Archives: Transcript

What is healing like after a hair transplant?
Hair transplant surgery is a pretty extensive procedure which can take much of a full day to
perform an example is called FUT or follicular unit transplantation also known as strip surgery
since a strip of hair-bearing skin is harvested from the back of the scalp for the purpose of
obtaining hair grafts to be implanted typically in the front of the scalp another method is called
FUE or follicular unit extraction where instead of harvesting a strip of skin individual grafts
are harvested with circular blades called punches many people with hair loss believe that their
only option is to have a hair transplant and they are concerned about specific issues such as the
healing process as well as the amount of hair growth to expect afterwards I’ll discuss some concepts
related to healing and how we help people in our practice who are considering having a hair transplant
or have already had one I’m Dr Amiya Prasad I’m a Diplomate of the American Board of Cosmetic Surgery
and a Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in practice in
New York City and Long Island for over 25 years I’ve performed surgical hair transplants throughout
my career as I mentioned earlier hair transplant surgery is a long procedure unfortunately the hard
reality of hair transplant surgery is that there can be a significantly high percentage of hairs
transplanted that don’t grow resulting in frustration for the patient and the surgeon to address
this and other challenges in 2011 I used a wound healing material called extracellular matrix by the
company ACell to enhance graft survival and donor area healing we observed that a year later that
hair grafts and the donor area benefited from the application of extracellular matrix in addition
even of greater significance was that native hair that was not transplanted had increased in number
and grew in thicker inspired by this remarkable event I worked over several years to create a
non-surgical treatment for male and female pattern hair loss called TrichoStem Hair Regeneration
over the many years of helping people from around the world with TrichoStem Hair Regeneration we’ve
helped many people before and after their surgical hair transplants with our system interestingly
we’ve helped many people whose hair transplants were performed many years ago actually improved their
appearance with regrowth of transplanted hairs which appeared to have stopped growing so let’s
take a step back before discussing how to help healing after a hair transplant and ask a simple question
and that question is is this the best time for you to undergo a hair transplant timing is very
important since the number of grafts regardless of technique is fairly limited even if you were to
have several surgeries in my practice I find that most people considering a hair transplant have
thinning hair as such there is a strong argument for maximizing your scalp coverage with a non-surgical
treatment before having a hair transplant simply stated every hair that naturally grows in and is
thicker is a hair that doesn’t have to be transplanted many of my patients considering hair transplant
are younger and are very motivated to have surgery I explained to them that I see many people who have
had multiple surgeries when they were young and as they got older and lost their existing native
hair their transplanted hair didn’t look very good and they had very little scalp coverage it’s
simply logical to see how much of your existing hair can be optimized before having surgery i also
see a lot of people who come into me after they recently had a hair transplant typically they’ve had
an FUE procedure and they’re looking online for information about the possibility of losing hair grafts
after surgery and how to deal with scabs generally speaking after 48 to 72 hours grafts are well
situated and are not likely to dislodge this doesn’t mean that they will necessarily grow basic hygiene
regimens are usually part of the post-operative care but separately in terms of helping people optimize
their hair transplant results we have helped a lot of people soon after they had surgery with TrichoStem
Hair Regeneration the rationale behind the strategy is that our treatment can potentially optimize the
environment for hair graft healing as well as reactivate native hairs to grow and thinning hairs to thicken
this can be significant benefit since FUE procedures yield can be limited due to graft transection during
harvesting and challenges with graft survival specific to FUE surgery as mentioned earlier we see a lot of
people who have had hair transplants years ago and even decades ago many of these people cannot undergo
any more transplantation and have lost most if not all of their native hair this leaves them with very
sparse looking transplanted hair I’ve helped many of these people with TrichoStem Hair Regeneration it’s
been my observation that a lot of transplanted hairs seem to stop growing yet the hair follicle is still
viable which is evident after regrowth post or after TrichoStem Hair Regeneration treatment we effectively
established in 2011 that hair transplant healing can be enhanced with regenerative technology since that
time we’ve established a new way to approach hair loss without surgery in addition to helping people who’ve
recently or not so recently undergone hair transplant surgery hair transplant surgery has limitations in
spite of many new techniques introduced the donor area can only yield so many grafts healing can be optimized
after surgery but in my opinion hair loss management is more than getting a hair transplant and hoping for
the best whether you plan to or already have had a hair transplant I find that developing a strategy which
leverages the benefits of our non-surgical treatment with TrichoStem Hair Regeneration and other medical
management options we’re able to help our patients look their best for the long term I hope you found this
information helpful and thank you for your question

