Archives: Transcript

Can Eye Bags be Removed without Surgery?
Eye bags or puffy eyes are caused by fat pockets that originates under the skin and muscles of the eye in the space called the orbit. These fat pockets are referred to as herniated fat. In spite of claims made by topical creams and so-called non-surgical heating devices, eye bags do require some type of surgical procedure for enhancement. In our practice, we focus on developing solutions for the concerns many people have with traditional plastic surgery such as having to have general anesthesia, excessive bruising and swelling, as well as prolonged recovery. We performed lower eyelid blepharoplasty under local anesthesia with LITE intravenous sedation in our Joint Commission certified facilities and our patients typically return to work in less than 1 week.

What is the Best Treatment for Tear Troughs?
The tear trough area is located near the inner corner of the eyes and is often an area of
concern. Improvement of this area is very much dependent on accurate assessment of the
anatomy on this area. The tear trough is affected by factors such as skin thickness, skin color,
bone structure and the presence or absence of fat pockets. In our practice, if there
are no prominent fat pockets, we often combine volume correction with skin quality improvement.
We routinely use a hyaluronic acid filler such as Restylane and platelet rich plasma.
Platelet rich plasma or PRP is derived from the patient’s own blood by the same method
used for standard blood tests. PRP stimulates collagen production and improves blood supply
Correction of volume with improvement in skin quality can make real difference for the tear trough

Why isn’t my hair getting thicker with finasteride? Finasteride is one of the
most prescribed drugs for the treatment of male pattern hair loss worldwide I
routinely prescribe finasteride as well as dutasteride for male pattern hair
loss many patients express their concern of continual hair loss and lack of
significant hair growth while taking finasteride they ask if it’s really
worth taking or they believe the drug just doesn’t work for them I’ll discuss
my experience with managing male pattern hair loss with patients who’ve been on
finasteride before even seeing me as well as my strategy for its role in the
management of male pattern hair loss I’m Dr. Amiya Prasad I’m a
Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic
and reconstructive surgeon I’ve been in practice in New York City and Long
Island for over 25 years throughout my career I managed hair loss with surgical
hair transplantation as well as finasteride since 1997 optimizing hair
transplant outcomes was my core objective for many years since hair
graft yield was frequently diminished by the survival of the transplanted hair
imagine the pain and frustration for the surgeon technicians and most importantly
the patient if 30 to 90 percent of transplanted hair just doesn’t grow I
experienced a significant revelation in 2011 when I used extracellular matrix by
the company a cell and platelet-rich plasma for the improvement of hair graft
survival and donor area healing I observed that one year after surgery
even in a patient with advanced hair loss that thinning hair became thicker
I made it a mission to determine the potential of this observation over the
next several years to develop a predictable and highly effective
non-surgical treatment for male and female pattern hair loss based on the
development of customized formulations and treatment plans using specific
characteristics such as age age of onset gender rate of progression and degree of
hair loss I created the TrichoStem Hair
Regeneration system I was able to help patients non-surgically
with long lasting results using one to two treatment sessions with the duration
of effect of 3 to 5 years that exceeded the effective scalp coverage of not just
one but two hair transplant surgeries at a fraction of the cost of two surgical
procedures and the convenience of having a treatment in less than one hour
patients have come to our offices every week from around the world to make
TrichoStem Hair Regeneration system more accessible I built a free-standing
center for TrichoStem Hair Regeneration in Northern Virginia separate from our
two locations in Manhattan and Long Island during the early development of
TrichoStem Hair Regeneration I question what the difference would be for someone
who was on finasteride before coming in and having their treatment finasteride
is a DHT or dihydrotestosterone blocker which works by blocking an enzyme called
5-alpha reductase this enzyme is responsible for the conversion of
testosterone to dihydrotestosterone in male pattern hair loss hair sensitive to
DHT is subject to hair thinning and eventually disappearing
an important point is that finasteride does not stop hair
progression but rather it slows down hair loss progression so to use an
analogy imagine a train going 100 miles an hour
being slowed down to 30 miles an hour it’ll still reach its destination
but much later I’ve had the unique opportunity since 2011 to observe hair
growth behavior in a wide range of men and women of all ethnicities and ages
this continues to be a unique and unprecedented perspective attributable
to the fact that I see patients after trichostem hair regeneration treatment
every three to six months and annually for five years and beyond
based on these long-term observations I concluded that there is a range of DHT
sensitivity among men that directly affects the effectiveness of finasteride
and trichostem hair regeneration for example I categorize men who start
losing their hair and their late teens and their early 20s as having high DHT
sensitivity men whose age of onset of hair loss is much later and slower I
classify as having lower DHT sensitivity based on these observations I have
customized treatment plans for different categories of male pattern hair loss
I’ve generally observed that men who are on finasteride whether they perceive
progression or stability of their hair loss trichostem hair regeneration
treatment has helped them have improved scalp coverage through the reactivation
of hair growth and thickening of individual hairs I’ve come to the
conclusion that finasteride helps to preserve the longevity of your hair
follicles lifespan but the nast right does not stimulate growth or max
my’s your potential scalp coverage essentially there’s an opportunity for
synergy combining a DHT blocker with trichostem hair regeneration with
patient data starting in 2011 the TrichoStem Hair Regeneration treatment
has shown visible improvement in hair thickness and scalp coverage in over 99%
of male and female pattern hair loss patients although there is finally in
the general community acknowledgment of the benefits of PRP or PRP with a cell
in the management of hair loss the current standard of practice amongst
medical retailers is to require patients to have scalp injections every three
months as a much more advanced system TrichoStem Hair Regeneration treatment
is typically only two treatments 18 months apart with sustained benefits for
3 to 5 years and longer so while a drug like finasteride is important to slow
down hair thinning in male pattern hair loss
it appears that finasteride alone does not maximize hair coverage particularly
in men who’ve experienced hair loss progression while taking finasteride the
unparalleled results from the synergy of finasteride with trichostem hair
regeneration makes this an optimal strategy in my practice I hope you found
this information helpful thank you for your question

Platelet-rich plasma or PRP is a process where we take your blood and we process it and we do that through a normal blood draws as if you’re going to a doctor to have a lab test. And with a centrifuge we spin it down and we concentrate the part called platelets. Now what does the platelets do? Platelets as many of you may know is actually a way to clot the blood and so when you have a cut the platelets clog the cut then generates the growth factor, those growth factors allows the cut to heal. So with platelet-rich plasma were actually tricking the body to stimulate collagen through process of healing, so in a way we are healing wrinkles. We’re also using it for hand rejuvenation and many of you may have heard some recent sightings of famous people who have young looking faces but very old looking hands uh unfortunately hands give away age or at least as one of the common things most people look at when they wanna guess how old you are. So taking your own blood having it spun down and then using the platelet-rich plasma is a short way to rejuvenate the hands it takes about half an hour to do and you’re done, you don’t have any anesthesia or any downtime of any significance, so that’s the short story on platelet-rich plasma.

