• LaserCap LCPro

    8 November 2016
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  • Fat Grafting for the Breast with HydraSolve® Lipoplasty

    8 November 2016

    Various fat grafting techniques for breast surgery have been proposed, but some have their critics.

    One viable alternative to standard liposuction is tissue liquefaction technology (TLT), as embodied in the HydraSolve Lipoplasty System (Andrew Technologies LLC; Irvine, Calif.).

    Dr. Myckatyn

    “By removing the fat with HydraSolve, the operating surgeon may be able to minimize the intermediate step of processing the fat for reinjection by effectively washing and separating the fat cells at the time of harvest,” says Terence M. Myckatyn, M.D., a professor of plastic and reconstruction surgery at Washington University School of Medicine in St. Louis, Mo.

    Unlike competing technologies that rely on heat or a water jet to process fat, HydraSolve synergizes water with heat to efficaciously separate the fat cells with minimal trauma, according to Dr. Myckatyn.

    After processing, “the fat is very clean, in tiny parcels, and ready for reinjection,” Dr. Myckatyn tells Cosmetic Surgery Times. “The actual clumps of fat are smaller than with other forms of liposuction and fat grafting. This translates into a smoother, easier reinjection back into the patient.”

    In 2012, HydraSolve became the first FDA-approved liposuction device for fat grafting.

    Dr. Myckatyn is co-author of a retrospective chart review in Aesthetic Plastic Surgery that involved 136 consecutive breast reconstruction patients, nearly all for either cancer or prophylaxis for cancer prevention, who underwent fat harvest with HydraSolve, for a total of 237 procedures (mostly bilateral).

    The abdomen was the donor site for 50% of the cases, with the remaining two sites being the flanks and the thighs.

    The overall complication rate for the study was 29%, with roughly 75% of adverse events due to fat necrosis at the recipient site.

    “I believe our results are on par with standard liposuction,” says Dr. Myckatyn, whose practice group since 2014 has used HydraSolve on about 350 patients, the vast majority for breast reconstruction.

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  • World’s First Mesenteric Fat Extraction – Andrew Technologies Press Release

    8 November 2016

    Andrew Technologies Announces World’s First Successful Mesenteric Fat Extraction, a Long-Awaited Breakthrough for Potential Reversal of Diabetes

    TUSTIN, Calif., October 17, 2016 – Andrew Technologies, LLC today announced that for the first time in the history of surgery, it has safely extracted mesenteric visceral fat in mammals, using the company’s proprietary Tissue Liquefaction Technology™ (TLT). These visceral lipectomy successes mark a positive start to the company’s proof of concept for a procedure that has the potential to reverse type 2 diabetes. According to the Centers for Disease Control and Prevention (CDC), diabetes is the seventh leading cause of death in the United States. Diabetes affects 29.1 million Americans, or 9.3% of the population, and 1.4 million Americans are newly diagnosed with diabetes each year. Some 86 million Americans aged 20 or older have prediabetes, which places them at greater risk for developing type 2 diabetes and other health problems. The World Health Organization describes the prevalence of diabetes as a global epidemic. In the fight against the epidemic of diabetes, safe removal of visceral fat may present a new weapon. Visceral fat is metabolically active fat that surrounds the kidneys and other organs and collects in the mesentery (the connective tissue around the intestines), and may cause type 2 diabetes and other diseases. There is convincing scientific evidence that the presence of excess visceral fat is highly correlated with a greater risk of type 2 diabetes, cardiovascular disease, NASH, high blood pressure, stroke, Alzheimer’s and many other disorders. The medical community has postulated for decades that removal of sufficient quantities of this metabolically active visceral fat might reverse the risk of some or all of these diseases. The mesentery contains the largest depot of visceral fat, and may have the strongest correlation with metabolic disease progression. However, research in this area has been confounded because surgeons have been unable to safely remove these fatty deposits, which contain significant blood vessels and nerves and lie in close proximity to vital organs and structures. Dr. Mark S. Andrew, founder and CSO of Andrew Technologies, led the surgical team and stated, “In this study, we were able to show that non-cutting TLT liquefies visceral fat with target tissue specificity. Using TLT, we performed visceral lipectomy in three baboons without damage to the abdominal organs, blood vessels or the mesenteric sheath. This advance has exciting potential implications for future treatment of millions of patients with type 2 diabetes.” Dr. Derek Huffman, Assistant Professor of Molecular Pharmacology and Medicine at the Albert Einstein College of Medicine in New York added “Over the past 15 years, our research team has been particularly focused on the role of visceral fat and its complications, particularly as it relates to insulin resistance, type 2 diabetes, cancer and aging. It is now well recognized among researchers and clinicians that visceral fat is an important risk factor for diabetes and other diseases, but there has been no way to safely remove it from the mesentery.” Dr. Richard M. Peterson, Chief of Bariatric and Metabolic Surgery at UT Health Science Center in San Antonio, TX, added, “It has been exciting to be part of this study, which demonstrated surgical capabilities with TLT that simply have not been available to us in the past. Following safe removal of visceral fat, the baboons have shown no ill effects in the recovery period, they’re doing just fine. I look forward to exploring the technology’s capabilities further as we move through the next stages of research.” Andrew Technologies will continue to provide updates on its research into using TLT for visceral lipectomy. Full results of the primate study will be published in a peer-reviewed journal in 2017.