How is TrichoStem Hair Regeneration different from other acell plus prp treatments?
Having focused on the use of acell plus prp since 2011 I have an established status
as a pioneer in the application of ACell+PRP for the non-surgical treatment
of male and female pattern hair loss over the course of several years an
extensive study of hair loss in hundreds of patients every year from
around the world i established a set of formulations for
ACell and PRP with corresponding treatment
protocols for categories of hair loss based on a
classification system which i developed this process of matching hair loss
profiles with customized treatment formulations
delivery methods and schedules for treatment and
follow-up became the system known as TrichoStem Hair Regeneration
we treat a wide range of male and female pattern hair loss patients with over
99 of our patients seeing a significant improvement in their scalp coverage
this means that i unintentionally established the first
significant treatment for hair loss since the introduction of finasteride in
the late 90s in my daily practice TrichoStem Hair
Regeneration is now the benchmark for application
of extracellular matrix by ACell with platelet-rich plasma or PRP
i’ve yet to see any other therapy which works better TrichoStem Hair
Regeneration treatment has been so significant over the past
more than 10 years that some medical practices
are trying to offer a generic and limited ACell and PRP treatment
their treatments are sold as if they’re doing the same thing
that we are unfortunately for their patients
they are not and the results or lack of results leave many people who have had
these generic treatments to come to our
offices for more advanced management of their hair loss i’ll
discuss why TrichoStem Hair Regeneration is
different from other ACell and PRP treatments
and how you can optimize your scalp coverage
without having to get painful scalp injections every month
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 the new york city and long island area for over 25
years i routinely performed hair transplant
surgery throughout my career as part of a
strategy to improve the healing of hair grafts in the area
where the hair grafts were harvested from i used
extracellular matrix by the company acell
this material is used to amplify the response of your body’s
own stem cells for wound healing for example in my practice i use
acellular matrix in my facelift incisions to optimize healing
and to minimize the visibility of the healed incisions
when i use this material during hair transplant
i was surprised to find that native hairs
that were not transplanted increased in number
and grew visibly thicker i made the decision to
challenge the conventional approach to treating hair loss with surgical hair
transplant with enhanced acellular matrix
by exploring the possibility of using this material
to treat male and female pattern hair loss
non-surgically the challenge was to achieve predictability and consistency
over several years i worked on formulations delivery methods
treatment timing and other variables until i was able to achieve
consistent and predictable improvement for
male and female pattern hair loss now with more than 10 years behind us i’ve
established a standalone non-surgical treatment for hair loss
which i trademarked TrichoStem Hair Regeneration
many people with hair loss first learned about ACell and prp
from our videos and websites about TrichoStem Hair Regeneration
they mistakenly assumed that they would get the same results from
other ACell and PRP treatments as they see
in our patients who’ve had undergone the TrichoStem
Hair Regeneration treatment they didn’t get the same results and
when they come in to see me they ask why they ask what’s the difference
between what you do and all those other doctors who offer
ACell and PRP I explained the answer lies in
understanding your specific type of hair loss and what
formulation and method is optimal for you
what does that mean well let’s start with the material extracellular matrix
by ACell which is a critical part of TrichoStem Hair
Regeneration extracellular matrix or ECM is an
advanced wound healing material that’s used by
the US military to help regenerate lost tissue
for battle related injuries ECM is made of processed porcine bladder
and has a remarkable ability to stimulate your body’s
own stem cells to regenerate tissue after injury
a dramatic example is how it was used to regenerate
an amputated fingertip by restoring the bone the skin soft tissue
and even the fingerprint the understanding of how to apply this
material for the most effective result proved to be difficult to work with as
the material is a fine powder and required special
instrumentation to measure mix and deliver
the question which always came up was how much
material was needed to get the best result and how much was
too little i further recognized that too much extracellular matrix caused a lot
of inflammation and would sometimes cause excessive hair
shedding unlike most hair transplant doctors who
only perform hair transplant surgery with most of the
work actually being done by their technicians
I perform a wide range of cosmetic and
reconstructive surgical procedures hands-on from beginning to end
i developed a lot of clinical experience while using
acellular matrix for abdominal incisions facelifts and even to regenerate lost
tissue in the ear and the nose i learned a lot about the behavior of
different types of tissue after varying tight ways of
material application as i stated the extracellular matrix
comes in a fine powder so from the technical aspects of
measuring and mixing they were always challenging i
continuously incorporated knowledge gained from the ongoing
experience from surgical application using precision measurements mixing and
delivery strategies it took months and years to see the most
effective weights volumes and ratios for the
optimal treatment for hair loss as you could imagine there were numerous
challenges and setbacks along the way since our first clinical observation of
the benefit to hair growth was seen in a hair
transplant patient one year after application
i knew that the minimal time for benefit with a single treatment
would likely be one year my mission was to minimize the number of treatments
to achieve the maximal benefits for the
longest period of time typically TrichoStem Hair Regeneration
patients only require one treatment session to
show significant increase in their hair growth and have thicker
hair depending on your hair loss
classification we also perform another treatment
at around 18 months to further thicken hairs
which are responsive to a second treatment for the past 10 years and more
we’ve observed these effects to last for three to five years or even longer
so why are all these medical providers offering ACell and PRP treatments
needing multiple treatment sessions typically
every one to three months in the first year and continuous
maintenance sessions for the second year it seems that the
approach that is being offered is a generically
limited formulation with no consideration
for your individual hair loss profile i have reason to conclude based on what
is being taught by the so-called mentors of
of these practitioners is that patients are really being treated with just PRP
and a little sprinkling of ACell’s extracellular matrix powder
so they can make the claim that it’s ACell plus PRP treatment
this generic approach also means that there’s no difference in treatment
if you’re a 21-year-old male with advanced hair loss
or a 50-year-old female with mild to moderate hair loss
this is what i call a shotgun approach blindly treating everyone the same
with little to no understanding about individual variation
with little analysis it’s clear that these practices are more interested in
transactions than they are in their patients results
i have a particular distaste for this way of working
since treating hair loss is very different
than someone trying botox for the first time
people suffering from hair loss who seek medical attention
are particularly vulnerable and have much
higher emotional stakes which need to be taken
seriously i assure the people who i see that TrichoStem Hair Regeneration
formulations are based on every individual patient’s
unique hair loss classification this customized formulation is based on
an algorithm that took me years to develop
which takes into account individual hair loss factors
such as age gender age of onset of hair loss degree of hair loss and other
factors such as previous hair loss treatments
and the use of hair loss medications like finasteride since most
ACell and PRP treatments are basically just PRP alone
with the little extracellular matrix added so they can
charge for ACell and PRP these treatments
need to be repeated the same way as ordinary PRP injections
which is every one to three months you would think
that the addition of acellular matrix would allow for there to be
a need for fewer treatment sessions than with PRP alone
but that just isn’t the case many of these practices have actually no
prior experience in managing hair loss so they simply decided to get on the
bandwagon and have another offering on their menu
of services as i discussed earlier about the
importance of being sensitive to the emotional
aspects of hair loss separating TrichoStem Hair Regeneration
from medical practices offering ACell and PRP
when i accept a new patient for hair loss treatment
I’m making a long-term commitment we monitor our patients
after the first month post-treatment and then
at three months six months and every six months for the duration of two years
at every visit i take high resolution standardized
digital photos which make comparisons so that you can see how you’re doing and
how you’re progressing these office visits typically are 30
minutes in length and at 15 to 18 month point after the initial
treatment session a second treatment which we refer to as
the booster is performed for you at no additional
cost since our patients are from all over the
US and around the world we often do these follow-ups over email
and Skype and FaceTime the question comes up occasionally as to
why the one-time cost of TrichoStem Hair Regeneration
is higher than a per session cost of common ACell plus PRP treatments in
the marketplace in actuality there is a much higher cost
to getting less effective treatments more
frequently in comparison to TrichoStem Hair
Regeneration many of our patients come in after
spending or wasting their money for three to four monthly injections
of generic ACell and PRP before coming to us
these same patients spend money on flights and hotel stays
to have our treatment we have so many people who come to
us from other countries although PRP and ACell is readily available to them
wherever they are i also find it interesting when it comes
to cost how much does it cost for you to take time from work from your
personal life to go every month to every three months
to have those painful scalp injections not to
mention the inconvenience and can’t be
overstated the pain of these multiple injections in the
scalp successful people understand the value
of our treatment and come to us because of the level of work we’ve done
that remains unparalleled one important aspect of hair loss is to
recognize that since there is no cure for hair loss that there needs to be a
strategy developed to maximize your scalp coverage for the
longest period of time that your genetics will allow i look at
each patient male or female and evaluate the other
aspects of their hair loss that can be optimized with medical
management in addition to our customized injection
treatment when you see our results for trichostem
hair regeneration treatment it’s important to understand that the
same results are not likely to be achieved with generically
dispensed ACell and PRP treatments being offered in the
greater marketplace the algorithm i developed that allows me
to customize each treatment on an individual
based on their age of onset of hair loss their current age their gender and hair
loss pattern is not available to any other practice
offering ACell and PRP unlike these transaction driven medical
retailers TrichoStem Hair Regeneration is an
approach where if i choose to take you on as a
patient I’m making a long-term commitment to
help you maximize the outcomes as much as you can
achieve for as long as possible
the medical retail marketplace creates a lot of misinformation to create a
false equivalency for example a laser or thread lift does not replace a facelift
yet marketers use very slick advertising to make you want to believe that you can
take a cheap shortcut in my office if you ask about ACell and
PRP I’ll be the first to tell you it’s not
ACell plus PRP it’s TrichoStem Hair Regeneration
I hope you found this information helpful thank you for your question