What can I do about skin damage and volume loss from laser treatment there
is no question that laser technology has had a significant impact on the
aesthetic field the ability to use lasers to target specific areas of the
skin has made a range of lasers indispensable in my practice over the
past several years there has been a proliferation of cleverly named devices
marketed directly to consumers using phrases such as erase the wrinkles and
no more turkey neck these lasers are promotive miracles only dreamed of in
science fiction it’s important to understand some of the science of how
lasers interact with your skin and why questions are continuously being raised
about the unintended consequences of laser treatment
one such unintended consequence is the frequent reporting by people who’ve
undergone treatment with lasers and comparable technology for the purpose of
skin lifting or tightening although intended to non surgically lift and
tighten the skin lasers and related thermal energy devices are being blamed
for skin becoming thinner and facial fat loss described as Halloween I’ll discuss
how I approach the issues which motivate people to seek these non-surgical
heating devices as well as how I help people who come to my practice with
undesirable skin changes after they’ve had laser and thermal energy treatment
I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been
practice in Manhattan and Long Island for over 20 years I routinely performed
both surgeon and non-surgical procedures for facial
aging I also routinely perform eyelid surgery facelifts and facial implant
surgery non-surgical procedures are something I
do every day in my practice such as the placement of hyaluronic acid fillers
botulinum toxin lasers and radio frequency treatment as well as
regenerative medical procedures using PRP and a seller matrix for skin quality
improvement as well as the treatment of hair loss before discussing my
therapeutic strategy for patients who come in with the depletion of collagen
and facial volume loss after laser and thermal energy treatment I think it’s
important to look at some assumptions about what happens to your appearance
with aging particularly in your 40s and 50s the first is the assumption that
your skin is loose and it needs to be tightened I have found that this
assumption is the biggest driver for the marketing of creams lasers and thermal
energy devices although there is some degree of skin laxity consistent with
age-related changes the more significant reason for the perception of skin laxity
is bone volume loss when you understand that bone volume loss is responsible for
supporting the skin it makes complete sense that the skin appears loose with
bone volume depletion the second assumption is that new devices are
better at treating the skin conditions than existing technologies this is not
true lasers and other technologies are tools a highly experienced specialty
trained physician is the most qualified to develop a treatment strategy for you
no device can replace that much of the industry focuses on messaging claims to
consumers about their device which are reinforced by
paid medical consultant endorsements they don’t allow for enough time for
there to be a more organic experience from doctors without bias to share their
first-hand knowledge through marketing the focus is about the device not the
professional by creating demand through name recognition of their devices these
companies have been very successful in selling or leasing devices and the
associated disposables to a range of practitioners these practitioners are
often more interested in transactions than they are long-term management or
the long-term consequences of their treatment the third assumption is that
the practitioner performing the laser or thermal energy device is as qualified as
a specially trained doctor to perform a procedure although the more modern laser
devices often have touchscreens to reduce the risk of incorrect settings
being used the devices aren’t a replacement for a proper history and
physical examination by a physician in New York State there is no licensure for
the use of lasers and thermal energy devices the fourth assumption is that
the skin can produce unlimited amounts of collagen and that collagen
stimulation can only occur by aggressive heat delivery to the skin so that new
collagen produced will lift the skin and make the skin more youthful let’s look
at what happens as a consequence of these assumptions consumers go to a
practitioner for the latest greatest laser or non-surgical lifting device the
practitioner who is paying a monthly lease for this device performs a
procedure the qualifications of this practitioner are assumed based on them
wearing medical attire like a doctor as weeks and months go by after the
procedure the patient experiences skin thinning and feels that they look worse
after the treatment the practitioner then offers a different
device treatment or performs a more aggressive treatment often applying a
higher temperature for a longer period of time now the skin looks even worse
and the patient is distraught about their appearance when a patient in this
situation comes to see me I evaluate their appearance with the same a
systematic approach I do with any facial aging examination I look from the inside
outward this means evaluation of the bone structure followed by the soft
tissue and fatty tissue layer below the skin and then the skin itself I
frequently observed that the patient’s bone structure has significant
deficiencies consistent with facial aging this means that from the outset
the decision to pursue skin heating was not addressing the most significant
basis for the appearance of skin laxity to address volume deficiency from bone
loss I perform a technique called structural volumizing where I use the
principles derived from facial implant surgery to place long lasting hyaluronic
acid fillers such as Juvederm Ultra Plus and Juvederm Voluma at the bone level
with Structural Volumizing of the cheekbones jaw angle jawline and chin the
improvements on the facial proportions result in a more youthful appearance
this is far more effective than what they went through with the high-priced
skin heating device the benefits of Structural Volumizing are appreciated
immediately as opposed to waiting to see if the skin is somehow lifted without
surgery after being treated with the miracle machine of the week I do value
the technology of thermal energy for fat reduction and skin tightening and use it
in my practice I use it as a tool for specific situations where I
feel it is the optimal choice what the patient needs for example if you have
some fat that creates the appearance of a jowl and you have good skin elasticity
I perform a jowl lift procedure non-surgically with a long pulsed 1064
YAG laser which I own I actually own all my lasers because I’m confident of their
value from my patients for years to come not because they’re the hot device of
the week moving outward towards the skin are the layers of the fact below the
scanner there is a difference between reducing areas of fat accumulation and
reducing large areas of fat under the facial skin when you look at someone
who’s younger their skin has this soft quality part of which is from a healthy
layer of what is often referred to as baby fat by delivering excess heat deep
below the skin these practitioners are literally destroying the fat the fat
layers under the skin are important not only as a cushion but also for their
blood supply and biochemical interactions with the skin if you look
at someone who is in their 70s or older you can appreciate how thin their skin
appears which is significantly attributed to diminished fat layers so
essentially these devices are being used in a way where the skin aging is
actually being accelerated I help my patients who come to me with this
condition using regenerative technology such as the use of platelet-rich plasma
or PRP PRP is a concentration of the wound healing cells and growth factors
in the plasma which are needed when you have an injury like a cut this treatment
has a beneficial effect on the surviving fat cells and can be performed over
several sessions I also use a material called acellular or extracellular matrix
which recruits your body stem cells for the purpose of healing i’ve uses
material in conjunction with PRP since 2011 for a
non-surgical hair loss treatment system I developed called trichostem hair
regeneration patients come from around the world for this treatment hair is a
