:: Greco Hair Surgery Blog ::

The Versatility of Cytokine Rich Plasma

2012-01-27T06:58:00.000-08:00

In our last Blog post we explained the difference between Platelet Rich Plasma (PRP) and Cytokine Rich Plasma (CRP). CRP contains the optimal levels of growth factors without the red blood cells (RBC), white blood cells (WBC), and platelet membranes. It also contains a natural bio-scaffold (ECM) with three times the levels of plasma protein levels needed for scaffold production contained in PRP.
CRP has advantages in non-surgical orthopedic injection treatments for tendons, ligament, muscle and arthritic joints because it does contain optimal levels of growth factors and cytokines, like “Interleukin IL-1ra antagonist”, which has demonstrated in studies and in clinical use to be a powerful pain reducer especially in arthritic joint disease.

“In patients with osteoarthritis in the knee, ACS injections demonstrated a statistically significant improvement in pain scores compared to hyaluronic acid and saline injections. While these results are preliminary, it does appear that levels of IL-1ra higher than found in circulating blood can provide clinical benefit”.

The following Case study is positive evidence of the use of CRP in a patient who had five knee surgeries facing the early stages of Osteoarthritis.

Case Study
This 36 year old patient underwent 5 knee surgeries for a fully torn ACL and four cartilage tears in both knees at various times. He presented with pain and decreased mobility and could not even bend down when trying to line up a putt. Listen to the patients results after just two treatments with CRP. Click on the link below to hear his story.
Call us for more information regarding all our Regenerative Medicine procedures!

727-791-3830
Feel free to email us at info@grecohairsurgery.com with your questions or comments

The Next Generation PRP

2012-01-01T08:30:00.000-08:00

Cytokine Rich Plasma

Cytokine Rich Plasma is a product developed by OroGen BioSciences where Cytokines or Growth Factors (Protein’s) contained in platelets can be released without the use of thrombin, calcium chloride or collagen and filtered, so that the final product is an analytical grade regenerative material made of your own protein.

CRP contains the optimal levels of growth factors without the red blood cells (RBC), white blood cells (WBC), and platelet membranes. It also contains a natural bio-scaffold (ECM) with three times the levels of plasma protein levels needed for scaffold production contained in PRP.

Because recent studies suggest optimal platelet level “below 3.8 x 105platelets/uL have a suboptimal effect, and concentrations above 1.8 x 106platelets/uL may have a paradoxically inhibitory effect”. 1 Additionally, the inclusion of leukocytes (White Blood Cells) in the preparation is also controversial because they are pro-inflammatory increasing tissue damage by releasing excessive amounts of reactive oxygen species in the inflammatory phase of muscle injury. 2

The inflammation process is a complex one involving protective cells of your body, white blood cells (leukocytes and macrophages). In Arthritis these white blood cells are attracted to the damaged joints and try to minimize the harm by dealing with what the cells consider "foreign"; that is, something that should not be there. In trying to defend against the affliction, these cells release oxidants as well as inflammation-causing molecules that can lead to further damage to the joint.

This same process is true in inflammatory hair loss conditions like Alopecia Areata. Researches are also finding that are finding that inflammation is becoming even more important in male and females pattern hair loss (Androgenic Alopecia) conditions.

In simpler terms, “it is a purer grade of your own regenerative material (growth factors in plasma proteins) because the cells that are not needed and may cause more inflammation have been filtered out. Therefore, CRP has the advantages of PRP, but we feel “it is more beneficial in tendon, ligament and bone repair as well as more advantageous in cosmetic collagen enhancement, fat-transfer and hair regeneration”.

With CRP we are continuing to advance the science of regenerative medicine not only in hair restoration, but also in non-surgical applications for bio-enhanced Cosmetics skin rejuvenation, collagen induction and Orthobiologic injuries.

References

1- Weibrich G, Hansen T, Kleis W, Buch R, Hitzler WE. Effect of platelet concentration in platelet-rich plasma on peri- implant bone regeneration. Bone 2004;34:665-671.

2- Tidball JG. Inflammatory cell response to acute muscle injury. Med Sci Sports Exerc 1995; 27:1022-1032

Call us for more information regarding all our Regenerative Medicine procedures!

