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Platelet Rich Plasma (PRP)

Peachy

Peachy

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#2
Ooops sorry, heading should read Platelet Rich Plasma....lol BM can you square up please?
 
T.C

T.C

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#3
I read about this on some forums.At the moment there arent alot of photos out there of recipients as it is fairly new.There seems to be slight variations between doctors who are performing it in the technique of stimulation from what I have read and the time between procedures but looks promising.Dr Feller is performing it and said he will be providing a service in the U.K soon.Cant wait to see some results.
 
Spex

Spex

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#4
Dr Feller is treating patients from his office in New York now and the first few have gone really well. All cases will be well documented. We will be offering PRP here in the UK in the not too distant future also - Feel free to contact me if you would like to be put on the list for treatment. - [email protected]

He treated the first guy the other day - here is a write up along with some info from the doc from another forum - There are several "youtube" videos on other topics will attempt to addthem here also to help. Quotes from Dr Feller - :

I am proud to announce that we performed New Yorks first PRP treatment in Great Neck today.

The patient had visited us twice for HT surgery consultations but was turned down on both occassions. When he asked if there was anything new available to patients in his situation, we told him about PRP and he decided to give it a try.

His entire procedure took about 25 minutes. We drew some blood from his arm and then processed it to obtain concentrated plateles. Then I numbed his scalp with a local anesthetic and injected the PRP into the dermis where the follicles live. Then I used a tiny needle and made 200 punctures in the skin to activate the platelets. I let him sit for 5 minutes during which his skin healed, washed his scalp with some clean water, and sent him home. That was it. Very undramatic. I will post photos when I get the chance.

--




Yes, I will be documenting ALL of them.


No, not a single injection. I inject PRP every CM or so to "seed" the dermis as evenly as I can. Then I poke the area that has been seeded about 200 times to ACTIVATE the platelets.

I guess I haven't made the mechanism of action of PRP clear, so let me summerize here:

Platelets in and of themselves are inactive and dormant. If they weren't, you're blood stream would be just one massive clot. Platelets only become active when triggered by disruption of tissue. So when you cut yourself, the platelets passing by in the blood stream at that time become ACTIVATED by the injury and start to do their magic- which is to clot blood and exude growth factors of different kinds to regenerate the skin and surrounding structures in an effort to heal them.

The blood has a relatively low concentration of platelets, so in PRP procedures we strive to concentrate the platelets 5-7 TIMES normal. Then we inject it into the dermal layer where the follicles live.

At this point the PRP concentrated platelets are in the dermis, but are inactive, so when I poke the area a few hundred times the trauma causes the platelets to activate. That's the general mechanism of action of PRP as I understand it. Perhaps Dr. Joe Greco can come on here and elobarate if need be, but I thing that pretty much says it.

The reason I turned that patient down twice was simply because he had too much hair for surgery at this time. That's what made him an excellent PRP candiate.

This patient is not on any meds and does not want to be- yet another criteria that made him an excellent PRP candidate.

While PRP is "experimental", I am not trying to experiment on patients. That is, I will not preclude patients who are already on finsateride, dutasteride, minoxidil, or anything else in the name of doing a study. Instead, I will treat all patients I feel are candidates for PRP and simply follow their progress in photos. Then I will do a retrospective study to see what the effects of PRP truly were.

PRP seems to play two major roles:
The first is to aid in reducing, arresting, or reversing miniturization. In this case the best patient is someone with ALOT of thin hair like diffuse alopecia. Another ideal patient is the one who is losing their hairline due to traction alopecia secondary to pulling the hair back into a ponytail.Yet another is the young person who sees areas of their scalp noticably thinning. Most of these type patients should NOT be candidates for HT in the areas that PRP treatment is recommended.

The second is the hair transplant patient. I now tell all my patients that they have the OPTION to get a PRP treatment 2 weeks to a month BEFORE their scheduled HT procedure to help prepare the donor area and recipient area for the surgery. Since PRP exudes EGF (Endothelial Growth Factor) it means new capallaries will be formed within the skin which can only help the donor area heal better and the recipient area recover faster after surgery. And before anyone worries about the area bleeding MORE during surgery due to the PRP treatment, it won't because the new vessels are capallaries and are therefore too small to make a difference in the volume of blood lost during surgery.