skin appendage I’ve observed that the quality of hair appears to improve when
the quality of the skin is improved using this technology the objective is
to maximally improve the viable remaining fatty tissue to help the skin
become healthier and more vibrant this now brings us to the skin composed of
the dermis and the epidermis the dermis is the foundation for the epidermis it’s
well established that there is a loss of dermis related to aging and
environmental exposures such as excess sun or UV light it’s also well
established that controlled injury can induce a repair response that can
improve the integrity of the dermis the problem occurs when the dermis is
injured beyond its capacity to generate enough collagen which results in
weakening of the dermis from collagen loss this is particularly difficult to
manage I’ve been told by patients who experience thermal energy induced
collagen loss that they were subsequently recommended to undergo
additional injury based procedures with an expectation that collagen production
will occur I disagree with this strategy collagen is a protein and can be thought
of as support cables the cells that make collagen are called fibroblasts after
such a significant injury to the dermis how can a practitioner be sure that
there are adequate fibroblasts with the capacity to produce the amount of
college needed in my mind the skin needs rehabilitation before being challenged
with another injury it’s like having a muscle injury and getting rehabilitation
for healing before being challenged with weight training
my strategy for rehabilitation on the dermis is to use PRP and hyaluronic acid
and use a micro infusion device to deliver this combination directly
through the dermis with virtually no trauma the hyaluronic acid provides a
scaffold for the collagen produced by the fibroblasts to strengthen the dermis
and enhance the healing process this has been established in studies for wound
healing and conditions where bone was exposed and effectively treated with PRP
and hyaluronic acid combination as far as the epidermis and any other issues of
pigmentation I usually make a decision based on my assessment of the skins
current state I would consider low-energy non ablative laser targeted
for pigmentation as well as conservative epidermal therapies such as hydro facial
it’s more important than ever for people to think twice before getting caught up
in the hype surrounding aesthetic technology in my practice I spend a lot
of time with my patients educating them about the risks and benefits of
aesthetic medical products and procedures which are being marketed to
them my role has become to be the primary care doctor for beauty many
people are being harmed by trusting their appearance to businesses who are
only interested in short term high profit marketers don’t want you as a
consumer to consult with a physician who will put things into perspective for you
that rather entice you and direct you to practitioners who are using their
products an ounce of prevention is worth more than a pound of cure as I stated
earlier it’s important to rethink the assumptions you have about facial aging
and the state of the aesthetic industry so you don’t make a wrong decision
companies and unethical petitioners are trying very hard to
commoditize aesthetic procedures and shout loudly over the voice of honest
and ethical doctors the practitioner is much more important for your appearance
than any product or device I hope you found this information helpful thank you
for your question

What are healing and side effects like after TrichoStem Hair Regeneration?
men and women who’ve undergone surgical hair transplants are familiar with the considerable
healing time after surgery that often takes a full day to actually have that surgery performed
these days many people are undergoing generic PRP or PRP+ACell treatments
which require frequent visits and multiple often very painful injections so it’s no surprise
that people who see the results we’ve had with our combination treatment
of PRP and extracellular matrix by ACell which we call TrichoStem Hair Regeneration
they want to know more about what they can expect after they have this treatment I’ll describe what
the process of the procedure is like as well as what the healing process is like afterwards
I’m Dr Amiya Prasad I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic
and reconstructive surgeon I’ve been practicing in New York City and Long Island for over 25 years
around 2011 I was using a material called extracellular matrix by the company ACell
for advanced wound healing to help hair transplant surgery facial cosmetic surgery as well as tissue
grafting procedures focusing specifically on hair transplant surgery for better graft survival and
donor area healing i was delighted to observe that a year after surgery that the transplant results
had improved and that native existing hair had increased in number and had thickened considerably
this inspired me to develop a non-surgical treatment to help male and female pattern
hair loss the success of my system has become a benchmark for non-surgical hair restoration
with patients coming from around the world for the TrichoStem Hair Regeneration system
after many years of medical colleagues being dismissive of my work it’s quite vindicating
for me to see how in the past few years they’ve all changed their minds and are offering PRP
or PRP+ACell treatments interestingly many of our TrichoStem Hair Regeneration patients
come to us after undergoing PRP scalp injections performed elsewhere
they come to us out of frustration after undergoing several treatment sessions without
improvement another reason they come to us is that they could not take any more of the pain of
PRP injections in their scalp which they had to endure every month to every two to three months
many practices offering prp scalp injections or even other formulations of ACell+PRP
choose not to use anesthetic as part of their treatment protocol
some people who’ve undergone these painful injections have stated that their doctor told them
that anesthetic would reduce the effectiveness of their treatment these generic protocols and
beliefs do not in my opinion meet the unique needs of every individual patient essentially
one size fits all doesn’t apply in any area of medicine including non-surgical hair treatment
i developed TrichoStem Hair Regeneration and customized systems for patients based on gender
age age of onset of hair loss rate of hair loss and extent of hair loss
in addition I look at other medical factors as far as numbers of treatment sessions are concerned
a TrichoStem Hair Regeneration patient will typically only need one maybe two
treatment sessions to thicken thinning hair and stimulate growth from dormant hair follicles
with the results lasting three to five years as far as pain is concerned we use both topical and
local anesthetic so my patients are comfortable when I place the TrichoStem Hair Regeneration
formulation I determined for them into their scalp
our patients feel fine after their injections and have their scalps massaged immediately afterwards
and some patients may feel some mild scalp soreness and tenderness for a few days afterwards
in contrast to people in other practices where you have to go back for repeated monthly injection
sessions a TrichoStem Hair Regeneration patient with more advanced hair loss may receive just
a second treatment around 18 months after their first you can just think for a moment about how
much more expensive and physically painful monthly generic treatments are in comparison to what we do
we are committed to our patient success with our treatment and we monitor the results with
office visits every three to six months for the duration of typically two years
we follow up with patients who are unable to see us in person afterwards with video consultation
people who also often ask if there are side effects
associated with TrichoStem Hair Regeneration or even for that matter PRP injections
short-term swelling tenderness bumps maybe some hair shedding are usually resolved in a few days
to a few weeks I have not seen any consistent or significant long-term side effects of either
PRP alone or TrichoStem Hair Regeneration as I mentioned earlier TrichoStem Hair
Regeneration is a system where we look at other medical factors contributing to your hair loss
this means that additional medical strategies can be employed to maximize the longevity
