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Originally Posted by HairRobinHood
Cool - it seems he learns fast (at least faster than Cooley).
I hope so.
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thanks for the post doc
can you briefly explain full depth extraction to partial depth ?
is partial the removal of the entire follicle with less surrounding tissue depth or does it leave a portion of the follicle behind which might contribute to the reformation of another follicle
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Originally Posted by drcole
I find this interesting.
I find this interesting too. Dr. Cole, frankly, your post and your whole ACell/CIT concept sounds like a 100 mhp driving Mercedes Benz with a missing wheel. I really wonder what good are all these “Societies of Hair Restoration Surgery” on this planet. It seems just to say each other “Hello, business colleague!” once a year? I guess not even the last …
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minimal depth extraction
A full depth incision would be from the surface of the skin to below the bulb. In a recent morphometry study done by Paco Jimenez, he found the distance from the surface of the skin to the base of the hair bulb was 4.156 mm +/- 0.439 mm. Thus a full depth incision around a follicle would be more than 4.156 mm deep on average. Paco goes on to say that most of the stem cells are primarily located between 1 mm deep and 1.8 mm deep or roughly the length of the isthmus of the hair follicle based on the well known bluge stem cell marker CK15. A minimal depth incision would be only as deep as necessary to extract a full intact hair follicle. I avoid plucking hair follicles and I certainly do not like to amputate them.
When I extract a full intact hair follicle, I ease it out. I do not cut around it and remove it. Easing the follicle out means that bits and pieces of the dermal sheath are left behind in the dermis and adipose. These bits and pieces leave potential stem cells behind. These stem cells have the potential to create new hair follicles.
When you ask Acell to do little things, it is possible that it will. When you ask it to do something on a large scale such as regrow an entire arm, you are not going to see it. I’m asking Acell to regenerate a tiny portion of dermis and epidermis. We are seeing that Acell can do this. We are also hoping that it will continue to be successful in promoting follicle stem cell neogenesis. To me the latter is not as likely as.
What we are seeing here is the formation of capillaries that are not usually seen following extraction of intact follicular units even with my minimal depth approach. My theory was that with the loss of the hair follicles, the body did not need to regenerate the capillaries. We also saw a decrease in pigmentation of the skin in many individuals following the removal of scalp hair follicles. With Acell we are seeing normal pigmentation and the formation of capillaries. In other words, it looks like normal skin. It is very exciting to me. In my opinion, the positive results we are getting with Acell are simply one more nail in the coffin for strip surgery.
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ACell
NY has been similar to Antarctica recently wreaking havoc with patients and office hours.
I have been very excited with my conversations with Artericyte (Please look them up). The feeling is that VEGF (Vascular Endothelial Growth Factor) is highly attractive for Adult Stem Cells which Matristem needs to convert to Active Progenitor Cells. Whether we need to utilize the wealth of stem cells from hip bone marrow aspirate is yet to be determined.Dr. Cooley will be working with the company as well as they have a principle in Charlotte. My team will be travelling to Philadelphia to learn the office technique. Where it may prove very valuable is in Auto-Cloning with Plucked hairs as it offers quick support and re-modeling of these somewhat skeletonized hairs. We will have to see.
I believe the early encouraging results from the enhanced PRP/ACell is even more exciting. If consistent, we have a "Vaccination" for hair loss.
One question we are trying to answer is how much micro-needling damage we need to create in the scalp with ACell injection to remodel scalp hair follicle stem cells to produce active progenitor cells--we may need to do more than one set of injections to achieve this. I believe the answers will come fast and furiously.
I am glad Dr. Cole is seeing the fruits of ACell. The question comes if the donor area is remodelled with the subsequent production of skin and hair, why perform a tedious and costly FUE as opposed to a strip method that "repairs itself". I think all methods have their place and my job as I see it is to try to help solve the problem and let each apply that solution to their respective techniques.
Thank You all for your encouragement and feedback--you don't know how helpful it has been!
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Dr Hitzig,
Are there, or will there be problems controlling the direction of growth with your injections?
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Originally Posted by drcole
In my opinion, the positive results we are getting with Acell are simply one more nail in the coffin for strip surgery.
I guess you didn't see Dr. Hitzig's ACell-strip-closure results?
If I'm not completely wrong, and just from what I have seen so far from Dr. Hitzig concerning strip-closure with ACell, that was so far the best I have EVER seen in my life concerning strip surgery - and basically I'm NOT really a "strip supporter", I have to add!
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Originally Posted by HairRobinHood
I guess you didn't see Dr. Hitzig's ACell-strip-closure results?
I don't understand your response; it seems something of a non-sequitur.
The point seems to be that if FUE surgery could be consistently accomplished with little or no loss of donor hair, why would FUT continue to be used?
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Administrator
Dr. Gary Hitzig Interview 1/23/11
Dr. Gary Hitzig discusses his recent findings on last Sunday's The Bald Truth
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