Nature's Youthful Lift: Turning Back the Hands of Time

Let’s face it–we all want to look good, to look our very best no matter what our age. So we diet, exercise, stay out of the sun, and use sunscreen. We do all those things we are supposed to do to take care of ourselves, but unfortunately, the hands of time keeps on ticking and we are still aging. Those fine lines and wrinkles just aren’t responding to the facial creams and lotions like they used to. On top of all this, you know you don’t have the money to invest in a surgical facelift and are not sure you would even want to, considering you may not end up with the desired results. Also, who wants weeks of painful recovery?  It seems like the options are few and far between. Or are they?

What if I told you there is a simple outpatient therapy that typically takes about 90 minutes that could give your complexion a whole new youthful glow and erase years off your face without pain, cutting, bruising or surgery? And…. it costs a mere fraction of a standard facelift?

PRP: Providing You with Options To Regain Your Youthful Look

I am passionate about my patients’ well being.  I am passionate about effective results. This is why I spend extensive time studying and researching evidenced-based therapies and cutting-edge medical practices for my patients. I am interested in going above and beyond the norm in medicine and providing my patients with options for improved health, options that do not include surgery.

I believe that healing patients without surgery is one of the holy grails of medicine.  What is it, you ask? Platelet Rich Plasma – PRP is a novel & unique therapy given at Sarasota Neurology. It is a therapy that can be used to provide great results in a variety of conditions, including regenerating your skin to its former youthful shine.

Platelet rich plasma (PRP) can be used to perform painless, non-invasive, non-surgical facelifts. It is a simple, painless outpatient procedure. With platelet rich plasma, a patient’s blood is drawn and the platelets are extracted into a small amount of your own blood plasma. Platelets contain numerous beneficial, natural growth factors and chemical messengers that aid in healing and tissue regeneration. As the PRP is derived from the patient’s own blood, there is no risk for rejection or disease transmission.

While the blood is being processed into PRP, the patient has a topical anesthetic put on their face and neck. There are no injections and this is a painless procedure. After the face is anesthetized, the skin overlying the face, forehead and neck are prepped to receive the PRP. The platelet concentrate is then applied to the face and in a specialized technique, administered into the subcutaneous tissue. Once the PRP has been applied, it is activated with thrombin, a naturally occurring protein that causes the platelets to release their many growth factors and start the tissue regeneration process. The last step involves applying a natural collagen mask to the face to allow the maximum growth factor penetration into the subcutaneous tissue. After the procedure is completed, moisturizing cream is applied and the patient may go home. There is no down time, no recovery time and no pain!

After the PRP Facelift

After the natural PRP facelift, some individuals may experience slight swelling, redness or minimal tingling discomfort but this passes quickly, usually within an hour or so. The procedure is complete and the facelift occurs naturally over the next 8 weeks. Since the PRP is applied evenly over the face, around the eye, brow, cheeks and neck, there is a symmetrical facial tissue rejuvenation. With getting a PRP facelift, one not need to be concerned about the outcome as the body is regenerating its own collagen and subcutaneous facial tissue. The end result is a symmetric rejuvenation with a fuller face, erasure of crow’s feet and other facial lines, a smoothing of the skin and improved color tone to the face. Results can be seen as early as two weeks after the procedure.

For maximum benefit, I highly recommend the use of special aesthetic cream and moisturizers. These are available through our office. You will be instructed on the care of your skin and suggested supplements and facial skin creams to get the most out of your non-surgical PRP facelift. With proper care and use of sunblock, the beneficial, youthful effects of PRP can last up to 18 months. Some report even as long as 2 years. The good news is that there is no limit on the number of times that you can have PRP applied for facial rejuvenation, unlike that of surgical facelifts which are limited to 2-3 procedures at the most. Better yet, the risks of getting a non-surgical PRP facelift are as minimal.

Are you ready to experience this for yourself? Are you ready to turn back the hands of time and experience Nature’s Youthful Lift? Contact my office to schedule your appointment right away.

