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An Update In Stem Cell Therapy

What are stem cells?

Stems cells are the foundation of every organ and tissue in our body. Throughout our lives stem cells replace injured tissues and cells that are lost every day, such as those in our skin, hair, blood and the lining of our organs. Stem cells have the ability to change into other types of cells, making them essentially unprogrammed cells or “shape shifters”. Since stem cells can become bone, muscle, cartilage and other specialized types of cells, they are at the center of a new field of science called regenerative medicine. Stem cells harvested from a patient have the potential to replace countless cells of the body and are capable of treating diseases including Parkinson’s, Alzheimer’s, Diabetes, Autoimmune Diseases and more. They may heal the body by replacing cells plagued with disease or the inability to produce a healthy immune system response by regenerating healthy new cells that can.

Simple Example of stem cells

When we have a paper cut on our finger, the damaged cells that were cut release chemicals on their own called growth factors. These growth factors activate dormant stem cells in the surrounding tissue which produce new skin cells and heal the wound. Once it is healed, the stem cells again become dormant. Stem cell therapy works essentially in the same way to heal injuries and diseases.
Two simple things define stem cells:
• They can “self renew” – Meaning they can multiply and produce greater numbers of themselves.
• They can “differentiate” – Meaning they can develop and change into at least two different types of specialist cells that carry out a specific function.

4 Known Types of Stem Cells

• Adult Stem Cells – Derived from an adult human body.
Most commonly used stem cell for treatments and widely accepted. In instances where adult stem cells are obtained from the intended recipient, the risk of rejection is essentially non-existent. Consequently, more US government funding is being provided for adult stem cell research.
• Embryonic Stem Cells – Derived from embryos.
These cells require specific signals to differentiate to the desired cell type. If they are simply injected directly, they will differentiate into many different types of cells, resulting in a tumor derived from this abnormal pluripotent cell development. The directed differentiation of ES cells and avoidance of transplant rejection are just two of the hurdles that ES cell researchers still face.
• Fetal Stem Cells – Derived from aborted fetuses.
These have developed further than embryonic stem cells and are a little more specialized – their options are limited. However, they can still produce most types of cell in the body.
• Induced Pluripotent Stem Cells (iPSCs) – From some parts of the human body.
These stem cells are engineered from older, fully specialized cells. Scientists encourage these limited cells to act like embryonic stem cells again, with the ability to become any type of human cell. This is a complex technique that has only recently been developed and is the subject of much ongoing research.

How is stem cell therapy administered?

Stem cell therapies are injected into the vein (intravenous treatment). There are two types of intravenous methods which are discussed below.
•Direct Injections – Injections administered directly into the site that needs repair such as muscles and tendons.
•Intranasal – Administered to a highly vascular pathway of the nose to encourage more stem cells to travel past the blood brain barrier.

what this means for Alopecia areata

Alopecia Areata is an auto immune disease where the immune system attacks hair follicles. It usually does not threaten health, but it can greatly affect the way a person looks. A patient that receives adult stem cell treatment injections (Platelet Rich Plasma (PRP) Treatment) will find that it will stimulate his / her immune system, promote cellular regeneration and improve symptoms associated with Alopecia. Platelet Rich Plasma (PRP) uses the patients’ own blood and processes it with a concentration of the body’s own cells which contain healing and growth factors.

alopecia areata Research

A blog published in Bernstein Medical Center for Hair Restoration detailed the success of a method that used hair cloning therapy to treat alopecia areata. The study was conducted by Marwa Fawzi, a dermatologist at the University Of Cairo Faculty Of Medicine, who used stem cells from the scalps of eight children with alopecia areata to regenerate their own hair.
Six months after the hair cloning treatment, the results showed a 50% increase in hair in more than half of the subjects. One of them, an 8-year-old boy, grew nearly a full head of hair after being almost completely bald before treatment.
After being convinced of the results, Dr. Fawzi analyzed the new skin samples on the head and examined the hair follicles themselves and found that the injected stem cells had migrated into the follicles. The stem cells stimulated the follicles to transition from a dormant phase to a hair-generating phase (just like our above paper cut example).
[calltoaction]To learn more about our Platelet Rich Plasma (PRP), please contact us at (817) 473-2120 today or email appointments@markbisharamd.com to schedule an appointment.[/calltoaction]

