First, there are many different ways to prepare PRP. PRP is just a concentration of platelets. You can obtain a concentration of platelets in many different ways. The least expensive way, which is what most doctors do, is simply to spin down a standard red top tube so that you get serum at the upper part of the tube. Then you draw off the top one or two cc of plasma and discard this. The remainder of serum is PRP. The quality of this PRP is not good, however. Others might not even take off the top 1 or 2 cc of plasma. Failure to remove the top fraction of plasma is not PRP, but they might call it PRP.
Then there are kits designed to prepare PRP. We have tested different kits to see how they compare between one another for specific growth factors by doing ELISA testing. What we know is that the concentration of platelets influences the concentration of growth factors, but there are many different types of platelets. Some kits produce low levels of specific growth factors.
After testing various PRP kits, we settled on the best option because we could obtain higher concentrations of many growth factors when compared to other kits. Other kits may be less expensive, but the quality of the platelets in the less expensive kits seems to influence the concentration of growth factors. We want the highest level possible. Not all methods of producing PRP are equal. In fact, some commercially available kits are junk in comparison to the top performing kits. I would also suggest that if your doctor is not using an excellent commercial equipment, and especially if the physician is using a laboratory red top tube, you are wasting your time and money with that PRP. Poor quality equipment is probably why so many patients fail with PRP.
Then we studied different kits to determine which kits best influence density following the injection of PRP. We found that some kits produced a 25% decrease in density at six months, while other kits produced a 50% increase in density at six months. We have not concluded that Acell offers benefits when combined with PRP. However, some doctors remain convinced that Acell does improve their results. Personally, I'm not convinced yet. We are still studying this.
Next, we began to study ways to increase growth factors even greater. We used high-frequency sound energy to burst the platelets. Since the only things we are interested in are growth factors, cytokines, and chemokines, it makes sense to eliminate the rest of the platelet. If you thought of platelets as lemons, we want the juice out of the lemon, but not the pulp, seeds, nor skin. Sonicated PRP is pure cytokines because we centrifuge off the waste products. Also, because we squeeze the lemon more, we get 5 to 8 times the concentration of growth factors that you can get from standard methods to activate PRP. In conventional methods of activation, much of the growth factors remain trapped inside the platelet. The byproducts of the platelet must be broken down by the body. With my method, we eliminate all the waste products of the platelet.
The benefit so far from my sonicated PRP is that grafts grow much sooner, following transplantation. We are also studying whether sonicated PRP results in improved hair density for your remaining hair in the area of hair loss following injection of sonicated PRP and comparing the increase in density to that of standard methods to activate PRP.
We see 80% of grafts growing at 3.5 months with sonicated PRP and 99% of grafts growing at 4.5 months with sonicated PRP. With standard PRP or no PRP, you would see only 30% at 3.5 months and 40% of grafts growing at 4.5 months. Much higher concentrations of growth factors and cytokines significantly boost the regrowth of grafts much earlier in the post-transplant phase.
Follicle stem cells are entirely new. Follicle stem cells are from your hair follicles. In other words, these stem cells are autologous follicle stem cells. We are injecting this alone or with PRP, as well as, putting them into FUE extraction sites in combination with an extracellular matrix or amniotic membrane.