Nature's Youthful Lift: An Alternative to Surgery

It’s unfortunate, but true—age discrimination exists, particularly in the job market. That’s why baby boomers are getting more plastic surgery than ever before.  They are looking for the competitive edge in the job market trying to fight this current recession with any and every weapon at their disposal, even if it means going under the knife.

What if there were a way to avoid the pain and risk of surgery and regain your youthful glow with minimal to no downtime and much smaller investment of your hard-earned income? There is…and it’s called Nature’s Youthful Lift™.

Nature’s Youthful Lift™

Nature’s Youthful Lift is a non-surgical face-lift. It is an outpatient procedure that takes less than 90 minutes and is performed at my office. The results will astound you and the price will too!

Sound too good to be true? Well, it’s not. As a passionate and committed neurologist, I have endeavored my whole career to provide my patients with leading-edge care and therapies that provide outstanding results without surgery. I am not opposed to surgery, but if there is a way to provide the same results without cutting, I choose that method.

Platelet Rich Plasma (PRP) is that method. PRP has garnered attention over the years of researchers looking for ways to help the body heal and regenerate through safe, more natural mechanism. I consider PRP to be a real holy grail in medicine – healing and generating damaged body tissue through concentrating the body’s own healing power. There are many, many ways PRP can be used to help the body. Right now, I want to focus on PRP’s amazing regenerative effects on the body’s skin system.

Platelet rich plasma (PRP) can be used to perform non-surgical facelifts. With PRP, a patient’s blood is drawn and the platelets are extracted into a small amount of your own blood plasma. Platelets contain numerous beneficial, natural growth factors and chemical messengers that aid in healing and tissue regeneration. As the PRP is derived from the patient’s own blood, there is no risk for rejection or disease transmission.

Now back to the actual procedure. It is a simple outpatient treatment that typically takes about 90 minutes.  The patient comes in and has their blood drawn. While the blood is being processed into PRP, the patient has a topical anesthetic (numbing medication) put on their face and neck. There are no injections and this is a painless procedure.

After the face is anesthetized, the skin on the face, forehead and neck are prepped to receive the PRP. The platelet concentrate (PRP) is then applied to the face and in a specialized painless technique, administered into the subcutaneous tissue. Once the PRP has been applied, it is activated with thrombin, a naturally occurring protein that causes the platelets to release their many growth factors and start the tissue regeneration process. The last step involves applying a natural collagen mask to the face to allow the maximum growth factor penetration into the subcutaneous tissue. After the procedure is completed, moisturizing cream is applied and the patient may go home. There is no down time, no recovery time and no pain! Simple, painless, and effective! I also highly recommend an ongoing skin care regime after the PRP to maintain the glowing results. The products are available in my office.

The Results

Now on to the exciting part! Over the next 6-8 weeks, PRP will naturally regenerate and rejuvenate your skin and subcutaneous tissue, putting more collagen in your skin and giving you a more youthful appearance. And that’s not all. It will also erase the sun damage and fine wrinkles lines. PRP also helps the skin improve its tone, color and quality.

If you think you maybe a candidate or want to give yourself an edge in this current economy, then contact my office and schedule your consultation right away.

The anagen phase is the hair growth period. It generally lasts for about eight years. At any given time, 85% of hair follicles are in the anagen stage. People with long anagen phase can grow long hair. Hair grows, on average, one half inch per month. The exact length of anagen time is determined genetically. In males who are prone to hair loss, the follicles are more sensitive to DHT (dihydrotestosterone) induced hair loss. When blood concentrations of DHT reach a certain level, hair shafts begin to miniaturize and subsequently fall out. DHT puts hair follicles into the catagen stage. This is the transitional phase of hair follicles. Normally it lasts for about two weeks. The hair shaft is detached from the hair follicle papilla and is pushed upward. The hair shaft does not necessarily fall out.