of the benefits of our treatment such as the use of DHT blockers like finasteride
so in summary recovery time after TrichoStem Hair Regeneration is basically minimal we
regularly have patients coming from around the world who get back on a plane the same
day as their treatment and go home uneventfully results typically last three to five years after
a single treatment session and a patient with more advanced hair loss will often come back for
a booster treatment after 18 months from their first treatment so I hope this information from
my experience has helped you if you’re interested in recommendations for your individual situation
you may contact us through our websites or call our offices to schedule a consultation thank you

What are the differences between hair shedding hair thinning hair loss and
hair fall? Hair loss is a common issue for both men and women seeing more hair
in the hairbrush or the shower floor or the drain can be very distressing we see
patients every day in our practice who are anxious to understand if they are
permanently losing their hair patients we see often use terms like hair
shedding hair thinning hair loss and hair fall to describe their situation
I’ll discuss these terms to help you understand these terms and situations
where there is potential long term hair loss as well as treatment I recommend in
my practice I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in
practice in Manhattan and Long Island for over 20 years I’ve been helping
patients with genetic pattern hair loss throughout my career with surgical hair
transplantation and medical therapies such as finasteride and minoxidil in
2011 I recognized a remarkable side effect of a wound healing material we
used to improve our hair transplant surgical results called acellular matrix
with PRP which resulted in reactivation of hair growth and thickening of
thinning hair I developed protocols based on my results with different
formulations and techniques and developed the Hair Regeneration system
for male and female pattern hair loss I founded TrichoStem Hair Regeneration
Centers to help make this treatment system geographically much more
accessible patients come to our offices for trichostem hair regeneration from
around the world the most common concern for people who are experiencing hair
shedding is the possibility they are experiencing permanent hair loss
according to the medical literature it’s normal to shed
fifty to a hundred hairs a day this is usually not perceivable because of the
rate of hair regrowth individual hairs continuously grow for two to six years a
period called the anagen phase about 88 to 90 percent of all your hair follicles
are in the anagen phase so most of your hair is growing invisible at any given
time hair eventually stops growing temporarily but only eight to ten
percent of hairs do this when hair stops growing it enters into a short
transitional phase called catagen when the hair shaft starts to separate from
the hair follicle or root this transitional phase lasts about four
weeks the hair then sheds in a phase called telogen tillage and is also the
resting phase where the follicle doesn’t produce hair for about three to four
months after the telogen phase the hair growth cycle starts again with the
antigen phase and the hair grows from the same follicle hair shedding where
200 or more hairs a day our shed is often associated with the temporary hair
loss condition for example hormonal effects from oral
contraceptives or hormonal changes before and after childbirth can be the
basis for hair shedding generally hair which sheds remains viable with the hair
follicles still intact and functional so the hair grows back a common form of
hair shedding is called telogen effluvium commonly telogen effluvium is
due to a stressful event that occurred two to five months prior to hair
shedding events that trigger telogen effluvium are often highly stressful
periods such as undergoing general anesthesia extensive surgery death and
the family divorce or hospitalization there is a condition called chronic
telogen effluvium which mostly affects women and is not directly associated
with a singular stressful event chronic telogen effluvium
is characterized by constant and significant hair shedding
with some relative stability in the density and overall scalp coverage there
is no direct treatment for telogen effluvium so you just allow for time to
let the hair grow back hair shedding is commonly caused in both men and women
who also undergo cancer treatment as the effects of chemotherapy results in
stopping of the active growth phase and is referred to as antigen effluvium
intervention is usually not necessary as the hair usually grows back after
chemotherapy is completed we’ve had some patients report that their hair quality
never came back to the way it was before undergoing chemotherapy hair thinning is
defined as a progression where hair density diminishes and individual hairs
after normal shedding come back thinner eventually the hair follicle disappears
altogether in male pattern hair loss a contributing variable to hair thinning
is the scalp sensitivity to DHT or dihydrotestosterone another aspect of
male pattern hair loss is the possibility of having a genetically
programmed limit to the number and longevity of hair growth cycles the drug
finasteride is used to reduce DHT it allows for prolongation of the hair
growth cycle however it has a limited value in the stimulation of hair growth
further we’ve observed many patients who’ve been on finasteride for over 15
years who still progressively lost a
significant volume of hair this doesn’t mean that the finasteride didn’t work it
just means that there are other variables which cause or contribute to
hair loss they continue in spite of being on the drug more than likely the
same individual would have had much less hair if they weren’t on the financed
female pattern hair loss is much more common than is generally acknowledged
affecting 50% or more of women over 50 there can be some association with
decrease in estrogen as well as genetic factors female pattern hair loss is
diffuse which leads to a decrease in hair density resulting in widening of
the hair part described as a Christmas tree pattern the term hair fall is
commonly used in South Asian countries to mean awareness of hair loss which can
be caused by hair shedding and genetic pattern hair loss as mentioned earlier I
developed a treatment for male and female pattern hair loss based on
observations of improved scalp coverage during hair transplant in areas not
transplanted when we used PRP or platelet-rich plasma with a cellular
matrix produced by the company a cell since 2011 I found ways to combine these
materials and develop algorithms which I refined over the years based on the
responses I saw trichostem hair regeneration is not just an injection
treatment I create customized treatment plans for male and female pattern hair
loss patients based on the patient’s gender age age of onset of hair loss
degree of hair loss and any prior medical treatment used for hair loss
although in large percentage of our patients have done well over over 5
years with only one treatment session patients who have moderate to advanced
hair loss may receive an additional treatment about 18 months or so after
the first treatment to maximize scalp coverage sustained hair growth and
thicker hair has been seen for 3 to 5 years or even more with this treatment
strategy our patients don’t need to come in for injections every month or every 3
months for the treatment to be effective we follow our patients with stead
digital photography and microscope photos every three to six months for the
duration of the treatment plan and yearly thereafter we have achieved
visible and long-term improvement in hair thickness density and coverage in
over 99% of our patients when it comes to experiencing hair loss proper
diagnosis and optimal management can make a big difference
for your long-term outlook we live in a time where people are being sold hair
loss treatments where the practitioner or vendor makes no commitment to your
long-term management if you’re experiencing hair loss and you’re
considering a procedure find a doctor who will perform a thorough evaluation
show you before and after photos of their patients and provide you with a
rational treatment plan which you can have confidence in it I hope you found
this information helpful thank you for your question

Are there any differences between PRP and ACell treatments for hair loss?
