Platelet Rich Plasma – Let’s face it- most people would rather not have to undergo any type of surgical procedure- even one as relatively easy as a hair transplant- if they can avoid it. That is where the therapies discussed on this page may fit in for you to help with the treatment of hair loss.
If you have spent enough time doing your research, you have learned that Dr. Epstein, along with his fellow plastic surgery-trained colleagues at the Foundation for Hair Restoration- Dr. Bared and Dr. Kuka- are recognized as truly ethical and innovative experts in the treatment of hair loss. Our doctors have developed and advanced techniques that will potentially complement the overall holistic treatment of hair loss. In some cases these procedures are best as stand-alone therapies, while in others they may help potentiate the results obtained by an FUE or FUG hair transplant. These cutting edge therapies include PRP, stem cell research, and lastly an innovative treatment called Fat Transfer which utilizes the patient’s own body fat (obtained through liposuction) to improve hair growth.
PRP with Fat Transfer
Dr. Epstein, who has performed approximately 12,000 hair transplants, is joined by two other plastic surgeons at the Foundation for Hair Restoration in providing these different cutting edge therapies. Dr. Gorana Kuka is a fellowship trained plastic surgeon from Europe who has particular interest in the use of PRP and mesotherapy for female and male hair loss. Her presence is a real bonus for the Foundation, as in Europe these cutting edge therapies have been used more intensively than here in North America. She has conducted research on the use of regenerative cells and fat transfer therapy as a potential treatment for hair loss.
Dr. Anthony Bared, a fellowship trained facial plastic surgeon who studied at the University of Miami and University of Illinois at Chicago, also performs state of the art hair transplants as well as a variety of non-surgical therapies. He has presented at national meetings on his research into laser light therapy and PRP (platelet rich plasma).
An Effective Development in the Treatment of Hair Loss
Over the past few years, cell therapy – in the form of growth factors, cell multiplication, and stem cells – have been the hottest area of potential innovation in many areas of medicine. Hair transplantation is no exception, and we are at the forefront in developing these applications.
Platelet rich plasma (PRP) therapy, using the patient’s own blood which is centrifuged to separate out this growth factor-containing component, is being actively used in the treatment of hair loss, both as a solo treatment and in conjunction with hair transplantation. Rich in growth factors and platelets (one of the human body’s most potent mediators of healing), PRP is applied to the scalp in several ways to help in the treatment of hair loss. Using our state of the art system, the most technologically advanced way to obtain PRP, we eagerly recommend PRP as an often effective therapy to help slow down and even reverse progressive pattern hair loss, and as part of a hair transplant procedure to improve outcomes.
The majority of our patients do show a positive response to PRP, including the slowing down or even the stopping of hair loss. In addition to being used as a stand-along treatment, PRP performed with a hair transplant has shown several possible advantages: to enhance the percentage take of the grafts and enhances healing, as well as reduces the chance of shock hair loss by strengthening the patient’s existing hair, and applied to the donor site it seems to speed up and improves healing. It can also provide several months of slowing down the ongoing hair loss process. Given our positive outcomes, PRP is routinely recommended at the time of a transplant, where it is performed for a small additional fee. As a stand-alone therapy, we usually recommend PRP to be repeated at two months, then every four to six months after that.
PRP with ACell
One way to potentially improve the outcome of PRP is with the addition of ACell, a regenerative matrix product derived from porcine bladder (the bladder has the ability to regenerate when damaged) that has been specially treated so that it is safe and pure. This PRP/ACell combination is injected into the anesthetized scalp in areas of hair thinning. We then recommend the therapy be repeated two months later, then every four to six months.
Here is where we insert this photo (slide 1) with the caption A patient in her 50s with female pattern hair loss. She is shown before and just three months after undergoing a PRP with fat transfer procedure. Read below to learn more about this procedure.
Purified Fat Transfer with PRP (PFTP)
In our FDA-approved study on the use of stem cells for the treatment of male and female pattern androgenic (pattern) hair loss, the source of the stem cells was the patient’s own fat. This fat, or adipose tissue, is obtained using liposuction, most commonly along the belly and hips, then manipulated using highly specialized devices that then separate the fat from the stem cells. At this point in time, the FDA prohibits the use of these purified stem cells to the treatment of just a few medical conditions, including scleroderma and heart damage, where its effects can be dramatic. However, one of our early observations is that fat alone, once purified then injected into the scalp with PRP, can promote hair growth.
We are currently recommended fat, added to PRP, to treat hair loss in certain patients in whom we feel it may be more effective than just PRP alone. This purified fat transfer with PRP (PFTP) is a proven effective way to pretreat scalp scars to improve the hair regrowth from a transplant, and we are also now using it as a stand-alone therapy to treat hair loss and are encouraged by the results.
With this PFTP procedure, a small amount (20 to 80cc) of fat is harvested using liposuction, then filtered to purify it. It is then injected along with PRP into areas of hair loss. The combination makes perfect sense: the PRP with its growth factors “turns up” hair follicle activity, while the purified fat supplies the energy for that growth. The entire procedure is performed under local anesthesia and oral sedation (if desired), and patients are presentable the next day without any noticeable changes to the appearance of the scalp.
To learn more about PRP as well as other innovations the Foundation doctors are bringing to their work, please contact us.
