ACell, a Current Review of Applications in Hair Transplant Surgery

[gillenator]

Thanks for posting this video, UK_.

It seems we've not heard from Dr. Cooley, in some while, on this topic. I'd be interested to read how is experiments with ACell are coming along.

To date, Dr. Cooley undoubtedly is still observing and documenting the trial periods, meaning, it first takes many patients to participate in these trials in order to obtain enough clinical results from these substances to substantiate his findings and conclusions. There will be more to come when he is ready to publish all in proper timing.

In simple terms, these things take time.

[Dutch_Dude]

What bad results? You got a link?

Type in Dr. Hitzig and then you get to his clinic...most of the results are not very impressive if you compare them to others...

[HairTalk]

To date, Dr. Cooley undoubtedly is still observing and documenting the trial periods, meaning, it first takes many patients to participate in these trials in order to obtain enough clinical results from these substances to substantiate his findings and conclusions. There will be more to come when he is ready to publish all in proper timing.

In simple terms, these things take time.

Just curious about your signature, Gillenator: what is your association with the mentioned doctors (i.e., Drs. Charles, Cooley, Harris, True, and Dorin)?

[gillenator]

They simply support what I do as an independent hairloss advocate in helping patients world-wide resolve their hairloss dilemmas. In other words, they endorse me but I am not employed by any of them.

[Follicle Death Row]

Dr. Cooley is now dipping follicles in Acell as part of the standard FUT.

http://www.baldtruthtalk.com/showthread.php?t=5356

I had wondered if doing so might increase the likelihood of the transplanted grafts taking straight away and not going into the usual shed and hibernation period. Dr. Cooley informed me that unfortunately this is not the case and that the rare occurence of the hair not shedding after HT is the same as before.

Thought this might be useful information for the thread.

[gillenator]

Dr. Cooley is now dipping follicles in Acell as part of the standard FUT.

http://www.baldtruthtalk.com/showthread.php?t=5356

I had wondered if doing so might increase the likelihood of the transplanted grafts taking straight away and not going into the usual shed and hibernation period. Dr. Cooley informed me that unfortunately this is not the case and that the rare occurence of the hair not shedding after HT is the same as before.

Thought this might be useful information for the thread.

FDR, good info to know. A few additional thoughts. My premonition is that Acell will increase overall yield which IMHO, is very important. And since we all have limited donor reserves, every effort to promote "graft survival" by minimizing the effects of ischemia reperfusion is worthwhile to the patient. Free radicals are not good for grafts once they leave their natural environment.

I am also interested in observing any long term positive effects in minimizing shockloss as well. In other words, "Can Acell also help reduce the level of trauma in the surrounding tissue in the recipient area?"

What do you guys think?

[gillenator]

Anyone feel that Acell has improved their overall yield? It may still be too early in use. Time will tell.

[John P. Cole, MD]

Acell and grafts

There is no question that Acell will benefit transplanted grafts. We encourage all patients to apply Acell fine particle to all the grafts and to have a low concentration of Acell injected into the recipient area. Hair transplant yields can vary based on a number of factors. One is the transection during graft harvesting and preparation. Another is trauma during graft implantation. Another is the storage solutions and temperature that grafts are stored in prior to implantation.

Graft transection is far more common than anyone will admit to in my experience. While visiting a clinic recently, i found that they were trimming off their transected hairs and implanting grafts without the transected hairs. In the absence of Acell, these transected hairs might have a 30 to 50% chance of survival, but not in the trash can. I encouraged them to stop trimming of the transected hair follicles and to also add acell to their grafts in an effort to stimulate growth of the damaged hair follicles.

Even without transection, follicles are traumatized. Most physicians still use normal saline to place their grafts in prior to transplantation. Why? Because it is cheap and many others use it. What is the problem with normal saline? First, the ph drops over time because there are no buffers and the water reacts with CO2. Second, when you chill normal saline, the cell membrane is paralyzed and can no longer pump water. Because the osmotic gradient is into the cell, the cell swells and then potentially bursts. Not a good thing for cells or graft survival. The way around this problem is to chill your tissue in hypothermosol. What's the problem with that? It costs over 200.00 USD per liter compared to under 10.00 USD per liter. How many physicians are willing to pay the extra price? Not many based on my expereince. Thus, Acell might even make up for the inherent cheapness associated with doing surgery.

In my opinion, you use chilling, a good cold storage solution, and Acell to maximize the growth potential of your grafts. that's the solution given todays current optimal standard of care in my opinion.

[HairTalk]

There is no question that Acell will benefit transplanted grafts. We encourage all patients to apply Acell fine particle to all the grafts and to have a low concentration of Acell injected into the recipient area. Hair transplant yields can vary based on a number of factors. One is the transection during graft harvesting and preparation. Another is trauma during graft implantation. Another is the storage solutions and temperature that grafts are stored in prior to implantation.