Catagen phase is followed by the telogen phase. This is the resting or dormant phase which lasts 1-4 months. For those follicles that come out of this dormant phase, they go back into the anagen phase where new hair growth occurs. The old hair shaft is pushed out by the newly growing hair. An average of 75 hairs are lost daily by most people. In hair loss treatments, stimulation of many follicles at once causes them to go from telogen to anagen phase. Shedding can occur during this 4-6 weeks period. This is normal as new hair shafts are being formed and old ones are pushed out.

In males with male pattern baldness (MBP) or androgenic alopecia (hormonal related hair loss), DHT binds to the follicles and causes hair to gradually thin out. This occurs from the front, back to the crown. There is a wide variation in MBP and is dependent on a number of factors. Medications exists that inhibit the production of DHT such as finasteride (Propecia®).. Minoxidil (Rogaine®), a medication for high blood pressure, can also help stop hair loss. The exact mechanism for by which Minoxidil works is not completely understood. Males can take finasteride and use topical Minoxidil. It is recommended that women not take finasteride due to the high risk of fetal birth defects.

Most accepted hair loss treatments work at best fifty percent of the time. That still leaves millions of people affected by hair loss which affects their self esteem and quality of life. It is here where platelet rich plasma may provide hope for thicker hair and new hair growth -  a treatment that does not involve surgery or medications.

There are few sites in the body that contain stem cells. Stem cells are undifferentiated cells that can transform into various tissue, depending on what tissue needs to be regenerated. In addition to bone marrow, the hair follicle is one of the only place in the body that stem cells are found. These hair follicle stem cells are located at the base of the hair root know as the bulge. When activated, these stem cells migrate to the hair follicle papillary area which is at the very base of the hair shaft. These stem cells then interact with the hair dermal matrix papillary tissues to begin to grow new hair. This complex interaction is mediated by growth factors and cytokines. Cytokines are cell-signaling proteins that are secreted by cells and are contained in platelet rich plasma. They are the signaling molecules that are involved in cell to cell communication. When activated, the hair follicle stem cells and dermal papilla cells release cytokines. PRP enhances and stimulates release of these cytokines.

The cells of the hair root are highly specialized for rapid growth and division. Given the right signaling, these cells produce actual hair and the pigment that give hair its color. The dermal papilla is in direct contact with the cells of the hair matrix. It is the dermal papilla that plays the major role in controlling hair growth. It is the complex interaction of the activated stem cells, hair matrix and dermal papilla that ultimately results in new hair production.

Hair growth is divided into 3 stages: anagen, catagen and telogen. Ninety percent of human hair is in anagen stage, which is the active growth stage. Anagen phase can last 2-6 years. Anagen phase is controlled by numerous factors. Androgens (e.g. testosterone) has a direct effect on anagen phase. After the anagen phase, hair enters the catagen phase which is short in duration, usually 2-3 weeks. During this time, the hair matrix stops producing hair and keratinizes (forms into solid protein.) This phase is then followed by telogen phase where the hair shaft falls out. Telogen lasts anywhere from 3-4 months. If the hair follicle is still active, a new hair matrix will form from the stem cells in the bulge area. New hair growth begins and this starts the anagen phase again. In androgenic hair loss (male pattern baldness, MBP) hair follicles end up staying in the telogen phase and no new hair growth occurs. This is under the influence of another androgen, dihydrotestosterone (DHT), which is a transformed version of testosterone. The conversion of testosterone to DHT is controlled by an enzyme, 5-alpha reductase. Medications are available to dramatically stop production of DHT and thereby slow down or stop the loss of hair.

The hair follicle stem cells in the hair sheath bulge give rise to new hair matrix cells. The sustained growth of the matrix cells and subsequent differentiation into hair producing epithelial cells are under the influence of cytokines and growth factors, primarily produced by the dermal papilla – at the very base of the hair follicle. The dermal papilla production of cytokines and growth factors is controlled by the bulge stem cells, hormones and other growth factors. Many of the latter are contained in platelet rich plasma.

