Prp + Extracellular Matrix (ecm) - Thoughts?
- Thread starter macaroni
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His prices are astronomical for PRP...i suggest if you want to do PRP+Acell you go to a few Drs in NYC that do it and get price quotes, compare I personally dont trust that Dr you are posting about. I have nothing valid to base that on just my 'gut' instinct.
I have not met any men here who have anything positive to say about PRP.
I did meet a few women on female sites that had good results.
So i am on fence keeping it in mind but definitely not 'that' guy. He is way over priced. Just my opinion.
there are a bunch of posts if you put in search area they do come up.
I have not met any men here who have anything positive to say about PRP.
I did meet a few women on female sites that had good results.
So i am on fence keeping it in mind but definitely not 'that' guy. He is way over priced. Just my opinion.
there are a bunch of posts if you put in search area they do come up.
dr. cole
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I was a little disappointed to see all the hype about Acell and PRP take shape. I say this only because I was the first in the world to combine the two. When you start something, it is a bit alarming when it takes a form of its own without any data to support it. That was in 2008. Before this, I had used Acell with my horses. Only later did Acell become approved for use in humans. The only reason I used the Acell was to prolong the release of growth factors from the PRP. The only reason I did that was that Joe Greco suggested that an extracellular matrix would help delay the release of growth factors. Once I started doing this, everyone jumped on board. Now we are studying it, but I don't think that the growth factors in Acell play any role at all. Maybe Acell produces a better result through stem cell promulgation. Perhaps not. We have studies cooking on this. We do know that PRP increases hair density. We also know that all PRP concoctions are not the same. Some produce more rapid and better results. Be most wary of the home blends. If they don't use a kit, steer clear. Angel Arthrex, for example, produces much higher growth factor concentrations than Regen. Homemade, inexpensive tubes are probably no better than sugar water. Platelet activation seems to be critical too. We have seen that with sonicated PRP that we can find up to 64 of 80 grafts growing at 3 and 1/2 months. That's huge. With sonicated PRP we find 5 to 8 times the concentration of growth factors. Now we want to study this high level of the cultured dermal papilla. Don't toss in the towel yet on Acell, but don't believe the hype either. Still, we may find that microparticles such as dalteparins and protamines do a similar function to Acell and at a fraction of the cost. So, we have to study them sooner or later.
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I don't understand the logic behind taking the great risk of getting Telogen Effluvium from the trauma for something that probably won't work anyways. It's all salesmen jargon in my opinion. If you have the money to get acell/prp during a transplant, then go for it. On it's own? not a good idea.
I can save you all that money, just let your hair grow out for three months like in the photos and it will appear you have more hair, which you will because it is longer. Until any of this actually goes through a Phase 3 study that is scientific and proven I would not do any of it.
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dr. cole
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There are a few points with PRP. I mean good PRP. I'm still not 100% sold on Acell as an adjunct, however. If it is just prolonging the duration of growth factor release, then a much lower cost solution exists with microparticles such as protamine and dalteparin. What I can say for sure is that good PRP increases hair density, increases vascularity, and over time increases hair mass. Initially, you are going to loose density with good PRP most likely because it stimulates anagen. That is an effluvium for sure. However, after a 6 to 12 months, you will have increased density and increased hair mass. The high concentrations of growth factors from sonicated PRP are growing transplants much quicker. This is not a gimmick. It's a fact. It objective data.
dr. cole
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The problem behind the logic of just letting your hair grow to increase coverage is that in androgenic alopecia, a much higher percentage of follicles are in the telogen phase, which means they are not growing. They are resting. In theory, a single hair grown long enough could cover the entire bald scalp. Unfortunately, no hair follicle stays in the active growing or anagen phase long enough to accomplish this mission.