Why are skin treatments not improving my acne scars?
Unfortunately it’s very common for people with acne scars to be frustrated with their acne scar treatments
I see patients who’ve been treated with multiple devices ranging from different lasers as well as
radio frequency and micro needling devices
patients also report having undergone chemical peels or platelet-rich plasma or PRP injections
and just not seeing the results that they were expecting I’ll share some of my experience helping
my patients who have acne scars I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon
and Fellowship-trained oculofacial plastic and reconstructive surgeon been practicing in New York
City and Long Island for over 25 years I routinely help people with acne scars using specific
lasers and radiofrequency devices I perform acne scar surgery such as subcision for tethered scars
I also have a lot of experience with PRP to improve skin quality texture and hyperpigmentation
these treatments mentioned can improve the appearance of acne scars because
they improve skin quality the skin texture and can even tighten and resurface the skin however
there is a major aspect of acne scars that these treatments cannot address especially the deeper
acne scars where there is deeper tissue loss acne scars are primarily the result of inflammation
inflammation can leave the skin architecture to be fragmented disorganized and leading to tissue
loss at the skin level and deeper the treatment of deeper acne scars may involve some form of
restructuring and restoration for example i perform a procedure to release the tethering
of the skin with the underlying tissue and the procedure is called subcision during subcision
different instruments are placed under the skin to release scar tissue that’s responsible for
pulling the skin inward subcision also stimulates collagen production as part of the body’s natural
healing response after the procedure subcision is generally performed for rolling type scars
after subcision for a rolling scar a hyaluronic acid filler can be placed
underneath the skin to support the skin for a smoother appearance
boxcar scars are more limited to the skin level and have defined edges they are also generally not
as wide as rolling scars I often use combination treatments to help people with boxcar scars
and for example I’ll perform a non-ablative laser for dermal tissue remodeling and use
hyaluronic acid with PRP to optimize volume and collagen production within the skin speaking
of hyaluronic acid an area that is frequently overlooked is volume deficiency below the skin
this volume deficiency can be due to bone projection fat volume or a combination of the two
I’ve had a lot of patients who for all intents and purposes came in to see me after they underwent as
much skin focused treatments as could ever be performed I recognized that for many of
these patients volume support below the skin can create projection and smoothening of this
acne scars fairly effectively so as opposed to placing the filler just below the acne scars
I often place the filler at the bone level with a specific technique called structural volumizing
now this technique allows more stable support of the skin from the bone level many of these
patients have been delighted by the results which they can appreciate immediately afterwards
aggressive marketing of devices in my opinion is why many people are frustrated after not seeing
benefit after one treatment this frustration causes many people to go from one practitioner to
another all of whom who claim to have the latest and greatest device unfortunately these patients
often end up damaging their skin even further recognizing that there are different types of
acne scars skin color and skin types so that there is no one best treatment that applies to everyone
with several modalities and techniques available to use for treating acne scars I generally take
a fairly conservative approach what I frequently do is to treat observe the results and customize
future treatments accordingly in my opinion rather than being manipulated by aggressive marketing
focused on financial transaction it’s better for you to identify a physician who can provide you
with the treatment plan and realistic expectation of results I hope this information from my
experience helped you
If you are interested in recommendations for your individual situation
you may contact us through our websites or call our offices to schedule a consultation thank you

Why did I lose facial volume after laser radio frequency treatment?

We are continuously seeing people who are distressed by facial volume loss after

treatment with thermal energy devices this reflects a growing trend in the

aesthetic field I feel that thermal or skin heating devices such as the various

branded laser and radiofrequency technology are often aggressively

promoted as substitutes for surgical procedures such as facelifts and neck

lifts although these devices can modify the

skin through collagen stimulation and remodeling which can be beneficial for

facial aging they are not in any way replacing surgery I’ve observed the

effects of these devices being overused for people who are not candidates for

this type of technology yet these devices continue to be aggressively and

deceptively marketed as alternatives to surgery in the state of New York people

who perform lasers and radio frequency device procedures do not have to be

licensed physicians or nurses this means that unlicensed individuals can perform

procedures which can permanently change and even damage your skin regardless of

who uses these devices improper and overly aggressive use can cause facial

volume loss I’ll discuss the role of laser or radiofrequency technology in my

practice and how you can understand the indications for this technology so you

don’t overcook your skin 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 Manhattan and Long Island for over 20

years I started using fully a blade of co2 lasers in the early 1990s since that

time I’ve continued to use light and radio frequency based technology in my

practice to help people improve the appearance of their skin prior to the

introduction of the co2 laser the gold standard for treatment of lines wrinkles

and skin discolorations was chemical peels with chemical peels whether

superficial medium or deep there is an ablation of different levels of skin

with regeneration of new skin a certain amount of collagen was created in

response to the peel which then improved the skin texture quality and color the

benefit that co2 lasers have over chemical peels is a skin tightening

effect caused by thermal energy delivered to the skin by the laser

the idea behind laser treatment is to apply a specific amount of heat from a

laser device to cause the skin to contract and to induce collagen

production through a controlled injury response these principles are relevant

when treating the skin which is about two millimeters in thickness there is a

general perception that facial aging only affects the skin which is why

anti-wrinkle creams and skin procedures are so popular the reality is that

facial aging is more significantly associated with bone loss and weakening

with sagging of the supporting soft tissue in clinical practice I’ve often

seen people in their 40s and 50s who feel that they may need some type of

tightening procedure this is because they pull upwards on the cheeks and show

me how they look better the basis for this perception is that soft tissue

volume is being repositioned through this action and improving the appearance

of areas where volume has been lost in my opinion

neither surgical lifting nor heat in skin-tightening is the optimal approach

to this type of situation if there is volume loss you restore volume however

it’s important to restore volume in the most anatomically beneficial way volume

loss is managed by the placement of injectable fillers in my practice I

prefer the hyaluronic acid fillers such as the Restylane and Juvederm family of

products traditional place where the fillers is within the skin at the level

of the dermis or just below the skin I approach facial volume loss differently

since a significant amount of volume loss is at the bone level I perform a

procedure called Structural Volumizing this method is based on applying the

principles used for the placement of facial implants such as cheek and chin

implants these implants are routinely placed on the bone and below the facial

muscles as a surgeon I’ve performed many of these procedures and I’m familiar

with this space I place long lasting fillers such as Juvederm Ultra Plus or

Juvederm Voluma to restore volume at the cheeks chin and jaw angle this method of

