Janna....SMG/Acell Question

[pvtpoint2010]

If you could give some SMG scar revision updates using Acell I and many others would be extremely grateful......

As several have read over past months many top Doc's have hinted of potential widening of strip scars due to acell's softening of the tissue.
SMG and other clinics have now been using it now for almost 1.5 to 2 full years...A good gauge of this being true is close at hand if some acell updatesa could be brought to the table regarding this issue..

This also has nothing to do with Acell and cloning of hairs just scar/tissue improvement VRS detriment

Thanks

pvt

 

[ejj]

i believe Dr Hitzig offers this treatment, may be mistaken but heard that he does , would be good to hear from his patients as to how there strip excision healed

ejj

 

[pvtpoint2010]

Was posted on another site on 03/14/2012


A word of warning

Trying to get an Acell update over the past 2 weeks I had a brief consult with one of NY's Top T-plant Dr's office.

I was told several patients from the Hitzig's office were starting to come over to various offices for massive repair!!...This was after the his false claims of better scars and hair multiplication lured them into his chair!

It seems as stated many times in the past that his practice is again using smoke and mirrors trying to get new uninformed patients into his office.


Being an Acell tester myself .....not from his office "THANK GOD"....on a scale of 1-10 with 10 being the best projected outcome I'd place it around a 3 at best..........

His office false claims in the past IS the reason for all my past Transplant woes spanning a time period of over 12 years and counting thanks to his oval punch techniques

Hitzig's office is claiming a 12 or better on his Acell results!!.....

Stay far, far away from his office!!!

 

[janna]

pvtpoint2010 wrote:

If you could give some SMG scar revision updates using Acell I and many others would be extremely grateful......

 SMG and other clinics have now been using it now for almost 1.5 to 2 full years...  Thanks

pvt

Hello PVT,

Yes, we have been offering ACell fine powder and wound strips for over a year. However, we do not use it on every patient. Before surgery, patients are made aware of the wound strips as an optional treatment. All feedback we've received from patients who have opted for the wound strips state they felt the healing was faster if nothing else. We have not heard that ACell makes the scar necessarily smaller for the scar revisions. For scar revisions or any post op patients giving feedback, it's difficult to attain good pics since their hairs have grown back. We have yet to hear that these patients feel their scars are worse off after their treatment with ACell wound strips.

There are several SMG patients who have been documenting their progress with ACell treatments. One in particular comes to mind is Sparta.

Here is his write up on his scar revision and use of Acell wound sheets. He just came back late March for Scar Rev#2. Scar Rev#1 consisted of removing scars on left and right side. He left the middle for Scar Rev#2.


***********SPARTA WROTE NOV 15, 2011 ***************

Let me give you my opinion since I'm in a similar situation and just had a scar repair.

I had a bunch of other strip surgeries back in the mid 2000s that left me with a nasty scar from ear to ear due to the doctor not taking out high enough and another doc taking from the same area and making it worse. I also had a certain doc in NO VA try to repair it and he didn't do much to it (IMO he made it worse).

I just had surgery with Dr. Ron back in October just last month and we are doing a 2 part repair. Sides (from ear to back side on each side) in 1 surgery and the back middle in other. The scar is a tad smaller then yours but in parts is 1/2 wide and goes ear to ear.

Using this as an example (line being scar)

Ear <------------------------------------------------------------> Ear

First surgery I just did was taking out the scar from the sides (like below)...leaving just the back middle for the second repair.

Ear < Remove Remove ----------------------- Remove Remove > Ear

Dr. Ron and I both decided (and from my experience with ear to ear stitches), that it is better to take it out in 2 pieces because you aren't putting tension across the whole back and sides. I strongly suggest during a scar repair in 2 parts or even 3.

It's been a month now and I can tell you the following.

1. IMO, staples are the way to go. I just had my first staples ever with Dr. Ron and my lord I cannot believe at the 1 month mark how GOOD my scar looks. I know scars can widen later but right now, there is no widening, no redness, no nothing....but I think there is another reason for that...which is....

2. Dr. Ron used 2 things on me. #1 One was a substance called Vitrase which he used to help with the scar revision. Janna can explain it what it does but from my understanding it helps with making the repair less tight. #2 He also used ACell in the closure and I swear on my life, my scar at even 1 week looked like it was almost fully healed and more like a scar from 6 months out, not 1 week. After 1 month, all that is red is some of the staple holes and a minor faint redness in the super skinny scar line.

Dr Ron and I decided to leave the staples in longer also. We left all of them in for 14 days and took half out at the 14 day mark. Then we left them in for another 7 days and took the rest out on the 21st day. I think in scar repairs you have to leave them in longer. He said I could have taken them out at 14 but told me if I could deal with them for 21 days, then to keep them in. I think it made a big difference because I don't have ANY tightness and I feel the rest of the scalp stretched and not the scar during those 21 days. I can also tell you that I like staples better. I never itched at all with them and barely knew they were there after the 5th day.