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International Society of Hair Restoration Surgery (ISHRS) 2015 Practice Census Facts and Figures

An estimated 397,048 surgical hair restoration procedures were performed worldwide in 2014 (a 28% increase from 2012)

  • In the United States, 112,409 hair restoration procedures were performed
  • In Canada, 5,488 hair restoration procedures were performed o In Mexico/Central & South America, 28,456 hair restoration procedures were performed
  • In Europe, 46,849 hair restoration procedures were performed o In Asia, 143,239 hair restoration procedures were performed o In Australia, 3,724 hair restoration procedures were performed o In the Middle East, 56,883 hair restoration procedures were performed

Estimated Surgical Hair Restoration Worldwide Market Size
Based on the estimated number of 397,048 hair restoration procedures performed in 2014, multiplied by the average fee* charged to patients for a procedure, the estimated worldwide market for hair restoration was calculated as follows (expressed here in various currencies).
This is a 28% increase since 2012.
• $ 2,472,332,531 USD (U.S. Dollars)
• $ 3,243,082,197 AUD (Australian Dollars)
• R$ 7,769,181,361 BRL (Brazil Real)
• $ 3,077,386,471 CAD (Canadian Dollars)
• € 2,225,840,977 EUR (European Euros)
• $ 19,166,832,114 HKD (Hong Kong Dollars)
• 158,528,434,200 INR (Indian Rupees)
• ¥ 310,606,552,827 JPY (Japanese Yen)
• ₩ 2,779,470,400,966 KRW (Korean Won)
• $ 38,837,130,025 MXN (Mexican Peso)
• SR 9,271,617,840 SAR (Saudi Riyal)
*The “average fee” charged for a procedure reported by survey participants and used in this calculation represents the overall average fee charged to all patients treated. Since the cost of procedures performed on individual patients may vary depending on the number of grafts and several other factors, the “average fee” as it related to this survey did not represent what all patients would expect to pay for a procedure, and should not be construed as a typical price for a hair restoration procedure.
Extrapolated Number of Hair Restoration Surgical & Non-Surgical Patients Worldwide
The extrapolated worldwide number of hair restoration patients treated in 2014 was approximately 1,055,480 (358,109 surgical patients and 697,372 non-surgical patients) – a 9% increase from 2012

  • In the United States, 244,207 hair restoration patients were treated
  • In Canada, 21,028 hair restoration patients were treated
  • In Mexico/Central & South America, 120,767 hair restoration
  • patients were treated
  • In Europe, 100,530 hair restoration patients were treated
  • In Asia, 427,709 hair restoration patients were treated
  • In Australia, 15,867 hair restoration patients were treated
  • In the Middle East, 125,372 hair restoration patients were treated

By Age and Gender

  • In 2014, 84.7% of all hair restoration surgical patients worldwide were male
  • In 2014, 15.3% of all hair restoration surgical patients worldwide were female
  • Since 2006, the proportion of female surgical hair restoration patients worldwide increased 11%
  • In 2014, 59.9% of all non-surgical hair restoration patients worldwide were male
  • In 2014, 40.1% of all non-surgical hair restoration patients worldwide were female
  • In 2014, more than half of both male and female surgical patients worldwide fell between the ages of 30 to 49 years old, 58.6% and 54.7% respectively

Trends by Country
Of the estimated 397,048 hair restoration procedures performed worldwide in 2014:

