ACell, a Current Review of Applications in Hair Transplant Surgery

[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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[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.

[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.

[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&#37; 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.

[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!

[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.

[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.

[wolvie1985]

Sorry Dr. Cole but you have avoided my question. I asked you to enlighten us as to how a hair that is 'groomed' is plucked differently than one that is plucked by Dr. Cooley and Hitzig. You responded with talk about the cells that emerge attached to the plucked hair and simply hypothesize that when the cells are attached, the donor won't regrow. You have no evidence to support this. There is no evidence to support your claim whatsoever that a hair that is plucked in a certain way it will not grow back (outside of repeated plucking of the same hair for years and years). When you pluck any hair, sometimes cells come out with it, sometimes it doesn't. This is why Cooley/Hitzig check each hair that is plucked and discards the ones that don't have the cells attached. But either way, cells attached or not, those hairs will regrow in the donor -- as has been repeatedly said, if the grooming business knew of a way to pluck a hair to ensure it wouldn't regrow, we'd have known it by now.

[John P. Cole, MD]

Yes, studies are difficult and numbers is what you need to look at the data.

What i think we should do is get a group of physicians together and set up a protocol that we all follow. suppose 10 of us get 5 results that come back in over the next year. That would make 50 total results. The pooled data would probably give us some statistically significant data. We don't do that, however. What we do is one or two cases. You can't get any meaningful data from that.

Dr. Hitzig and Dr. Cooley have seen promising results with plucking hair. Now it is time to do the study. i'm all for being a part of that along with Drs. Rassman and Bernstein.

What i'm doing today is treating as many donor areas as possible with Acell. Eventually, i will have some data that means something, but it is going to take time. It is possible the results will show it only works on a small percentage, but i'll know at some point. It is not really all that expensive to treat a donor area with Acell. I annotate exactly what we do in each case. sometimes it is prp plus Acell. Sometimes it is just Acell.

i did a study recently that i submitted for publication. i treated a donor scar with 50 beard hair grafts and Acell. The growth was 96%. in the same patient i treated a different area of the donor scar with 6 chest hair. the result was a zero percent yield. In one patient, it is meaningless, but suggestive that more trials are necessary.

[Bakez]

Of the top of my head, I've seen three cases where there was definite growth in the Acell extraction sites. In addition, the donor healing was much better than with typical FUE. I can usually spot a donor area that had FUE right away based on my experience level. The Acell treated donor area extraction sites heal better than anything i have ever seen. In fact, i had one case where i could not find any evidence that a procedure had been done.

Most of my patients come to me from other cities. That makes patient follow up much harder to accomplish. I suspect i will see more in the coming year who come back for a check up or more work. Until then, all i can say is that i'm very pleased with the results thus far. I need to see more results before i can consider this a major break through, however.

The enclosed photo was a patient who had over 1800 grafts to the frontal part of his scalp. When looking through his donor area, I could find a few white spots. I could find a few areas where i knew a graft had been taken, but the skin healed without any white spotting. I did not see as many extraction sites as there should have been, however. This clearly suggested that many extraction sites had regrowth. Actually, it more than suggested it. This case was from when i was using just Acell powder plus PRP. i could not be sure i was getting powder to all the sites back then. Then i came up with a mixture of hyaluronic acid and Acell. That is when i really could insure that i treated all the extraction sites or at least nearly all of them. Now i'm seeing much better healing in general and apparent regrowth in at least 3 cases. One of those donor areas was flawless. It blew me away.

OK

This is quite exciting then. It is a shame that it seems that scientific investigation in hair loss appears to be almost impossible. You have to wait months or a year to find out whether something worked, that is if you see the results again at all.

It must take a lot of organisation to record the methods used on each patient and then evaluate the results

[John P. Cole, MD]

Listen guys there are many people who read these forums whose hair loss has made them bitter. Sometimes they are bitter because they have lived with hair loss a long time and there is nothing they can do about it. Sometimes they are bitter because they had a bad result from a physician. Sometimes they are bitter because they did not feel they got the result they hoped for from their physician. They were not born this way. They were often dealt a bad hand by life. Responding in a bitter way is sometimes the only relief they have from the pain they feel inside. It may be their way of coping. I try to understand their pain and let them take it out on me. If hurting my feelings, makes them feel better then I'm willing to accept the humbling criticism.

[John P. Cole, MD]

Of the top of my head, I've seen three cases where there was definite growth in the Acell extraction sites. In addition, the donor healing was much better than with typical FUE. I can usually spot a donor area that had FUE right away based on my experience level. The Acell treated donor area extraction sites heal better than anything i have ever seen. In fact, i had one case where i could not find any evidence that a procedure had been done.

Most of my patients come to me from other cities. That makes patient follow up much harder to accomplish. I suspect i will see more in the coming year who come back for a check up or more work. Until then, all i can say is that i'm very pleased with the results thus far. I need to see more results before i can consider this a major break through, however.

The enclosed photo was a patient who had over 1800 grafts to the frontal part of his scalp. When looking through his donor area, I could find a few white spots. I could find a few areas where i knew a graft had been taken, but the skin healed without any white spotting. I did not see as many extraction sites as there should have been, however. This clearly suggested that many extraction sites had regrowth. Actually, it more than suggested it. This case was from when i was using just Acell powder plus PRP. i could not be sure i was getting powder to all the sites back then. Then i came up with a mixture of hyaluronic acid and Acell. That is when i really could insure that i treated all the extraction sites or at least nearly all of them. Now i'm seeing much better healing in general and apparent regrowth in at least 3 cases. One of those donor areas was flawless. It blew me away.

[Bakez]

I may have confused some people about my involvement with Acell. I have been using Acell for over a year on humans. I first began following it in 2007.
It was used in veterinary applications long before it was indicated for humans. i own horses so i was interested in Acell.

I put Acell on my grafts. I use PRP. I put Acell in my extraction sites. I put PRP in my extraction sites. i also microneedle. i think the full menu offers more potential than any one alone.

i am open to doing a hair pluck trial. I've communicated with Dr. Cooley, but we have not discussed his technique. I think the first thing they could do is publish a video on how they pluck their hair followed by how they apply acell to the grafts. My bet is that they are working on a soluble form of Acell to coat the plucked follicles with, but they have limited experience with it yet. Dr. Hitzig should publish a video on how he is making his PRP from the occipital artery. I'm not sure i'm ready to go needling the hip for stem cells.

i have two soluble forms of Acell now that i use on my donor area extraction sites.

While i have my concerns about all this plucking business, i definitely have the tools to evaluate the results. I'm also curious how well it works especially in the donor area.

Look, here is hair regrowth in a donor area extraction site treated with Acell 2 months after the extraction procedure. Interesting.



i'm not sure you can publish a good quality video on this forum. Can you?

Is that growth just a one off though? Or have you been seeing more and more of these?

[HairRobinHood]

Please let's keep focus on the main subject. If you want to brawl look for a chatroom.

The main subject? You'll find the main subject here:

http://www.baldtruthtalk.com/showpost.php?p=19088&postcount=1

... and in particular here.

http://www.baldtruthtalk.com/showpost.php?p=21870&postcount=259

[SilverSurfer]

Not Again

Please let's keep focus on the main subject. If you want to brawl look for a chatroom.