arussell

Please do not put words in my mouth. I said, "not all systems are the same" Not all give you the same amount of platelets, and the use of activators etc. I explained that we do not do packages to be done every three months and I explained why. I never used the words inferior, I never insinuated anything other than different, and at that fee it had to be because our cost is more than that. I will work on an EXO thread. I have meant to do this for a while so it is actually a good time. Thanks.

You are comparing apples to oranges. I did not say the fee for other clinics. We have never done a series of injections because it does not follow logical sense. Your hair grows in cycles and the hair that can be rejuvenated is less with each cycle. one of two ways to look at it, do it and when your results are apparent make a decision to do it on an annual or semi annual time frame or just wait until you feel you need more. Ask this clinic what SYSTEM they use, if they use an activator, what there platelet count is, etc. As stated, not all clinics offer the same thing, and not all treatments achieve the same results. Stimulating growth factors to heal a wound is not the same as activating stem cells to rejuvenate "aging" ones.

Here is some information that we share with patients. It is not a magical cure but it is a step forward in this mystery called hair loss. What are Exosomes? Exosomes are micro-vesicles, about 1/1000th the size of a normal cell, and are involved in normal intercellular communication. The exosomes in our treatment come from an FDA cleared biologics company that takes donated human mesenchymal stem cells, which are purified in the laboratory. To date, no complications or adverse events have been reported using this product in applications ranging from wound healing, orthopedics, anti-aging, and hair restoration. Mesenchymal derived exosomes are considered by many to be the most exciting new development in regenerative medicine. The unique benefit of these exosomes is that they are stem cell derived and bring a wide array of growth factors to stimulate the body’s own natural regenerative potential. When injected into the scalp, the result is thicker, healthier hair. In the past, we injected platelets (PRP) and stem cells to thicken hair. This involves introducing a lot of ‘unnecessary stuff’ with the goal of including ‘good stuff’ that will find its target. After a PRP or stem cell treatment, the body has to clear away the debris left behind. With Exosome therapy, a much higher concentration of ‘good stuff’ is injected and without the ‘unnecessary stuff’, providing a more effective procedure. In this way, Exosomes are one step beyond PRP and ‘Stem Cell’ therapy. The exosomes contain 200+ growth factors that are known to promote healing, regenerate normal tissue, and for our purposes, to thicken hair. These growth factors include VEGF, PDGF, and FGF, which have all been shown to thicken hair. Importantly, MSC derived exosomes have been shown to contain Wnt 3a, which activates the Wnt/βcatenin pathway which is critical for hair regeneration. How many treatments will I need? We perform the treatment as a stand alone treatment. The initial results become apparent in 3-6 months. Our long experience has shown us that the duration of PRP treatment depended on the patient, both their genetics and whether they were taking hair loss medications (e.g. finasteride, minoxidil). So a patient with strong hair loss genetics and not taking medications would require more frequent PRP treatments compared to a patient with mild genetics who was taking medications. Results may vary from patient to patient, as will the duration of benefit. Since the early experience with Exosomes is showing results superior to PRP and stem cells, we can surmise that the duration of benefit will be as long or longer.

We have offered treatments in combination with a transplant for years. It makes sense it exacerbates healing but its true purpose it to rejuvenate hair that is withering away from DHT. Results and impact depend on many things such as what system and techniques were used as well as activators. Big difference is that with EXO it does not have the "junk" that is not needed so there is not any inflammation that is often an accompaniment of PRP. Without this inflammation the activation takes place sooner than later and the addition of an activator is not needed.

PRP was not $1000 ever. This tells me that an inferior system that is inexpensive was used. The kits alone are this much basically and that would be without actiators added such as ACell or the addition of Regenera. I didn't say I could not share photo's, I have to gather them to post. Our photo base is not setup on what is done but by patient so I have to have time to look for them. I will put it this way, we do not advertise anything. We give information and allow patients to make their own choices.

Mycroft I know you are aware that many things in this industry are largely unregulated so many of these recommendations come from practical experience. Many things can contribute to the end result. Dr. Cooley does not recommend anything added or done in the initial healing so that nothing disrupts the process. The body thinks of the hair as non essential (the body can live without any) so if something is not exactly in balance then the hair can suffer. If EXO treatments or PRP were to be introduced shortly after a transplant the brand new "roots" could be lifted. Some is theoretical but who wants to risk a failure or poor or delayed result? It also can "muddy" what is thought to be the end result. We do combinations of transplants and treatments at the same time a lot. The new growth phase is the same for rejuvenated hair or the newly grafted hair. We expect onset of growth to begin around 3 months. If you do a treatment say at 2 months post transplant this will reset that growth phase.......