Graft transection is far more common than anyone will admit to in my experience. While visiting a clinic recently, i found that they were trimming off their transected hairs and implanting grafts without the transected hairs. In the absence of Acell, these transected hairs might have a 30 to 50% chance of survival, but not in the trash can. I encouraged them to stop trimming of the transected hair follicles and to also add acell to their grafts in an effort to stimulate growth of the damaged hair follicles.

Even without transection, follicles are traumatized. Most physicians still use normal saline to place their grafts in prior to transplantation. Why? Because it is cheap and many others use it. What is the problem with normal saline? First, the ph drops over time because there are no buffers and the water reacts with CO2. Second, when you chill normal saline, the cell membrane is paralyzed and can no longer pump water. Because the osmotic gradient is into the cell, the cell swells and then potentially bursts. Not a good thing for cells or graft survival. The way around this problem is to chill your tissue in hypothermosol. What's the problem with that? It costs over 200.00 USD per liter compared to under 10.00 USD per liter. How many physicians are willing to pay the extra price? Not many based on my expereince. Thus, Acell might even make up for the inherent cheapness associated with doing surgery.

In my opinion, you use chilling, a good cold storage solution, and Acell to maximize the growth potential of your grafts. that's the solution given todays current optimal standard of care in my opinion.

Dr. Cole, do you feel ACell will permit in-vivo hair multiplication (thereby very greatly expanding the donor supply, if not making it limitless [for all practical purposes]), be it in conjunction with plucking or with intentional-transection F.U.E.? In the latter technique, do you believe the quality of re-growth from transected follicles — that is, the color, texture, and thickness of hairs — will be acceptable? I understand patients, even now, sometimes get wiry or coarse re-growth, perhaps from grafts or recipient-incisions that have been subjected to trauma.

Thank you.

[gillenator]

Possibly that is why some grafts regrow with a wiry projection of the hair shaft, due to partial transection?

Another question, "Can Acell improve hair shaft diameter?"

[John P. Cole, MD]

Yes, i do believe that Acell has the capacity to regenerate hair in donor area extractions. I am concerned about how often this occurs. I have a difficult time believing what your eyes are telling me. I want to see more proof. I am still open to the plucking theory, but continue to have my doubts, but them i have my doubts about what I seeing with donor regeneration, as well. I'm thinking of additional objective studies to evaluate what I am seeing. I also am concerned about the delivery of Acell. Very recently i switched to a more viscous hyaluronic acid that rapidly metabolizes to deliver the Acell.

I do think Acell might increase hair shaft diameter, Gillenator. This is good and bad. On the hair line, i really don't want this, but in other areas, it can improve coverage.

I really don't know what causes some hair to grow in curly or kinky. It can happen with any form of HT, be it FUT or FUE. It is not terribly common, but it occurs. i have not seen an increase incidence with Acell, however.

It is always good to see your comments, Gillenator. I miss hanging out with you in DC. I also miss your chili. It is awfully good. I hope you are in good health.

[UK_]

Acell seems to work wonders for some.

http://singularityhub.com/2011/07/12/miracle-powder-regrows-fingers-now-thigh-muscle-for-marine/

[RichardDawkins]

Thanks Dr Cole for the valuable input here.

Try to extract the hairs like in the Gho protocol, i think regeneration will be more consistent then.

But i was right Dr Cole will be the first to admit if he was wrong in the past and the first who asks the community for help. Such a shame that other clinics still run with the FUT i dont care about anything else thing.

[John P. Cole, MD]

This was pretty impressive. While a child that amputates the tip of a finger is likely to regrow the tip without Acell, an adult is not. This is not to say that it cannot happen in the absence of Acell in an adult. Still, it may be more likely in the adult and child with Acell. What is described in this article is quite amazing and indicative of the power of this extra cellular matrix. Certainly, without Acell, we did not see the follicle regeneration that we are seeing in FUE extraction sites that we are seeing with Acell.

Furthermore, with Acell we are seeing improvement in hypopigmentation when follicle regeneration does not occur. Both the diameter and degree of hypopigmentation in FUE extraction sites with Acell is reduced when follicle regeneration does not occur.

[John P. Cole, MD]

You know, i've tried to get Dr. Gho to tell me specifically what he is doing, but have not been able to get this information from him. It is very hard to get behind something you don't know much about. When FUE first came out in the turn of this century, no one knew how to do it. When i first began doing it in 2002, i had no idea if the grafts would grow because they lacked adipose tissue. i tried my best to have patients wait for results, but they just kept coming. Fortunately, the grafts grew beautifully. We had a few poor results that were over come with advancements in the procedure, but over 98% were great from the beginning. Body hair was a different animal in that sometimes it did really well, while other times it did not do so well. The point is that I did not know what Dr. Woods was doing in 2002 and I don't know what Dr. Gho is doing today. It is impossible to replicate a procedure that you do not know how it is specifically done or how to improve upon it based on how it is currently done.