ACell, a Current Review of Applications in Hair Transplant Surgery

[John P. Cole, MD]

No, i have not avoided your question. I showed you what a plucked hair typically looks like when you jerk it out at home. It is not likely to grow following transplantation no matter what you put on it. This is what a plucked hair looks like when you pull it out at home. Of course, you have left all the cells behind that make a hair and these are going to produce a new hair unless you get some sort of chronic scarring that seems to occur with people who pluck their hair every day in a condition called Trichotillomania. in that these people pluck a larger area, i can only surmise that after years of habitual plucking, they create a massive inflammatory response that seems to affect a large area on their eyebrows, eyelids, or scalp. Please note that not everyone with Trichotillomania suffers from permanent hair loss. Most of them get hair regrowth just like men and women all over the world get when they pluck unwanted hair.

I then showed you what Dr. Hitzig and Dr. Cooley are calling a plucked hair. It is not your typical plucked hair. it is nearly the full, intact hair follicle.

if you want to know how Dr. Hitzig and Dr. Cooley are plucking hair, i suggest you ask them. I've already stated that they need to show a video of how they are plucking hairs such that they are pulling out nearly intact hair follicles. I've also stated that i would like to know exactly how they are doing it.

Dr. Cooley has already mentioned that as he got better at plucking hair over time. This probably had an influence on his Acell pluck survival and his Acell pluck results.

This is really quite simple, and it is black and white. I'm sorry if you do not understand this. If you don't, then i do not know how i can make it any more clear for you.

it really is not my responsibility to clearly show the methods of any other physician's research. it is up to them to define their methods. Without methods, no one can repeat the work or verify the results.

My responsibility is to point out concerns i have with the claims made by another physician, and that is what i have done. My concerns are based on the documentation provided by Dr. Cooley where he showed what his plucked hair that he treated with Acell looked like. I know enough about the structure of a follicle to state very emphatically that what he demonstrated was a nearly intact hair follicle. I have shown you what a nearly intact hair follicle compared to a fully intact hair follicle looks like today. I suggest you study those comparisons very carefully to see what the tiny differences are in the two structures.

If you like, pluck some of your hairs and send them to me. i'll magnify them for you and show you how they are different from what Dr. Cooley and Dr. Hitzig are calling a plucked hair follicle.

[John P. Cole, MD]

Normal plucked hairs

Normal plucked hairs look like this. What do they consist of? Dead Keratin and a tiny portion of the internal root sheath. They will not survive transplantation even with Acell.

I suspect that you do not have a very good memory. i will refresh you. Dr. Cooley presented two examples of what he called plucked hairs. One was a scalp hair and one was a beard hair. In reality, these were not plucked hairs. They were closer to an intact graft than a plucked hair. In fact they were 90 to 95% of intact single hair follicle grafts. This concept may be impossible for you to grasp, but these are the facts.

[plopp]

Also we will doing our first case of eyebrow plucking with ACell + PRP and remodeling some of the plucked eyebrow hairs to reshape an eyebrow. Will keep you posted

I'm soo anxious to see this work. Have had a scar in my eyebrow that has bothered me to death for half my life. Also, plucking from the eyebrow, I guess it will be quite apparent if the donor regrows or not, so this is definitely an interesting case to follow. Best of luck with it, Dr Hitzig!

[wolvie1985]

"i will refresh you. Dr. Cooley presented two examples of what he called plucked hairs. One was a scalp hair and one was a beard hair. In reality, these were not plucked hairs. They were closer to an intact graft than a plucked hair."

No, Dr.. In reality, these WERE plucked hairs. Because they were plucked out of the scalp using tweezers. Period.

Sometimes when I pluck my hair, it comes out with what you consider to be a 'nearly fully intact follicle'. Sometimes I don't. Either way, that hair has been plucked, and plucked hairs grow back. You are telling us that if you pluck a hair in a certain way, it will not grow back. I am saying this is wrong. When Dr. Cooley says he has gotten better at plucking, I understand that to mean that he has a) gotten better at plucking the hair so that the cells come out with the follicle every time, rather than say 50% of the time b) gotten better at recognizing how much material is required at the end of the hair in order to achieve regrowth in the recipient.

