First PRP treatment in New York-Dr. Alan Feller

[Bill - Seemiller]

Dr. Feller,

 

I'm not sure if you addressed this or not, but just like one must stay on Propecia and Rogaine to continue to receive their benefit, will patients need to return for subsequent PRP treatments? Or is PRP a "one and done" treatment program? Or because it's still experimental, are you working to discover this?

 

Thanks for keeping the public informed of your use of this procedure.

 

Best wishes,

 

Bill

[greenmud]

Dr. Feller,

 

So if someone is on PRP does that mean they will keep their native hair. Would this be a good alternative to using Rogaine or Propecia for those who just want to hold on to what they already have?

[Dr. William Lindsey]

Dr. Feller,

 

We haven't spoken about this specifically, but I do own a needle-less injector. I used it from '95-'02 to inject kenalog (steroid) into hypertrophic scars or keloids. It works very well on earlobe keloids, particularly on patients afraid of needles.

 

I recall reading that it actually blows the medicine into the skin/scar at 30mph. When I first bought the device (I had learned on one during my fellowship and had to buy a new one for myself) I tried it on my hand. OUCH.

 

I had a combination of a bloody spot on my left hand dorsum and lidocaine sprayed around the "target".

 

Unless newer ones are better and gentler, I can not imagine that it wouldn't completely destroy platelets upon impact with the skin; and no significant growth factor would reach deeper where it is needed.

 

I am anxious to see how the system works for you and your patients. Congratulations.

 

Dr. Lindsey McLean VA

[blowdry]

Dr Joseph F. Greco04-08-2009, 08:13 PM

Can the infusion of platelet rich plasma (PRP) help to reverse or slow the process of Androgenic Alopecia?

 

I just posted the study we did on my blog so you can read the results of the study. It demonstrated that the treatment group increased hair diameter when compared to controls at 4 months and 8 months. All we can do is slow it down. I will be posting a video of the patient demonstrated in the study soon and he is now at 13 months. We plan to do another session.

 

Does this therapy actually reverse hair follicle miniaturization and ???wake up??? dormant follicular stem cells?

 

It does in Alopecia Areata where this occurs. This is also demonstrated in the study.

 

Hello Dr. Greco I think we all have many questions for you.

 

Does this treatment work as well or better then Propecia?

 

We are not saying that this therapy should replace any FDA approved therapy and it was never intended to replace any therapy. We have been utilizing PRP cellular therapy the past two years in surgery and noticed increased density sooner which prompted the study on non transplanted hair.

 

That being said, it is an adjunctive option for hair surgeons to utilize in surgery, especially in the vertex or crown of young patients both male and females who are thinning.

 

Non-surgically, we recommend it 1- in conjunction with FDA therapies, 2-in those patients that may have noticed a reversal after being on approved therapy or 3- for those patients who had side effects to Propecia or Rogaine.

 

Do you have to be on any medication for this to work?

 

 

No

 

When will it it be available?

 

It is available now in surgical procedures and I know Dr Cooley is using it. I have a number of hair surgeons scheduled to visit and we will share our experience with them. Any hair surgeon who understands PRP processing is able to use it.

 

What is very important to understand is that ???not all PRP is the same???. It can be processed differently with higher concentrations of platelets and growth factors. If the PRP is not at a therapeutic level it will not work as well, so someone not skilled in processing may use it and not get the same results. Additionally, if it is used in a non surgical application and used on someone who has more extensive hair miniaturization or someone who is older it will not work as well, similar to Propecia.

 

We are only beginning to understand how it works in hair applications and caution must be taken and realistic expectations must be given to patients. The most important thing about this therapy is that it is safe because it is your own cells, there is no downtime and it can be used in combination with other therapy.

 

How many people have you treated and what were the results.

 

Over 300 the past two years. My partner Bob Brandt is the real guru in PRP. In the past 12 years his company has done over 28,000 PRP procedures in almost every application other than hair. It is with this background that we are studying the effects of growth factors in hair restoration.

 

Does it work on everyone who still has some hair?

 

No. Unfortunately Paul, there is no silver bullet yet.

--

[1973kop]

Dr Feller

 

when will this be available in the UK also could PRP have any positive affect on graying hair?

[Ron J]

I was watching a show and saw that PRP was used to accelerate & aid in a snake bite victim who was left w/a baseball size whole in his stomach. The healing was amazing. This is the same type of treatment, no?

[pmill]

Dr Feller how long does it usually take to see results to know if the prp treatment is working?

[Dr. Alan Feller]

Pmill,

That's a great question, and the answer is: I don't know.

 

I had a patient return 2 weeks after PRP treatment and there was NO question that his hair looked thicker. I don't mean because his hair might have been longer or he used a volumizing shampoo or something like that, I mean a cosmetically signficant difference. I took photos and a video which I will present here when I get the chance. He's a participant on this site and a recent HT patient although I forgot his handle.