PRP and ACell injection treatments when performed effectively can significantly increase hair density and coverage
in men and women who suffer from genetic pattern hair loss PRP and ACell treatment are often sought out by people
who’ve undergone several treatments with PRP or platelet-rich plasma alone without significant benefit after many
sessions oftentimes there are improvements seen in hair growth after PRP injection but the growth is typically not
sustained beyond the short term in addition a lot of people are looking for an alternative to surgical hair
transplantation as well as ways to improve their results after recently having hair transplant surgery with PRP and
ACell the key ingredients are spelled out in a generic name and there is often an assumption that the formulation
execution results of PRP and ACell treatment are the same between doctors in reality results formulations and treatment
protocols are not universal I’ll discuss how PRP and a cell treatments differ amongst doctors and how you can decide
which treatment is best suited for your hair loss condition I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon
and Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in practice in Manhattan and Long Island
for over 20 years I’m actually one of the original pioneers of PRP and a self treatment this began when I first used
extracellular matrix or ECM by ACell to improve healing when I performed hair transplant surgery the word a cell is
actually the name of the company that produces the material called extracellular matrix or ECM extracellular matrix
or ECM is an advanced healing material derived from pig bladder although this is stem cell technology this material
is not made up of stem cells the extracellular matrix material actually stimulates your body’s own adult stem cells
to behave in ways which significantly improves wound healing I became more experienced with this material and its
behavior by using it for incisions when I performed facelift surgery and other cosmetic and reconstructive surgical
procedures I observed when using this material for hair transplant surgery that not only did the hair grafts heal
better but the native thinning hair unexpectedly became thicker the hair thickening effect was observed over one
year after surgery I was inspired by this observation to work on developing optimal concentrations of ACell with
PRP in addition to delivery methods to potentially create a standalone procedure to help men and women with genetic
pattern hair loss without surgery since there was no prior knowledge in this area I spent years developing and refining
the process for maximal effectiveness with consistent results and very importantly to achieve the most benefit for the
longest period of duration which requires the fewest number of treatments in spite of many years of skepticism and frequent
dismissal of the concept from many members of the dermatology Plastic Surgery and hair restoration surgery community the
success of our treatment we call TrichoStem Hair Regeneration as a standalone procedure since I started in 2011 could not
be ignored and has become so well recognized that patients have been coming to us from around the world for male and
female pattern hair loss treatment the improvement in scalp coverage we see is based on the reactivation of hair that
is present but not growing as well as thickening of thinning hair our success in changing the way hair loss is treated
has resulted in the same doctors who are skeptics about PRP and ASL to now offer their own limited single formulation
which requires that their patients come in every month to every three months for scalp injections of PRP or PRP with a
self so if you are experiencing hair loss how do you determine first of all if PRP or PRP with a cell is appropriate
for you and if it is which method will be most effective for you since the time of initiating my work of PRP and ACell
I looked at specific characteristics and every patient I treated and look at how they responded to the treatment dosing
and methods which I employed for them I examined every patient and performed microscopic and high-resolution digital
photography every three to six months for the duration of five years or more based on these observations I recognized
the need to create individualized treatment plants for example a young male with aggressive hair loss needs a treatment
strategy which is different from a middle-aged woman with slow progressive hair thinning I see many people who are
experiencing hair loss and had gotten treatment in a shotgun approach regardless of their age gender or degree of hair
loss unfortunately this makes people being treated for hair loss to be frustrated and feel that this treatment category
just doesn’t work in our practice we spend a lot of time looking at our patients we look in depth at medical history as
well as hormonal issues medications and other variables to properly diagnose each patient before determining if he or
she is a candidate for PRP and ACell or as we refer to our system TrichoStem Hair Regeneration I can attest from experience
that one approach to hair loss treatment cannot be applied to every patient after I assess a patient and diagnosed them with
androgenetic alopecia or genetic pattern hair loss I provide them a treatment plan for example if you’re a 40 year old male
who began to lose hair in your early 30s and you have a moderate to advanced degree of hair loss you might be a candidate
for a two-year treatment plan during which you would receive two treatments separated by about 18 months the benefits of
two treatments as well as other therapies would likely result in improvement which would be sustained for 3 to 5 years for
most female pattern hair loss patients we have also had comparable and often longer lasting results I can say that I’m very
happy to see the continued growth and recognition of PRP and ACell as a treatment for hair loss however I must stress that
hair loss is progressive and is managed not cured in so many ways I see parallels between the marketing of PRP as well as
ACell by doctors with little to no prior hair loss treatment experience with hair loss management such as having performed
hair transplant surgery and the aggressive marketing of devices for skin tightening or fat reduction which are being used
for people who are not good candidates for these procedures I see this as a part of an overall trend which I refer to as
cosmetic medical retailing in cosmetic medical retailing the practitioner is more of a sales person who is not interested
in a long-term doctor-patient relationship my role as a doctor is to first diagnose manage and advocate for the patient’s
best interest in cosmetic medical retailing the patient is more of an opportunity for a one-off transaction with no concern
from the fact in the long-term implications of any treatment they sell even worse it’s common for particularly unethical
medical retail practices to steal before-and-after photos we are constantly being informed about practices stealing our
photos and misrepresenting these photos as their own I have found that many people who are trying PRP or ACell plus PRP
in clinics where treatments are scheduled monthly or multiple times per year find themselves stopping after three to four
treatments which is understandable having multiple injections in the scalp every month to every three months can become
pretty irritating more importantly the question is why do you need so many injection sessions if you think about it the
