Medesthetics

SEP 2014

MedEsthetics magazines offers business education and in-depth coverage of the latest noninvasive cosmetic procedures for physicians and practice managers working in the medical aesthetics industry.

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DETAILS 30 SEPTEMBER 2014 | Med Esthetics researchers noted a 3% to 52% increase in follicular density. In 2011, Rinaldi et al. 2 , found that PRP reduced diffuse hair loss and stimulated hair growth. In 2012, Kang et al. 3 , sug- gested the CD34+ hematopoietic stem cells concentrated using Smart PReP PRP (Harvest Technologies, harvesttech. com) could assist angiogenesis. Despite a lack of compelling literature, physicians are us- ing PRP with positive results. In Sarasota, Florida, Joe Greco, MD, of the Greco Medi- cal Group is injecting Emcyte Pure PRP with Cytokine-Rich Plasma and extracellular matrix to prolong exposure to growth factors. His company, OroGen Bioscience, devel- oped a method patent for processing blood to produce Cytokine-Rich Plasma. His treatment technique involves the use of an anti-infl ammatory diet, medications, depot injections, and Dermapen microneedling or rollers. He esti- mates 70% of patients return for additional hair treatments. In Beverly Hills, California, Baubac Hayatdavoudi, MD, reports success using PRP with follicular unit extraction for hair transplantation surgery in the scalp, as well as PRP monotherapy to increase follicular density and induce ana- gen in telogen (resting) follicles. Gordon Sasaki, MD, FACS, co-author of this article, is combining PRP depot injections with Dermapen mi- croneedling to enhance the topical absorption of PRP in the scalp. Microneedling creates thousands of microchan- nels in the epidermis to stimulate growth and healing. Each microchannel serves as an express conduit for PRP absorption through the epidermis and a center of the cas- cade of wound healing in an enhanced cauldron of human growth factors. Dr. Sasaki believes that microneedling itself has a positive effect on the early stages of AGA. Garry Lee, MD, co-author of this article, uses PRP depot injections alone and in conjunction with microneedling, and is in the process of adding medications and LED laser treat- ments to treat hair loss. TREATMENT PROTOCOLS Patient selection is critical for success. Drs. Lee and Sasaki exclude patients with advanced AGA (Norwood V-VII or Ludwig III). This includes patients with traumatic alopecia and autoimmune alopecia, as they may have insuffi cient adnexal normal tissue to mount an adequate response. The concern with autoimmune alopecia is that even if the healing cascade is stimulated and anagen prolonged, the baseline autoimmune etiology may counter treatment efforts. Contraindications for treatment with PRP include: signifi cant platelet dysfunctions; hypofi brinogenemia; local infection or septicemia; pregnancy; poor blood clotting; keloid-prone patients; sensitivity to bovine thrombin—if used; and hemodynamic instability. Prior to treatment, Dr. Sasaki obtains labs including CBC with platelets; serum iron; and estrogen, testosterone, thyroid, pituitary and antibody panels. He follows with Before After Before After Before After Before After Dr. Sasaki's patient underwent microneedling with PRP to reverse hair loss. PHOTOS COURTESY OF GORDON H. SASAKI, MD, FACS

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