Is it safe to transplant hair into thinning areas, or do you risk damaging existing hair in these regions?
This is an excellent question and the answer ultimately depends on your doctor’s judgment and your personal hair and hair loss characteristics. The major concern, of course, is whether a transplant will damage the existing hair in the thinning area. If the existing hair is very limited, and likely to fall out eventually anyway, most surgeons would feel comfortable performing a transplant and implanting grafts into this region to restore some density. Even if the existing hair is lost, the net benefit of having it replaced with permanent hair will be worth it.
On the other hand, if the existing hair is relatively dense and/or in good condition, most surgeons would prefer that you first try medical therapy for 6 to 12 months, to see if you can slow your hair loss or even restore some hair. Some surgeons, however, may feel comfortable proceeding with a hair transplant. In this case, your doctor must be careful not to place an excessive number of grafts in this delicate region because this could lead to increased shock loss. Make sure your surgeon speaks honestly with you about the risk of shock loss and limited re-growth if you choose to go this route.
Don’t forget that everyone has only a limited supply of donor hair on their scalp. You do not want to jump into anything, particularly if you are not sure how your hair loss will progress in the future. Top hair transplant doctors will discourage you from rushing into anything and will help you create a long-term plan for combating your hair loss.
A host of new treatments that show promise in improving healing and hair growth, as well as reducing the appearance of scarring will now be offered to our CIT (Cole Isolation Technique) patients. CIT is a non-strip hair transplant procedure invented, and performed exclusively, by John P. Cole, MD. These new treatment offerings include ACell’s MatriStem, PRP (Platelet Rich Plasma), and micro-needling. All CIT patients are encouraged to take advantage of these promising new interventions.
ACell
ACell’s MatriStem regenerative medicine is creating huge buzz in the hair restoration industry. Matristem is a product that is primarily used to treat damaged tissue, and to minimize scar tissue formation. This FDA-approved technology encourages tissue formation at the site of damaged tissue. Unlike stem cell therapy, the use of MatriStem does not require the harvesting of tissue and is, therefore, much less costly than stem cell therapy. MatriStem will be used on CIT patients to significantly reduce patients’ post-op recovery time, permitting an even swifter return to daily activities. This product offers exciting promise to our hair transplant patients.
Platelet Rich Plasma (PRP)
PRP therapy involves the injection or topical application of plasma containing five times the amount of platelets found in circulating blood. PRP is derived from each patient’s own blood which is separated to form a high concentration of platelets containing over thirty growth factors. These factors have been shown to promote faster healing, collagen synthesis, and the formation of new blood vessels. When applied, PRP can enhance donor site wound healing, reduce donor scarring and enhance healing at the recipient site. We are exploring the possibility that PRP may help patients maintain their native hair, and possibly even improve graft yield following a hair transplant procedure. One study found that PRP treatment enhanced graft growth by as much as fifteen percent. Although we cannot predict the true value of these possibilities at this time, we are hopeful that we will uncover further benefits, such as these, with PRP therapy.
Micro-needling
Micro-needling is a collagen induction treatment that can be used to improve the appearance of scars. Tiny surgical steel needles on a hand-held roller are used to stimulate collagen production in the dermis layer (second layer of skin). Use of the roller causes collagen and elastin to be produced in the dermis as skin, and a small number of blood vessels, are pierced. Collagen and elsastin proteins directly improve the appearance of skin. This treatment will not typically cause swelling, and any trauma to the skin is minimal. Results from this process vary from patient to patient, but the treatment may be beneficial for patients with minor to extensive scarring in the donor area. Compared to other interventions, such as laser treatment, this process offers a much less expensive and invasive form of skin rejuvenation.
The Cole hair transplant group now offers Platelet Rich Plasma (PRP) to his patients. Platelet rich plasma, (PRP) is derived from the patient’s own blood and is rich in growth factors. Because it is derived from the blood, it is termed autologous and is safe. It is a cell based therapy using the patients own growth factors. The growth factors are concentrated however. The concentration of platelets is increased often over 5 times their natural concentration. This results in a super concentration of beneficial growth factors. The benefits of this therapy have been understood for years in many disciplines of medicine, but only recently have they been applied to hair restoration surgery and hair restoration in general. There are numerous reports that PRP promotes faster healing, but it is still to early to say that it increases hair coverage or a higher yield of graft growth.