    About Andrew Technologies, LLC

    Andrew Technologies, LLC, is a privately funded medical technology company founded in 2007 and committed to improving patients’ lives through precision surgery based on Tissue Liquefaction Technology™. The first device using this new approach to surgery was AquaLase, launched by Alcon in 2003 for cataract surgery. Andrew Technologies received FDA clearance for HydraSolve, the second TLT device, in 2012. HydraSolve is primarily used to transfer fat for breast reconstruction following breast cancer treatment and for aesthetic body contouring www.hydrasolve.com. In addition to HydraSolve, Andrew has an impressive research pipeline that includes minimally invasive surgery to correct type 2 diabetes and adipose stem cell treatments.


    Public Relations Contact:

    Amy Phillips Pascale

    Communications 412-327-9499


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  • Two New Studies Demonstrate Advantages of Andrew Technologies’ HydraSolve® as the Company Heads to ASPS 2016

    8 November 2016

    Two New Studies Demonstrate Advantages of Andrew Technologies HydraSolve® as the Company Heads to ASPS 2016

    TUSTIN, Calif., September 19, 2016 Andrew Technologies, LLC today announced the first published clinical study of HydraSolve for breast reconstruction and the availability of new clinical data comparing HydraSolve to suction-assisted liposuction (SAL) as it prepares to attend the American Society of Plastic Surgery (ASPS) meeting this week in Los Angeles. The HydraSolve study titled, “Fat Grafting with Tissue Liquefaction Technology™ (TLT) as an Adjunct to Breast Reconstruction,” will appear in the December issue of Aesthetic Plastic Surgery and is currently available online. In this retrospective study, researchers at Washington University in St. Louis reviewed the charts of 136 consecutive patients who underwent TLT subsequently used in 237 breast reconstructions, evaluating donor and recipient site complications. The overall complication rate at the recipient site was 28.7%, however the clinically evident rate of fat necrosis was only 6.3% per treated breast. Bruising (ecchymosis) was the primary donor site complication, with 71.1% experiencing minimal bruising and widespread bruising occurring in only 10.4% of patients. “We concluded that TLT with HydraSolve is very different from other fat harvesting modalities,” explains one of the study’s principle investigators Dr. Marissa Tenenbaum. “Although donor and recipient site complications are similar to other methods used to harvest adipocytes for fat transfer, the quality of the harvested fat and the procedure’s efficiency make HydraSolve a sound option.” Thirty-one patients have now been treated by five plastic surgeons in the new study titled, “A Multicenter, Prospective, Randomized, Single-Blinded, Controlled Clinical Trial of HydraSolve vs. Suction-Assisted Liposuction.” The investigators found that after the procedure, the sites treated with HydraSolve had reduced bruising, swelling and treatment site tenderness compared to the sites treated with SAL. HydraSolve’s fat extraction rate was 40.4% more efficient than SAL, and surgeons’ cannula stroke rate was 65% lower with HydraSolve. Surgeons’ satisfaction rating for HydraSolve was higher than SAL, and they found it required less exertion. The study will be submitted to a leading plastic surgery journal later this year. “We were encouraged to find such a clear advantage to the tissue liquefaction approach from both the patients’ and surgeons’ perspectives,” says study author Dr. Bill G. Kortesis of Hunstad Kortesis in Huntersville, N.C. “Recovery is so important to our patients’ wellbeing and their satisfaction with surgery, so it is exciting to see the potential for a more comfortable experience. The fact that surgeons are able to achieve these outcomes with greater speed and comfort in the OR makes HydraSolve a logical choice.” Andrew Technologies Chairman and CEO Tom Albright adds, “Breast reconstruction following successful treatment for breast cancer is one of the most important applications of HydraSolve. We take great pride in offering patients a natural solution with safe, effective fat transfer. HydraSolve’s low complication rates and more comfortable recovery allow patients to get back to their lives after cancer.” Attendees at the American Society of Plastic Surgeons (ASPS) Plastic Surgery Expo September 24, 10 a.m. to 6 p.m., in Los Angeles can learn more about HydraSolve by visiting Andrew Technologies at Booth #1531 in the Los Angeles Convention Center.