restoring volume lost by aging is much more impactful than any thermal energy

procedure once you understand this principle

you’ll recognize why heating up the skin makes no sense when the underlying issue

is the facial bone volume loss for people who are in their 50s and older

sagging of the supporting tissue called the smash and platysma muscle results in

gels and loose neck skin the optimal procedure for this type of situation is

a facelift or face a neck lift surgery this group of people is particularly

susceptible to the false promises of thermal based non-surgical face lifting

in addition at this time of your life your skin is thinner and the layer of

youthful fat under the skin continues to diminish in my practice I help many

people over the past two decades overcome their

fear of facelift surgery by performing these procedures and my certified office

operating facilities under local anesthesia with light intravenous or IV

sedation by avoiding both general anesthesia and institutional facilities

such as hospitals where you can feel like a number

my patients are able to undergo more definitive surgery with quicker recovery

the science behind thermal induced collagen remodeling as well as thermal

induced fat reduction is sound and can be effective the problem is that people

who are looking for a solution for volume loss and deeper tissue sagging of

being sold procedures which don’t deliver an often result in making you

look worse than you did before it is often the case that after thermal

treatment is not successful the practitioner will often dial up the heat

intensity or prolong heat exposure to the skin excessive use of heat or

prolonged exposure to thermal energy devices can result in loss of fat below

the skin a layer of fat under the skin is important for the appearance of

smooth and youthful skin this means that the treatment makes the skin end up

looking older other complications include skin burns blistering scarring

and prolonged redness during consultation it’s routine for patients

to ask me about different devices which they hear about I suggest to them to

first take an overview of the problems which concern them before determining

the options which suit their needs I take an

inside-out approach this means understanding the presence and extent of

one bone volume loss too soft-tissue volume loss three support

tissue and skin sagging and four skin quality in terms of wrinkling

discolorations and vessels based on understanding of the potential benefits

of thermal energy devices in improving skin thickness and smoothness I

developed strategies to achieve these goals with significantly lower risk we

use a variety of lasers in our practice such as fractional co2 fractional erbium

nd AG Q switch as well as radio frequency devices such as peleve when it

comes to aging skin there is usually a combination of issues such as wrinkles

and discolorations if we focus on the typical objectives of a therapy which is

to both stimulate the production of new collagen and improve the arrangement of

the collagen bundles skin looks younger and thicker and more even than we could

look at all the ways these objectives can be achieved

we should also factor in what is the potential capacity of a person’s skin to

produce collagen this capacity to produce collagen will be limited by

factors such as age sun damage smoking and previous treatments for many people

who come in for consultation they’ve previously had chemical peels lasers and

radiofrequency treatments this means there may be no effect or benefit from

thermal energy treatment or even potential breakdown of the skin’s

integrity this is why a proper examination by a highly experienced

physician is important before signing up for a treatment in my practice I

routinely combine technologies to improve the skin let’s consider a common

situation such as skin affected by chronically excessive sun exposure and

aging for the fine lines I use fractional and fully ablative RB

co2 laser for discolorations I use a q-switched laser for dermal thickening I

will use limited heating with long pulsed erbium as well as nd-yag laser

technology the technology used with long pulsed nd YAG can be used for both skin

remodeling and tightening as well as fat reduction for many patients I will also

do a procedure called skin boosting this is where I combine PRP or platelet-rich

plasma combined with hyaluronic acid and use a device to deposit this mixture

directly into the dermis and this is done without any bleeding or bruising

this combination will stimulate the collagen production and improve the skin

without heating many people who come to our office upset and angry about facial

volume loss from overuse of a thermal energy device performed elsewhere are

relieved to have a rejuvenated appearance by a rational approach from

the inside out most often a combination of structural

volumizing with skin boosting and an epidermal treatments such as hydro

facial results in a natural and improved appearance deceptive and high-pressure

marketing in the aesthetic field is not going away anytime soon the key is to

find a doctor you can trust and who you feel understands your cosmetic concerns to help you look your best

I hope you found this information helpful thank you for your question

Can I have laser treatment for wrinkles but without the downtime?

Since the mid-1990s laser treatment has become well established as one of the most

effective ways to treat wrinkles of course the term laser evokes

science-fiction imagery which implies immediate results with no downtime in

reality there are different ways that lasers can be used to help improve the

appearance of wrinkles based on principles which determine how the skin

heals after light energy is absorbed by different parts of the skin and how

different forms of energy interact with these parts of the skin one approach for

example is using a laser like the co2 laser which is absorbed by water to

remove the top layer of skin so afterwards a new smoother and more

youthful layer of skin can come in this is known as ablation in addition to

removing wrinkled and discolored skin the heat generated by the co2 laser can

cause the skin to contract and stimulate cells called fibroblasts to produce

collagen another laser technology which can improve the appearance of wrinkles

without any downtime is a non ablative laser when you learn about the existence

of these two very different options how do you decide what to do at a time when

a lot of lasers are aggressively marketed to be the best laser for

wrinkles every other day it’s helpful to understand some principles of laser

treatment so you can see past the noise and the hype if your goal is to improve

the appearance of wrinkles I’ll discuss how I apply customized strategies which

include lasers to help my patients improve their wrinkles without downtime

every day in my practice I’m Dr. Amiya Prasad I’m a Board-certified cosmetic

surgeon and Fellowship-trained oculofacial plastic and

reconstructive surgeon have been in practice in Manhattan and Long Island

for over 20 years I’ve been performing laser treatment since the mid 1990s with

the first fully ablative co2 lasers as technologies changed I continue to

integrate newer technologies such as fractional co2 and erbium laser as well

as more recent technological advances such as long pulse erbium and nd-yag

laser in addition to non ablative technology such as q-switch laser I also

perform radiofrequency treatments like peleve particularly for darker skin

types who are not laser candidates I was also among the first proponents of using

platelet-rich plasma or PRP for improving skin quality when the first

fully ablative co2 lasers were used in the 1990s the outer layer of facial skin

would be removed leaving the skin raw the aftercare was essentially burn

management downtime was for several weeks with intense redness lasting for

months once the new layers of skin came in and the wrinkles improved the

patients were mostly happy with their results this prolonged downtime as well

as conspicuous appearance in the first week to two weeks kept a lot of

potential patients away from this treatment fractional laser technology

allowed for shorter healing times for partially ablating the top layer of skin

and allow the skin to heal faster fractional laser treatments such as co2

and erbium are very effective in improving skin quality and texture as

well as stimulating collagen but they still require some downtime although

much less than fully ablative laser treatment so how can we apply the

benefits of laser technology without any downtime by first understanding the

underlying problem the skin we’re trying to address I look at it this way the

skin which is about two millimeters in thickness is made up of two

the dermis and the epidermis the dermis is the backbone or foundation of the

skin this foundation is supported by cables made of collagen aging health and

environmental factors caused breakdown and loss of collagen loss of collagen in

the skin has an effect on the skin like the brakes and the foundation of a

structure that would be like a building lines or wrinkles which are present at

rest refer to as static lines can be the result of loss of support caused by loss