  • Mexico/Central & South America experienced the biggest increase in the number of procedures, with 28,456 procedures performed in 2014 (an 82% increase from 2012)
  • Since 2006, the number of hair restoration procedures around the world jumped 76 percent by 2014
  • From 2006 to 2014, the Middle East saw the largest increase (363%) in the number of procedures
  • From 2006 to 2014, Mexico/Central & South America experienced the second largest increase (167%) in the number of procedures

Trends by Recipient Area
From 2012 to 2014, hair restoration procedures performed on non-scalp areas jumped in every category worldwide.
Facial (moustache/beard) procedures increased 196% o Chest procedures increased 170%
Eyelash procedures increased 90%
Pubic procedures increased 62%
Eyebrow procedures increased 52%
 

  • Asia conducted the largest amount of eyelash (1,256), eyebrow (7,515), facial hair restorations (4,199), chest (491) and pubic (706) hair restoration procedures.
  • The largest increase in facial hair restoration procedures from 2012 to 2014 occurred in Mexico/Central & South America (814%), followed by Europe (297%).
  • When members were asked which of the following non-scalp hair restoration procedure sites males and females were most interested in discussing, the majority of members reported women were most interested in discussing eyebrow procedures (92.2%). Men were most interested in discussing facial (63.8%) or eyebrow (31.5%) procedures.

Notice: Please refer to the full report of the 2015 ISHRS Practice Census, located at:
https://www.ishrs.org/statistics-research.htm.
The objective of the survey was to gather reliable statistics with regard to the volume of hair restoration procedures performed, patient demographics, surgical techniques, treatments used, and other practice dynamics. The margin of error for the sample is plus or minus 4.9 percent at the 95 percent confidence level.
 
The ISHRS commissioned Relevant Research, Inc. of Chicago, IL, USA, to help develop the survey instrument, collect the data, analyze the findings, and prepare the summary report. Relevant Research, Inc. is an independent survey research company specializing in surveys and statistical programs for professional societies and trade associations. All data collected from ISHRS members was kept completely confidential by Relevant Research, Inc.
The 2015 ISHRS Practice Census is published by the International Society of Hair Restoration Surgery (ISHRS) and is a compilation of information provided solely by participating physicians. The information published in this survey was developed from actual historical information and does not include any projected information. Neither Relevant Research, Inc. nor ISHRS has verified the accuracy, completeness or suitability of any information provided here, and ISHRS does not recommend, encourage, or endorse any particular use of the information reported in this survey. ISHRS makes no warranty, guarantee or representation whatsoever and assumes no liability or responsibility in connection with the use or misuse of this survey.

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ARTAS Hair Studio Increases the Amount of Hair Transplanted

Recently, Restoration Robotics launched  ARTAS Hair Studio.  This state of the art product allows the patient and surgeon plan and produce a simulation of a possible outcome.  Although this product has some limitations to the realistic look of the transplanted hair, it does allow for a formal interaction between the surgeon and the patient that spawns more thought into the over- all operative goal and leads to increased numbers of hairs being transplanted.

The most common cause of dissatisfaction of hair transplant patients in my practice and in patients that come to me from other practices is that they didn’t get the thickness that they wanted.  The ARTAS Hair Studio allows the patient to “Test Drive” their appearance and modify the operative plan under the guidance of the surgeon.  It becomes the surgeon’s ethical and responsible role to provide guidance on safe and age appropriate hairline design, donor capacity, and realistic expectations on social and physiologic downtime.  The ARTAS Hair Studio becomes paramount providing a sneak preview to esthetic results that vary with amount of hair.
Put together with a well informed consult discussing preventative hairless measures backed by randomized double-blinded placebo controlled trials, the ARTAS Hair Studio is quickly becoming the standard of care in hair restoration planning and patient education.
ARTAS Hair Studio also integrates directly with the robot and becomes the operative plan for the patient ensuring that the patient is receiving exactly what he is intending to recieve.
For a consultation please call 817-473-2120 or email appointments@markbisharamd.com.  Skype and other internet-based consultations are available.
Mark A Bishara M.D., P.A. and Paragon Hair Clinics care for patients world-wide.
Dr. Mak A Bishara, M.D. P.A. performs robotic follicular unit graft selection for residents living around Mansfield, Southlake, Dallas, Arlington, Fort Worth, and surrounding the DFW area in North Texas.