727-791-3830

PRP Improves Aging Skin

2011-11-25T08:17:00.000-08:00

Evidence Based Study
By Gilbert Amgar, Christian Bonnet, Alain Butnaru
and Fabienne Herault-Bardin

ABSTRACT

Autologous platelet rich plasma (PRP) plays an important role in soft tissue healing. The purpose of this study was to evaluate the efficacy of this facial skin treatment through objective parameters. Biometric parameters, including anisotropy, transepidermal water loss (TEWL), micro-relief, and hydration were used to determine the relative success of the treatment. The study, which included 37 female patients, demonstrated an average of 24% improvement in the anisotropy coefficient after the third week. The TEWL and micro-relief parameters also improved significantly (P < 0.05 in all parameters tested). In addition to these results, this study suggests that certain measured values may be used to predict the success of the aesthetic use of PRP.

This is an excellent evidence based study by Dr. Gilbert Amgar, a friend from Paris and aesthetic physician who specializes in “self rejuvenation” utilizing cellular PRP therapy. We are finally getting much needed objective studies to verify what we have been saying and doing with Bio-Facial skin rejuvenation since 2007.

To read the article please CLICK HERE

Featured in Anti-Age Magazine Journal

2011-10-21T14:32:00.000-07:00

This September issue of the French Anti-Aging journal featured an article by Joseph F. Greco, PhD, PA/C. The Anti-Aging journal is sold throughout Europe and features selected cutting edge procedures developed in Cosmetic, Dermatologic surgery and hair regeneration by experts attending the EMMA Congress in Paris, France Oct 1st 2011.
Dr. Greco’s article was the subject of one of four lectures he presented as a Faculty member in the 1st European Masters Course in Hair Restoration surgery. Dr Pierre Bouhanna, of Paris, an author of five textbooks in hair restoration surgery was the course director while other faculty members included physicians from France, Italy, Switzerland, Israel, Turkey as well as the United States.

To read the article in English, please CLICK HERE

7th European Congress - Paris France

2011-09-30T06:34:00.000-07:00

Aesthetic Dermatology • Aesthetic Surgery • Anti-Aging Medicine

Joseph F. Greco, PhD, PA/C will be a faculty member at the 1st International Hair Surgery Masters Course, Oct1, 2011 in Paris, France. The Course runs in conjunction with the 7th European Congress, European Masters in Aesthetic & Anti-aging Medicine, EMAA, an International conference that attracts over 2,000 physicians from around the world.

Dr. Greco will be presenting four lectures on his experiences utilizing autologous cellular therapy in hair restoration surgery, non-surgical hair regeneration and the use of cellular therapy in hair loss diseases like Alopecia Areata and Discoid Lupus.

Additionally, Dr. Greco will speak on Tips and Pearls to achieve the maximum in a surgical hair restoration procedure and be the moderator of two sessions.

Regenerative Medicine

2011-09-09T09:59:00.000-07:00

Case Study “Grease Burn”
The female patient in the photo below (Fig 1) suffered a grease burn one week prior to treatment. A small quantity of her blood 25 mls was drawn, processed, filtered then concentrated to produce protein rich plasma. The solution was literally dripped on the burn site, a perforated dressing was applied and the wound was covered for one week without any other treatment. No antibiotics, creams or other treatments were used.

Fig1

One week later (Fig 2 below) the dressing was removed. Compare the result before and after treatment.

Fig1

Because grease burns generally cause a scar the patient was followed for one year. In, Fig 3 below, note the lack of any scaring from the grease burn at one year.

Fig3

Discussion
The reason for the rapid healing and lack of scaring is because when the patient’s growth factors are concentrated and applied to the injured area, healing rapidly occurs. Protein Rich Plasma is a powerful anti-inflammatory, so when the body can quickly transition from the inflammatory phase into the healing phase, less scar collagen and more natural collagen is produced, therefore, less scaring.

In addition to wounds, the same principle applies for other soft tissue injuries such as muscle, tendons and ligaments. The quicker the healing the faster the cells can regenerate and healing can begin. Thus the benefits of using protein rich plasma in hair transplant surgery are faster healing, less scaring and an overall enhanced result. This particular case is a visual example of the power of Regenerative Medicine.

Why Wait?

2011-08-15T08:53:00.000-07:00

In the latest issue of the Hair Transplant Forum International, Walter Unger, MD Toronto, Ontario, Canada one of the most published and respected Hair Restoration surgeons in our field writes:

“Last year, in an issue of O, The Oprah Magazine, one of our esteemed colleagues was quoted as saying that “only about 20% of female patients with thinning hair are candidates” for hair transplantation. If I had been asked, I would have said that of the women that I see in consultation, only 20% are not candidates and, at the very least, a majority are. More specifically, at most, only 20% of the women that I see do not have sufficient acceptable donor tissue for at least one small session of 800-1,200 FUs. Acceptable donor is hair that is judged to be permanent and that lies in the area of scalp considered to be the donor area for males. Although many of the women we see have more than one such session available in their donor area, if even one procedure is carried out in a well-chosen, cosmetically important area, they can achieve a very satisfying cosmetic result”.