cost of these injections adds up over time and without any significant long-term benefit these injection treatments
become financially and logistically unsustainable essentially set up for failure I can state from having many years of
experience with ACell with PRP starting in 2011 that a proper diagnosis with a customized treatment plan limited to no
more than two treatment sessions provides an expected average duration of 3 to 5 years this appears to be at this time
the most effective strategy which is the basis of our success with TrichoStem Hair Regeneration since 2011 I’ve been
helping men and women from around the world with genetic pattern hair loss improve their appearance TrichoStem Hair
Regeneration is a system which involves the application of a range of individually customized formulations delivery
methods and treatment plans as a growing number of doctors start to offer PRP and a cell the challenge is for patients
to be able to make informed decisions about which strategy is suited for their needs I am open with my patients about
my knowledge derived from my experience developing our system I’m clear with every patient about the reality that hair
loss is genetically hardwired and progressive you should expect during a consultation for the doctor to answer your
question directly and honestly be wary of claims that sound too good to be true nor should you get vague answers about
what to expect after treatment in my practice I provide every patient with the treatment plan and a clear schedule of
treatments needed to achieve improved scalp coverage for what is typically three to five years I hope you found this
information helpful thank you for your question

Is treatment still needed after a hair transplant?
For many years during consultations for hair loss treatment I found that a lot of my patients with male
pattern hair loss were under the impression that the most definitive solution for their hair loss was a
surgical hair transplant hair transplantation regardless of the method used is the transplantation of
genetically resistant hairs from the back of the scalp to the front of the scalp while hair transplant
surgery does put hair in areas with little or no hair it does not change the continuous progression of
hair loss afterwards i’ll discuss why having a hair loss treatment strategy is very important especially
after a hair transplant i’m Dr Amiya Prasad I’m a Board-certified cosmetic surgeon and Fellowship-trained
oculofacial plastic and reconstructive surgeon I’ve been in practice in New York City and Long Island for
over 25 years throughout much of my career hair transplant surgery was a significant part of my practice in
an effort to improve the outcomes about 10 years ago i started using a wound healing material called Acellular
matrix to improve the healing process in the donor area and to improve the survival rate of the hair grafts
we observed that a year later thinning hair that wasn’t transplanted became thicker this discovery inspired
me to come up with a system to treat hair loss the challenge was to come up with a predictable treatment
protocol for customization in order to meet the unique needs for each type of patient i developed a system
where i factored in key variables such as age gender age of onset of hair loss and severity of hair loss to
customized treatments that will work best for your profile this treatment can be used for men and women who’ve
previously had a hair transplant our treatment for hair loss which i trademarked TrichoStem Hair Regeneration
has also been very successful as an alternative to hair transplant surgery as a pioneer of this new treatment
for over the past 10 years i’ve helped a wide range of people who came from around the world with scalp
coverage improving in over 99 of patients it’s clear why TrichoStem Hair Regeneration stands as the benchmark
to compare any other ACell plus PRP treatment for hair loss that interestingly appeared so many years after we
started hair transplants are marketed and perceived by consumers as a solution for genetic pattern hair loss
the reality is that hair transplant alone does not treat progression of genetic pattern hair loss at all the
characteristic progressive hair thinning will continue after surgery for example when you see a person who had
an obvious hair transplant where you see the so-called plugs of hair that are growing in isolation they’re often
labeled as having had a bad transplant in reality they didn’t start out that way they actually probably looked
pretty good for a few years after their transplant surgery however with time only the grafted hairs that are
genetically resistant to hair thinning remained while hair thinning continued and the native thinning hairs
eventually disappeared this is one of the main reasons why i discourage men in their 20s to undergo hair transplant
even with multiple transplant surgeries rapid hair thinning will leave the coverage sparse and looking unnatural
not only will they not look like the same as contemporaries who don’t have hair loss but as they get older and reach
their mid 30s the residual grafted hair will have poor density look artificial in my experience a lot of people
who choose to undergo a hair transplant as a solution for their cosmetic concerns are frustrated by the limited
results of their surgery invariably they end up having a second transplant where they are further frustrated so
they find another surgeon to do their third transplant in the end regardless of the number of surgeries they had
they find themselves in a situation where they’ve spent a lot of money undergone a lot of pain and recovery and
no longer have any more hair left to harvest for further transplantation this is not a good position to be in
unlike other cosmetic surgical procedures like eyelid surgery facelift surgery or breast implant surgery there
is much greater variance in the outcomes of hair transplant surgery in the marketplace the advertising does not
reflect the actual reality of hair transplant outcomes in my opinion the problems arise due to patient selection
the setting of unrealistic expectations and basic issues regarding blood supply bleeding and scar tissue oftentimes
the patient who has undergone two transplants had the second transplant done by the same surgeon who did their
first transplant however there was no difference in how the surgeon approached the second procedure consequently
the yield from the second transplant is not only less than anticipated but there is often further hair loss due
to the trauma to native existing hairs and poor graft survival when it comes to patients who have had hair
transplant surgery before coming to see us they essentially fall into three basic situations one an individual
who had hair transplant several years prior and is looking to avoid having to do a second hair transplant while
they’re experiencing hair loss progression two an individual who has in the past three months had a hair transplant
and wants to optimize their healing and growth of their existing native hair three an individual who has had two
or more hair transplants over several years and is noticing the quality of their transplanted hair is diminishing
in addition to worsening of their scalp coverage due to natural progression in order to understand how we manage
these patients we should first briefly cover how TrichoStem Hair Regeneration treatment is used for people who have