of collagen a universal goal in the claim of superiority for every new

technology in the stimulation of the skin to produce collagen if you look at

the claims made by technologies such as laser or radiofrequency and micro

needling they all list the stimulation of collagen production as being a

significant benefit much of this stimulation of collagen is based on the

physiologic response of the skin to a medically induced controlled injury the

skin recovers from injury by producing collagen there is however a limit on how

much collagen can be generated by your skin regardless of the technology this

concept is something that I have observed as being generally ignored by

practitioners it is common in our practice to see a patient

after they had several different laser treatments by several different

practitioners over the course of a few years I often find the skin to be

scarred or thinner than I would expect this is the result of over treating I

compare this injury to the skin to be comparable to the type of injury which

occurs if you force someone with weak muscles to lift weights that are too

heavy this means that a strategy for wrinkle treatment needs to be well

thought out before being implemented to improve the appearance of wrinkles laser

treatment can be used to stimulate collagen in the dermis to restore

support and new the top layer of skin to restore

even texture and color during my assessment I look at what my patient

wants to improve and determine the level of severity of the fine lines they’re

interested in treating I explained to my patients that as a general rule the

deeper the lines the more aggressive the laser treatment needs to be practically

speaking I find that unless I’m doing a surgical procedure such as eyelid

surgery or facelift surgery when people are already taking a week or so off so

they have a period of time they will not be seen my patients generally prefer to

avoid procedures where the skin is ablated and they have to be out of

commission even for a few days for minimal to moderate depth wrinkles laser

treatment can be performed without ablation and without the downtime one

laser I use is a non ablative 1064 YAG laser the outer layer of skin is

preserved but the heat of the laser can penetrate into the dermis to induce a

collagen response and remodel the skin since wrinkles are often associated with

Sun induced skin discolorations I also treat these discolorations refer to as

solar disk crummiest and solar lenta goes I use the q-switch laser to treat

pigment at this level without ablation of the top layer skin in our office we

use the same q-switch laser for tattoo removal I then deliver platelet-rich

plasma or PRP to induce maximal collagen production within the body without using

heat PRP is a concentration of wound healing and growth factors present in

your blood PRP is prepared by drawing a patient’s blood and then spinning the

blood in a centrifuge to separate the platelets the skin can benefit from PRP

with collagen stimulation improvement in blood supply increase in skin thickness

which ultimately results in a nice glow and luster to the skin which is fairly

unique to PRP while PRP is often injected into the skin or applied

topically after micro needling I find that a treatment we call skin boosting

by using a specially designed device effectively delivers PRP directly into

the skin without causing swelling bleeding or bruising PRP can also be

mixed with hyaluronic acid to provide a scaffold for the fibroblasts to place

collagen more effectively as well as adding hydration to the dermis to

improve the skin surface or epidermis without downtime we help our patients

with a procedure called HydraFacial HydraFacial uses water for the same

effect as microdermabrasion to remove dead skin cells from the outer skin

layer while avoiding irritation often associated with traditional

microdermabrasion glycolic acid and hyaluronic acid is often used during the

HydraFacial session which provides maximum benefit to the epidermis Hydra

facial also involves no downtime and the skin can look really good right after

the procedure more aggressive lasers have an important role in wrinkle

treatment as skin improvement fractional and partially a blade of lasers like co2

erbium and Andy AGG are still highly effective for combined treatment or

improvement of the dermis and epidermis although downtime is required anytime

the outer skin layer is partially ablated it can be for a limited time in

my practice I strive to help my patients with minimal to moderate wrinkles with

combined combinations of technologies such as non ablative laser PRP and Hydra

facial to get maximum results with no downtime I provide my patients with

perspectives and a strategy for maintenance consumers our bra

with aggressive messaging from companies who pay celebrities to claim that the

secret to their youthful appearance is the technology that the celebrity was

paid to endorsed you can potentially avoid getting your skin cooked and

damaged by finding an ethical and highly experienced doctor to be with you for

the long-term so you can achieve your goals and look your best

I hope you found this information helpful thank you for your question

Will facial fillers leave my skin stretched as the filler fades?

This question comes up often enough so I spend a lot of time in consultation

helping my patients understand the specifics of how I place facial fillers

I explain why the skin should not be over stretched and as a consequence

become more loose when fillers placed accurately and in harmony with your

natural facial structure I’ll discuss how I use fillers in my practice and how

I make a point of showing my patients the anatomy that is relevant to

understanding the way I perform filler placement 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 perform filler treatments for upper and lower eyelid

hollowing lip enhancement facial lines and for acne scars every day in my

practice I also used my experience as a face lift and facial implants surgeon to

place long-lasting hyaluronic acid filler at the bone level I use this

technique of Structural Volumizing to create definition of the cheeks jawline

chin by applying this approach my patients look more balanced as opposed

to bloated and pillowy I believe that a concern about looking deflated after

filler is metabolized originates from people seeing too many overfilled faces

the effects on the skin in an overfilled face can be compared to what happens to

people whose bellies become stretched from weight gain so it stands to reason

that after significant weight loss there is a

lot of loose skin the same type of effect could result from the skin being

stretched from over filling the face this does not happen when I perform

filler placement it comes down to understanding the anatomy and balance a

few years ago some very well-known celebrities were being referred to as

pillow face in the media this was because the doctors they went to placed

excessive volumes of filler in their cheeks to make them look younger

instead the filler spread onto the skin and made their faces appear more rounded

patients will sometimes ask me how can these famous people who can afford the

best looks so bad I won’t presume to speak for the

celebrities or their doctors but I can describe what I do that’s different

let’s talk about cheek volume enhancement I find that there are two

basic scenarios we see in our practice one is a younger person with a relative

genetic deficiency and the other is a person who has lost facial volume from

aging what is the basis for this volume deficiency it’s bone structure your

facial appearance is most directly affected by your bone structure bone

structure is like the frame that supports your house so I approach filler

placement from the bone structure using techniques to deliver long lasting

hyaluronic acid fillers with blunt cannulas at the bone level this provides

remarkable support and definition of the overlying skin this approach is not what

is most commonly practiced fillers are placed over zealously just below the

skin to compensate for the anticipated spread of the fillers beyond the

location of the attendant placement this makes people

look bloated I look at the face for balance using the golden ratio as a

guide the golden ratio is seen throughout nature and is very well

illustrated by the facial structure of people like models and actors Structural

Volumizing allows for strategic placement without the need to stretch

the skin when it comes to placing the volume in areas such as the lips where

bone structure is not directly involved I focus on subtle correction to create

definition so there is a balance with the rest of the face essentially the

facial features should look natural like you never had anything done sure the

situation occurred that you can’t continue with filler placement after the

fillers are metabolized your appearance will be the same as if you hadn’t done

anything not worse because you had filler placed it comes down to

understanding what features you’d like to enhance and understanding the method

being employed and what results you should expect

I hope you found this information helpful thank you for your question

Some people have said to me, “you look so refreshed”, some people have said “you

look so much younger”.