What I'm saying is, it is well established that plucking a hair with a pair of tweezers by grabbing on to the hair and pulling - no matter what angle, strength or speed you pull - that hair will grow back. You are simply hypothesizing that this is not the case - and it's not enough to show images of a Cooley plucked hair and say "based on my knowledge and experience, too much of the follicle has been pulled out - it won't grow back in the donor". That flies in the face of all the other evidence we have that prove that plucked hairs grow back no matter how much material was pulled out with it.

We would have known by now that if you plucked a hair, maybe 10% of the time it won't come back because 'a nearly fully intact follicle came out with it'. Never heard that. Girls who groom their eyebrows don't hear "hang in there, cause 9 times out of ten, the eyebrow hair will grow back, but you can get lucky 1 times out of 10 and it won't'.

I have had handfuls of hair pulled out of my scalp at one time during wrestling matches. Guess what, out of all those handfuls, you would think that some of them would have had 'nearly intact follicles' pulled out. And yet all the hair grew back. So, I do understand what you're saying, Dr.. I just think your own claim is far more unfounded than the science you are attempting to discredit.

[rapunzal]

just to open the discussion further on plucked donor regeneration as it is a good debate.

i listened to Dr Cooleys interview with Spencer Kobren. He stated that the hair follicle is made up of two main structures. The epithelial cells and the mesenchymal cells and that if plucked corrctly you can get the epithelial cells. So assuming a perfect pluck "Dr Cole's Bart Pluck" leaves behind the mesenchyme layer at the donor which contains the dermal papilla which is the small piece at the end of "Dr Cole's Homer follicle".

Perhaps it has already been demonstrated how only a few of these remaining dermal papilla cells can induce follicle regeneration at the donor site can be found here.

http://www.aderansresearch.com/pdfs/...pBio_08_05.pdf on page 2

and

http://www.keratin.com/aw/aw042.shtml

In other words the small amount of dermal papilla cells alone induced the formation of a new follicle by calling upon epithelial cells from an unknown location possibly from existing nearby hair follicles or the epetherial cells in the skin.

[rapunzal]

perhaps this study has already been done

extract from an article in the Dermatology Times 1st Feb 2003

Hair Harvest - 'Auto-cloned' beard hair viable alternative donor source for transplantation

Chicago - The beard region may serve as a useful harvesting site for hair transplantation in men who already have a severely depleted scalp donor supply, Gary S. Hitzig, M.D., said at the annual meeting of the American Society for Dermatologic Surgery.

He reported the success of this beard hair "auto-cloning" procedure in a series of five men. The beard hairs are extracted using a tweezing protocol to remove the shaft and bulb while leaving the follicle intact. All of the men were followed for at least one year and were noted to have hair regrowth at both the sites of hair harvesting and transplantation as confirmed by hair counts performed with a hair densitometer.

[Spanish Dude]

Dr. Hitzig published autocloning results in 2003, using beard hairs and without Acell.
And he claimed 80-85% yield, no less!!
But now, 8 years later, where are the full restaurations?

http://www.hairsite4.com/dc/dcboard.php?az=show_topic&forum=12&topic_id=3857&mesg_id=3857&page=3

Copy: >>>>>>>>>>>>

Sat Jun-07-03 10:23 PM:

Dr. Hitzig has successfully done a series of 1-for-two hair transplants on 5 paitents using their beard hairs. The beard hairs are extracted using a tweezing protocol to remove the shaft and bulb while leaving the follicle intact. Approximately 80 percent to 85 percent of the transplanted hairs grew in the scalp, and the follicles left in the donor beard region continue to generate beard hairs.

"Our experience with this technique offers promise for men wishing to improve their appearance after an earlier hair transplantation procedure but who lack the donor supply for additional treatment. Further study may also lead us to the use of beard hairs as a source for in vitro cloning of scalp donor material, and if that technique is successful, we would be able to obtain an unlimited supply of donor hair and perhaps eradicate genetic baldness," said Dr. Hitzig.

