PRP and ACell Review by Dr. Cole I want to review the work we have been doing with PRP and ACell over the past year with my patients. We engaged in many studies to evaluate the benefits of PRP in treating hair loss with and without the addition of ACell, evaluated traditional techniques to activate the PRP, and investigated a new method to release growth factors using sound energy, or sonication, to lyse the platelets. Our research is groundbreaking work that has not been performed at any other center, and while much of the data is still in progress, I want to bring you up to speed on the advantages of using sonication to lyse the platelets. Our initial studies revealed that PRP prepared with the Arthrex Angel system resulted in a 50% increase in hair density, but PRP developed by Regen resulted in a 25% decrease in hair density. We therefore concluded that the method used to prepare the PRP is critical. Unfortunately, many physicians use tubes similar to the Regen system to spin their PRP since these systems represent an inexpensive and simple route for collection, which may be advantageous to the physician but does little for the patient. The Angel system, on the other hand, is far more complex with settings to increase the platelet concentration far beyond that of other systems and filter away red blood cells, granulocytes, and other undesirable cells in PRP. We have shown that using the more complex Angel system of PRP preparation affords greater increases in platelet concentration and hair density. I heavily invested this past year in laboratory equipment that would allow me to quantify the concentration of growth factors in untreated and activated platelets. I bought ELISA (enzyme-linked immunosorbent assay) test kits along with the requisite analytical instrumentation to read their results in addition to a $23,000.00 sonicator. With these items, I conducted a comparative study of the various methods that can be used to activate platelets. Specifically, I used traditional means, such as adding bovine thrombin or calcium gluconate, and my novel sonication approach for lysing platelets, and what I found in these in vitro was that sonication performed for the proper duration of time and sequence could result in a 5 to 8 times greater concentration of growth factors using the Angel system. We further found the Regen method of preparing PRP did not come close to these levels of growth factors regardless of the method employed to release growth factors. Initial in vivo studies comparing sonicated PRP with calcium gluconate-activated PRP, the preferred clinical route of activation at present, indicated that grafts grew much more rapidly when the soncicated PRP was used. In fact, at the three-month follow up we saw up to 80% of the sonicated Angel PRP-treated grafts were growing. Based on this finding, we embarked on an additional study to evaluate the benefits of sonicated PRP on the rate of graft growth. I remain very excited about the potential to accelerate graft growth rates with sonicated Angel PRP; hence in the month of September, we are offering 50% off sonicated PRP with Acell with your hair transplant so that we can determine how well this method influences the rate of graft growth. Let us know if you are ready to try this incredible advancement in the field of hair restoration surgery. In the month of September, we will begin to evaluate the ability of a combined microparticle-PRP therapy to prolong the release of our very high concentration of growth factors.