Update on Scarless Surgery (piloscopy)...

[Dr. Carlos Wesley]

To those requesting an update on Pilofocus, here is an article recently published in "The Verge". While both informative and somewhat provocative, the story contains a few points that require clarification:

 

1) The patient quoted with a large, red donor scar is not actually a surgical patient of mine, but rather a patient with whom I had a consultation as he sought treatment for his cosmetically-unacceptable surgical scar that he received after having undergone surgery with a different surgeon at a different location.

 

2) Amongst the many interviews I granted to the journalist, one took place immediately following a very in-depth consultation during which I counseled a severely-depressed teenager. Although his hair loss was his stated source of depression, I also worked to find him a psychiatrist that has helped him through his clinical depression. This is a rare instance and certainly does not reflect the majority of the healthy and confident patients with whom I meet. I was, therefore, disappointed in the otherwise well-written article when I felt that this unique psychiatric referral was presented as my preferred treatment for many. It falsely portrays our medical issue of hair loss as frivolous when, in reality, I feel so strongly about its importance that I have dedicated my professional career to treating it.

 

 

[Blake Bloxham]

Very cool! Look forward to more updates.

[bismarck]

Dr. Wesley,

 

I am quite excited about your piloscopy technique.

 

Could I ask, does the technique require virgin scalps? That is to say, have you attempted the procedure in patients that had been previously had FUT or FUE?

 

Also, what do you think the time frame is for this becoming clinically available beyond trials?

 

How many incisions do you require in the scalp to enter the subgaleal plane? How effectively does the scalp readhese following intervention?

 

You are one of the true innovators of hair loss today, and if successful, your procedure has the potential to completely obviate FUT and FUE. Thank you!

[KO]

Dr Wesley, what are your thoughts on the donor regeneration concept as shown in the article below?

Hair regeneration from transected follicles in... [Dermatol Surg. 2009] - PubMed - NCBI

 

Would this be possible with the Pilofocus technique?

[bismarck]

Dr Wesley, what are your thoughts on the donor regeneration concept as shown in the article below?

Hair regeneration from transected follicles in... [Dermatol Surg. 2009] - PubMed - NCBI

 

Would this be possible with the Pilofocus technique?

 

I am not sure we will hear back from Dr. Wesley any time soon, but it seems intuitive that he would.

 

From his talk at the 2013 ISHRS, he spoke about about cutting the follicles within 1 mm of the skin's surface, so a targeted bisection seems like it would be very possible. I would even think more possible than by the technique published by Toscani et al.

 

I wonder about the effect of infusing PRP or acell on residual stem cell material at the harvesting site -- perhaps this would aid donor regeneration.

 

I expect he will try for full follicle removal initially, but I expect many tricks to follow.

 

Wesley plans to share the piloscope with a few of the industry’s top surgeons by 2015, make adjustments based on their observations, then release it more widely. He hopes the piloscope will be freely available to hair doctors by early 2016.

I would love to see this in the hands of Lorenzo, Feriduni or Konior. I normally don't get excited about new innovations in hair loss intervention, as I've seen so many come and go, but this really catches the attention for its inherent simplicity and grace.

 

It's almost like the idea was already there, waiting to be discovered. Like Elton John talking about Piano Man, "I wish I'd found that one first."

 

[Puig] worries about surgical complications like hematoma (bruising) or other swelling that could lead to infection. And Dr. Jim Harris, a prominent hair transplant doctor near Denver, Colorado, is skeptical that surgeons will be able to access enough scalp from a single small incision, "which means more than one incision will be required

I think these are reasonable concerns, but no way to know until clinical trials. Multiple incisions, if necessary, would still be dramatically less scarring than current approaches, and I expect would decrease as current technology advances. Also, perhaps less visible entry points could be feasible (ie. post- or supra-auricular).

 

 

Excited to see where we're at by 2019, or even 2016.