According to Mr. Oz, the technology so far can only be used on beard hair since the surgical tweezers can NOT handle the much more smaller scalp hair, but the testining has been 95% sucesful. In addition, they're are already testing in vitro to remove ONE single beard hair from a human and use that one hair to duplicate a series of hairs on a synthetic mantle ( artificial skin).

Check the following article for the whole story:

http://www.dermatologytimes.com/dermatologytimes/article/articleDetail.jsp?id=47883

Dr. Hitzig's site also has a little information on this procedure:

http://www.nyhairloss.com/gsh-procedures.htm

I want to mention that based on what I gathered from this forum, Dr. Hitzig is controversial--he's a veteran HT surgeon with a few class-action suits brought against him. He also reportedly hired a moonlighting New York City Department of Sanitation worker to be an assistant on his surgical team and allowed the guy to do more than what he's supposed to be doing (on the patients). However, I think those things should not undermine his efforts in looking for a better way of treating hair loss.
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[RichardDawkins]

Ok Guys lets stop right here before the fronts get harder and HairRobinHood will come up with some Gho talk.

KeepHoping has offered himself as a "guinea pig" at Dr Cole to test regrowing donor and also succesfull transplantation of ONLY plucked HAIRS (Hairs not Grafts)

This is what we should focus now and nothing less, and yes i know the answer the one question " Will plucked hairs regrow in Donor area", the answer is Yes but now it is time to put stupid internet arguments aside and communicate together and get something accomplished.

Believe me there were some ideas like "Lets work together" at hairsite but almost all of those ideas have been destroyed by Iron.Man´s endless insults or by other users there.

So lets do it like this, KeepHoping will get in touch with Dr Cole and the will test it as Dr Cole has given his opinion about how to test things. And also let Hitzig and Cooley do their stuff and give them time to redefine their findings and make plucking a "state of the art" technique.

Also i would like to be Dr Hitzig and Cooley a little bit more transparant at this point.

Also as Dr Cole stated, they should get in touch with Dr Rassman, Dr Bernstein and him.

OR

We could just keep arguing over and over again if hairs grow and where all those pictures are, and in 4 years we are still here with no results.

@ SpanishDude : Sorry you absolutely annoy me, now you bring up some Lawsuits against Dr Hitzig, only because you read about them here. Thats your SOP right, wait until something for your world of conspiracy theories come up and then annoy people at message boards with things not even connected to each other.

You and all you "Transform a NW7 to NW1" crap. Have you seen this repair patient with scar Tissue and Nw7? And now he is well everything but not a NW7 anymore.

You and Iron.Man (HairRobinHood) did as mentioned here before, destroy hairsite

[Spanish Dude]

Leeroy, it was you and Iron_Man who destroyed Hairsite, not me. In fact you were banned there (and logged in with a new name Stevie.Dee).
And now you are trying to derrail my post.
My post underscores that Hitzig claimed 80-85&#37; yield in 2003. That was autocloning without even using Acell. Where are the wow results? 8 years after?

p.d. the lawsuit was mentioned in that 2003 post. It wasn't my comment.

[RichardDawkins]

And to give a straight answer

Yes I do belive and know for sure that plucked hairs (intact) always grow back in thir plucked area. Period

My own experiments show that. Also another really obvious proof, girls who wax their bikini zone, their legs etc. The hair always come back to haunt them ALWAYS.

Also another fact is, that follicles even if they got damaged, can and will regenerate themselves. Why?

1) Damage on a smaller scale will always heal without leaving scars
2) The head is very energetic when it comes to blood vessels etc
3) Surrounding cells provide the help to recover

there is a very simple analogy for hairs, they are refered to as "weeds" or "pest plants"

If you hack a pest plant above the surface, its roots remain in the ground and will produce another fully plant.

If you pluck it out and just a little bit of root work sticks in the bottom, and you throw away the plucked plant, you can say sure fire that in the next year you will have two pest plants to take care of

And if you pluck this one "Patient Zero" pest plant all the time it will come back the next year every time.