I also feel that stitches cause shock loss and stretching from experience. Having the experience now of multiple stitch closures (tri and all) and now staples, I would NEVER go back to stitches. That's just my opinion.

I would avoid Feller. I got a bad vibe from talking to him.

Go see Dr. Ron and Im sure he can help you. Im going back in Feb/March to have my middle back part of the scar removed..and Im chomping at the bit because again, I cannot stress enough HOW GOOD of a job Dr. Ron did..and yes it's only 1 month, but I never felt or had a scar look this good at 1 month. I would also suggest thinking about the Vitrase and ACell...I'm literally floored at how well my scar is healed..and it has to be the ACell. I also ate really really well during the 2-3 weeks and ate lots of healthy foods and proteins and avoids most fatty and bad foods. I think that helped but again that is just my personal opinion on the food (but some say protein helps scars heal faster).

**********************************************************

Here are Sparta's before and after scar revision#1 and the 3rd pic is from his most recent scar revision #2

 

[pvtpoint2010]

Thanks Janna
Hope to see a few more soon!

 

[janna]

Here is a pic sent by Sparta who came to us for a scar revision. We used ACell wound sheets -

Sparta's scar revision was done in two steps - did the two sides in October of 2011 then the middle section scar was excised in March of 2012. Sparta sent me these pics yesterday to update his files. He is well happy with the outcome of his scar revision. It's difficult to say just how much of the healing and the finer scar was the result of ACell or due to the technique itself.

 

[topccat29]

Looks very good not sure it has anything to do with Acell though.

Common sense would tell me that a scar is like a broken bone. It heals stronger at the break point then the surrounding bone. A scar seems to be the same with the skin although unsightly much stronger at the point of the incision. I would think that the scar itself which actually aid in keeping the wound tightly closed and prevent it from stretching like we have seen on several other Acell patients.

By what mechanism does Acell prevent skin from stretching?

 

[pvtpoint2010]

Janna did you use staples or sutures?

 

[janna]

He had staples. 2 layer closure- absorbable sutures then staples on the outside.

Topcat, here is a link to ACell Wound care on their website. The site will give you more info than I ever could about their products.

http://www.acell.com/woundcare.html

 

[topccat29]

Yes I have read their literature and nowhere could I find that it prevents a wound that is under tension from stretching. The reason I ask is because I have seen a few cases where it does exactly the opposite it causes the wound to stretch more than it would if nothing was applied.

They also mention plucking in their literature. I have yet to see one single patient that has had a successful plucking procedure yet this company feels very comfortable mentioning it in their literature.

 

[pvtpoint2010]

Janna ,

According to Acell's application directions it says to check and repeat process every 7 days.

ive been saying all along that just one treatment with Acell may not be enough to give a complete result.

Most Docs however just use it directly after surgery and that's it

Doesn't it make sense to test a few willing patients using several applications rather then just 1 ?

DEVICE APPLICATION
1. Clean wound bed by removing necrotic tissue and scar tissue to obtain fresh tissue edges. Irrigate excessive exudates and control bleeding.
2. Remove device from container using standard aseptic/sterile technique. Cut device slightly bigger than area to be covered.
3. Rehydrate device in room temperature sterile saline or sterile lactated Ringer €™s solution in a sterile dish for five (5) minutes prior to use.
4. Large Wound €”More than one device may be necessary to obtain complete coverage. Overlap device edges slightly to assure coverage of entire wound.
5. Wet Wound €”Cover device with non-adherent dressing such as petrolatum gauze, followed by application of an absorptive dressing such as a calcium alginate. Secure dressings to wound site.
6. Dry Wound €”The non-adherent dressing should be followed by application of a hydrogel dressing to keep wound moist. Secure dressings to wound site.
NOTE: Keep device and wound bed moist.
WOUND CARE FOLLOW-UP
1. Inspect wound for adverse reactions every 7 days; remove exudates and apply new device to any non-covered wound areas.
2. Do not remove any remaining device that is intact on wound surface. As device is resorbed, it may form a caramel-colored gel.
3. Rinse wound surface gently leaving the caramel-colored gel intact and re-apply another device.
4. Repeat wound care follow-up process weekly until wound has epithelialized.
5. Monitor tissue surrounding edges of wound. As wound healing occurs, redness and swelling will decrease and drainage will become less. These are signs of wound healing and often seen before new epithelium is obvious.

 

[Sparts]

Hey everyone....

Wanted to give some feedback about the update Janna posted (that's me)



At 4 months...everything is looking great. I contribute this to various factors which I'll go over. I do believe the ACELL and Vitrase helped with this revision.

