry Cooley, MD]

Dr Cooley and Dr Hitzig,

I think a lot of repair (or otherwised scarred) patients - like myself - would appreciate it if we could have a little more info on the yield in scar tissue. As the spanish guy pointed out, we've heard everything from up to 50 % to down to only occasional success.

What's likely to be the most contributing factor in the success rate of autocloning in scar tissue? Would it be the thickness of the scar or the width? Any pointers in terms of those two characteristics as of yet?

Thanks!

I don't know the actual success in scar tissue but I believe it depends on several factors. When I said 40-50% in an interview, I was referring back to several cases I had recently seen in followup. I have attached a couple representative photos. In these photos, you see the hair shaft sticking out from being implanted 6 months earlier, and new hair sprouting out from around it. However I later had cases where the success was lower or even zero, as in EJ's case, which is very disturbing to me. I suspect that the wider and thicker the scar tissue, the lower the success. We need mesenchymal stem cells to make the follicle regeneration work, and they are likely absent in scar tissue. At this point, I prefer to tell patients that plucking doesn't work well in scar tissue but that we are actively working on techniques to overcome this.

[plopp]

Dr Cooley and Dr Hitzig,

I think a lot of repair (or otherwised scarred) patients - like myself - would appreciate it if we could have a little more info on the yield in scar tissue. As the spanish guy pointed out, we've heard everything from up to 50 % to down to only occasional success.

What's likely to be the most contributing factor in the success rate of autocloning in scar tissue? Would it be the thickness of the scar or the width? Any pointers in terms of those two characteristics as of yet?

Thanks!