Conclusion
“A substantial majority view of expert hair restoration surgeons (20 of 28) is that at least 40% of patients they see with FPHL have acceptable donor area reserves for at least one session of hair restoration surgery. (Six of 28 thought only 20-25% are acceptable while 8 of 28 thought 70% or more are candidates.)”

Comment
I would also agree with Dr Unger that a larger majority of females can have very exceptional results with hair restoration surgery, especially with the advent of cellular therapy that maximizes the yield of transplanted grafts. Additionally, many females today that have recession in the facial area and scaring can look ten tears younger with just one session of facial framing.

(See our female patients below)

See Our Cellular Therapy on Fox TV

2011-07-28T11:10:00.000-07:00

This patient suffered from Discoid Lupus and experienced over 15 areas hair loss throughout the top of her scalp. Additionally, she was developing a linear scar in her forehead, which also effect patients with this skin disease.
The patient was treated with traditional therapy for 2 years with steroid injections, without results, prior to referral to our clinic. Her skin was becoming thinner and hair was not growing back.
  The patient was treated with only one session of PRP and this was the result at 6 months after one session. In addition to hair growing in the previous areas of hair loss, the patient’s hair character improved and the linear line that was developing on her forehead resolved. This was the first time PRP has been used to successfully treat this scaring alopecia. See the video featured on Fox FV.

A layman's explanation of PRP, OroGen Plus and Regenerative Medicine

2011-07-16T07:57:00.000-07:00

By Bob Brandt, OroGen BioSciences

Platelets are the mediators of all wound healing. They regulate and modulate the rate of repair that the other healing cells perform. Think of them as the maestro leading the orchestra into a beautiful musical piece. First he directs the horns to play. Then, he asks the strings to join in and all the time, regulating the flow, depth and tempo.

Now, because we have used so many platelets, the signal they send out is heard all over the body by a different subset of cells. Kind of like a construction crew…the plumbers, carpenters, electricians, brick layers, painters, etc. They all have a specialty that is needed to construct a building. If we put a skeleton crew of construction workers at a jobsite, it takes quite a while for the job to be completed. Now if we increase the crew by ten fold, we hopefully can have our building up in a fraction of the time. The same is true with PRP and wound repair.

Now imagine this. Our construction crew is driving to work and the bridge that they have to cross to get to the job site collapsed during the night. They can all crawl down the embankment and up the other side to get to work, but it is going to take a very long time for them to get to their destination and they are going to have to expend a lot of energy to accomplish this. The same thing happens when we are trying to repair a torn ligament or tendon, broken bone, diabetic wound or possibly a spinal fusion. To a cell, looking over torn ligament fibers is akin to looking over the Grand Canyon. They will probably never get from one side of the fiber to the other, so the injury remains chronic and eventually some scar tissue will form, but the fibers never mend themselves.

Our process (OroGen Plus) uses the body’s own material to make a bridge so that the cells have somewhere to cross. We call this a matrix or scaffold and it contains not only fibrin, but also vitronectin and fibronectin, in concentrated quantities, two very important proteins needed for wound healing. Inside of this matrix are the conductors, or the Pied Pipers, who are calling out to all the healing cells (including stem cells) in the body to come join the party at Fred’s injured leg. We have taken the simple and expanded on it to make it super juice in a way to make it easier and simpler to use. This is regenerative medicine!

Does PRP increase levels of DHT?

2011-06-09T06:14:00.000-07:00

Does PRP increase levels of DHT that will cause hair loss? NO

It has been theorized by some individuals on the internet (though not in scientific studies) that if small concentrated amounts of a patient’s blood are injected into the scalp this will lead to hair loss do to increased levels of DTH. In our experience the past four years utilizing PRP in hair restoration surgery, this has not occurred. If that were the case, it would have been reported by now because PRP is used by many clinicians throughout the world.

To put things in perspective. The body has approximately 5,000 ml’s of blood and in PRP preparation about 60 ml’s are drawn and platelets are increased. The other blood cells (RBC’s, WBC’s and plasma) are decreased from 60ml’s of blood to about 8 ml’s of PRP. Since there are many ways to process PRP it is possible to remove some or most of the cellular components leaving just pure growth factors in a small quantity of plasma (which is 90% water). While less than 10% of testosterone in converted into DHT, “how much DHT can be contained in 8 ml’s of plasma containing 90% water”? Also, how long does it take the body to metabolize it own cellular material? Generally days to weeks certainly not years. Additionally, if increased amounts of DHT causes baldness, then why are men with low testosterone levels bald?