MORE ABOUT PLATELET RICH PLASMA (PRP)
PRP is obtained from a small amount of the patient’s blood by spinning it in a centrifuge at such high speeds that it isolates the platelets (the body’s mediator of healing) and growth factor proteins. The PRP and growth factors can then be utilized in several ways to enhance the results of the hair transplant procedure:
- Added to the scalp where hairs are transplanted, decreasing bleeding and bruising, accelerating healing, and reducing shock hair loss, meaning patients look better sooner after the procedure
- Speeding up and increasing the percentage of transplanted hair growth
- Better healing of the donor site incision and FUE donor sites – this is where PRP seem to be particularly effective
Pictured above are results of a PRP with ACell stand-alone procedure. This patient underwent one session of PRP therapy in our office and the photos were taken 8 months apart. Note these results may not happen in all patients, but are becoming more and more common.
As part of our commitment to state of the art care, PRP is now provided with the hair transplant procedure for any patient who desires or is appropriate for it. Furthermore, as the addition to the scalp of PRP can thicken thinning hairs and help reawaken dormant hairs, PRP is also offered as a stand-alone procedure as a treatment for male and female pattern hair loss, where it can be effective in slowing down shedding or active hair loss. Your doctor and/or patient advisor can answer any questions you have about this therapy.
What is PRP?
PRP stands for platelet rich plasma. Blood, in addition to red and white blood cells contains platelets, rich in growth factors and are the most potent healers of the body. Growth factors promote healing by restoring the normal architecture and strength of the tissue. In a PRP injection, the patient’s own blood is processed at high speeds (we use a state-of-the-art system), resulting in higher concentrations of the patient’s own platelets with growth and healing factors, which are then injected to promote healing, increase local blood flow, and stimulate hair follicles to grow healthier.
Is PRP new?
No, the technology has been used for years in surgical applications and wound care, initially as a healing adjunct to open heart surgery. The use of PRP for the scalp is fairly new and evolving into a promising treatment for use both as an adjunct to a hair transplant and as a way to reverse hair loss. It is generally accepted that there is a significant response rate to PRP of approximately 70-80% in certain regions of the body, although this data mainly involves multiple studies with small population groups.
How is PRP used to treat hair loss?
Based upon the anecdotal reports of colleagues and our own work, we have been using PRP and mixing it with ACell, a regenerative matrix product derived from porcine bladder (the bladder has an ability to regenerate when damaged) that has been specially treated so that it is safe and pure. This PRP/ACell combination is injected into the scalp after the scalp has been anesthetized into areas of hair thinning or falling out. We then recommend the therapy be repeated after six months and then once every year.
How is PRP used to help the result of a hair transplant?
We see three potential benefits in PRP/ACell when a patient is having a hair transplant. First, it is injected into the FUE or FUG/strip donor area to promote healing and reduce scarring. Second, it is injected into the recipient areas of the scalp (where the grafts get placed) to accelerate healing and potentially improve graft regrowth, particularly in scalps that have scarring whether from a prior transplant or another injury, and also in the crown region where hairs have a tendency to have a lower percentage of regrowth. Third, the PRP/ACell is used to treat hair loss in other areas of the scalp not being transplanted, much as it is used as a stand-alone therapy.
Do I have to worry about the use of blood products?
No, your own blood is used for the PRP procedure so there is no transfusion risk.
What do I have to do prior to and after having the procedure?
The patient should avoid all anti-inflammatory medications for seven days prior and three days after the procedure. This includes prescription anti-inflammatory medications as well as over the counter naproxen, aspirin, and ibuprofen (cardiac patients should continue taking aspirin). It is fine to take pain relievers like Tylenol (acetominophen) and narcotics like codeine (if a hair transplant was performed at the same time). Patients on blood thinners (Coumadin/warfarin/Plavix/Pradaxa) are not candidates for PRP injections. Right after the PRP procedure, the patient is fully presentable.
How long does it take?
The entire process takes about 90 minutes. The majority of the time involves drawing and processing the patient’s blood for the injection. The patient is then ideally seen at two and six weeks to access for healing and early results.
What can I expect during the procedure?
Using sterile equipment, approximately 80cc of the patient’s blood is drawn from a vein and placed in a specialized tube to be centrifuged. As the PRP is being processed, the scalp will be anesthetized using nerve blocks- since local anesthetics can inhibit the PRP, local anesthetics cannot be injected into the actual areas of the scalp being treated. It then takes several minutes to inject the PRP with ACell into the affected areas of the scalp. To activate the PRP, the scalp is then treated with a roller or tiny needles with hundreds of tiny microdots made. If the PRP is being performed with a hair transplant, at the onset of the procedure the blood is drawn, then the PRP is prepared then injected into the recipient and donor areas that are already anesthetized, as well as any other areas experiencing hair loss.
Are all PRP treatments the same?
No, after much research we have chosen to use the state of the art Angel® PRP system, made by Cytomedix. This system produces the most pure, correct concentration of PRP due to its sophisticated computer technology. In addition, we also mix the PRP with ACell which helps promote the regenerative activity of the PRP, so it is added to the treatment to improve the chances of a positive response. Your patient advisor or doctor can answer any other questions you may have.
Having your PRP performed by us means that it is being done by doctors who truly specialize in hair loss so are able to properly treat you, and also that it will be a painless, easy experience. You read more about PRP here.
PRP is very much a real procedure, where proper technique can make the difference in the outcome. We perform hundreds of PRP procedures every month for hair loss, and have learned how to achieve the best outcomes. In addition, whether combined with fat transfer or the addition of ACell, the treatment potentially has a better chance of having a positive response. Dr. Epstein, Kuka, or Bared can answer any other questions you may have.
Platelet Rich Plasma complications/Risks:
There are very few risks with the procedure, and all rarely occur. These can include temporary bruising in the area where the blood was drawn or the PRP was injected, and a temporary worsening of hair loss. After the procedure, any usually mild discomfort or headache can be effectively treated with a simple analgesic like Tylenol. You will be presentable right after the treatment.