    About HydraSolve

    HydraSolve is a novel liposuction device based on the proprietary surgical innovation, Tissue Liquefaction Technology™ (TLT), which combines natural saline solution with low levels of temperature and pressure to liquefy only targeted fat tissue. Because fat tissue is liquefied, the cutting of fat by forceful thrusts of the cannula is no longer required. HydraSolve is the first liposuction device FDA cleared for autologous fat transfer. The device is primarily used to transfer fat for breast reconstruction following breast cancer treatment and is not intended for treatment of obesity. Fat transfer and liposuction are surgical procedures that have risks similar to other cosmetic surgeries. For more information, please go to www.hydrasolve.com.


    About Andrew Technologies, LLC

    Andrew Technologies, LLC, is a privately funded medical technology company committed to improving patients’ lives through precision surgery. Founded in 2007, Andrew received FDA clearance for HydraSolve in 2012. HydraSolve is primarily used to transfer fat for breast reconstruction following breast cancer treatment. In addition to HydraSolve, Andrew has an impressive research pipeline that includes minimally invasive surgery to correct type 2 diabetes and adipose stem cell isolation.


    Public Relations Contact:

    Amy Phillips

    Pascale Communications



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  • HydraSolve® from Andrew Technologies to be Presented to a Global Audience at Prestigious IMCAS Paris Meeting

    8 November 2016

    HydraSolve® from Andrew Technologies to be Presented to a Global Audience at Prestigious IMCAS Paris Meeting


    January 20, 2015. Tustin, CA. – Andrew Technologies LLC will exhibit for the first time at the upcoming IMCAS Paris meeting, where HydraSolve® will be one of the featured new devices during the Research and Development session on February 1st http://www.imcas.com/en/imcas2015/schedule/session/id/2428. Dr. Christopher Godek, past-President of the New Jersey Plastic Surgery Society and the largest user of HydraSolve®, will present on his experience with HydraSolve® in liposuction and fat transfer patients. During the meeting, Andrew Technologies executives will be available at exhibit booth # WB8 to discuss HydraSolve® with surgeons, potential distributors and Global Key Opinion Leaders. IMCAS is the largest Medical Aesthetic meeting in the world; it has an attendance of over 4,500 from 80 countries.


    About HydraSolve®

    HydraSolve® is a novel liposuction device based on the same patented Tissue Liquefaction Technology™ that was launched in 2003 by Alcon as the AquaLase® Liquefaction Device for precision cataract surgery. Hydrasolve® combines natural saline solution with low levels of temperature and pressure, to liquefy only targeted fat tissue. Because fat tissue is liquefied, the cutting of fat by forceful thrusts of the cannula is no longer required. The specially designed HydraSolve® cannula is manufactured with aperture edges that have a rounded radius of curvature that do not cut tissue.  It is the energized saline stream, inside the cannula, that liquefies targeted fat tissue while not liquefying or cutting blood vessels, nerves or connective tissue. HydraSolve® achieves liquefaction of fat tissue by cell disaggregation, not by emulsification and the lysing of cell membranes. HydraSolve® is the first liposuction device FDA cleared for autologous fat transfer. For more information, please refer to www.hydrasolve.com  HydraSolve® is designed to contour the body by removing localized deposits of excess fat and is not intended to treat obesity. Liposuction is a surgical procedure that has risks similar to other minimally invasive cosmetic surgeries.


    About Andrew Technologies, LLC

    Andrew Technologies, founded in 2007, is a medical technology company committed to improving patients’ lives through body aesthetics and pursuit of surgical applications of Tissue Liquefaction Technology. Andrew Technologies is a venture capital funded company; our primary investors are NJTC Venture Fund www.njtcvc.com, StepStone Group LP www.stepstoneglobal.com and WFD Ventures www.wfdventures.com.

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  • LaserCap® Company Receives FDA Clearance for LCPRO Women’s Hair Loss Treatment Device.

    8 November 2016

    LaserCap® Company is pleased to announce that it has received FDA 510(k) clearance for its’ pioneering device, theLCPRO, as an effective women’s hair loss treatment and to promote hair growth. With a powerful 224 laser diodes, it has the optimal power level for hair growth, while offering complete scalp coverage. The LaserCap LCPRO is not only safe and effective, but completely portable, hands free, simple to use and can be worn discreetly under any hat. It is the perfect solution to restore your hair and promote hair growth without surgery or drugs.

