ACell, a Current Review of Applications in Hair Transplant Surgery

[RichardDawkins]

@Dr Cole : Nice to hear that you willing to test plucking. I think Keep Hoping will contact you then.

[John P. Cole, MD]

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?

[RichardDawkins]

We are talking about PLUCKING as an additional treatment especially for people with depleated donor.

And instead of a long post with extracts from the 70s you could just cut to the chase if have something to report where balding people can benefit from.

But i see its another Gho praising

[HairRobinHood]

Now who really thinks that if you leave only this tiny round part in the donor area and remove the rest of the intact follicle that you will get 100% regrowth in the donor area?

Lection #1 …

During the 70s, a well-known and respected researcher tried to develop a surgical procedure which involves “direct scraping” of the sweat glands by using a special “tissue shaver”, in an effort for a radical treatment of hircismus and hyperhidrosis …

1978 Sep;62(3):355-60.

Abstract
We have developed a subcutaneous tissue shaver for the radical treatment of hircismus and hyperhidrosis. With this shaver the sweat glands can be removed from the undersurface of the axillary skin through a small incision. We report 3,000 cases of hircismus and hyperhidrosis treated by our method. The postoperative scar has been minimal, healing has been quick, and good results were achieved by this method.

Just a few month later, the well-known and respected researcher reported almost excited about an “unexpected side effect” as a result of his newly developed surgical procedure …

1978 Dec;4(12):921-5.

Abstract
A subcutaneous tissue "shaver" was used in the treatment of axillary bromhidrosis. Regeneration of axillary hair was observed postoperatively even if subcutaneous tissue and dermis were removed almost up to the level of sebaceous ducts. Hair regenerated more often in male patients whose sebaceous glands and follicular isthmus were designedly left intact than in female patients whose sebaceous glands were designedly removed completely. Some function of apocrine and eccrine glands tends to return over a two-year period.

Just about 5 month later: The well-known and respected researcher was “pissed off“ because his new developed subcutaneous tissue shaver didn’t always work in such a way, so that each and every part of the hair follicle (of course including the sebaceous glands too) is completely removed after his new surgical “tissue shaving” procedure, so that he finally suggested his colleagues via a scientific follow-up paper the following:

1979 May;5(5):407-11.

Abstract
From our experience, the most important requirement for permanent epilation by electrocoagulation is not only to destroy hair bulbs, but also to destroy the isthmal regions of hair follicles and the sebaceous glands.

The reason, why the researcher suggested this, because he observed on his 3000 treated patients (!), through histological studies etc, that even there is a TINY part of the hair follicle left behind within the tissue (after removal of practically almost the whole follicles including sebaceous glands), that this damn thing called “hair follicle” always fully regenerated and finally did again what it normally is doing best: producing hairs! – “unfortunately” including the sebaceous glands too. How bad concerning the researchers initial intention with his “tissue shaver”!

Conclusions

According to the well-known and respected researchers suggestions, I would recommend you doctors like Woods, Rassman, Bernstein or Cole etc, IF you really wish NO re-growth of removed hair follicles like through “FUE”. I can guarantee you an almost 100% success rate for no re-growth of follicles including hairs! So all these guys are definitely the way to gho for such procedures, as suggested and described by the mentioned well-known and respected researcher - or suggested in FUE studies (= how can I perfectly and once and for all destroy a patients hair follicle) by removal of "intact" hair follicles.

[RichardDawkins]

On behalve of me and a lot of other people i say

Thank you KeepHoping

[KeepHoping]

Dr. Cole,

with the recent developments showing some thickening of native hair with PRP/Acell (and the idea of taking stem cells from the hip for the PRP as Dr. Hitzig is starting to experiment with) are you going to implement PRP/Acell needling along with your FUE procedures with grafts dipped in Acell to see if you get the robust outcomes and the hair counts that far exceed the amount of grafts transplanted as reported by these doctors? Or at least to try it and see what kind of result you could get? I would fly to Atlanta to see you if it was something you would be willing to try out, I would put up before and after pictures and would be happy to be your Guinea Pig for the experiment.

[KeepHoping]

Guinea Pig

I would gladly be a guinea pig for this, it has caused me enough suffering and I would be glad to take one for the team for us to find results, nobody deserves to deal with hair loss at a young age, I would gladly volunteer to take part in an experiment and I am a US citizen.

[RichardDawkins]

I appreciate your willingness to actually work with both doctors (thats something i miss from those other self proclaimed "experts").

I personally hope that you get together with both or one of them as soon as its possible because a lot of repair patients and hairloss sufferes in general would be very pleased.

As i said before it would also be nice if there is someone here who would do the "guinea pig" part and get the study done with your ideas and contributions, i would do it as i said if i were a US resident and without hesitation.

So my only advise or recommendation to you Dr Cole, as a hairloss sufferer, get in touch with them and do another step towards helping hairloss suffering people.

Maybe someone here is willing to do the guinea pig job i really hope so.

And i mean, "If donor regrow is possible even with FUE sometimes why not go the extra mile"

[John P. Cole, MD]

I hear you man. i want this concept to work as much as anyone. The issue is merely that what you are plucking contains a small amount of internal dermal sheath and a dead hair follicle. I would love to see Acell make this grow. On the other hand, what Dr. Hitzig and Dr. Cooley are doing is plucking the external root sheath, internal root sheath, and dead hair follicle. they missing only a tiny fraction of the follicle at the base around the bulb. If you pluck a nearly intact hair follicle a few may regrow, but most will not.

think of a follicle as your foot. The part that grows the hair is your sock. Your hair resides in your shoe. when you pluck a hair, you tend to pull out your foot and leave the sock in your shoe. You may have a few fibers on the foot from your sock, but mostly you have a bare foot. The sock that remains behind has the ability to grow a hair. The part that you pulled out of your shoe cannot grow a hair. Now, if you can remove almost the entire sock and leave only the outer part of the toe of your sock in your shoe, then what you remove can regrow an intact follicle. the part tiny amount of sock that remains in your shoe, will not grow a follicle.

when i say we should study the benefits of plucking on the recipient area and the donor area, i mean that we should tattoo a place on the back of the scalp rather than on the beard. While you can remove tattoos easily later on, no one really likes them in a visible place unless a tattoo artist is doing the work. For that matter, we could simply pluck all the beard and see what grows on top and what regrows.