If PRP is performed in an area where grafts are already grown out it will not harm them. Think about it, even a massive surgery in and around prior transplants very rarely harms the original transplants. The amount of trauma from a PRP treatment is FAR less than that.

I suppose there is ALWAYS a risk of shockloss as some peoples physiology are more sensitive than others, but I have to state that I HIGHLY doubt shockloss can occur as the result of a PRP procedure. The wounds are just too small.




According to the scant data we have for the efficacy of PRP on follicles, it seems that a return visit would be called for every 6 to 8 months. If PRP is effective in your case, I suspect that you would return EVERY month for several hundred needle pricks without hesitation. Fortunately you don't feel the sticks because I numb the scalp with local anesthetic prior to the procedure.

Needle-less injectors may or may not work. My concern is whether the high pressure will rupture the platelets. I will order such an injector and shoot it though pig skin. Then I will examine under the microscope. If the platelets are intact then I will consider needle-less injectors.


I have no idea how many terminal hairs it will produce. Dr. Greco showed a cosmetically signficant amount during the Fox newscast he was on, I'd be happy if most people achieved that level of growth.

I have not heard nor read one word about PRP enhancing any kind of untoward growth like tumors, and it is unlikely that it is capable of doing so. I had a conversaton with the rep of the most successful PRP company in the world and he never heard of it either.


If the patient has extensive baldness in an area without ANY miniaturized hairs and no chance for a hair transplant, then there is no point in offering PRP at all.

To me, any person with a thinning area of scalp extensive enough to worry them, but not enough to justify a hair transplant, is an instant candidate. This goes double for women in particular who can't use finasteride.

Like Propecia, Minoxidil, and Dutasteride PRP is NOT a magic bullet.At least not yet. But the only way to find out its potential is to simply do them and report on the results. Perhaps PRP is where crude HTs were 40 years ago and it will just take some clever hard working doctors to maximize its potential. One thing is for sure, it's potential extends far beyond other junk therapies like lasers, steroid injections, magic shampoos, etc...

Growth factors are the stuff of life. They are real, tangible, well understood, and proven. Stands to reason that they would have a beneficial effect on any tissue they came into direct contact with...hair follicles and surrounding skin included.

-Dr. F
 
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Prohairclinic

Prohairclinic

Prohairclinic FUE and SMP
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#5
Here is an update on our PRP.

We started out early august 2009, performing PRP treatments to a series of test patient. We use identical PRP centrifuge as dr. Greco has used during his trials. Most likely we are using the same protocols (I stand to be corrected since we learned PRP through dr. Jones).

here is our first result after 2,5 months

Top left : crown just before PRP treatment
Bottom left : crown just after PRP treatment
Top right and top bottom : 2,5 months after PRP treatment.

Please note that no topic or any other concealers where used. Although the pictures are not of best quality, it is quite clear that there is an effect visible. Also note that the pictures are taken using about the same angle.
 

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janna

janna

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#6
Bverotti wrote:
and top bottom : 2,5 months after PRP treatment.
Hi Bart,

You probably meant bottom right?

There seems to be an improvement. Do you have any other test patients to report?

The angle of the pictures taken certainly plays a part - the immediate (bottom left) after treatment looks worse than pre-treatment (top left). I know this is not something you can control either but, it would be ideal if the length of hair from pre treatment and progress treatments were the same too.

We are still on the fence about the treatment. We are keeping a close eye on results so thanks for sharing your progress.


 
S

scarred5

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#7
there seems to be an improvement as far as i can see, this is something that may not work on everyone just like most fda approved treatments,
 
north country boy

north country boy

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#8
Hi scarred i dont think this treatment has been FDA approved, but i could be wrong NCB
 
Prohairclinic

Prohairclinic

Prohairclinic FUE and SMP
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#9
Hi Janna,
You have very sharp eye;) Now I know why you make such a good assistant ;););)

We have several other test patients, including our own German rep 'Moses'. He will also document his result. From what he told me he can clearly feel and see a difference.