What we see universally with good PRP is a decrease in density initially. Thus, yes we are promoting telogen effluvium. The telogen hairs are shed and replaced with anagen hair. We have a paper that will publish this fall showing that with Regen PRP we saw a 25% decrease in density at 6 months, but with Angel PRP there was a 50% increase in density at 6 months. I saw an improvement in Hair Check in only a single patient at 3 months and that was with sonicated PRP. Most have a decrease in Hair Check even at 6 months. The improvement in Hair Check comes later when the new anagen hair becomes long enough to measure. That's when you see an increase in coverage. What remains to be seen is how long the annual or treatments with good PRP every 6 to 12 months will have a positive influence on the anagen phase. We know that in androgenic alopecia, the anagen phases shortens, while the telogen phase lengthens. Can good PRP alter this physiological response indefinitely? The good news with Regen PRP appears to be that density, and Hair Check do increase after 9 months, but we know that the concentration of many growth factors is not as high with Regen PRP so Angel is most likely a better option due to higher levels of many growth factors.
What PRP seems not to do well is solve advanced thinning. There must be a point where growth factors alone will not stimulate enough new anagen follicles to address this problem. Advanced thinning is where PRP seems to fail.
What I noted many years back, around 1999, is that follicular units are last to disappear. Hair follicles within follicular units are lost much earlier followed only later by loss of the follicular unit. The loss of follicles before the follicular unit led me to postulate that patients should begin on Propecia before the bald spots become evident rather than later. I think the same theory should apply to good PRP. The interesting thing about Propecia is that uncommonly, Propecia can solve balding spots. Perhaps if we studied enough men on PRP, we would see a similarly low percentage that has improvement in the bald spot.
One theory proposed by Andrew Messenger is that every follicular unit has a primary follicle and secondary follicles. The primary follicle is the first to appear. The secondary follicles appear later. The arrector pili muscle grows to the primary follicle and contains necessary stem cells for follicle regeneration with successive cycles of anagen to catagen to telogen and back to anagen. He theorizes that the arrector pili muscle grows out like a vine to primordial secondary follicles and subsequently gives these secondary follicles a stem cell niche from which to develop into terminal hair follicles. With advanced androgenic alopecia, the network of stem cells rich arrector pili muscle outgrowths recede and detach from the secondary follicles. Without this stem cell niche, the secondary follicles fail to resume a new anagen phase following a prolonged telogen phase. This theory supports what I have seen in biopsies of the balding scalp where individual follicles remain where there used to be a multiple hair follicular unit. Often vellus-like hairs lacking pigment and diameter remain and may represent once thriving secondary follicles.
In androgenic alopecia we first see a miniaturization of follicles followed later by a loss or presumed secondary follicles followed later by a loss of the primary follicle leaving a bald surface area. The early miniaturization phase may be where we see benefit from good PRP. I have not seen an advantage in advanced androgenic alopecia from quality PRP. Not yet and perhaps never.
PRP does not seem to improve hair diameter in my studies either. Hair density alone appears to be the benefit we see from PRP. It could be that PRP helps only in the very early stages of androgenic alopecia when the stem cell niche to the secondary follicles is most abundant and more active.
What we see universally with good PRP is a decrease in density initially. Thus, yes we are promoting telogen effluvium. The telogen hairs are shed and replaced with anagen hair. We have a paper that will publish this fall showing that with Regen PRP we saw a 25% decrease in density at 6 months, but with Angel PRP there was a 50% increase in density at 6 months. I saw an improvement in Hair Check in only a single patient at 3 months and that was with sonicated PRP. Most have a decrease in Hair Check even at 6 months. The improvement in Hair Check comes later when the new anagen hair becomes long enough to measure. That's when you see an increase in coverage. What remains to be seen is how long the annual or treatments with good PRP every 6 to 12 months will have a positive influence on the anagen phase. We know that in androgenic alopecia, the anagen phases shortens, while the telogen phase lengthens. Can good PRP alter this physiological response indefinitely? The good news with Regen PRP appears to be that density, and Hair Check do increase after 9 months, but we know that the concentration of many growth factors is not as high with Regen PRP so Angel is most likely a better option due to higher levels of many growth factors.
What PRP seems not to do well is solve advanced thinning. There must be a point where growth factors alone will not stimulate enough new anagen follicles to address this problem. Advanced thinning is where PRP seems to fail.