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Facts About Hair

Let’s talk more about hair. Here is more information on the science of hair.

Functions of Hair

The reasons we have hair, and the functions of its growth patterns, are not completely understood. Our prehistoric ancestors were much hairier than we are today; the reason for the decreased hairiness of modern man is unknown, although it is reasonable to assume that it parallels the use of clothing for warmth and protection from the sun and physical trauma. Hair is integral to our body image and can have a profound influence on our self-esteem and self-confidence. There is no other part of the human anatomy that can be changed or manipulated so easily. Hair can be groomed, styled, waved, straightened, dyed, braided, or cut, and, unlike tattoos or body piercing, changes made to our hair can be completely reversed. Hair serves as an important means of self-expression, and the loss of this form of self-expression in those going bald may account, at least in part, for the despair that they may experience.

Hair Anatomy

Hair is simple in structure, but has important functions in social functioning. Hair is made of a tough protein called keratin. A hair follicle anchors each hair into the skin. The hair bulb forms the base of the hair follicle. In the hair bulb, living cells divide and grow to build the hair shaft. Blood vessels nourish the cells in the hair bulb, and deliver hormones that modify hair growth and structure at different times of life.
Each hair follicle measures about 3-4 mm in length and produces a hair shaft about 0.1 mm in width. The hair follicle has five main parts. Starting from the bottom of the follicle, they are; the dermal papillae, matrix, outer root sheath (ORS), inner root sheath (IRS), and the hair shaft.

Hair Growth

Hair growth occurs in cycles consisting of three phases:

  • Anagen (growth phase): Most hair is growing at any given time. Each hair spends several years in this phase.
  • Catagen (transitional phase): Over a few weeks, hair growth slows and the hair follicle shrinks.
  • Telogen (resting phase): Over months, hair growth stops and the old hair detaches from the hair follicle. A new hair begins the growth phase, pushing the old hair out.

This Information is brought to you courtesy of Dr. Bishara and The Paragon Plastic Surgery & Med Spa
 

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Lasers and Lights

Lasers and light-based therapies– (for hair removal, anti-aging and skin rejuvenation) have nearly become everyday tools for people seeking smooth, blemish-free or simply more youthful-looking skin. The terms laser and light-based therapies are often used interchangeably, however, there are crucial differences in how the technologies work and what they effectively treat. Here’s a breakdown:

Lasers
The term laser is actually an acronym that stands for “light amplification by stimulated emissions of radiation.” Ablative lasers safely injure the skin at first, but eventually creates a healthy healing/wound response that results in collagen production. By delivering a deep, single wavelength of energy, these are often used to remove deep lines or scars and typically require one session. Nonablative lasers do not damage the skin, which is a plus, but may be less effective and require multiple sessions. These are used to correct skin concerns and remove tattoos and hair by targeting the dark pigments in the hair, which eventually leads the hair follicles to become inflamed and disabled, and voila! Smooth, hair-free skin after a few sessions. Lasers do, indeed, emit radiation-yet in tiny amounts that are deemed harmless.

Light
Intense pulsed light (IPL) delivers a broader spectrum of light energy, unlike lasers’ single wavelength, and is a light source-not a laser. IPL is a strong, in-office treatment used for hair removal, discoloration, broken blood vessels and sun damage reversal. Another type of light therapy, light emitting diodes (LED) is a shallower, gentler treatment, ideal for collagen boosting and rejuvenating the skin. LED comes in a variety of colors, red for fighting acne, blue combat bacteria and yellow to reduce redness.
Dr. Bishara and The Paragon Plastic Surgery & Med Spa provide a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. Please contact our office at (817) 473-2120 for more information or visit our website at www.MarkBisharaMD.com.

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