I wake up every morning and I’m like “Oh my god”, and I look in the mirror, I can’t

believe it—I can’t!

It’s like amazing.

People know that I look different and they can’t figure it out, so it’s not where

you see people that walk around and some people that got a facelift and they’re like, you

know, their eyes—it’s a subtle change that people can’t figure out, they just

know you look good and you look refreshed.

People just think I look happy and they don’t know why.

Are there ways to make fillers last longer?

People are sometimes hesitant about having cosmetic filler treatment because they worry that the results may

not last as long as they would like another reason for hesitation is fear of

ending up with exaggerated looking cheeks particularly after seeing people

in the media with pillowy or doughy looking faces I’ll discuss how cosmetic

fillers can be placed in a way that’s not performed by most doctors I apply

this method every day in my practice and achieve long-lasting and natural results

for my patients 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 I routinely perform facial cosmetic surgery such as

facelifts and the surgical placement of facial implants this surgery based skill

set has been instrumental in my ability to place cosmetic fillers at the deeper

bone level I call this deep placement of filler Structural Volumizing as it adds

structure and definition to the face not just volume the advantage is that you

look natural not overfilled or doughy as a cosmetic eyelid surgery specialist I

believe in having a natural aesthetic in my approach to upper and lower eyelid

surgery I also routinely perform filler treatments for the eyelids lips and nose

these areas are subject to different variables that affect longevity which I

will elaborate about further to begin with when we talk about types

of cosmetic fillers I prefer using hyaluronic acid fillers such as from the

Restylane and Juvederm family of fillers hyaluronic acid exists naturally in the

body so these fillers are safely metabolized over time this is in

contrast to permanent and semi-permanent fillers which can become very complex to

manage in the event of a complication such as an infection or foreign body

reaction there are three variables which impact the metabolization of hyaluronic

acid fillers the physical characteristics like the elasticity and

viscosity the effects of facial movement and the presence or absence of the

enzyme hyaluronidase in a particular anatomic location

generally speaking thicker and more viscous hyaluronic acid fillers last

longer than softer and less viscous hyaluronic acid fillers I place thicker

fillers in facial areas where there tends to be little to no movement such

as the cheeks jawline and chin a thicker filler such as a Juvederm Voluma can

last in these areas for up to two years I find that softer fillers are better

for areas where there’s more movement such as the lips when placed in an area

such as the lips softer fillers typically last about six months to a

year the placement technique used for softer

fillers in delicate areas such as around the eyes and lips is critically

important to achieve an aesthetic appearance with maximal longevity in my

experience this is best achieved using techniques where there is minimal

inflammation and minimal swelling the hyaluronic acid which naturally exists

in your skin plays a vital role in the support and hydration of your

skin as part of your body’s natural metabolic processes the enzyme

hyaluronidase breaks down hyaluronic acid in the skin as new hyaluronic acid

is produced this means that hyaluronic acid placed during a procedure can also

be affected by the hyaluronidase which exists naturally in

your skin since hyaluronidase is not present in

the space between the bone and the overlying muscle hyaluronic acid filler

placed in the space does not break down in the same way as it would in the skin

as I mentioned earlier a major issue associated with conventionally placed

cheek filler is too frequently seen unnatural results like the people

walking around with soft and pillowy looking faces this doughy look is due to

filler being placed in the fat or soft tissue level which is not strong enough

to hold the filler in the intended shape it was originally placed the filler

weighs down the face or migrates to make the face look bloated by performing the

technique I use called Structural Volumizing for deeper filler placement

I’m able to achieve facial definition and more natural-looking results for my

patients this method of placing filler at the foundational bone level allows a

hyaluronic acid to essentially be stabilized by the bone and the overlying

muscle layer my patients look more defined and natural without the risk of

filler migration or their face looking soft or bloated when Structural

Volumizing is performed for the cheekbones chin jawline and jaw angle

it’s referred to as the Y Lift the Y Lift is often referred to as a

non-surgical facelift I found that my experience performing

facelift surgery as well as surgical implants has been invaluable in my

approach to performing Structural Volumizing as a surgeon I’m able to feel

the levels I’m placing the filler in and be certain about the anatomy of where I

am in fact I’ve often observed many well-intended doctors mistakenly

believing that by contacting the bone with the needle while performing filler

placement that they’re placing the fillers at the bone level in actuality

the fillers are placing is being placed at the soft tissue level or just below

the skin Structural Volumizing not only allows for enhanced filler longevity and

better definition but it can also have a lifting effect as we get older and

facial volume decreases due to bone muscle and fat loss this shrinking of

facial structure leaves less support for the skin as a consequence there appears

to be a perception of the skin sagging or stretching when volume is added at

the bone level to rebuild facial structure

a skin lifting effect often results Structural Volumizing does not replace a

facelift for people whose skin soft tissue and underlying muscles need

lifting tightening and repositioning however for a lot of my patients in

their 40s 50s and 60s with facial volume loss that is more

significant than the skin is soft tissue sagging structural volumizing or why

lift can look as if they had a facelift one of the characteristics of Structural

Volumizing is that there is very little use of needles in comparison to

conventional filler placement in fact the precision placement of filler is

done not with needles but rather blunt tip cannulas this strategic application

of blunt tip cannulas means that there is typically minimal to

no bruising swelling or discomfort I often see patients who come in

requesting a facelift assuming that they have sagging skin and jowls they’re

often surprised to learn that what is commonly referred to as jowls may

actually be the result of volume loss at the mandibular notch making the area

appear to be sagging by restoring volume to the jawline particularly in the

mandibular notch area you can achieve a continuous contour and better defined

jawline your profile can be enhanced by improving your chin projection without

placing a chin implant sunken cheeks can be made more full and youthful looking

with a better definition and structure that simply isn’t possible with more

traditional filler placement techniques it’s important to understand that

youthful faces are not just full but also defined and balanced while results

can resemble a facelift the actual procedure to treat the jawline chin and

the cheeks can be done in about 20 minutes

patients can look pretty good right after the treatment and can even return

to work afterwards which is why some patients come in during their lunch hour

I routinely see my patients after two weeks to see how they look after

everything has settled oftentimes doctors try to overcome the limitations

of hyaluronic acid fillers placed in the traditional fashion by choosing or

selecting semi-permanent or permanent fillers which generally tend to be

thicker as mentioned earlier should there be any

complication such as infection these fillers need to be surgically removed

with structural volumizing my patients get better definition

the safety of reversibility unique to hyaluronic acid fillers should the need

arise to have to dissolve hyaluronic acid the enzyme hyaluronidase sold under

brand names such as Vitrase or Hylenex can be used to safely dissolve the

hyaluronic acid without needing to perform surgery by combining

longer-lasting and thicker hyaluronic acid fillers with advanced

techniques such as Structural Volumizing I’m helping my patients look their best

at any age my approach to maximizing safety with

longevity and reversibility has helped my patients enjoy a more youthful look

for much longer periods of time than had been previously possible with

traditional approaches to the application of hyaluronic acid fillers

I hope you found this information helpful thank you for your question

What’s the difference between PRP alone and TrichoStem Hair Regeneration?