What I noted many years back, around 1999, is that follicular units are last to disappear. Hair follicles within follicular units are lost much earlier followed only later by loss of the follicular unit. The loss of follicles before the follicular unit led me to postulate that patients should begin on Propecia before the bald spots become evident rather than later. I think the same theory should apply to good PRP. The interesting thing about Propecia is that uncommonly, Propecia can solve balding spots. Perhaps if we studied enough men on PRP, we would see a similarly low percentage that has improvement in the bald spot.
One theory proposed by Andrew Messenger is that every follicular unit has a primary follicle and secondary follicles. The primary follicle is the first to appear. The secondary follicles appear later. The arrector pili muscle grows to the primary follicle and contains necessary stem cells for follicle regeneration with successive cycles of anagen to catagen to telogen and back to anagen. He theorizes that the arrector pili muscle grows out like a vine to primordial secondary follicles and subsequently gives these secondary follicles a stem cell niche from which to develop into terminal hair follicles. With advanced androgenic alopecia, the network of stem cells rich arrector pili muscle outgrowths recede and detach from the secondary follicles. Without this stem cell niche, the secondary follicles fail to resume a new anagen phase following a prolonged telogen phase. This theory supports what I have seen in biopsies of the balding scalp where individual follicles remain where there used to be a multiple hair follicular unit. Often vellus-like hairs lacking pigment and diameter remain and may represent once thriving secondary follicles.
In androgenic alopecia we first see a miniaturization of follicles followed later by a loss or presumed secondary follicles followed later by a loss of the primary follicle leaving a bald surface area. The early miniaturization phase may be where we see benefit from good PRP. I have not seen an advantage in advanced androgenic alopecia from quality PRP. Not yet and perhaps never.
PRP does not seem to improve hair diameter in my studies either. Hair density alone appears to be the benefit we see from PRP. It could be that PRP helps only in the very early stages of androgenic alopecia when the stem cell niche to the secondary follicles is most abundant and more active.
dr. cole
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I think the patient who followed up today was interesting. We performed a PRP study on him June 19, 2015. On the left side of his crown, we administered only Regen PRP without activation. On the right side, we delivered PRP with autologous thrombin. This study was an activated vs. not activated PRP research.
He was over two months late for his one-year follow-up. That was disappointing.
The right side went from a density of 180 hair per square centimeter to 280 hairs per square centimeters. The left side went from 190 hairs per square centimeter to 230 hairs per square centimeter.
Both activated and not activated PRP induced an increase in hair density. However, activated PRP outperformed not activated PRP. These results coincide with a study we are publishing showing that activated PRP produced a 50% increase in density at six months, while not activated PRP did well, also; however, activated PRP outperformed not activated PRP as this case demonstrated. What I liked about this evaluation was that he showed a positive PRP influence beyond 12 months. Something good came from a less than optimal scenario.
He was over two months late for his one-year follow-up. That was disappointing.
The right side went from a density of 180 hair per square centimeter to 280 hairs per square centimeters. The left side went from 190 hairs per square centimeter to 230 hairs per square centimeter.
Both activated and not activated PRP induced an increase in hair density. However, activated PRP outperformed not activated PRP. These results coincide with a study we are publishing showing that activated PRP produced a 50% increase in density at six months, while not activated PRP did well, also; however, activated PRP outperformed not activated PRP as this case demonstrated. What I liked about this evaluation was that he showed a positive PRP influence beyond 12 months. Something good came from a less than optimal scenario.
I had Prp shot alone in December it did not grow any hairs. My crown still has hair but it is thin and didn't improve. It did however "I think" have a slight impact on the front of my hair seemed like a slight improvemt a little more thicker. This was 6 months after. I went again June got another 1. The slight improvemt I think I was seeing came 6 months after so I gotta wait still go see if more improvemt can come. It is expensive and results are no where close to the ones in those videos. I'm also on realself it's a community with doctors and a lot of them say Prp works great for their patients.