On this episode of the Anti-Aging Hacks podcast, we discuss Hair Transplants, PRP, Stem Cells and a whole lot more about hair loss.

In particular, we discuss the following topics:

1. How do hair transplants work (FUT and FUE) and who is the right candidate?

2. How does Platelet Rich Plasma (PRP) strengthen and boost your hair?

3. How can your own Stem Cells be used for the best boost to your hair?

4. Why are a lot of Dermatologists doing PRP wrong?

5. Could fat transplants in your head be important for retaining your hair?

Hair loss is such as important component of anti-aging, and in this episode we pick up where we left off in episode one.

To hear the basics of how we lose our hair, and what to do to keep as many hair on your head as possible, listen to episode 1 of hair loss here.

Here are the notes from this call:

Restoration Tier: Hair Transplants 2:10

– Two different ways of Hair Transplants

– Follicular Unit Transplantation (FUT)

– Follicular Unit Extraction (FUE)

– Follicles are extracted from the back of the hair and then 

Follicular Unit Transplantation 3:33

– Take a long area (Strip of tissue) from the back of the scalp and stitch or suture it back together

– Dissect the strip to extract hair follicles

– Then transplant these follicles to the front or crown area of the scalp

– Can get thousands of hair follicles from a single strip and surgery

– These follicles are not affected by DHT so they will not fall out again from the front

– Downside is that this leaves a scar on the back of the head where the follicle was extracted

– Takes 7-10 days for scar to heal, there may be some swelling and discomfort

– If you need a second surgery, then this gets a little more complicated. Less scalp tissue to work with, and need to work around the scar

– Because of tightness of the skin in the back of the scalp, these hairs around the scar can start thinning

– FUT is still the gold standard

– This takes 6-10 hours total: excising the strip, pulling individual hair out, and replanting them to the front

Follicular Unit Extraction (FUE): 7:15

– Newer technique, been around for 15 years

– Can use a punch like device to extract individual follicles one at a time

– This is done under a microscope

– Shave the back of the head, and pull out individual units one by one. Can do 800-1000 grafts in one hour

– Then move to the front of the head and put those units in one by one

– Big advantage is that there is no linear scar

– The other advantage is that you can come in anytime to do more follicles as there is no scar

– A challenge is to get people to get to shave the back of their head

– Robot can also do extraction or transplantation

How many grafts do people do in one hair transplant 10:35

– Depends on patients need

– Full head of hair has about 80 follicular units per square centimeter 

– So on areas where you are balding, it is ideal to get patient to at least 40 follicular units per square centimeter

– If people have very thin hair, then may need to get to 50 or 60 hair follicles per square centimeter

– Skill and art is important, as the direction and angle of the hair is important

– Cost analysis comes out of how much hair a patient needs transplanted in an area

Does Hair Transplant Shock Old Hair 17:18

– Anytime you put a needle or blade near hair, there is a risk of shedding hair. This is called shock loss. This hair typically grows back

– Around 3 months, patient will have fewer hair due to shock loss. But around 9-12 months, all the shocked hair should come back

– A bad surgeon may damage your hair follicles and that damage may be forever

How Long Does Hair Grow back after Transplant 19:45

– Timing is variable, but one year is a good indicator of when the transplanted hair should be back

– Sometimes it may take 1.5 years

– Most people will have 80% of transplant within 9 months

Enhancement Tier: Platelet Rich Plasma (PRP) and Stem Cells 21:00

– This is regenerative medicine and is being used as anti-aging medicine as well

– Uses your own cells to enhance hair follicles and tissues

– All tissue in body comes from three stem cell lines Ectoderm (outer part of skin, outer part of eye, and part of hair follicle), Mesoderm (muscle, joints, liver, kidney, spleen), Endoderm (gut and colon lining)

– Hair follicle is extremely complex, comes from two stem cell lines: Ectoderm and the Mesoderm

– Cell to cell interactions are important, and the cells know what to do

– They key is to stimulate the cells so they can do their job

 PRP for hair Details 26:50

– Platelet are the sentinels, they are usually the first responders to an injury. they help form scabs and released growth factors to release collagen etc.

– Platelets are used to induce healing and stimulate follicles in the scab

– Stimulating growth via platelets increases the anagen phase of hair

– Dr. Welter thinks PRP stimulates the hair and causes thicker hair

– PRP relies on patients’ own blood

– Standardization is sometimes hard to achieve because of different platelet counts in different people

– 85% are very good responders, 5-10% are okay responders, and 5% do not respond at all

How does PRP work 28:55

– Takes about 90 minutes

– 60 cc of blood, they do a high density platelet concentration. Around 4-6 platelet concentration is ideal

– Also use Pronox to relax the patient, and 

– Then inject PRP, also do microneedling of the scalp at the same time

– The micro trauma also draws in platelets

– High density PRP lasts about a year. Peak at about 9 months.

– Some people can last 1.5 years, some people 10 months

– Can see stimulation and improvement of hair shaft diameter and hair counts

– Some doctors do low density PRP where they have you come in very often, Dr. Welter does not prefer this method

– At some point, Male Pattern Baldness becomes irreversible

– It is much easier to stimulate hair that are thinning rather than those that are gone

– PRP was great for women

Stem Cell Therapy for Hair 34:00

– Stem cells are being used for anti-aging as well as for specific regions

 – PRP has results for 9-12 months, wanted to figure out if stem cells would be more effective

– In 2005, an article showed that there were 2 Million stem cells in fat

– We now know that all tissues have stem cells, but they are not always abundant

– With fat, they are easy to get to with just a simple liposuction with a cannula

– In 2011, Dr. Welter did first ever hair stimulation treatment from stem cells from fat

– Stem cells can last up to two years

– The procedure is very similar to PRP with the addition of a small liposuction. Dr. Welter also adds PRP to the stem cell mix

– 10-15cc of aspirate for stem cells, and PRP is 6-8 cc

– Inject at 3-4 mm depth

– 50 or 60 injections per procedure

– Electronic pen micro-needling after PRP/Stem cells

– Bone marrow is very good potency, but bone marrow is high potency and also high abundance and quite easy to get

– FDA is regulating stem cells

– Balding scalp has a thinning of fatty layer, and donor area has a thicker area of fat

– Transplanting fat to the balding areas of the scalp may be a new therapy in the near future

– As discussed above, the best anti-aging hacks for hair loss are multi-factorial. There is not one treatment to rule them all just yet.

Dr. Welter Contact Information:

– Regeneris Boston

– NE Hair 

– Instagram: @docstemcell

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