    “The dream of the LCPRO and of our entire product line, is to bring an affordable and effective solution to a large number of people who are frustrated with the limited options available now that are truly effective, safe and portable”, says Michael Rabin, M.D, LaserCap Company co-founder and inventor of LCPRO. “Receiving FDA clearance substantiates what we have seen in clinical studies.” The LCPRO™ device is available by physician only and is now being sold by over 250 doctors in more than 60 countries.

    LaserCap Company, the country’s leading developer of advanced low-level laser wearable devices, is a pioneer in the low level laser therapy (LLLT) industry. Since 2006, the vision has been to empower women and men through innovations in hair regrowth; contributing to better hair and stronger confidence. Its mission is to be the global leader in the light-based therapeutic device industry, by providing safe, effective and affordable hair loss treatment solutions.

    The LaserCap LCPRO has a number of distinct features compared to similar devices on the market today:

    • The most technically advanced, portable hair treatment device.
    • 224 laser diodes are embedded into the device’s soft, flexible dome-shaped membrane.
    • 100% coverage of the scalp in each and every treatment, so optimal dosage of pulsating low level laser energy is provided to all essential hair follicles.
    • Built-for-comfort. As comfortable as wearing a regular hat.
    • Device is portable, ultra-light, built for comfort and hands-free, and comes with a rechargeable power-pack.
    • Improves the overall quality of hair – makes it thicker, fuller, stronger and shiner.
    • Proudly made in Cleveland, Ohio.

    “There’s clearly been a strong shift in momentum towards alternative therapies for hair loss, like low-level laser therapy,” said Dr. Rabin “For the last two decades, the hair loss industry has been dominated by a few FDA-approved medications and surgery, but we’re now seeing a growing awareness within both the public and medical community about the efficacy of treatments like low-level laser therapy, and the relative advantages of utilizing a treatment that carries no risk of side effects or other complications. Only a few years ago, laser therapy was not well understand by the public, but it’s since cleared a number of important hurdles in terms of scientific validity and proven treatment effectiveness. Additionally, as most women are not candidates for hair transplant surgery, LLLT provides a safe, nonsurgical solution to hair loss.” In the age of cosmetic and plastic surgery, women are searching for non-surgical, non-invasive alternatives. Having truly effective, non-surgical treatments for female hair loss is now at the forefront of personal improvements women are seeking out.

    “It’s so incredibly easy to use and so convenient, instead of having to put on messy creams or other products that only camouflage my hair thinning.” Says Starr, an LCPRO patient. “Everyone can find 30 minutes every other day to use the LCPRO cap while at home or on the go.”

    LaserCap® Company was co-founded in 2006 by Cleveland doctor and inventor Michael Rabin, M.D and internationally-acclaimed Cleveland hair restoration physician Robert Haber, M.D., along with M.I.T.-trained optical physicist David Smith, PhD and in collaboration with Harvard-based photomedicine expert Michael Hamblin PhD.

    For questions or inquiries, call 216-672-0639 or email info(at)lcpro(dot)us. http://www.lcpro.us

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  • Crowning Glory

    8 November 2016


    Hair restoration procedures in the United States jumped 27% from 2012 to 2014, and the worldwide market for hair restoration surgery increased 28% from $1.9 billion to $2.5 billion, according to the International Society of Hair Restoration Surgery (ISHRS) 2015 Practice Census Results.

    “Hair restoration is about 40% of my practice, mostly men and a few women with androgenic alopecia, but we also see female patients for scar revision,” says facial plastic surgeon Sean R. Weiss, MD, of Khoobehi and Associates in New Orleans. “Facelifts can leave areas behind and in front of the ear where hair doesn’t grow properly, and I have great success restoring sideburns and hair lines for these patients. Although this is currently just a tiny fraction of our business, it is something I think we’ll be seeing more often in the future.”

    While men have been the primary focus—and still make up the majority of patients—for practices that offer hair restoration services, a growing number of women are seeking treatment for age-related hair loss and thinning. In 2014, women comprised only 15% of surgical hair restoration patients, but they made up 40% of nonsurgical patients, according to ISHRS data.

    “My husband is a hair transplant surgeon, and we found that his practice really didn’t serve the unique needs of his female clients,” says Mary Wendel, MD, medical director of Medi Tresse in Wellesley, Massachusetts, New England’s only medical hair rejuvenation center catering exclusively to women. “It is often harder for women to seek help, and we soon realized that a transplant office populated with men was not ideal.”