Enthusiasm on your part will help drive these guys to study plucking and Acell. i'd need to visit Dr. Cooley to see what he is doing and how he is doing it if i were going to venture into this arena.

[RichardDawkins]

This may seem right BUT as you can see there is a demand in the balding community for this. And i think this plucking in combination with Acell is definitely worth trying.

But i can understand that this may sound unbelievable to most people but, if we dont try it then we wont know for sure.

If i would be a US resident i would glady be your "Guinea Pig" for this procedure or Hitzig/Cooley.

And this means much because iam not a fan of FUT or hasty reactions, but this time well its only a win/ win situation (and i was more then just sceptic at first) but some biology departments at the university did try plucked hairs with an ECM substance and it worked.

The key thing is the tissue left at the plucked hair. Sometimes even when hair falls out by natural cause you can see white dry and solid tissue stick to it, but its dry and dead.

As a self experiment i did to myself i plucked different hairs from different "zones" from my body

1) nose hair (there are three hairs in particular which drives my nuts)
2) eye brows ( there are around six or so which stick out)
3) temple area (there i used a mole as reference point to see if it grows back) actual scalp hair
4) beard hair (again i used a mole as reference point)

Timespan : Around 6 years or more

Observations : Every single plucked hair had at least three times a substances stick to it, the tissue. I could also exactly predict when it in fact had this tissue around.
- everytime when i felt a little sting in the plucked area i could say "White substance" and it was

Result :
1) nose hair : still growing (which sucks) and i witnessed NO difference in size or diameter.

2) eye brows : still growing but in longer time spans. No change in diameter or size

3) temple area : scalp hair is still growing, no decrease in density, size or diameter also no irretations there (scar tissue and or blemishes or redness)
Also no whitening when tanned.

4) Beard hair : dont get me started it grows like i dont know. No signs or redness, scar tissue or anything visible

Conclusion : All areas still grow there natural hairs, i plucked those areas approximately more then 10 times in six years and all of them had some tissue stick to them at some point.

I also did a small experiment with chest hair but after a while i left it because it was really painful to tweeze those hairs all the time, but what i saw was it still grows and even with replacing it with tissue stick to it.

Everyone can btw do this himself at home and observe the things. Maybe those who wanna try it could exactly write down the numbers and charts and stuff.

But believe me nose hair hurts like hell.

So my conclusion is, plucked hairs will regenerate themselves even when you pluck a terminal hair with tissue stick to it.

But i cant test the second part of it "Plucked hairs transplanted with Acell" because i lack the equipment like Acell

[John P. Cole, MD]

Plucked follicle

This is a stained version of the plucked almost fully intact vs the fully intact follicle. The one on top looks like Bart Simpson. This is the almost fully intact plucked follicle. All it lacks is the round part at the base of the follicle. Now who really thinks that if you leave only this tiny round part in the donor area and remove the rest of the intact follicle that you will get 100% regrowth in the donor area?

In other words, Bart Simpson is missing the top round part of his head. So is the plucked nearly fully intact plucked follicle. So are people who really think that this round part of the head could regrow a fully intact Bart Simpson.

[John P. Cole, MD]

Plucked hairs

These are both follicles obtained from the donor area. The one on top is a fully intact follicle. The one on the bottom is an example of the hairs that both Dr. Cooley and Dr. Hitzig are calling plucked hairs. What is the difference? The difference is a minuscule amount of tissue at the base of the follicle. In other words, the plucked follicle is almost fully intact. Naturally, if you transplant this almost fully intact follicle, you would not be surprised to see a high percentage of them grow. If you add Acell to them, you might see a higher percentage of the follicles grow. What you are not likely to see is a high percentage of growth from the minuscule amount of tissue that remains in the donor area. In other words, you are better off to have fully intact follicles transplanted to the top, which have a much higher probability of growth than these almost fully intact plucked follicles in my opinion.

[John P. Cole, MD]

Plucked hairs

These are plucked hairs that are derived from grooming. Both males and females produce this sort of plucked hair when grooming their eyebrow, ears, beard, nose hairs, or any other unwanted hair. You can put Acell on these plucked hairs all day long and I have very little faith in the potential for hair regrowth. If one could get these hairs to regrow, you would indeed have an inexhaustible supply of hair or "autoclonning".

[RichardDawkins]

Dr Cole

does this mean that you are also trying and experimenting with Acell and plucked hairs or are you suggesting your idea of doing it to others?

WOuld be nice to hear that you are also go for the plucking with Acell.

[KeepHoping]

Dr. Hitzig,

What is happening with the the patients who have gotten hair transplants with PRP/Acell? What is the growth like? How many more hairs are you getting than anticipated? Is it like 3 to 4 times than what's expected? I want to get an idea of how much coverage can obtained with a lower amount of grafts when implementing Acell/PRP into the mix. I'm trying to plan the next move at this stage and want to get an idea of the results coming in and when we will be able to see them?

A big thank you to all the doctors working with Acell and experimenting to find a solution.