Success with PRP and ACell Mesotherapy

[Billena]

This 28-year-old female came to our office fed up with her progressive and distressing hair loss. She was referred to our office by an endocrinologist. After examination with a magnified folliscope, Dr. Wesley determined that she may be a good candidate for treatment with platelet-rich plasma (PRP) and ACell. She returned just over five (5) months after her treatment for follow-up evaluation. Her results can be viewed below:

 

[fisher4man]

Could you please provide more information about the technique of the treatment

 

I do not ask about the harvesting method of PRP, asking about

1- The technical details of PRP/Acell application on the head,

2- How many session(s)?

3- Any pre-procedure hormonal working?

4- Are there any other patients treated with the same protocol at the same period?

5 - How can we eliminate the other factors that may cause hair regrowth in women with partial, incomplete hair loss?

6- If we accept that this is success, where the success comes from? PRP or Acell??

[ontop]

Fisherman..great Qs

 

I would like to see pics of the same Pt in 12/14 mths wihout anymore PRP/Acell treatments.

Because what I've seen & read between 4 & 11mths shows the strongest results, esp in females, then fades away to start all over again.

 

Its a hard sell to me this PRP/Acell. TBH

[Blake Bloxham]

Bilena,

 

Very interesting. Do you have any images of these female patients 12+ months out?

[fisher4man]

Bilena,

 

Very interesting. Do you have any images of these female patients 12+ months out?

 

There is only one female patient here.

 

7- Are there any male patients treated?

8- What is the survival time of platelets in blood? In tissues, when injected? More or less? Is that enough time to stimulate hair growth - a continuous ongoing process??

[Blake Bloxham]

^^ I meant female patients treated with ACell/PRP in general (not this particular patient).

[fisher4man]

^^ I meant female patients treated with ACell/PRP in general (not this particular patient).

 

Ahh, yes, sorry, got it now. But I think this is the only patient treated. I wonder if she have been referred to the other patients after 500 (more or less) pinpricks.

 

9- Were PRP and Acell mixed in one syringe or were they injected separately? Why did you combine both? Wasn't any one of them enough? Do you think that they have some synergistic effect?

[Billena]

Thank you for your comments. Regarding the specific medical questions, I will let Dr. Wesley respond to those this week. In response to requests for examples of male patients treated with scalp injections of platelet rich plasma (PRP), we are posting results from a previous male patient in his 30s. Bothered by the thinning in his crown, his response to PRP treatment can be seen at various stages throughout his recovery. Please note that not all patients can anticipate such benefit. Just as with surgical hair restoration, proper patient selection for PRP treatment is very important.

 

 

 

 

[ontop]

Thanks for the video..

 

I would still like to see this same Pt 12mth later without more PRP/Acell treatment.

The problem I have that i see results in the first several mths then fades away.

 

I think PRP / Acell can be effective at the time of HT surgery to give a boost to new folicals & blood flow but that's it for me unless somebody can prove otherwise.

[fisher4man]

Thanks for the video..

I think PRP / Acell can be effective at the time of HT surgery to give a boost to new folicals & blood flow but that's it for me unless somebody can prove otherwise.

 

Ontop,

 

Hair follicle cells go comatose phase after HT, they just try to survive for 3-4 days, then they can not function (produce hair) for 1-3 months. Nothing can stimulates them in this period. And platelets life time is less than one week after injection

 

PRP or Acell during HT is big advertorial gimmick for that reason, and for many additional reasons.

 

Can you stimulate a worker (lets say crane operator) who has fallen off from 20 metres and now in comatose sleep in intensive care unit to start his work (to operate crane, function) immediately?????? We hope he will survive and also has a quiet convalescent period in normal hospital room for 2-3 months before start functioning.

[fisher4man]

I am so sorry but video shows the (operative room) lights lighten the head of the patient before procedure and his feet after the procedure. After all, the head remains in dark. Thanks to this forum, we know what that means...