    Nadia Satya Urato, MD, of Urato Dermatology in Framingham, Massachusetts, is also seeing an increase in female patients at her practice. “For women, hair loss is perhaps more devastating than for men because luxuriant hair is so tied to femininity,” she says.

    While physicians specializing in hair restoration still don’t have the silver bullet many patients seek to stop hair loss, their ability to help men and women with thinning hair is improving with new noninvasive procedures and more effective surgical treatments.

    Noninvasive Options

    med_image004All of the physicians we interviewed recommend a comprehensive approach to hair loss that includes not only a thorough scalp examination and testing to rule out systemic conditions that might cause thinning hair, but also a discussion of nutrition and lifestyle. All but one of our panelists recommend minoxidil, which works by increasing blood flow to the follicles, and finasteride, which inhibits DHT, for appropriate patients.

    Some patients even combine the two medications.

    Richard P. Giannotto, MD, of Giannotto Clinic in McClean, Virginia, is cautious. “I feel that minoxidil and finasteride have too many side effects to be used long term,” he says. “I do recommend saw palmetto for many patients desiring a natural remedy to help slow down hair loss progression.”

    Androgenic alopecia is the most common cause of hair loss among both men and women. “Men can begin to see the effects of male pattern baldness in their early 20s and often seek help at that time,” says Jeffrey Epstein, MD, a facial plastic surgeon with offices in New York City and Miami, and spokesman for the International Alliance of Hair Restoration Surgeons. “With men we often use a combination of medical and surgical treatments. To help younger men hang on to the hair they have, we prescribe medications such as Propecia (finasteride) and low level laser therapy (LLLT). For women, who comprise about 30% of our practice, we combine Rogaine (minoxidil) and LLLT treatments. Shampoos such as Nizoral (ketoconazole dandruff shampoo, McNeil) or Nioxin can help clean up the scalp and perhaps improve the effectiveness of other treatments.”

    John Kahen, MD, founder and medical director of Beverly Hills Hair Restoration, says shampoos that inhibit DHT “show fairly positive effects on my patients suffering from hair loss.” He also recommends minoxidil and vitamins targeted to hair and nail growth.

    Dr. Weiss encourages all of his patients to use minoxidil and finasteride if they can. “These medications not only help patients hold on to existing hair but can help improve the quality of hair growth, even for patients after transplant surgery,” he says. He also recommends vitamins such as BioSil and Viviscal to support the overall quality of hair growth.

    “I like Propecia for older men with more advanced hair loss who may be thinking about hair transplantation but aren’t ready yet,” says Dr. Urato. “It helps them preserve the hair they have and can give them a small amount of regrowth, about 15%. I am less likely to suggest it to younger men because of its side effects.”

    Low Level Laser Therapy (LLLT): “We are thrilled with LLLT,” says Dr. Urato. “It is safe, safe, safe and it works, works, works. I’ve used several devices but my favorite is the iGrow (Apira Science). It’s easy to use, but I am frank about expectations. LLLT won’t suddenly produce luxurious hair growth, but it can help patients keep what they do have and add on average 20% regrowth. Most women are thrilled with the responses they get. During the first month they are relieved that their hair is no longer falling out as it was and then during the next few months they begin to see new growth. Fewer than 2% express dissatisfaction.”

    A randomized, blinded study of the iGrow Hair Growth System published in the October 2014 issue of Lasers in Surgery and Medicine compared 24 female patients treated with iGrow to 18 patients treated with a sham device. The iGrow produced a 37% increase in hair growth, significantly higher than the sham device. The iGrow System is FDA approved for both men (January 2013) and women (December 2014).

    “We have been using LLLT for years, especially in the post-op care of transplant patients,” says Dr. Giannotto. “Healing is quicker and graft growth is accelerated. LLLT as a stand-alone program is a wonderful way to help stop the progression of hair loss in men and women. It can also be used as a preventive measure in patients just beginning to notice hair loss. The original FDA study showed that 87% of men using LLLT stopped the progression of their hair loss. My patients love the program.”

    Platelet Rich Plasma (PRP): “I have performed countless platelet rich plasma (PRP) procedures in my clinic over the past two years generating successful results. PRP is truly an innovation to the world of hair restoration,” says Dr. Kahen. “I also use PRP therapy in conjunction with my hair restoration surgery procedures. It helps patients recover quicker while also creating more density and speeding up the hair growth process. PRP is more appropriate for patients with androgenic alopecia.”