I also wanted to mention that just like most things in the hair world, a lot of things are largely unregulated. Having said that, before Dr. Cooley ever promotes something, not only has he done research to determine validity but we also do treatments with patients permission at Dr. Cooley's expense. AFTER he has collected his own data using visual observation, very good photography and discussing with his "group" , we then offer it to patients. We have done 1000's of treatments of EXOsomes at this point it is newer but not experimental.

EXOsomes cause less inflammation and overall seem to work faster in the response phase. They provide as good if not better results with no restrictions and less chance of swelling or headache that are the two most common complaints. We do have before and after photo's that we share during a consultation. Over all it seems to be more impressive but the jury is still out on if it last longer than PRP. We still can do PRP but we do not promote it.

I have to agree with Mycroft and Steeeve in their comments about what kind of system is used and the addition of a Matrix. I do want to interject to say we no longer promote PRP or PRP Plus as Dr. Cooley coined it after adding ACell to all applications. PRP has been a good procedure and has had some good results but people need to know what part of what is responsible for healing or growth. I think there is a lot of misunderstanding out there. We have replaced PRP with EXOsomes. EXO treatments are jammed packed little packages of stem cells with out the extra things that many PRP applications have. It is the extra that the body has to clean up so to speak and this is part of the end results predictability. We have far less inflammation issues now. Neither treatment is meant to grow hair where you no longer have it... (wishful thinking!!!) and if you understand the growth phases, if done in advance they can prepare the scalp and help the mini hair, if done at the time of this will enhance growth of because it is helping to rejuvenate the DHT effected hair while the new hair is taking root and beginning to grow. Dr. Cooley will not agree to either done after a transplant in the initial healing phases so as not to introduce anything that could confuse the cycles.

haircrown123 this response is tedious at best. The type of harvesting is not what achieves natural results. Going to a doctor who has artistic talent and great technique is what gives you that result. To imply that with any surgery there is not pain is a disservice. In any surgery you have to have locals administered which is uncomfortable and no one can know any patients threshold for pain. Incisions are made in the recipient area as well as harvesting regardless of the harvesting method. This sounds like pure advertising with less than optimal disclosure......

Etika please read my prior posts. FUE is promoted in a way that is not always full disclosure by some clinics. BOTH harvesting methods "provide excellent and assured results". Both have advantages and disadvantages as I have discussed at length. To say FUE is the only method to provide this is not only incorrect it does patients a disservice in not allowing them to choose what is the best method for them. We do both, and achieve equally good results from either.

Rob, As you said this is your opinion and is in no way based on practical experience or fact. I have pointed out over and over BOTH FUT AND FUE ARE GOOD PROCEDURES IN THE HANDS OF THE RIGHT SURGEON AND TEAM. BUT.... SOME OF YOUR OPINION IS JUST BASICALLY INCORRECT or perhaps you do not understand the basics. You are correct in saying there is only a certain number of grafts that can be harvested regardless of the method. You are incorrect in saying you can harvest equal amounts without consequence. In either method (being redundant here) you have plus and minus to think through. If you have dark hair and very white skin, donor density, skin laxity (for FUT). But if FUE is done and over harvested you are left with diffusely thin donor that nothing can really fix. If an FUT is done and the donor scar is almost undetectable (which is the case in most surgeries using good techniques, a small FUE can be done and is always offered to anyone doing FUT. A stretched scar can occur but is not the standard, it is the exception AND is the reason it is REASONABLE to do FUT first if trying to maximize graft harvesting and to complete with FUE. Dr. Cooley does both methods and does both with success. But either can have limitations. FUT is not the older procedure, FUE is not the newer. FUE is, in FACT, the older, the old plug technique refined. That is not my opinion, it is fact. BUT FUT has also evolved and the old short wide scars or stacked scars are not something that good surgeons now create. Closure technique revolutionized with trico closures in the late 90's early 2000's. No one now uses multi -blades. Suture material has changed, enzymes are used to enhance laxity and much much more. FUE if great for someone who is on medications, does not have extensive loss and family history is not strong for NW 6-7. The patient is well educated on what can occur without meds, pattern of loss and other facts. I worry about some of the very large FUE surgeries done going into the areas of the scalp deemed unstable..... what then, what if the FUE graft is taken from areas susceptable to DUT/ AGA no meds are given or explored, donor is tapped out and loss occurs. I can tell you. In the old days of plugs, no one discussed future loss, hair was moved successfully within native hair and then... 10 years and BOOM... big white round scars. Now, with current FUE the scars would be small BUT THEY ARE STILL JUST AS MUCH A SCAR AS AN FUT SCAR. I repeat both are good procedures in the right scenario. RESEARCH IS THE KEY PEOPLE. Below is a prime example. This patient went somewhere else and had FUE, yes I know where and yes the doc is well known. He came to us with more loss (he was not on meds) and afraid he would have more diffuse thinning with additional FUE. If you look closely you will see Dr. Cooley's FUT scar, which if there was not diffuse thinning would never be visible. With FUE you have to shave the donor, with FUT that is not necessary. BOTH will give you hair where you desire it! But BOTH create scars. With FUE you are able to return to the gym faster because there are no sutures. These are facts, not opinion. I like both and will discuss both factually. Remember this, bad news travels faster than good news. So if someone is unhappy they tell everyone, if they are happy they tell a select few.