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No we transsect the "Pest plant" (like FUE) without Acell

Now all we have is an empty hole in the ground with no rootwork and no live whatsoever BUT there are some minor remains left, some really small root works.

No our beloved gardener think, that is actually a brilliant idea to pour "fertilizer" in this hole because he wanna plant a coconut tree the next day.

WHat happens next in a time lapse is pretty obvious and simple. The remains in the ground will form, guess what, another pest plant.

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Only because hairloss is scary, we should think of it as something impossible to beat.

CONCLUSION (Please read carefully)

If there is the smallest of smallest of smallest molecule or "NEEDED" material left, it will regenerate PERIOD.

Thats btw another reason why with FUE progression, there are more and more cases where some grafts in the donor have regenerate themselves.

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And in the pest plan example, fertilizer is just a simple stupid solution for nice plants to grow shiny. But Acell on the other other hand is like "rehabilitation program, surgeon, nurse, aftercare and an extra life" all combined.

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My prognosis or prediction is pretty straight forward and i wanna share it :

1) Acell/PRP will halt and stop hairloss and reverse it to a certain point

Results : hairloss stopped but NOT a full head of hair only a few more grafts or so

2) Plucked hairs with Acell for creating a perfect dense hairline and induce some autocloning

3) FUE with Acell or Plucking with Acell as full hair restauration solution

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Thats the end of the story and please Dr Cole i really respect you effort, i really do and also your scepticism but at one thing you have to believe the hairloss suffering people, because they all speak because they witnessed it themselves

"Plucked hair fully regenerates itself"

[plopp]

Guys, I want the donor to regrow more than anyone. Nevertheless, it is well known that hair plucking may result in scarring alopecia. Whether that is a long term effect from overplucking or more of a game of chance everytime you pluck, I don't think anyone can say for sure at this point. The same goes for the extra damage that might or might not be induced by Cooley's and Hitzig's plucking technique.

I think this is just one of those painful 'wait and see' cases. I do agree with Dr Cole that a scientific study would be of tremendous help and shouldn't be too costly to set up.

[rapunzal]

actually all i was suggesting is that a study of the donor might have already been done by Dr Hitzig himself

[RichardDawkins]

Hmmm iam always curious when 2 post poster are agressively try to downplay some new things.

And now it doesnt result in scaring, only if the hairs are plucked wrong. And if you would really really want infinite donor to be a real thing, you wouldnt come up with such stuff

And here you can see there is a girl who plcuked her hairs for 11 years and the hair grows back

http://web121.sun-15.de/wbb2/thread.php?sid=1eebb84f94c99c535a3f2b9739718dd9&postid=10711#post10711

[plopp]

Hmmm iam always curious when 2 post poster are agressively try to downplay some new things.

And now it doesnt result in scaring, only if the hairs are plucked wrong. And if you would really really want infinite donor to be a real thing, you wouldnt come up with such stuff

And here you can see there is a girl who plcuked her hairs for 11 years and the hair grows back

http://web121.sun-15.de/wbb2/thread....0711#post10711

LOL, well, I'm always suspicious when people who have only been on here for less than a month makes outrageous claims of infinite donor without anything to back it up . But seriously, ask the people who suffer from trichotillomania or overplucked eyebrows, and you will know that plucked hair don't always regrow. As I said before, it might just be that scarring of the hair follicle occurs first after repeated plucking (cf. Cooley's statement of expanded donor, not infinite). It might be that different types of hair may be more suscpetible to this sort of trauma. It might be that different plucking techniques result in different outcomes in terms of regrowth. The bottom line is that we just don't know as of yet and that, currently, only anecdotal evidence of regrowth is present.

I do believe this to work, and I certainly wish it to more than anything in the world. That aside, I still think it's too early to make any grandiose claims of solving the riddle of hair loss.

[RichardDawkins]

Thats reasonable

On the homepage there is the average time it takes for hair to grow back eyebrow and scalp hair

Another question is, if this scaring will occur when you use Acell on the Donor pluck side ;-) so i highly doubt it