I am proud to announce that we performed New Yorks first PRP treatment in Great Neck today.

The patient had visited us twice for HT surgery consultations but was turned down on both occassions. When he asked if there was anything new available to patients in his situation, we told him about PRP and he decided to give it a try.

His entire procedure took about 25 minutes. We drew some blood from his arm and then processed it to obtain concentrated plateles. Then I numbed his scalp with a local anesthetic and injected the PRP into the dermis where the follicles live. Then I used a tiny needle and made 200 punctures in the skin to activate the platelets. I let him sit for 5 minutes during which his skin healed, washed his scalp with some clean water, and sent him home. That was it. Very undramatic. I will post photos when I get the chance.

Dr. Feller
Great Neck, NY

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Feller Medical, PC
Great Neck, NY

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

Providing Hair Transplants and Platelet Rich Plasma (PRP) Treatments

Wow. Exciting news, particularly since I'm pretty interested myself. Are you going to be documenting any of these cases/

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*A Follicles Dying Wish To Clinics*

1 top-down, 1 portrait, 1 side-shot, 1 hairline....4 photos. No flash.

Follicles have asked for centuries, in ten languages, as many times so as to confuse a mathematician.

Enough is enough! Give me documentation or give me death!

Excellent news Dr. Feller. When you say "injected the PRP into the dermis" do you mean this was accomplished via a single injection?

What do "200 punctures" exactly accomplish? were you just trying to have blood exit through this many places to assist the circulation of the PRP?

Could you please explain the reason for turning him down twice previously for an HT? was it poor credit? (half joking since i suspect the profession would hardly blink if I offered to pay them to do an HT on my cat given this economy)

Was or is the patient on minox or fin or any other compound that could later be misconstrued as growth as a result of the PRP treatment?

Also was this a localized experiment (eg the crown area) just to see effectiveness, or was the patient treated with the intent to achieve growth throughout the scalp?

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My Hair Loss Blog - Hair Transplant with Dr. Ross

i hope and wish that his result turn up to his expectations when it's all said and done.

kudos to you Dr.F for taking on the challenge.

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Thana,
Yes, I will be documenting ALL of them.

Mike,
No, not a single injection. I inject PRP every CM or so to "seed" the dermis as evenly as I can. Then I poke the area that has been seeded about 200 times to ACTIVATE the platelets.

I guess I haven't made the mechanism of action of PRP clear, so let me summerize here:

Platelets in and of themselves are inactive and dormant. If they weren't, you're blood stream would be just one massive clot. Platelets only become active when triggered by disruption of tissue. So when you cut yourself, the platelets passing by in the blood stream at that time become ACTIVATED by the injury and start to do their magic- which is to clot blood and exude growth factors of different kinds to regenerate the skin and surrounding structures in an effort to heal them.

The blood has a relatively low concentration of platelets, so in PRP procedures we strive to concentrate the platelets 5-7 TIMES normal. Then we inject it into the dermal layer where the follicles live.

At this point the PRP concentrated platelets are in the dermis, but are inactive, so when I poke the area a few hundred times the trauma causes the platelets to activate. That's the general mechanism of action of PRP as I understand it. Perhaps Dr. Joe Greco can come on here and elobarate if need be, but I thing that pretty much says it.

The reason I turned that patient down twice was simply because he had too much hair for surgery at this time. That's what made him an excellent PRP candiate.

This patient is not on any meds and does not want to be- yet another criteria that made him an excellent PRP candidate.

While PRP is "experimental", I am not trying to experiment on patients. That is, I will not preclude patients who are already on finsateride, dutasteride, minoxidil, or anything else in the name of doing a study. Instead, I will treat all patients I feel are candidates for PRP and simply follow their progress in photos. Then I will do a retrospective study to see what the effects of PRP truly were.

Thanks GQ.

-Dr. F

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Feller Medical, PC
Great Neck, NY

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

Providing Hair Transplants and Platelet Rich Plasma (PRP) Treatments

Hey Dr. Feller --

Like everyone else, I've been following this thread closely. I'm curious as to who would make a suitable candidate.
Are the best candidates people with a lot of hair in the area of treatment, or might it work on a more barren area of scalp?

If PRP is done in an area where grafts already have grown out, do you think it can harm the grafts?

In general, do you think there could be any risk of shockloss from wounding the area?


Thanks!

Ceasar,
PRP seems to play two major roles:
The first is to aid in reducing, arresting, or reversing miniturization. In this case the best patient is someone with ALOT of thin hair like diffuse alopecia. Another ideal patient is the one who is losing their hairline due to traction alopecia secondary to pulling the hair back into a ponytail.Yet another is the young person who sees areas of their scalp noticably thinning. Most of these type patients should NOT be candidates for HT in the areas that PRP treatment is recommended.

The second is the hair transplant patient. I now tell all my patients that they have the OPTION to get a PRP treatment 2 weeks to a month BEFORE their scheduled HT procedure to help prepare the donor area and recipient area for the surgery. Since PRP exudes EGF (Endothelial Growth Factor) it means new capallaries will be formed within the skin which can only help the donor area heal better and the recipient area recover faster after surgery. And before anyone worries about the area bleeding MORE during surgery due to the PRP treatment, it won't because the new vessels are capallaries and are therefore too small to make a difference in the volume of blood lost during surgery.

If PRP is performed in an area where grafts are already grown out it will not harm them. Think about it, even a massive surgery in and around prior transplants very rarely harms the original transplants. The amount of trauma from a PRP treatment is FAR less than that.

I suppose there is ALWAYS a risk of shockloss as some peoples physiology are more sensitive than others, but I have to state that I HIGHLY doubt shockloss can occur as the result of a PRP procedure. The wounds are just too small.

Thanks for your participation Ceasar. You have been hailed.

Dr. F

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Feller Medical, PC
Great Neck, NY

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

Providing Hair Transplants and Platelet Rich Plasma (PRP) Treatments

Thanks for the explanation Dr. Feller. I know I drilled with a lot of questions at once.

I recall reading somewhere on this forum that PRP would need to be repeated periodically to maintain its effectiveness against MPB. Is that recollection accurate? if so I would be (hypothetically speaking) a little hesitant to make a visit every, say- three months, to get several hundred needle pricks in my scalp.

My question then is would this treatment benefit from one of the various needle-less injection systems that have recently been made available (using high pressure vs needles)???

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My Hair Loss Blog - Hair Transplant with Dr. Ross

I hope this pans out. How much terminal hair do you hope to produce with this treatment? Is there any risk of a tumor developing, as another poster suggested.

Dr. Feller - You explained which patients are ideal for PRP. In what situations would you simply turn someone away from doing PRP because they simply are not a good candidate?

Thanks