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Reprinted with permission by Dr. John Cole
www.forhair.com

John P. Cole, MD

Perhaps the most significant advancement in hair restoration surgery this year has been in the area of corrective procedures for prior pluggy looking hair transplants. We have successfully removed grafts using Follicular Isolation in a much more rapid fashion than we could remove them in the past. In the past we were limited to the removal of one row of pluggy looking grafts at a time. Today we can remove multiple follicular units within a larger graft. This markedly speeds up the removal process. Typically two strong sessions are required to remove the majority of the pluggy looking grafts. In some very pluggy cases at least one additional session may be required. This is a significant advancement in terms of time. There are other improvements, as well. One of these is our newer techniques leave less scarring than the older techniques created.

Before Plugs Repair

After Plugs Repair

Dr. Cole and Dr. Jimenez are beginning a study looking at the follicular sheath for evidence of stem cells. One way to look for stem cells is to look for CD34. CD34 is known as hematopoietic progenitor cell antigen and is thought to be a marker for stem cells. The tissue will be immunostained with a monoclonal antiCD34 antibody. There are flase positives for this stanin as it can react with endothelial cells, as well. It has been demonstrated in the bulge of mice and outer root sheath in the past though it is not as easy delineate the location of the bulge in humans. The value of this study will be to provide evidence that very well trimmed grafts produced by follicular isolation contain the stem cells necessary to produce new growth. It may also provide more data for our hair multiplication efforts. Of further interest is that CD34 has been shown in embryonic messenchymal cells that are associated with epithelial germ cell placodes.

We recently removed back hair from a patient who had the back treated with laser hair removal devices multiple times. The hair re-grew on his back despite multiple treatments with the laser. This was fortuitous, however. The re-growth has allowed him additional hair for the top of his scalp since his scalp donor hair is virtually depleted. If he had know about the capacity to perform body hair transplants sooner, he would not have treated his hairy body with laser hair removal and he would have had even more hair for the top of his head.

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