    Dr. Wendel calls PRP her go-to treatment “for women with androgenic alopecia or alopecia areata, not alone but in combination with minoxidil and LLLT. We have the larger devices in our practice but often use the LaserComb (Hair-Max) or LaserCap (LCPro). We have more experience with these devices and don’t believe that bigger is always better.”

    “PRP is an awesome way of enhancing healing and growth after transplantation,” adds Dr. Giannotto. “We use it on every patient undergoing a restoration procedure. PRP can also be used to prevent or slow down the progression of hair loss. Several of our patients have noticed good hair growth beginning several months after the procedure. It is important to counsel the patient undergoing just PRP (no surgery) so that they understand that this is not a permanent solution to hair loss and usually requires maintenance sessions every four to six months.”

    Dr. Epstein doesn’t use PRP as a stand-alone procedure but he does find it useful for some patients to provide additional treatment of their hair loss. “We combine the PRP with ACell MatriStem, which is a regenerative matrix that seems to improve outcomes,” he says. Dr. Weiss and Dr. Urato do not offer PRP, saying there isn’t enough evidence to support its efficacy.

    Surgical Solutions

    “Surgical hair restoration techniques have certainly progressed, especially in the last five years. When I started performing hair restoration surgery, we were in the era of mini-grafts and micro-grafts,” says Dr. Giannotto. “This technique was replaced by follicular unit transplantation (FUT) in which a strip of donor hair with follicles intact was removed. This strip was dissected under microscopy and the grafts were isolated and implanted into the donor area. Using microscopic studies, this technique was refined by dissecting follicular units from the strip— defined as a group of one to four or more hairs—and the glands that supply them. Splitting follicular units down further destroyed their growth potential. The advantage of the FUT method was that a variety of follicular unit sizes could be isolated mimicking natural hair growth patterns.”

    The downside to FUT is that, while it offers good results in the transplant area, it is painful and often leaves a troublesome scar in the donor area. “We prefer FUE (follicular unit extraction), which leaves no linear scar, causes less discomfort and allows for quicker recovery,” says Dr. Weiss. “We use the ARTAS robotic system to aid follicular extraction with all of our patients now. We have found it to be better than handheld automated devices because of its computer algorithms, precision and accuracy—all of which facilitate a better quality procedure.”

    When describing the benefits of ARTAS to his patients, Dr. Weiss likens it to a baseball pitcher who will inevitably tire during a long game. “The pitcher eventually gets tired and his accuracy and precision decline. A robot is not subject to such fatigue and continues to produce high quality grafts for the duration of the procedure,” he says. “The ARTAS robot allows me to improve the quality of care I can offer patients.”

    About half of hair restoration surgeons are now using some type of automated system for FUE. Dr. Epstein uses several handheld, powered FUE devices, including the NeoGraft Automated Hair Transplantation System and a custom-designed E-Fue System. “We don’t use ARTAS at this time because our current systems are providing outstanding results and the technology is still undergoing improvements. Surgical technique is the most important aspect of the transplant procedure,” he says.

    “I have used NeoGraft, ARTAS and SmartGraft techniques,” says Dr. Giannotto. “All are good although results may vary from surgeon to surgeon depending upon technique. ARTAS is totally robotic in that the machine harvests the grafts and in some instances creates donor incisions as the physician controls the parameters of the procedure from a computer screen. NeoGraft and SmartGraft are physician-assisted automated FUE procedures in which the physician holds the handpiece and actually selects the units to be harvested. All of these automated systems add irrigation to keep the grafts moist and collect the grafts via suction. There is no gold standard, but my new workhorse for large cases (greater than 2,000 grafts) has become the SmartGraft machine. What ultimately gives the patient the best results should be the criterion for choosing a particular procedure.”

    Even with advances in FUT and FUE technologies, about half of hair restoration surgeons prefer traditional surgical techniques. “Although there are advantages to ancillary machines such as decreased labor for the surgeon and a reduced number of staff required, I personally don’t favor the use of ancillary devices in my procedures. I firmly believe the machines used in hair restoration cannot replace the precision and judgment of a skilled surgeon,” says Dr. Kahen.

    Regardless of which surgical technique you prefer, it is vital to develop a long-term plan before settling on a treatment modality. “Women need to be careful about transplants because of the progressive nature of hair loss,” says Dr. Epstein. “And men need a long-range plan for the same reason.”

    Ongoing Research

    Current noninvasive hair restoration options offer moderate improvement for most patients at least in the short term, but physicians working in this specialty are hoping more effective treatments will be available soon.