never had a hair transplant and are experiencing androgenetic alopecia or genetic pattern hair loss the TrichoStem
Hair Regeneration treatment has over a 99 success rate for men and women experiencing genetic pattern hair loss the
success is defined as visual improvement in hair thickness and scalp coverage with TrichoStem Hair Regeneration we
are essentially reactivating hair that is not growing because of a prolonged resting phase where thickening hair
that was thinning and increasing the longevity of the hair growth cycle one of the advantages of TrichoStem Hair
Regeneration over hair transplant surgery is that native hair grows much closer together than what can be achieved
even with multiple hair transplant surgeries further by thickening thinning native hair and stimulating hair growth
trichostem hair regeneration treatment can achieve better scalp coverage than not just one but two hair transplant
surgeries for many of our patients typically we treat each patient with a two-year plan where we do two separate
treatments approximately 18 to 24 months apart and we expect sustainable benefits in the range of three to five
years or even more additional medical management including dht blockers nutritional and medical therapy may be
indicated depending on the category you’re in we see our patients every three to six months and review results with
them to show how they are progressing over time for patients who have had hair transplant surgery it appears that
our TrichoStem Hair Regeneration system provides an optimal environment to help both their hair grafts and their
native hairs i have the unique perspective of performing hair transplant surgery for many years and developing a
significant non-surgical treatment for genetic pattern hair loss with all of this clinical experience in my opinion
you can optimize your appearance with non-surgical options and delay if not avoid further hair transplantation in
the near future regardless of the type of hair transplant you’ve had or plan to have your genetic pattern hair loss
will continue to progress although hair transplant surgery has a potential role for improving appearance particularly
for men with frontal hair loss it’s important to recognize that a strategy for the long term is critical to avoid
regret and frustration I hope you found this information helpful thank you for your question

What’s an alternative treatment to surgical hair transplants?
when you go online and search for a solution for hair loss
you are often flooded and then stalked by
ads from hair transplant clinics for a long time a certain percentage of
people were resigned to pursue a hair transplant because
there was no other alternative fortunately as a byproduct of my trying
to improve the outcomes of my hair transplant surgeries i developed
a non-surgical alternative to hair
transplant which has been very successful for over
10 years i’ll discuss my perspective on this
alternative approach which can for most of my patients
actually exceed the results of hair transplantation
I’m Dr Amiya Prasad I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive
surgeon I’ve been in practice in New York City
and Long Island for over 25 years for many years
hair transplant surgery was amongst the most popular procedures
i performed in my practice as a cosmetic surgeon i was
used to a high rate of satisfaction for my facial and
body cosmetic procedures and at the same time i was
frustrated with getting consistent results
and having comparable satisfaction with hair
transplant surgery the two areas that i wanted to focus attention on was to
optimize hair graft survival so the yield would improve
and to get better healing of the donor area
where the strips of hair bearing skin was harvested
in an effort to achieve this i applied extracellular matrix by ACell
with prp at the time of surgery i recognized that in addition to
improved graft yield and donor area healing
that thinning hair became thicker i focused my attention and resources to
determine how to optimally dose and deliver this
material for different types of hair loss for
both men and women this work took many years and
ultimately i was able to achieve consistent results for both men and
women with androgenetic alopecia and created
TrichoStem Hair Regeneration with only one to two treatment sessions
we’ve been helping people from around the world improve their
appearance and their confidence with over 99 percent success
many of my patients who were considering hair transplant surgery
prior did not feel that they needed surgery after
having TrichoStem Hair Regeneration treatment
there is no question that TrichoStem Hair Regeneration
is now the industry benchmark for ACell and prp treatments which seem to
appear on mass many years after we developed
our treatment i often see people who professionally speaking were not ideal
candidates for hair transplant surgery and yet they
underwent not just one but several
hair transplant procedures these patients perceived that their
only option was to undergo hair transplant surgery
unfortunately they fell victim to the aggressive salesmanship of hair
transplant factories both in this country
and for considerably lower cost internationally there are two groups of
people who in my opinion with limited exception should not have
hair transplant surgery one group is men in their 20s and the
other is women who typically have a diffuse
hair thinning pattern when estimating the
incidence of hair loss in men we use a general rule of thumb
called the Rule of Decades for example if you are in your 20s about 20 percent
of your contemporaries have hair loss while 80 percent don’t if you’re in your
50s you are probably aware that 50 or more of your contemporaries have hair
loss essentially the age of onset and the
rate of hair loss needs to be factored when considering a
treatment strategy that involves hair transplant surgery the source
for hair for transplantation is the limited
donor area in the back of the scalp a younger man who undergoes hair
transplant will continue to lose hair at a much
faster rate by the nature of their type of hair loss
in comparison to a middle-aged man with the same level of hair loss this
means that the donor area will run out sooner if the transplantation is
performed repeatedly to keep up with the ongoing hair loss
it’s also important to understand that the aesthetic expectations
are different for a younger man in comparison to a middle aged man
this means that regardless of the amount of surgery performed on a younger man
who is suffering from moderate to advanced hair loss
it is unlikely that they will achieve density and coverage
comparable to the 80 percent of their peer group
unfortunately a lot of men who choose to have
several transplants beginning in their 20s
often regret having had these surgeries when they are in their
mid to late 30s this is because they continue to
lose their hair and the remaining hair they have
is transplanted hair she doesn’t have good density and
doesn’t look very natural i treat a lot of women with hair loss in my practice
this type of hair loss is referred to as female pattern hair loss
and is also called androgenetic alopecia this type of hair loss is characterized
by diffuse thinning with no areas of smooth
non-hair-bearing skin hair transplant surgery has the potential of making hair
loss in women worse because of the loss of
existing hairs as a consequence of trauma caused by the
incisions made for implanting hair grafts the term