[Dr. Carlos Wesley]

Thanks again for your comments on this interesting subject. Your crane worker analogy, fisher4man, is certainly an interesting one! It's actually five days until transplanted hair follicles have established their own capillary network. The life of a platelet is 10 days. However, it's not necessarily the platelets, but rather their growth factors and cell recruitment that benefit the follicle during this vulnerable period. Although I agree that PRP/ACell therapy is by no means a guarantee, I have seen it show promise in the appropriate candidate (those with miniaturized hairs that are often surrounded by evidence of dried keratinocytes).

 

And, yes. The OR lighting may not have been exactly the same. We therefore included the magnified timeline images in the video to demonstrate the true progression of hair growth in the male patient.

 

Thanks, ontop, for your comment. The female patient will likely return for a repeat injection at the 7 month mark after her first. Studies on PRP injections have demonstrated that it's roughly at the 7th month when hair caliber and growth peak from an initial injection. After that time period, we'll continue to monitor her.

 

I've been asked to write about PRP in the "Future of HT" section of the upcoming "Hair Transplantation" text book. To illustrate how much uncertainly is surrounding this therapy, at the 2013 ISHRS Meeting, a panel of five hair restoration specialists were asked to describe their PRP injection protocol. All five of them used different methods to isolated the PRP, all five had different concentrations of PRP, all five had different preferred intervals or treatment, and all five reported slightly different patient results.

 

Although it's a procedure with promise, there's a LOT yet to be determined (much like low level light therapy). The one thing I would say with certainty is that you should avoid PRP injections if the doctor tells you it's "guaranteed" and/or if they are suggesting it without first carefully examining the patient with a magnified camera to closely evaluate the scalp.

[ontop]

Thanks Doc for your input

I for one is thankful of how honest you came back with your post.

 

Seems like a lot more homework need to be done on this PRP stuff.

[fisher4man]

After somebody examines the patient with a magnified camera to closely evaluate the scalp, and understand that this is good indication for PRP, can he ensure and guaranty the result?

 

If there is very little change for the threapy to be effective, and if the therapy is so invasive for the patients (removing her/his blood) , so why should we try it? What is the change of the PRP therapy to be effective if indications show a patient to be suitable for the treatment.

 

And, an advice to the community; please make a google search using these keywords;

investigator bias or experimenter bias.

[fo11icu1ar]

I know for what its worth, PRP can be used for a myriad or treatment modalities. I'm a physician and in my field it has been studied and used.

I think basically if you could isolate VEGF, EGF or some of of the other pre/pro stem cell inducing progenitors and inject that, the results would be amazing on the right candidate.

 

But in terms of who is the right candidate... and hair transplant. I don't know and that is beyond my scope of practice or area.

 

But... I did have 2 hair transplant surgeries for mid scalp and crown.

And had Dr. Carlos Wesley do PRP for my frontal area along with the first surgery which was mid-scalp. Sep 2012.

 

A few months after the first surgery, which was the mid scalp. Maybe one.

My God... the front area where he did PRP was rock solid, size/thickness of the hair follicles.

He noticed it and showed it to the other surgeon there, who really didn't know what to think.

I started noticing and wanted him to see. I even noticed new little growth from below my frontal hairline. And since 9/12 this has stayed and continued to improve. And I truly hope it does.

 

My theory, I do have an immunological background and education. Maybe it is a combination of the new follicular grafts and mediators being released by the protein synthesis/mRNA signaling and protein translation specific to them "spilling over to the less fortunate areas" along with help from new mediators such as VEGF opening/dilating the blood vessels in the area PRP was placed. In my case PRP was front and transplanted hairs mid-scalp so not too far from one another for signal switch induction. Perhaps. Who cares actually... it worked.

 

Who is the right candidate... who knows. Maybe someday, eventually when we understand the science better we will.

 

Anyhow... it worked awesome for me. And am soooo lucky he did it. And I found him.

 

 

*And on a side note, I owe him a review. Its 2 years late. I should have wrote it right after my visit, regardless of the results, just based off his professionalism and compassion level.