Growth factors in PRP that positively affect hair growth include the following:

*Platelet-Derived Growth Factor (PDGF)
*Basic Fibroblast Growth Factor (bFGF)
*Insulin Growth Factor 1 (IGF-1)
*Vascular Endothelial Growth Factor (VEGF)
*Keratinocyte Growth Factor (KGF)

Some of these growth factors promote the production of a specialized protein – stromelysin, a zinc based growth factor – which accelerates dermal papillae cell growth. Zinc supplementation with other supplements may help in this process.

Growth factors and cytokines that have a negative effect on hair growth include:

*Transforming Growth Factor Beta (TGF-b)
*Epidermal Growth Factor (EGF)
*Interleukin 1 Alpha
*Fibroblast Growth Factor (FGF)

PRP can be injected into the scalp to stimulate hair follicle by release growth factors and stimulating stem cells. Activation of platelet rich plasma with thrombin, after injection into the scalp, helps to reduce the negative effects of TGF-b and EGF. Interestingly, human growth hormone (HGH) has no direct influence on hair growth either positive or negative.

Androgens are various hormones produced by the adrenal gland or from testosterone, can have varying effects on different hair growth, depending on the type of hair. Certain hair, such as that on the eyelashes have no effect from these androgens. Hair on the sides and back of the the head are only weakly affected by androgens. There is a strong effect of androgens on hair on top of the head. Of these, dihydrotestosterone (DHT) has the strongest influence on scalp hair. It binds to receptors on the dermal papilla cells. Through a complex interaction, this androgen-receptor complex stimulates production of cytokines which control the growth of hair matrix cells. These same cytokines which have a positive stimulation effect on the hair follicles on the sides and back of the head yet inhibit hair growth over the top of the scalp. The latter results in hair follicle atrophy, hair miniaturization and eventual hair loss.

Vitamins may have an effect on hair growth as well. Retinoic acid (derived from vitamin A) and vitamin B6 (pyridoxine) can have a negative effect on factors involved in hair growth. Biotin (vitamin B7) on the other hand can has a positive effect on hair and nail growth. It is commonly used as a supplement to enhance or improve hair growth.

Medications can have a mild to dramatic effect on hair thinning and hair loss. Chemotherapy agents used for cancer can frequently cause hair loss. ACE inhibitors, beta-blockers, Depakote (valproic acid) and lithium are some examples of commonly used drugs that have a negative effect on hair growth. Conversely drugs such as minoxidil, finasteride and spironolactone may help in promoting hair growth. While minoxidil can be used by anyone, finasteride should be used only in males and spironolactone by women.

From this information, it is obvious that there are many complex interactions between cells, growth factors, cytokines, hormones and other mechanisms that can have positive or negative effects on hair growth. This has given researchers the opportunity to investigate many avenues to promote wanted hair growth. Research continues to develop safe and effective methods for sustaining hair growth and generating new hair growth. Biopsies in individuals with advance hair loss show that scalp hair follicle density is the same in bald regions as it is in hair growth regions. Finding the mechanism to turn these dormant hair follicles “on” is ongoing. At this time, platelet rich plasma appears to be very safe and effective.

While PRP is effective in stimulating new hair growth and thickening existing hair, its effect lasts up to 12 months. In order to sustain fuller hair, PRP needs to be given about every 9 months. With a successful hair transplant surgery, the effects are significantly longer in duration. Properly done hair surgery transplants may last years. However, hair surgery is a complicated process that must be done with precision to have desirable outcomes. The final outcome may not be seen for a year. The effects of PRP on hair growth can usually be seen in 3 months with the duration of full effect for about 9 months. Think of PRP as a long acting fertilizer for your hair and scalp. Your lawn need fertilizer to be added at least twice a year to sustain a lush lawn. The same can be said about your hair needing PRP to sustain a dramatically better appearance.