 

This doesn't mean everyone will get results within 2 weeks, or even that they will get results at all, but it was a very promising and unexpected surprise so early in my use of PRP for hairloss. At least we're heading in the right direction.

 

-Dr. F

[Rachmunas4life]

Sounds like I am the ideal candidate. I think I will try this before the HT route since I am 26 and have slight recession in the temples of my hairline. There is miniaturization on the left temple so PRP is sounding great!

 

Around 1,000 FUE is what I was first thinking of doing. Or doing PRP first and FUE a few months later might be a good idea.

 

I already sent my e-mail address to Dr. Fellers contact form a short while ago. I would be more than happy to post my results to this great forum!

[wtb_hair]

Cannot wait to see the results!

 

Question though, Dr. Feller, you said that the patient was a recent HT patient. Will there be a set time between post HT and PRP treatment? I can see PRP possibly helping where shock loss is concerned and faster growth for new grafts. Sorry if you've covered this and I just missed it!

[pmill]

Originally posted by Dr. Alan Feller:

Pmill,

That's a great question, and the answer is: I don't know.

 

I had a patient return 2 weeks after PRP treatment and there was NO question that his hair looked thicker. I don't mean because his hair might have been longer or he used a volumizing shampoo or something like that, I mean a cosmetically signficant difference. I took photos and a video which I will present here when I get the chance. He's a participant on this site and a recent HT patient although I forgot his handle.

 

This doesn't mean everyone will get results within 2 weeks, or even that they will get results at all, but it was a very promising and unexpected surprise so early in my use of PRP for hairloss. At least we're heading in the right direction.

 

-Dr. F

 

Thanks for the quick reply Dr Feller, that is some pretty good news, and i know we dont want to overhype this. I'm very anxious to see the pics. Thanks

[Scorpian]

Dr. Feller,

 

I know someone asked this, but it wasn't answered. I'm sure many people are curious to know the answer to this as well. Since PRP treatments are supposed to "reverse minituarization" to a degree, do you think it could halt hair loss or slow it down considerably? I know the hairs become "thickened", but does that mean that the miniaturization process has been reversed or slowed down? Thanks.

[Bill - Seemiller]

Scorpian,

 

I don't mean to answer for Dr. Feller, but I thought I'd take the opportunity to share my thoughts on this.

 

In theory, I believe it ends up being successful at reversing miniaturization, it should also slow down or stop the progression of pattern baldness. However, there is no scientfic data at this time to support such a claim. It will be interesting in time to see the kind of data Dr. Feller collects. I trust he'll report his findings as he continues with these experiments.

 

Best wishes,

 

Bill

[Dr. Mohammad Humayun Mohma]

As I do not have any experience of PRP for hair growth I cannot really say anything.

Though I have some reservation on it.

The cause of MPB is the presence of genes of hair loss and as soon as the hormones DHT reach the target area they combine with receptors of the hair follicles and the process of miniaturisation starts.

I am not sure how PRP will stop opr revert this process. YES it helps in the healing process as we have been using it for healing in burns pts after mesh grafts and also using it for fillers like effect or expediting the growth of indegenious collagen. I at that time thought of it as a adjuct for hair growth but just could not think of reason how it will help.

So presently i am not very keen to include this procedure in hair restoration. It can only work as a growth factor but how it will prevent the receptors permanently from DNT no clue as yet.

Second in Western world where the majority of population are type I to III Skin type and high prevelence of Carcinoma of skin, I am not sure how that issue will be addressed?

But it wont be my major concern, and then is gthat a continous treatment or just couple of sessions or 5 sessions and what the final out come as oppose to the cost involved?

[Dr. Alan Feller]

The study by Dr. Joe Greco and Bob Brandt showed that hairshafts increased by 10% in the study group. That's pretty amazing and also implies that it reduced or halted miniturization. This study was made available in the last edition of Hair Transplant International Forum and is available to all.

 

Dr. Mohmand,

You should really consider including PRP in your hair practice. All Hair doctors should. I don't own stock in any PRP company nor am I part of the PRP industry, I just offer it as good advice to all HT doctors.

 

As you are well aware I am not a fan of LLLT for the reasons we've discussed in the past. Unlike LLLT, PRP is based on rock solid and repeatable science. There are also no contradictions with respect to PRPs mechanisms of action-such may not be said for LLLT.

 

Since PRP cannot cross from the cell into the nucleous it can not affect DNA and therefore can't induce or promote mutant growth such as skin cancer so you need not have any reservations.

 

DNA induced DHT receptor expression is clearly a main mechanism for hairloss, but not the only one- as those who are still losing hair on DHT blockers can attest to.

 

Devascularization is most likely another main reason for hairloss and I suspect that the mechanisms of DHT receptor site stimulation and devascularization work together to ultimately produce baldness. Since PRP contains at least 2 growth factors responsible for re-vascularization (endothelial growth factors) it is clear that PRP has the potential to make up for loss of vascularity secondary to MPB, miniturization, and other types of hairloss.