for this is often called collateral damage
this is why i generally don’t recommend hair transplant for most of my female
pattern hair loss patients for these two groups of hair loss
patients a hair transplant alternative is
really necessary as i stated earlier the TrichoStem Hair Regeneration treatment
can be administered without the risks of exhausting the
donor hair and causing collateral hair loss i also
want to make clear that trichostem hair regeneration is not
just about the injection treatment but rather it’s about a treatment strategy
when i meet a patient i develop a customized treatment plan with
modalities to optimize hair growth these modalities
can include pharmaceuticals topicals nutritional
supplementation and hormonal therapy TrichoStem Hair Regeneration increases
the number of visible hairs on the scalp by reactivating hair that is not growing
and thickening thinning hair resulting in significant
improvement of scalp coverage this phenomena is very important to
consider when you understand the technical limitations
of hair transplant surgery your existing native hair even when it’s thinning
can be as dense as 50 hairs per square centimeter
when you undergo hair transplantation you can only get about 20 hairs per
square centimeter this is because the ability of the skin
to heal with multiple incisions for hair grafts
is limited by the structural integrity of your skin
and the limitations of blood supply if you place too many grafts
the skin falls apart and the hair grafts simply don’t survive
it’s for this reason that many patients who have had hair transplant surgery
are dissatisfied with how unnatural their grafts appear
in terms of density and they are resigned to undergo another
surgery hoping to improve their density this means they are paying twice and
further depleting their donor area regardless of whether you’re undergoing
FUT or FUE surgery the donor area is a
limited supply of hair grafts in order to achieve
density that looks natural you need a lot more than the number of grafts you
can maximally harvest from the back of the scalp it’s simply a
surface area mismatch the top of the scalp is a lot larger
than the limited area of hair bearing skin that is genetically
resistant to hair loss by increasing the number of hairs and
thickening existing thinning hairs which are naturally at a
much higher density than can be achieved with a hair
transplant hair regeneration can achieve very
effective coverage without surgery although the marketing
of hair transplants seems so alluring
essentially hair transplantation is moving hair from one
location to another unfortunately there is a
certain percentage sometimes as high as 90 percent of hairs
which don’t survive being moved from one location to another
further as mentioned earlier collateral damage to existing hairs
in the recipient area results in significant loss
of potential density and coverage in spite of transplantation
the popular procedure of follicular unit extraction or
fue has what’s known as a transection rate
transection means that when the hair graft is harvested
a certain percentage typically 30 percent of hairs
do not have the root or follicle necessary for growth when
implanted this means that 30 of the grafts are not going to grow in
addition there is a percentage of grafts that are intact
which don’t survive i see so many patients every week who have had
three hair transplants and are frustrated and disheartened by this type
of experience since they’re no longer able to have any
more surgery they need a new approach to their
situation typically i find that i can help them
improve the appearance of their hair grafts
as well as the few native hairs remaining
with TrichoStem Hair Regeneration in fact i’ve helped many people with old
hair transplants by not only improving the quality of
their transplanted hair but also by reactivating hair that was
transplanted and simply not growing it’s important to understand that hair
transplant surgery is very traumatic to the scalp if you just
think about a surgery where you have 1500 to 2500 stabs on the scalp
you can imagine how there can be vascular compromise and scar tissue
resulting in a sub-optimal environment for hair growth
by using acellular matrix and platelet-rich plasma
i believe i’m creating a better environment
by optimizing blood supply and recruiting your adult stem cells
into the deeper layers of skin where the hair follicles are
it’s important to recognize that particularly with procedures like
fue hair is being harvested from areas outside the true permanent zone
this means that these grafts are subject to thinning
just like the hairs that have been lost from the top of the scalp
after all this does it mean that there’s never a situation where a hair
transplant would be indicated of course not
there are cases of advanced hair loss particularly
frontal hair loss where there are no more
viable hair follicles to treat non-surgically
typically the same patient who would benefit from transplantation to the
frontal area also has some hair in the mid scalp
and behind in the crown recalling that hair transplant is still
very limited by the number of hairs that can
be successfully transplanted in the
limitations of achieving natural density a strategy can be employed where optimal
coverage can be achieved maximally before the patient undergoes
hair transplant surgery as has been seen
by looking at celebrities who had obvious hair transplants which everyone
identifies as such it’s important to recognize
that the frontal hairline is defined by natural density
with the transition behind the hairline as opposed to isolated grafts in a line
comparable to a picket fence so the strategy that i recommend
is to undergo TrichoStem Hair Regeneration
first to maximize coverage before undergoing hair transplantation
simply stated every hair that we are able to
regrow and improve scalp coverage allows the hair transplant surgeon
to focus the limited number of grafts to smaller surface areas we’ve also helped
many patients who underwent hair transplant and then discovered
trichostem hair regeneration while they were online
i found that patients who have undergone hair transplant surgery can
benefit in terms of optimizing the hair graft growth as well as
their native hair growth i often joke with them that at the one year point
after surgery the surgeon who performed their transplant
will want to take credit for how good they look because of the improved
density achieved with TrichoStem Hair
Regeneration that’s okay with me in conclusion
although the marketing of hair transplant surgery creates the
perception that the only way to address significant
hair loss is to have a hair transplant we have
proven for over 10 years that a non-surgical treatment such as
TrichoStem Hair Regeneration can not only be comparable but actually
yield results that exceed not only one but two hair transplant surgeries
in a marketplace driven by transaction and profit
there’s often little attention paid to the long term consequences
of any aesthetic intervention whether it’s a laser treatment
cosmetic surgery or hair transplant a patient with hair loss is different
and compared to a patient who is interested in trying botox
for the first time hair loss has a significant
emotional impact and i feel that people who
come to me with hair loss need an honest opinion and a treatment strategy
not a transaction
I hope you found this information helpful
thank you for your question