After so many years of my advocacy to help patients with the benefits of PRP or platelet-rich plasma there has been a recent sharp rise in PRP treatments for hair loss being offered what’s interesting is that this sudden acknowledgement by the sellers of PRP treatment for hair loss has resulted in people looking for the optimal strategy for their hair loss the question comes up what is the difference between PRP being offered by a range of medical retailers and what I developed which is called TrichoStem Hair Regeneration

I’ll explain what is the night and day difference between generic PRP as is offered by everyone with a centrifuge and our system for managing hair loss called TrichoStem Hair Regeneration

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 the New York City and Long Island area for over 25 years

I’ve been performing hair transplant surgery throughout my career in the late 2000s I used this wound healing material called extracellular matrix by ACell to improve the healing and survival of hair grafts after transplant surgery I was also using this material to help healing surgical incisions during cosmetic surgery procedures such as facelifts

About a year after applying this material during hair transplant surgery not only did I observe the hair grafts healing better but I was surprised to see that native hair that wasn’t transplanted increased in number and became thicker I took the initiative then to take this discovery and develops for customization of PRP and a cell as a standalone non-surgical treatment for male and female pattern hair loss

I’ve been performing these treatments for people from around the world since 2011 I essentially established a new category for the treatment of hair loss particularly as an alternative to hair transplantation which I trademarked as trichostem hair regeneration long before

This recent acceptance of PRP I was among the first doctors to use platelet-rich plasma or PRP in the cosmetic field to improve skin quality and texture although PRP was being used in dentistry and orthopedics many if not most dermatologists and plastic surgeons were dismissive and openly disparaging of any doctor advocating the use of PRP the hypocrisy of this head-in-the-sand behavior was that the medical literature had thousands of articles from around the world in peer-reviewed journals with overwhelming evidence of the value of PRP for a range of applications

Thanks to some weekend courses and industry promoted financial schemes these same people are now happily making money by promoting PRP in their offices

I guess they had a change of heart so what is the benefit of PRP for hair loss well PRP can stimulate hair growth in people who are suffering from genetic pattern hair loss however this effect on hair growth has several limitations the first is the duration of effect is limited by the type of hair loss you have this means that the effect on hair growth can be very short this limitation is that the injection of PRP for hair loss requires multiple treatments typically performed once a month we see a lot of people who tried these monthly PRP treatments they report how they were frustrated by the physical pain they experienced the inconvenience and the limited results they saw even after suffering through multiple injection sessions

The doctors nurses or physician’s assistants administering PRP injections insisted that they come in for even more injection sessions without providing a clear explanation about what to expect afterwards many of these patients report that no anesthetic was used during their treatments which means that each individual scalp injection was extremely painful

Some patients report that they were told that using anesthetic will actually be detrimental to their results which just simply isn’t true another limitation of this PRP alone approach is the longevity even if maximum results possible are achieved with PRP alone the results are limited to the short-term stimulation of hair growth many practices offering PRP injections alone require multiple injections in the first year usually monthly or every two to three months and then maintenance injections in the second year which can be anywhere from three to six months

Basically the maintenance sessions are just to sustain limited results but with constant and essentially a never ending treatment horizon what we do in our practice with TrichoStem Hair Regeneration is completely different from how PRP alone is being used by medical retailers PRP is not the main ingredient in our treatment system but rather PRP is used in combination with extracellular matrix by the company a cell the formulation and delivery methods are customized to each individual’s unique hair loss profile

This is why many of our TrichoStem Hair Regeneration patients are actually former patients of other practice is using PRP alone or practices that are using less effective applications of ACell and PRP it’s important to be aware that when hair is thinning the hair growth cycles actually become shorter and the resting phase or dormant phase gets longer

TrichoStem Hair Regeneration reactivates these resting hair follicles resulting in an increase in the number of visible hairs and induces thinning hair to grow and thicker this combination of benefits results in significantly more scalp coverage for years there’s a difference in outcome and longevity from well appreciated by patients who are formerly treated with common PRP injections only as I mentioned a major advantage of our system is that far fewer treatment sessions are needed to sustain long-term benefits for years

In fact a significant percentage of trichostem hair regeneration patients only needed a single treatment session to improve their appearance with results lasting three to five years and even longer ordinary PRP treatment protocols or even other common ACell and PRP formulations need to be repeated every month to every three months with uncertainty of how well they may or may not work the success rate of TrichoStem Hair Regeneration is well established for over ten years with over 99% of our patients seeing visible increase in their hair coverage I felt so inspired by our consistent success that several years ago I built a free-standing facility exclusively for TrichoStem Hair Regeneration in Northern Virginia in Tyson’s Corner I observed hundreds of patients every year from around the world and developed my own classification system to provide optimal treatment strategies for each individual patient for example a 21-year-old male with advanced hair loss needs a different approach to treatment in comparison to a 50-year-old female with moderate and diffuse hair loss yet when you walk into a place offering PRP or PRP and generic a cell there is no difference does that even make sense of course not as discussed earlier your hair loss is unique to your category

I provide every patient with a customized treatment plan specific to his or her hair loss category as determined by my classification system I have found a benefit from many people with moderate to advanced hair loss to perform two separate treatment sessions over the course of two years this is because I observed that a significant percentage of fine hair growth resulting from the first treatment session can be significantly thickened further with a second treatment session

This second treatment session is usually performed 15 to 24 months after the initial treatment we call this in our practice the booster session which is part of our whole treatment plan so there’s no additional cost it can’t be overstated that a significant advantage of trichostem hair regeneration system is the longevity of results results that can last three to five years in both men and women with no more than two treatment sessions within this two-year time frame

Since we have been administering this treatment to patients since 2011 and we follow our patients closely we have well-documented results for patients who were treated for four to five years prior with a single treatment session and sustaining improvement in their hair growth most of the current in generic hair injection treatments being offered can’t claim close to this longevity of effectiveness

Most of these people were not actually performing any type of hair loss treatment such as hair transplant before taking a weekend PRP course this means they took a weekend course sponsored by a company selling centrifuges and kits and then went home and started selling their hair loss treatment services what they don’t appreciate in their excitement to make money is just how deeply emotional hair loss is for people seeking treatment

This is not the same as someone just trying Botox for the first time as opposed to these practices who indifferently sell hair loss injections