 

PRP is helpful for healing wounds, but I don't use it in that capacity for hair transplants. In my experience HT wounds and donor areas close so well that they really don't need any "extra help", although other credible doctors believe it does.

 

The bottomline is that when compared to ALL other non FDA approved hairloss remedies, PRP provides for the greatest potential with the broadest and soundest scientific basis. It's the solid foundation of PRP that swayed me.

 

Do your own research and come to your own conclusions. Call Dr. Joe Greco. He is a very personable and knowledgable person and is only too happy to discuss his findings. I highly encourage you to include PRP in your practice.

 

-Dr. F

[hdude46]

Good info Dr. Feller,

 

Three questions:

1) Dr. Greco mentioned all PRP is not equal and that if the Dr. is not trained properly it will not work. I assume you are using it the EXACT way Dr. Greco is?

 

2) Would getting PRP once a year suffice? The reason i ask that because a $600-700 treatment plus a plane flight is a lot of money for something that needs to be done more than once a year. I recall on that informational video Dr. Greco said the results lasted a year, but wanted to confirm that with you.

 

3)When could we possibly see this getting FDA approval for hair loss?

Thanks!

[Dr. Alan Feller]

Hdude,

 

1. All PRP is NOT alike. The equipment we use is the established best in the industry and is already FDA cleared for PRP production. Lower end instruments only allow for approximately 4 times concentrate of PRP. The system we use gives 5 to 7 times concentrate CONSISTENTLY. It's more expensive, but the greater concentrate means greater potential for succcess, so it's worth the extra money.

 

I spoke with Dr. Greco at length and he generously told me his protocol so I am using it. I have also talked with several other doctors who have visited Dr. Greco and they confirm that we are performing the same protocol. We're even buying our disposables from the same companies.

 

I am not taking a leadership role in the PRP field. I am happy to be a follower and would rather utilize an established protocol than try to come up with a new one of my own.

 

2. Greco's published study showed best results were noted between 6 and 8 months, so it stands to reason that it would be best to get another treatment around those times. Whether it is worth it or not to take a flight I suppose is up to the individuals satisfaction with results and personal financial situation. I suspect that soon most or all HT doctors will be performing PRP so it probably won't be long until you won't have to fly somewhere to get your treatment.

 

3. PRP is not eligible for FDA approval because PRP is not a product to be sold since it comes from your body and goes only to your body. The equipment Dr. Greco and I use to produce PRP is already FDA registered and FDA cleared, not to mention patented.

 

-Dr. F

[hdude46]

reco's published study showed best results were noted between 6 and 8 months, so it stands to reason that it would be best to get another treatment around those times. Whether it is worth it or not to take a flight I suppose is up to the individuals satisfaction with results and personal financial situation. I suspect that soon most or all HT doctors will be performing PRP so it probably won't be long until you won't have to fly somewhere to get your treatment.

 

Much thanks Dr. Feller...when could be a reasonable time to expect pics of PRP results from you?

[Dr. Alan Feller]

I already have pictures and a video I'll be posting in a few days. It will cause a stir because he is only 2 weeks post PRP, yet there can be no question that his hair is noticably fuller. I have a possible explanation for this, but I'll go into it when I present him.

[stilldeciding]

Originally posted by Dr. Alan Feller:

I already have pictures and a video I'll be posting in a few days. It will cause a stir because he is only 2 weeks post PRP, yet there can be no question that his hair is noticably fuller. I have a possible explanation for this, but I'll go into it when I present him.

 

can't wait

[stilldeciding]

PRP is helpful for healing wounds, but I don't use it in that capacity for hair transplants. In my experience HT wounds and donor areas close so well that they really don't need any "extra help", although other credible doctors believe it does.

 

We all know that FUE yield is lower than strip, repair patients heal slowly, and donor/recipient sites CAN have scarring, especially donor which is almost always visible to an extent when shaved down.

 

Wouldn't these reasons be enough to at least use PRP soley for healing purposes also?

[hdude46]

dr feller, and plans to post that video or pictures this week?

[Dr. Alan Feller]

Still,

No. I don't think so. PRP won't make any cosmetic difference to any scar tissue.

 

Hdude,

I didn't forget, I just haven't had the chance to put together a presentation. I will post on this thread when I can get to it. Time is REALLY tight and I don't have a marketing department or any help like that.

[hunter56]

Dr. Feller,

 

Is the best way for one to determine if they are an appropriate candidate for this procedure to contact your LI office directly. I just sent a message through the contact us form.

 

Hunter

[wtb_hair]

I do not believe this was answered in this thread, but does anyone know whether or not the PRP procedure leaves its stamp? Like any scarring or anything. I would assume since PRP is all about healing, that it would not and if it did would heal up to where scarring would be non-existent.