    Bimatoprost (Latisse, Allergan), which patients have been using for several years now to grow longer, stronger eyelashes and enhance brows, may offer some hope for scalp hair as well. Results of Phase 2 trials of Bimatoprost Scalp, due for completion in January 2015, were disappointing, according to a report from the Belgravia Center, one of the largest hair restoration centers in the U.K. The acquisition of Allergan by global pharmaceutical company Actavis may slow any further progress for a time.

    Drugs that inhibit prostaglandin D2, found in excess amounts on bald scalps, are already being used to treat asthma, and KYTHERA (acquired by Allergan in June 2015) has initiated trials of KYTH-105, a selective oral antagonist of PGD2 for use in treating androgenic alopecia. In early research studies, PGD2 inhibitors were found to extend the anagen (growth) phase of the hair cycle, thereby promoting the growth of hair. “I am fascinated with prostaglandin therapy and am excited to see where that may be headed,” says Dr. Wendel.

    Dr. Weiss is looking forward to further advances in robotic technologies. “Eventually, I believe robotic technology will be developed not only for the extraction part of the hair transplantation procedure but for graft placement as well,” he says. “We are looking forward to watching that technology develop. I also think we will find less invasive ways to restore hair growth. Stem cell technology offers one possibility. Researchers have been able to isolate cells important to hair growth and eventually we may be able to inject a stem cell solution that will stimulate hair growth—but probably not for 15 to 20 years.”

    Dr. Epstein is more optimistic. “We hope to see more stem cell research and perhaps a breakthrough in stem cells for hair restoration in the next five years,” he says.

    Scientists are investigating stem cells in different ways for use in hair restoration. Angela Christiano, a dermatology professor at Columbia University with a special interest in hair genetics, has formed a company to investigate growing hair stem cells in the laboratory that can be injected into the scalp, thereby regenerating inactive hair follicles. According to an article in the New York Times (April 15, 2015), she would start by harvesting a patch of 50 to 100 hairs from a patient’s scalp and then dissect and duplicate them under laboratory conditions to produce millions of stem cells, enough to inject all over the scalp. Christiano hopes to begin clinical trials of the technique in 2016 or 2017.

    Gene therapy is another avenue of research. Curis is working on a model using sonic hedgehog, a protein that plays a role in organ development—but there are dozens of genes that control hair growth so this protein alone is unlikely to hold the key to hair restoration.

    The online journal PLOS (January 21, 2015) includes an article by researchers from Sanford-Burnham University that may be central to the development of hair restoration stem cell therapy. They created dermal papilla cells from embryonic stem cells and showed these cells could stimulate hair growth. The research was done with mice and will have to be duplicated in humans. With so much progress made and so many promising solutions in the pipeline, physicians have a wealth of information to share with patients who are struggling with thinning or lost hair.

    Linda W. Lewis is the contributing editor of MedEsthetics.

    Photo copyright Getty Images.

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  • Solutions for Thinning Hair, including LaserCap® – The Physician’s Choice for Light-Based Hair Regrowth

    8 November 2016


    We have 11 solutions to tackle thinning hair. Photo: Carlton Davis Trunk Archive

    Losing your hair can be extremely stressful, especially if you think you can’t stop it. But fear not! There are a number of ways to fight back, stop the shedding in its tracks, and even grow new hair. The first step is to find out why it is happening. “It could be age, genes, hormones, or a combination. You can really develop it anytime after puberty, although more people in their 40s and 50s are affected,” explains dermatologist Dr. Sejal Shah. Naturopath Nicole Weigl always recommends blood work to discover the reason. “This will rule out the most common causes of hair-thinning in women, which are anemia, hyperthyroidism or hypothyroidism, and high testosterone,” Weigl says. For women, hormones are a common trigger. For example, the massive hormonal shift from pregnancy to postpartum can cause hair to fall out in clumps.

    While many people simply attribute hair loss to aging, there are a number of unexpected reasons why it happens. Stylist Roman Kusayev of the Roman K Salon in New York has seen firsthand that sudden weight fluctuations can cause strands to shed. Stress is a common factor, too, making alternative therapies that help with stress, like meditation, part of a holistic solution. A poor diet can also be a cause. Iron deficiency is the most common culprit, so adding a supplement or changing your diet can help. Hair loss can even be caused by how you apply your products.

    “Smothering your scalp stops pores hair follicles from breathing, so try to put your product on your hair root and less on the scalp,” says Robin Narvaez, a stylist at Eliut Salon in New York City. The good news is there are a lot of options to try, from herbal supplements to lasers. The key is patience. “In general, with most hair treatments you are looking at about six months,” says Shah. It is also important to manage your expectations. “The primary goal is to prevent it from getting worse,” says Shah. “It’s unlikely your hair will go back 100 percent.”