In my practice when I accept a patient for hair loss treatment I’m making a long-term commitment to helping you as best as I can sometimes we’re asked why there is a difference in the cost for trichostem hair regeneration in comparison to common PRP sessions

Some people are mistakenly assuming that our treatment is just PRP which it’s not as stated in detail earlier aside from the level of effectiveness which has been clearly stated is important to remember that the one-time cost of trichostem hair regeneration covers the entire treatment plan including follow-up visits to our office or follow-up meetings through email Skype or FaceTime during which we track your results after the first month and we do this after 3 months and every 6 months for the duration of 2 years

These follow-up visits include my taking high-resolution standardized digital photos which I compare for you so you can see how much you’re improving each visit is typically 30 minutes for patients who have had a second injection treatment or booster after the first treatment there’s no additional cost or charge for the second treatment this is in sharp contrast to PRP where you’re charged for every treatment session and with most practices not indicating how many treatment sessions are needed and how long the treatments will be effective

There’s no real horizon further many of these practices tell their patients that they only have a 50% chance of seeing any improvement we stand behind TrichoStem Hair Regeneration with you receiving one to two treatment sessions and seeing improvement lasting three to five years or even longer it’s common knowledge that time is money with ordinary PRP injections alone people spend a lot of time going to the doctor’s office for monthly injections or every three month injections and with an indefinite time frame for ongoing treatment

This means that the first session costs accumulate and quickly exceed the one-time cost for a TrichoStem Hair Regeneration to your plan in addition the time being spent on treatments with ordinary PRP alone could otherwise be used for making money or enjoying your personal time the math is simple multiple sessions of PRP will cost more in the long term both financially and in lost time with unpredictable results and uncertain longevity we also use trichostem hair regeneration treatment for increased scalp coverage for people who’ve had previous hair transplant surgery patients who’ve had several hair transplants in the past can see thicker hair growth of their thinning native hair and even from their transplanted hair this is because it’s common for me to see transplanted hair progressively thinning years after a hair transplant

Another group who benefits is male patients who are taking finasteride for many years but then you see the benefits of thicker hair growth after TrichoStem Hair Regeneration treatment we also help a lot of women with hair loss and have noted that in women taking spironolactone to address their testosterone levels also experience thicker hair growth after TrichoStem Hair Regeneration as an early proponent of PRP in the aesthetic field I can speak with great confidence about the benefits of PRP for wound healing and for skin quality improvement when used alone for hair loss it has significant limitations such that the patient can get frustrated with the need for this constant treatment to compound this inconvenience and cost and having uncertainty about the benefits makes this even more undesirable

While our TrichoStem Hair Regeneration has PRP in the formulations powered ten plus years of experience with customized combinations of PRP and a cellular matrix clearly exceeds the generically blind application of PRP for anyone with any type of hair loss hair loss is far too complex to be indiscriminately treated with PRP alone since hair loss cannot be cured

I strive to optimally manage your hair loss by delaying the progression and maximizing your scalp coverage with typically only two treatment sessions which can sustain benefits for over five years when a patient asks us about our PRP treatment for hair loss we simply say it’s not PRP it’s TrichoStem Hair Regeneration

I hope you found this information helpful thank you for your question

What are the risks of Botox?
Botox or botulinum toxin injection for aesthetic
purposes has been the most popular non-surgical cosmetic medical procedure
in the world for years in the United States the other botulinum toxins
available to us are Dysport and XEOMIN as one of the first doctors to
use botulinum toxin in 1993 before he was used for cosmetic indications I can
discuss my experience and how I counsel my patients about the risks of botulinum
toxin 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 as I mentioned earlier as an oculoplastic surgeon I was among the
first group of doctors to administer Botox to patients for the treatment of
neurologic conditions like hemifacial spasm and been nine essential
blepharospasm in fact I was a division chief at a hospital soon after my
fellowship training and I was the only one at the hospital allowed to use
botulinum toxin if other doctors at the hospital wanted to use botulinum toxin
they had to contact me and to present the request and it was up to me to
approve their use of Botox at the time I was so focused on the numerous medical
and neurologic uses of Botox I questioned how it would be possible that
people would willingly subject themselves to having a neurotoxin
responsible for paralysis and death as in the case of botulism for the purpose
of improving wrinkles clearly the world has more than embraced botulinum toxin
for aesthetic purpose the applications of botulinum toxin for
facial enhancement and even underarm sweating are very well-established
botulinum toxin is not a filler it works by interfering with nerve signals that
go to muscles by blocking the nerve signal the muscle doesn’t contract for
example in a situation where you have deep frown lines the muscles responsible
for these lines are the corrugator and pro serous muscles after botulinum toxin
is administered the lines are diminished since the muscles are not as active this
effect can last about 3 to 6 months in my practice I typically treat people
every 4 months the more common concern I address is a fear of looking overdone
this concern is usually followed by the recitation of a list of famous people
where the patient says looks botoxed or frozen as with any facial enhancement
evaluation I discussed the potential role of botulinum toxin in the context
of other issues which are typically present such as hooded upper eyelids and
under eye bags cheek volume loss and thinning lips I show examples of area
specific treatments such as crow’s feet lines frown lines depressed brows and
downturned lips the effects of botulinum toxin are generally seen at three days
and peak at about two weeks my patients don’t look frozen or fake they just look
better since I see my patients routinely two weeks after injectables I assured
them that I can start conservatively to see how they respond as with any
procedure which involves needles there are some people who have more anxiety
about needles than they do about the outcomes of treatment I offer my
patients topical anesthetic as well as nitrous oxide sedation so they can be
more comfortable people are able to drive after receiving nitrous
our sedation which is commonly used for dental procedures I also used the
smallest needles and my technique has been consistently successful in terms of
patient comfort asymmetries and botulinum toxin affecting non-targeted
muscles inadvertently is a risk asymmetry such as uneven brows can be
addressed with additional placement of botulinum toxin to create a better
violence sometimes a facial muscle can be effected such as in the upper eyelid
resulting in temporary mild ptosis since the botulinum toxin was not directly
placed in this area the effect is caused by relatively low dose which means the
muscle activity typically returns much sooner than the intentionally treated
muscles problems with botulinum toxin and other fillers are often associated
with people thinking that cheap Botox or fillers is a good idea
understanding the minimum cost to the practitioner it’s obvious that a lot of
the typical low cost botulinum toxin is delivered by over dilution of the
product so the effects don’t last as long as they as they should instead of
calling it cheap Botox it is often referred to as expensive water on a more
serious note the product is as good as the practitioner performing the
procedure knowing the muscular anatomy and understanding how to precisely dose
and place it’s truly an art which takes years to develop you can decide how much
your facial appearance is worth investing in I think that I can state
from my personal experience that the risks of botulinum toxin can be
minimized by having the procedures performed by an experienced physician in
an office setting who will be there for you should something unexpected occur I
hope you found this information helpful thank you for your question