Dr. Cole plan to treat the CIT extraction sites with PRP to improve dermal healing. Dr. Cole also interested in reports that injection of PRP into the grafted area may improve hair yield. For example, Ubel found that PRP improved graft growth by 15%. Greco has reported that up to 75% of patients respond to when he combines his patented matrix complex. Therefore, they are considering its use in the recipient area. There are some that feel it may be useful in the treatment of miniaturizing hair associated with Androgenic Alopecia. Dr. Cole feel it is too early to make any claims with regard to improved yield or improved coverage, but is very interested in the possibilities. Current recommendations on the treatment of native hair with PRP suggests that the treatments should be repeat
ed every 10 to 11 months.
Dr. Cole and the Cole hair transplant group are also offering microneedling to our patients to improve natural collagen induction in dermal layers.
I am appealing to any experienced FUT professional (doctor or patient) for a favor. I did my surgery on last week and I cannot tell if my doctor (who is highly reputable) did as many grafts as he said. Could you kindly look at the attached photo and give me your opinion as to how many incisions/grafts this appears to you (we focused just on the frontal area)?
Many thanks to any one who gives me some guidance.
If you really want to improve your capacity to know exactly how many recipient sites were made, you should insist that your physician use the Counting Incision Device from Device For Hair. You can see this at Counting Incision Device (C-ID) . This device will cost your physician only 22.00 to use and he can give it to you at the end of the case. This device allows you to know precisely the number of incision sites filled with grafts and it is the only way you can know for certain how many incision sites were made. Of course, if you have a site that is not filled with a graft, then you should not be charged for the graft.
We have found that most physicians are not willing to spend the extra 22.00 to be accurate with their incision site count. While the Physician is making thousands of dollars on your procedure, he appears to be less concerned with accuracy and more concerned with the extra expense. Therefore, you might want to purchase one for your physician and insist that he use it and then give it to you at the end of the case. This way you can be certain what was done.
Don’t rely on the surgery staff to count your grafts or your incision sites. They have no real interest in being accurate and they are often more concerned with what they are going to have for dinner than an accurate graft count. Try sitting at a counter and cutting grafts day in and day out. It becomes routine and monotonous. Over time, the surgery tech’s mind begins to wander and they next thing you know, they have lost count.
Insist that your physician use the Counting Incision Device (CID) so that you can be certain what the exact graft count is.
One important point to consider with the CID is that it is disposable. There is no way to properly sterilize it once it has been used. Insist that the physician use a new one on you and not one that he used on someone else the day before. It really is up to you to insure that you get what you pay for and that your physician use properly sterilized single use CID instruments on your case.
Getting back on the subject of your grafts, there is some elongation noted and many of the hairs appear to be falling over to the side suggestive that they are about to be expelled from the skin and lost in your shower drain. This would not happen one day after a procedure.
Our latest study on body hair transplants involved a bald crown and a small number of grafts from the back, chest, and beard. We transplanted 137 grafts from the back and 65 were growing at one year for a yield of (47%). We transplanted 28 from the chest and 24 were growing at one year for a yield of (86%). Finally, we transplanted 24 from the beard and 15 were growing at one year for a yield of (63%). The cosmetically most significant growth was with beard hair. The patient was trimming all the body hair grafts to equal the length of hair in other regions. This study confirms previous studies where we noted that different regions of body hair seem to grow at a higher yield than other regions when transplanted to the same individual in the same region of the balding crown. The before photos and after photos are depicted in the following photographs.
(Click on the image to enlarge)
Body hair sometimes produces a very significant result, but often times the result is subtle. All individuals should keep this in mind when considering body hair transplants. We continue to recommend head hair first over body hair whenever possible.