    1. Rogaine: One of the most well-known hair-loss treatments has products designed for both men and women. “For hereditary hair loss, the primary treatment would be 5 percent Rogaine,” says Shah. The topical treatment, which you apply to the scalp twice daily, is the only FDA-approved hair-loss option for women.

    2. At-home lasers: Cutting-edge hair-loss treatments that you can do at home use light therapy to stimulate hair follicles. “I find laser devices to be helpful with hair loss,” says Shah. Run the HairMax laser comb through hair a few times a week to see results. In the company’s clinical trials 93 percent of participants saw regrowth. Another option Shah recommends is the Laser Cap, which uses light waves to boost hair, and can be hidden beneath a hat.

    3. Prescription medication: Propesia is a once-daily prescription pill that is FDA-approved for men, but not for women. However, many women are using it off-label to help with regrowth. tumblr_inline_ny9t1iibbz1ttt6fg_1280Note that only post-menopausal women can use it, since it can cause birth defects. There are also less well-known prescription options on the market that Philip Kingsleytrichologist Anabel Kingsley recommends. “Dianette, Yasmin, and Spironolactone can help women experiencing hormone-related hair-thinning. These can be especially beneficial for those with polycystic ovarian syndrome, as it often raises levels of male hormones and results in a reduction of the anagen (growth) phase of the hair-growth cycle,” says Kingsley. “Oral anti-androgenic medications are most effective when used alongside topical anti-androgenic scalp drops.“

    4. Hair transplants: The procedure involves take a three- to four-inch strip of hair from the back of the hair and placing it where there is a lack of hair. It’s an intensive procedure that can take between three and eight hours. “This is really best for people who have limited areas of hair loss, it is not great for people who have hair loss at the crown,” explains Shah.

    5. Platelet-rich plasma: This is how it works: “We draw your blood, thin it, separate out the platelets that get concentrated in your plasma and then re-inject into the scalp,” explains Shah. “Those growth factors nourish the hair follicles to encourage growth.”

    6. Scalp drops: Applying hair growth serums directly to your scalp is one solution for thinning hair. “Daily application of targeted scalp drops can help improve overall volume if you are experiencing genetic hair-thinning or increased daily hair-shedding,” says Kingsley who has seen strong results with clients using the Philip Kingsley Tricho 7 line. “Kerastase makes some amazing hair-growth products,” says Kusayev about Densifique and Initialiste. “Put it in twice a day wet or dry, and massage it in. After three weeks, you will see it strengthen the roots and make hair grow faster and healthier.”

    7. Viviscal: This over-the-counter herbal remedy gets mixed reviews. “I have so many clients on it and it really regrows hair,” says Kusayev. However, Dr. Shah hasn’t seen has consistent results. “Viviscal is not really well-established. Some [of my patients] find it helpful, some not helpful at all.”

    8. Vitamins: Addressing nutritional deficiencies is one way to fight hair loss. “I tell my clients to take biotin, 5,000 mcg a day, or 2,500, if they already have biotin in their multivitamins. This will start to work within three weeks,” explains Narvaez. “If your hair is falling out, take 25 mg of gentle iron daily. In my clients, I’ve seen it stop hair from falling out within one week.” Kingsley says that nutrition is a key aspect of solving the problem: “Even small deficiencies that may not affect other parts of the body can affect the hair. Supplements can be great hair helpers as they provide hair cells with a boost of essential vitamins and minerals. The best ones will contain a mixture of iron, vitamin C, B vitamins, biotin, vitamin D, and amino acids. Due to the nature of the hair-growth cycle, it usually takes six to 12 weeks to see results.”

    9. Herbal supplements “My favorite herbs for thinning hair are gotu kola and horsetail,” says Weigl, who recommends low amounts given under the supervision of a naturopath.

    10. Rosemary oil: Nutritionist Josh Axe swears by rosemary oil to stimulate hair growth. “Many people also claim that it can prevent baldness, slows graying, and can be used to treat dandruff and dry scalp,” says Axe. Studies have shown a 22 percent increase in regrowth.

    11. Diet: The source of your hair loss could be as simple as your diet. “As hair is composed primarily of protein, this is perhaps the most important nutrient to hair growth,” says Kingsley. “We suggest including at least 120g in weight of a ‘perfect protein’ that contains all essential amino acids, like eggs, fish, poultry, lean meats, and low-fat cottage cheese. The best vegetarian sources are quinoa, seitan, tofu, pulses, and nuts.”

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