Hair Transplant Blog Featuring John P. Cole, MD

hair transplant treatments
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.

What are the ways to camouflage strip hair restoration scars?

Camouflaging Strip Scars

Scars in the donor area from strip harvests may be problematic for many men. They may be short or run from ear to ear. Sometimes they widen over time, occasionally to more than two centimeters, which is deforming. This is usually due to an overly tight scalp, too low a placement, or poor surgical technique. They also change the direction of hair growth below the scar, relative to above the scar, which may cause a “shadow” of the linear scar to be evident even with the hair grown out somewhat.

IN order to minimize the appearance of scars, several strategies are available. There are cosmetics such as Dermatch, which may help disguise the scar. The hair may also be grown out fairly long to attempt coverage. This, of course, may not be an option for those with an over harvested donor region.

Surgical scar revision may be attempted, often without success. This consists of excising the scar and them suturing up the wound, hoping that the resultant scar will look better than the original one. This can work in some instances; however, if the condition that led to the scarring is not remedied, then even the best revision may fail.

Grafting into the scar is another option. Because yields tend to be lower in scars, this may take more than one surgical procedure over many months to have a significant cosmetic effect. Either body or scalp hair may be used; scalp hair is generally a better choice if it is available.

What are the common used hair transplant techniques and how are they different from CIT?

Hair transplant surgery can be done using several different techniques, including old-style plugs, strip harvest, The Cole Isolation technique (CIT), and body hair transplantation (BHT). Plug harvesting is only mentioned for historical reasons; it is a very poor technique and should not be used in the modern era. Strip harvest using only two incisions became popular during the 1990’s, and is still widely used today. CIT is very new, having been used only the past 5 or 6 years, but is beginning to challenge strip surgery in some areas as a procedure with much less scarring. BHT is used mostly for adding hair to scalp hair surgeries, and in patients who have had much of their scalp donor hair removed. Scalp hair is always better, and BHT is seen as a complement to scalp hair.
Hair grows on the scalp in separate units, which are known as follicular groups or follicular units. They contain 1, 2, 3, 4, or rarely 5 or more hairs. During the CIT procedure, a special tool is used to take these hair groups out one at a time. The advantage is that no long incision or wound is made in the scalp, and therefore no long scar results. Also, there is very little pain after the surgery, and the hair grafts come out ready to place in the balding areas, with no trimming needed. Sometimes there are tiny white dots left where the hair s were taken out; these are very small and if the hair is more than ¼ inch long or so, the dots are invisible.
These hair grafts are then placed into tiny slits or holes made by the surgeon into the balding or thinning hair areas; in about 3 or 4 months the first of the “new” hairs begin to sprout and by the end of a year, the full result of the transplant will be seen!