Will it work on everybody?
How long will the effect last?

We dont have any answers to these questions apart from the study by dr. Greco.

One thing is pretty sure however : there seems to be no side effects of the treatment.
Nobody reported any kind of inflamation or infection
Nobody reported any major pain after the treatment
Nobody experienced shedding in the treated area.

Bart
 
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Mountain

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#11
What do you think of injecting PRP into the donor scar area at the end of surgery or one week later to help get a good closure, with minimal scarring?
 
Bigmac

Bigmac

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#12
Hi Bart

Are you charging the patients to have PRP,if so how much is it.

Thanks bm.
 
Prohairclinic

Prohairclinic

Prohairclinic FUE and SMP
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#13
Hi BM,
We charge 500 Euro for a treatment, or 400 Euro for HT patients.
 
Bigmac

Bigmac

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#14
Hi Bart

I`m still on the fence regarding PRP for treating hairloss and patients having to pay for the treatment.I know most clinics are charging for this,i personally would not pay to have an experimental treatment.

I do hope it works out for gthe patients trying it.How many patients have had PRP with you so far and how often do you recomend they have the treatment.

Thanks bm.
 
Prohairclinic

Prohairclinic

Prohairclinic FUE and SMP
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#15
Hi Brian,
We talked long about offering PRP into our clinic.
It is a grey area, it is not proven, but on the other hand it is not unproven either.

The PRP centrifuge we use is quite expensive. On top of that we can only use 100% disposable kits that where specifically designed for this centrifuge. These kits are very expensive and make up for about 50% of the costs of the treatment.
Add some costs for local numbing and the roller + dr. time + assistants time. We do earn some money of the treatment, but it is not like we are printing PRP money either.

I believe we have treated about 20 patients in total. We only treat people after they have fully understood the treatment and it possible effects ... or even no effects.

Tommorow we have one of our test patients drop by. Over the phone he sounded positive about the treated area.
I hope to give you an update soon.

Bart
 
Bigmac

Bigmac

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#16
Thanks Bart for explaining your approach on PRP.I`ll look forward to seeing the updates.

bm.
 
north country boy

north country boy

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#17
Hi bart, are any of your patients using any more products, proscar,minoxidol etc ? and does the patients need to come back for top ups every 6-8 months as stated by Dr feller, if this is the case, 1000 a year soon adds up, cheers NCB
 
janna

janna

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#18
Bverotti wrote:
The PRP centrifuge we use is quite expensive. On top of that we can only use 100% disposable kits that where specifically designed for this centrifuge. These kits are very expensive and make up for about 50% of the costs of the treatment.
Hi Bart,

When we did the research on PRP treatments, we found that the PRP kits would be 100% disposable here in the US too - no matter which machine you use. One source had very expensive centrifuge with costly kits too but the most cost effective kits and centrifuge were from Dr. Greco's supplier. They offered free centrifuge if you commit to a certain number of kits per month. Since the treatment is experimental, this seems like a good route to take.

Mountain,

In regards to treating the donor scar with PRP, I think most clinics feel this is where we know it will be most effective. It certainly doesn't seem like it would do any harm. Applying PRP to areas with thin hair to regenerate the weak follicles is where it's still unknown.
 
Prohairclinic

Prohairclinic

Prohairclinic FUE and SMP
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#19
Hi Janna,
We had to purchase the machine (same one dr. Greco uses). They did not offer us any alternative.
The technician that came to install the machine had never heard that their machine was going to be used to treat hairloss. He ended up as a test patient at the end of the day:)

BTW, we had one of the test patient come in today, 2,5 months after his treatment. Pictures and video where taken.

Keep an eye on this thread ... hairlossexperiences will get the premiere !
 
T

Tiberius

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#20
Interesting concept Platelet Rich Plasma, Beverotti have you tested this in scar tissue?