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.
This class 3 vertex patient has medium caliber, dark brown hair with well above average donor density. Dr. Cole’s treatment plan for this patient was to transfer 740 CIT/C2G grafts into the vertex. C2G is a CIT (non-strip) preparation method where advanced technology allows our surgical team to harvest over 1500 grafts in an 8-hour day, without exposing any scalp. This method gives our patients the option to leave our clinic without any trace of extraction/harvesting in the donor area. The goal of this patient was to improve the overall appearance and density in the vertex that once existed. Subsequent to the CIT procedure, the patient received a small session of micro/mini grafts. The pre-existing mini grafts may require redistribution to eliminate the grafted appearance.
Transplanting too high of a density into a recipient area that is already relatively dense can cause fatal trauma to the pre-existing (native) follicles. High densities placed into an already progressively thinning crown can create a bigger problem than most patients seem to know prior to the procedure. For example, a surgeon transplants 200 multi-hair grafts on a patient who only has a 50 sq. cm. size area of recession, the patient will have a great risk of having an unnatural appearance.
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Listen to my audio tweet about CIT hair transplant surgery for hair loss.
A bad strip hair transplant can be revised by a skilled surgeon but why not to avoid it in the first place and get a non-visible scars technique?
Get all the answers in this podcast:
I have been recommended 600 to 1000 grafts to the front. I would like to know what is the highest density and graft count with more aggressive density on the front hairline. I would like to have the front hairline to be suitable for a 36yo that is not on meds.
You can go with the maximal density, but I’ve seen many patients from physicians who claim to place 70 to 100 grafts per sq cm that are growing 20 grafts per sq cm. One of two things occurred. One is that the patients received 20 grafts per sq cm, which is not likely. The other is that they received 60 to 70 grafts per sq cm and they lost 50 grafts per sq cm because the placed density was much higher than their scalp could tolerate. There are studies out there showing that densities of 40 per sq cm grow only 73%. I like to keep my maximal density between 40 and 50 per sq cm because I have seen consistent growth rates above 90% in my hands. The other problem with poor growth from an attempt to achieve maximal density is that it may poison the scalp for future surgery and nothing may grow subsequently. It is best to stick with a safe density of 45 per sq cm on the hair line and in the rest of the scalp. This seems to work best for my patients. It’s not as if 70 per sq cm will not grow in some patients. The problem is that you cannot tell which patients it will grow in and which patients it will not grow in. The only way to tell is to try it and if it does not work, the patient is in real trouble.
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