1. Vitrase: I got Vitrase (spelling) injected before the surgery. It loosens up the tissue and I can tell you for a fact that never after surgery or weeks later did my scalp feel tight. I think this goes a long way in really helping with scar repairs. I've had multiple surgeries before and every time the medicine wore off, the wound felt tight. Neither time has my scar/head felt tight after Vitrase.

2. Acell. I believe the Acell accelerated the healing process. Now mind you, some of the Acell stuff you are reading is about people sprinkling Acell into wounds. The Acell is really helping heal the deep tissue faster IMO and also the scar itself. It's not sprinkled..it's a thin sheet that is put under the scar then closed. It allows the deeper tissue to heal up faster and take some pressure off the outer skin (this is my opinion).

3. Staples. Let me say again. Staples staples staples. BAR NONE staples are the way to go. I was against getting staples and Dr. Ron convinced me to do them. The reason I got those bad scars IMO was because of sutures (and docs that took too much). Sutures just cannot do what staples do and the tension on the wound is MUCH greater due to the suture having to go around the whole scar. The staples on the other hand close the scar nicely and are actually smaller, leaving a smaller area of tension and are only on the outside...with the prongs 'pinching' the wound closed. These staples are like a quarter of an inch if that. Sutures lines go much taller...usually 3/16 at least.

4. Time. I know Janna cringes every time I tell her this (because of infection)...I firmly believe that a longer time with staples in is the way to go. In fact, I've told Janna straight up that IMO scar repair patients should have a minimum of 14 days for half the staples and 21 days for the rest. I actually went 21 days for taking half out and 28 days for the rest this time around. You're probably wondering how that didn't bother me or itch like hell nor get infected. Well I keep the wound super clean and honestly staples don't itch because they don't go all the way under the skin like sutures do. Most individuals get sutures out at 10 days...which is not enough time for the tension to subside in the healing process IMO. By leaving these staples in for 21 days and 28 days...the rest of my scalp adjusted/stretched and when they came out, I had no tension what-so-ever. I can't say the same about sutures coming out at 10 days. Every time I had that done, I felt the scar being tight and honestly feeling like it was stretching.

5. Activity. I didn't do ANY activity that moved my head much at all. No sit-ups, no weights that involved head movement, etc. Only ran and played softball this spring.

I'd say the final scar is less then 1/16 of an inch if that. You can only see it if you really hold up the hair and look...but running a comb through it you just cannot tell without looking really hard. Brushing it to the side and down...virtually undetectable.

Feel free to ask me any questions.

I'm going back up later in the year (NOV) for some FUE into the remaining tiny scar line, old punch holes and some into the crown/top. This will be my final repair surgery...YAY! ¬b`

I owe a lot to Janna and Dr. Ron for really fixing this horrible scar I had..without them I'd still have a hideous scar...now it's virtually gone.

If you need a scar repair or any repair work (or even just normal work) go to Shapiro. Bar none the best in the business.

-Sparts

 

[Bigmac]

Hi Sparts, its all looking great at 4 months post op, it has worked very well for you so far.

Thanks for updating us and supplying your pictures to Smg.

 

[topccat29]

Sparts thank you for the clarification and that the Acell factor is just your opinion. In my opinion nutrition specifically the foods we put into our bodies will determine not only our healing rate but also our susceptibility to certain diseases such as cancer, heart disease, etc just a wild theory €¦..lol €¦ €¦. I don €™t believe many clinics recommend this approach much.

There is one clinic that states they get 60% regeneration of hair follicles after fue extraction and applying Acell but only in some patients. Not sure where they get that number from and they have not provided solid proof but still feel comfortable telling others about their great discovery. Almost like the John of God of hair. My main issue with Acell is that for as long as it has been out I have yet to see solid proof that is does anything at all when compared to not using it.

I €™m not trying to knock your result as it looks fantastic. I know 3 people who all had cancer and went to visit a man is South America, John of God as he supposedly cures cancer. They all believed that he was doing something to help cure the disease but they are all dead and all their money couldn €™t help them. Sometimes our hopes get the best of us and sometimes we believe something when it is based on nothing.

Thanks for taking the time to post.

 

[Sparts]

No problem BigMac.

RE: Topcat's post...

TopCat,

I just still want to clarify that in no way do I believe the Acell grew hair cells back or anything of that sort. I know some people are saying they can pour Acell into a dime sized wound and then hair sprouts out of that...no way do I believe that.

I do feel that the Acell strip accelerated the healing of the incision/scar repair.

Just wanted to make sure you understood the difference.

And yes, like you, I do feel that the foods and medications and environments around us determine most of our health.

 

[topccat29]

Sparts yes I understood and thank you for clarifying it.