Research published by Geoge Cotsarelis, M.D.has shown that the density of hair follicle stem cells is the same in bald areas of the head as it is in areas that are growing hair. Further research by Dr. Fabio Rinaldi has shown that platelet rich plasma can stimulate these hair follicles in bald areas (alopecia) to activate and grow new hair. Another study on patients affected with hair loss showed thickening of the hair shafts after administration of PRP, resulting in a fuller appearance of growing hair.  At this time, no other therapy has shown to more consistently stimulate new hair growth. Further research is being done to better understand the process. Hopefully, one day a medication will be able to be used to more effectively reactivate these dormant hair follicles.

Activated Platelets in PRP

Where Does PRP Come From?

A small amount of your blood (30-60 cc) is taken from your arm. The blood is then placed in a special kit and centrifuged. The centrifuge processes the blood, extracting the PRP, leaving the excessive plasma and red blood cells in the container. The PRP is a concentration of platelets and growth factors, concentrated up to 500%.

How Is PRP Administered?

The top of your scalp is cleaned and anesthesia is given in an area on the top of your head, about the size of your hand. PRP can then be injected into the anaesthetized area of the scalp. It is distributed, via multiple injections of small amounts of PRP, over the scalp. You do not feel anything because of the anesthetic. The PRP is then massaged into the scalp to better distribute the growth factors and further stimulate hair follicle stem cells.  This stimulates a mild degree of inflammation that triggers the hair growth process.  For the first day after the procedure, some patients may feel a mild soreness or irritation of the scalp. This is expected and clears quickly.   Chemical proteins in the PRP, known as cytokines, send out signals to recruit other cells to stimulate hair growth and thickening of existing growing hair. This process of growing new and thicker hair takes 6-8 weeks to start noticing the difference. Maximum hair thickness and growth is reached at 6 months…

How Many PRP Treatments Are Necessary?

The response to PRP therapy varies from patient to patient and also depends on the degree of hair loss.  Most patients respond well to anywhere from 1-3 treatments, given at 6-9 month intervals.  As opposed to cortisone injections, there is no actual limit on the number of PRP treatments that can be given, as tissue regeneration will occur with each treatment. The risks and side effects of PRP treatment are quite minimal and do not change with repeated treatment. The PRP actually has a bactericidal effect, so the risk of infection is minimized. As PRP is derived from your own blood, there is no risk of transmissible diseases. The effects of PRP will eventually lessen if treatments are not continued, over a year.

By the age of 50, fifty percent of men are affected by hair thinning and varying degrees of hair loss. It is estimated that 35 million men in the United States are affected by significant hair loss. Significant in that it affects their self esteem, personal relationships and abilities for higher performance in the workplace.  The majority of these cases are different degrees of Male Pattern Baldness (MBP) also known as androgenic alopecia. This can range from receding of the hairline in the frontal scalp and temples to complete hair loss over the top of the scalp, leaving  hair growing only on the sides and back of head. Regardless of whether hair is receding or there is more major hair loss, this can all take a negative toll on a individual’s lifestyle and confidence. It should be noted that of individuals with life-affecting hair loss, 40% are female. Most people do not notice thinning of hair until over 50% or greater loss of hair occurs in any one area. Fortunately, there are multiple options available to both stop hair loss and to potentially regrow hair. Many of these options do not involve surgery.

Platelet rich plasma therapy (PRP) has been used in hair regrowth therapy for the past five years. Reports have indicated that PRP administration results in thickening of existing hair and stimulates dormant hair follicles to grow new hair. In existing hair, PRP stimulates the stem cells supplying the hair follicle essentially to produce more keratin, the major component of a hair, to grow hair. This leads to a thickening of existing hair shafts. PRP can also attach to hair follicle stem cells in the “bulge” area. This is the area of the hair follicle that controls hair production and where the stem cells are located. It is the interaction of these activated stem cells with the rapidly dividing cells of the hair follicle dermal papilla at the follicle base that produces new or improved hair growth.

In summary, platelet rich plasma is currently the state-of-the-art method for treatment of hair loss and thinning. Combine this with other hair treatment options such as Rogaine® (minoxidil) and/or Propecia® (finasteride) as well as other supplements and one can potentially regain the hair they once used to have. The first step is for you to make the decision and commitment to getting a new head of hair!