FUE has advanced, but so has FUT/FUSS. FUE is the evolution of the old plug transplants, it is not THE advanced technique. It is not always better but can be in some situations, the same is true for strip. It takes a skilled surgeon and team for EITHER procedure. It takes research and disclosure from clinics to potential patients to educate them of the benefits vs the downfall of EITHER. I have been a part of this community and have witnessed the evolution first hand. Facts are facts..... both create scars..... neither cure balding..... both can effectively move hair and in skills hands provide a natural restoration. Neither are perfect. Simrangoyal, I am Clinical Supervisor for Dr. Jerry Cooley. I have also had the honor to be the past chair and the Forum (ISHRS publication former editor for the Assistants Corner). I have been a part of this forum since it's beginning. I am fairly knowledgeable having been in this field for 20 years, about either. Dr. Cooley does not use old techniques. We do both procedures as do many other surgeons; using the latest technology available. Sometimes what is promoted as the latest greatest but in reality is the opposite. Research is key to finding the truth.......

FUE is best for some situations, not all. All of this has been gone over again and again. Both have advantages and disadvantages. FUE does not give perfect more natural results. That is the skill of the surgeon and the clinic. Both can give great results if the patient makes a decision based on fact not on what someone is telling him. Neither are painless that will depend on the individual patient. Nothing is perfect!

"I think the reason is, it gives better results than FUT technique on average. I am not saying it is better because better is a relative term. When we compare all the results of both techniques, FUE seems to be more natural, denser overall. But there are many surgeons who are very successful with FUT type surgeries. But when compared, I believe FUE gives the surgeon more freedom to fill the bald areas. The doctor can pick each follicle according to a schema and the rest is talent. Moreover, I don't know why but usually, when the hair grows, after a certain length, it looks unnatural if it was a FUT. Ordinary people can't see it but if you keep seeing hair, you can tell the difference. I have heard that even the most experienced doctors who have been conducting FUT for decades are now learning FUE technique. I believe the shift will be towards FUE more and more each passing year. Here is my article about FUE and why doctors are switching to it more and more each day, I believe I touched very important points. I do not believe better results are given with FUE and certainly not more density on average. As for hair not looking natural with FUT, if the team is highly skilled then this does not occur. In fact, in our clinic, all FUE grafts are placed under a microscope to ensure they are true 1,2.3 etc and to trim any debris. It is placing that can damage hair and make it look less natural. Incisions have to be carefully made by the surgeon according to the size of the follicle and then placed by skilled placers to avoid crushing or hooking in placement. Both FUE and FUT will give natural results using good technique. As I pointed out above choose carefully what is in your best interest. " Bill the above words are the quote that I was disputing with the last paragraph. I disagree with this statement totally. I do not think results are superior with FUE as I said. Both have advantages and disadvantages. I hate for one to be promoted as the end all of end alls. The fear of the linear scar is from OLD scars or clinics that have not used the newer better methods of closure. BOTH leave scars and the biggest issues I am afraid we will face in the future from FUE is over harvesting, diffuse thinning and just by nature of diffuse thinning fewer available donor grafts to transplant. I have seen quite a few young patients who have done large FUE left with bad moth eaten looks in their donor and not a lot of great options for repair...... Results are pretty similar with the same graft count. But we still dissect under a scope even the FUE so they would all look natural......