Dr. Cole discusses Morti’s journey to a hair transplant following attempts at regenerative medicine

[John Cole MD]

Morty and I began our journey together two years ago. Morty had a long history of hair loss that advanced to a Norwood 5 pattern. I was concerned he would not respond to regenerative medicine because he let his problem deteriorate into a nearly slick bare situation. He was on a low dose of topical finasteride and might have benefited from a more concentrated preparation, but we tried many forms of regenerative medicine. To respond to regenerative medicine, we need stem cells to initiate a new growth cycle.

Morty had some growth from his topical finasteride preparation, but it wasn’t much. Though I was not optimistic we initiated a full course of regenerative medicine in addition to his pharmaceuticals. We harvested adipose cells from his abdomen and processed them into a stromal fraction cocktail to inject into his scalp. We also injected a high concentration of over 1 million platelets per milliliter that we lysed using sound energy to create very high concentrations of growth factors. To these, we added Exosomes of bone marrow origin, amniotic membrane, and ACELL. I also added 5 mg of oral minoxidil at this time. Following these injections, Morty had a more significant increase in hair in the crown, mid-scalp, and frontal tuft that used to be completely devoid of hair.

Morty and I met many times during these two years and remained in touch. We had dinners, breakfast, and lunch on several occasions. I monitored his progress carefully. Then about 7 months after his first round of injections we added more adipose cell aggregates along with PRP. I felt it was time to proceed to the next step given the limitations of regenerative medicine in his advanced state of hair loss. We began to plan surgical intervention. One could say that we did all we could to bring his hair back without surgery, but the response just wasn’t enough. The scalp was very well fertilized for hair grafting with all the cell-based therapy in the preceding year.

I had an opening in my schedule before Thanksgiving in November 2021 with one caveat. I had a root canal planned for one of those days and I had an eye exam scheduled for the next day. Morty was a trouper and gave me the two days I needed to perform nearly 4000 grafts. I had to stop surgery at 2pm the first day and then had to end and restart surgery the following day, but we hit our target.

I was concerned about his fine hair and very high telogen hair rate in his donor area, but we pressed on. We performed the first complete telogen hair from the scalp study ever performed, as well. Given the need for additional resources, we did a small test trial of beard hair to the scalp in the top of the crown.

The day after surgery, Morty joined my family and friends for a Thanksgiving meal. Later, we sat down to discuss our journey together along with a bit of history regarding the hair restoration field. We concluded that Morty needs to undergo a Tichotest to evaluate his genetic predisposition to pharmaceutical and nutraceuticals. His fine hair needs all the push we can give.

Experience demonstrates that progress with regenerative medicine continues to improve over time. The benefits of regenerative medicine coupled with a recent mega session of hair transplantation provide an optimistic future for Morty. I am looking forward to his continued progress on cell-based therapy, pharmaceutical intervention, and surgical intervention. I can hardly wait to see where he is in the next six to twelve months.

This video was posted on Forhair's youtube channel

 

[bullitnut]

This is very interesting with promising results… It could be the future for hair loss treatment.

 

[Bigmac]

Great video with some excellent points of interest discussed. The regenerative medicine is certainly an avenue that looks promising. Who knows how Morty would have responded if it had been administered earlier when the hair loss was not as evident. Taking his time with his research and the hair loss regimen he is on should hold him in good stead to hold onto his remaining hair and compliment his hair transplant.
I’m looking forward to seeing his progress.
Thanks for sharing this video, it certainly had my full interest.

 

[John Cole MD]

Yes, Bigmac, it is so important to begin regenerative medicine as young as possible. Morti had steady improvement over time and with the injections, we added to his pharmaceuticals. The first sign is a decrease in color followed by the diameter of the hair shaft. The last thing to go is the number of hairs in a follicular group or unit. Two hair groups, three hair groups, and four hair groups all become fine, lightly pigmented single hairs. Eventually, even this last hair is lost. In regenerative medicine, the process is in the opposite direction. There is an increase in number, then diameter, and finally color. Depending on how advanced the hair loss is, the ability to restore diameter and color can be the most difficult to bring back. I've had patients get great results, but the hair is still finer and lighter than I would like to see. If the response is good enough, I can add grafts from the donor area, which have a darker color and greater diameter to augment the regenerative process. I'll try to get an example up in the coming days.

 

[Techno1]

Following.

 

[Philw]

I like dr cole
He looks like a nice down to earth,no bullshit kind of guy
Wish i had met him before my poor hair transplants
Good video and easy to understand

 

[Techno1]

I agree with you Philw, very down to earth and explains the subject matter in great detail.