Regenerative technology is the latest breakthrough innovation in the practice of hair restoration. An entirely new and unique application of a medical device, called an Extra-Cellular Matrix (ECM), is being used for scar reduction and treatment of hair loss. ACell Inc, MatriStem© is a specific ECM product, demonstrating excellent results.
ECM devices are a cornerstone of medical research in wound healing and tissue regeneration because of their ability to remodel and repair damaged tissue.How Regenerative Technology initiates a new chapter in Hair Restoration:
Since the 1960’s, the evolution of hair restoration has seen many important innovations, the most significant being the development of the Follicular Unit Graft. Early hair surgeries transplanted large 4mm grafts, or “hair plugs.” The introduction of the more aesthetically pleasing Follicular Unit Transplantation (FUT) has enabled surgeons to distribute donor hair across larger areas of the scalp, virtually eliminating the “doll hair” look of hair plugs, delivering impressive natural results.(figure 1_ below)
Fig. 1 Old "Plug style hair transplantation (L) and Contemporary Follicular Unit Transplantation (R) FUT
How Regenerative Technology initiates a new chapter in Hair Restoration:
Since the 1960’s, the evolution of hair restoration has seen many important innovations, the most significant being the development of the Follicular Unit Graft. Early hair surgeries transplanted large 4mm grafts, or “hair plugs.” The introduction of the more aesthetically pleasing Follicular Unit Transplantation (FUT) has enabled surgeons to distribute donor hair across larger areas of the scalp, virtually eliminating the “doll hair” look of hair plugs (fig. 1, delivering impressive natural results.
The introduction of medical therapy with Rogaine (Minoxidil) and Propecia (Finasteride) added a new dimension to the treatment of Androgenetic Alopecia. With daily use, patients could slow down, and in a few instances, reverse their hair loss. As long as these medications were used every day, the results were often substantial. In the long run, however, compliance was an issue and many well-intentioned patients who were not consistent with the daily use became disillusioned with Propecia and Rogaine as a non-surgical treatment for baldness. Today, medical therapy is usually positioned as an effective way to maintain existing hair. When combined with FUT, Propecia and Rogaine have proven to be very useful.
Despite these advances, a skilled hair restoration surgeon is still challenged by:
- A chronic shortage of donor hair.
- Progressing hair loss due to patient non-compliance or intolerance of medical therapy (Propecia and Rogaine).
- The build up of donor scar tissue with subsequent transplant procedures, open donor and multiple strip scarring from old graft harvesting techniques, and over-harvesting of hair follicles by Follicular Unit Extraction (FUE) (figure 2).
Fig. 2 Donor scars from plug and strip overharvesting and poor closure technique
Fig 2-A Contrary to some promotions FUE transplantation is not scarless and does deplete donor hair.
Regenerative Therapy for hair loss, utilizing ACell, bridges the gap between donor hair supply and demand because it produces new hair follicles while stabilizing and reversing miniaturized hair. Results have been clinically demonstrated (figure3), opening a new chapter for the successful treatment of hair loss patients.
Figure 3 ACell+PRP injections stimulate minaturized hairs.
What is an Extracellular Matrix?
Present in all mammalian tissue, the ECM is the thin layer that wraps around all the cells in our organs and tissues. Produced by the cells it surrounds, the extracellular matrix has two main functions:
- Structural Support – The ECM is a biological scaffold composed of several types of proteins including Elastin, Collagen, Hyaluronic Acid, Proteoglycans and Glycoproteins. The combination of these proteins determines the qualities of the tissue that they reside in. For example, collagen and elastin provide resiliency to youthful skin; but scar tissue feels dense, rigid and inflexible.
- Cell Communication – The cells in our bodies “talk” to each other using special protein and hormone messengers. Because the ECM surrounds every cell, it can influence these “conversations” by controlling the passage of chemicals to and from cells in the surrounding tissue. It can even initiate communication by releasing its own unique chemical messengers in response to changes in the local environment, which is even more important in the instance of tissue damage.
How does and ECM like Acell work?
Fig. 4 ECM provide structural support at the cellular level for new tissue growth.
When introduced into damaged tissue, ECM devices like ACell will:
- Provide structural support at the cellular level for new tissue growth (Figure 4).
- Recruit a high concentration of growth factors and adult stem cells into the area of injury
- “Activates” the stem cells, which then orchestrate the regeneration of new native tissue.
- Dramatically increase the blood flow in the injured tissue. (A process called angio-neogenesis).
One way to conceptualize this process is to imagine a neighborhood that has been damaged by a storm. ACell acts like the first responder team and begins to organize the clean up and rebuilding effort. It sets up a sophisticated communication network that calls other important “rescue workers” (growth factors and stem cells) vital to the reconstruction of the damaged homes and businesses. Large populations of various cell types are called to the scene to begin the cleanup of debris (damaged cells). ACell builds “new roads” by growing many new blood vessels to facilitate the removal of cell debris and carry in new raw materials needed for the repairs. Stem cells are activated by ACell, which in turn supervise the reconstruction by using the available blueprints (DNA) that specify how the neighborhood was built. The activation of adult stem cells is a critical step in the process, fundamentally changing the way the stem cells cells behave in the rebuilding phase. Without stem cell activation, the result would be a clean up of all the junk from the neighborhood, and little to no reconstruction; in other words, just scar formation would occur.
When ACell MatriStem is introduced into the injured tissue, the balance is shifted from scar formation to tissue remodeling and regeneration. By activating adult stem cells present in the tissue, ACell begins to rebuild damaged tissue so it’s like new again rather than forming the dense, rigid scar tissue that would normally be present. Acell rebuilds as though there never was an injury.
Fig. 5 ACell applied to linear strip wound prior to closure - ACell appears to rebuild damaged tissue so it’s like new again rather than forming the dense, rigid scar tissue that would normally be present.
How is ACell being used to treat hair loss patients?
Dr. Gary Hitzig a New York Hair Surgeon has pioneered the successful application of ACell in the treatment of hair loss. Dr. Hitzig has developed protocols for the use of ACell in a variety of clinical scenarios:
- Treating genetic hair loss using ACell with FUT.
- Treating genetic hair loss using ACell alone.
- Treating Scarring alopecia and donor scars
If you are interested in consulting with Dr. Niedbalski to see if you are a candidate for an ACell treatment, please contact Northwest Hair Restoration at 253.572.2949
What is FUE?