Hair loss (related to DHT) is directly determined by how sensitive you are to androgens. Your sensitivity is determined by triplet repeat mutations in the androgen receptor gene on the x chromosome. It's the downstream effects caused by DHT binding to the androgen receptor that causes hair loss so a mutation that causes a defective androgen receptor gene is cumulative throughout the generations and each following generation will potentially have MPB that is worse than the previous generation.

Hair loss is multi factorial and stem cells play a much more important roll in AGA (male pattern) than previously thought, especially since the findings of Garza et al, 2011. This study essentially demonstrated faulty scalp stem cells result in insufficient quantities of progenitor cells that then allow the 5DHT to begin the miniaturizing of hairs genetically sensitive to 5DHT.

Our experience with cellular therapy has demonstrated: (1) the signaling of follicular stem cells with growth factors and follicular revascularization to promote reversing miniaturization in AGA, as well as, (2) reducing inflammation and turning on dormant stem cells in inflammatory hair diseases such as in Alopecia Areata and Dicsoid Lupus. Cellular therapy is as an adjunctive treatment used with FDA approved medicines like DHT blockers or Rogaine. It can be used in patients who have failed traditional therapy, used in patients who do not want to take medicines or for those who have encountered side effects to traditional medicines.

In summary, our experience utilizing autologous regenerative therapy the past four years has proven to be safe. We have not experienced any clinical negative side effects, short term or long term, in our patients nor has anyone reported side effects in their patients using cellular therapy. Utilizing your own cells to regenerate damaged cells is the future of Medicine.

Common questions

2011-05-10T18:37:00.001-07:00

Does Arterial Blood have more Platelets than Venous Blood? NO

Is it more beneficial to use arterial blood in PRP than venous blood because there are more platelets? NO

This is a question patients have been asking since it has been reported by some clinicians utilizing PRP that arterial blood is superior to venous blood, “because it contains more platelets”. This is not true, in fact, when a Pathologist at one of the country’s premier Blood Banks was asked this question they responded, “There is generally not a significant difference in platelet counts in arterial vs. venous blood in humans, certainly not one that would justify an arterial vs. venous stick.”

Arterial blood - blood found in arteries; "except for the pulmonary artery the arterial blood is rich in oxygen". About 92% of blood is comprised of Red Blood cells “that carry oxygen” and about 4% of blood is made of Platelets “that contain cytokines or healing capable growth factors”. In PRP, the objective is to reverse the ratio of red blood cells to platelets so we can utilized a higher concentration of healing capable proteins or growth factors to repair damaged tissue and regenerate cells.

Arterial blood would be beneficial in blood doping where higher concentrations of oxygen are desired for increasing athletic performance. This is just the direct opposite of what is desired in the preparation of platelet rich plasma.

What is the Difference Between OroGen Plus and A Cell in Hair?

2011-04-28T10:16:00.000-07:00

There have been many questions by patients regarding the difference between A Cell’s extracellular matrix ( ECM) and OroGen Plus (ECM) so this is an explination and our reasoning behind using a natural protein matrix for hair regeneration.

Fig 1, below left, demonstrates that the ECM in OroGen Plus is derived from your own plasma proteins (fibrin, fibrinectin and vitronnectin). When the plasma is concentrated the proteins become highly concentrated and form a bio-scaffold.

Fig 2, below right, is a scanning electron microscope view of the OroGen Plus ECM after “your own concentrated proteins are mixed with your own growth factors to form this ECM”.

OroGen Plus
“Extra Cellular Matrix”
Made from your own “Natural Proteins”

Fig 1

Fig 2

The benefits of this complex is that “your” growth factors are entrapped inside “your” protein (ECM). This complex then “calls” or “signals” other cells to migrate to the bio-scaffold where these new cells can attach and then proliferate or spread. When this happens tissue regenerates.

Since hair is made from your own protein…. “does it make sence that regenerating hair from your own protein and growth factors”, which OroGen Plus has demonstrated in Androgenic Alopecia (Male Pattern), Alopecia Areata and Discoid Lupus is a reasonable and safe way?

A Cell
“Extra Cellular Matrix”
Made from Pig Bladder

Fig 3

Fig 4

A Cell is an acellular ( no cells) ECM made from the lining of a pigs bladder ( Fig 3). A Cell extracellular matrix ECM, (Fig 4, above right) is comprised of a “combination of multiple growth factors and multiple types of collagen known to promote tissue regeneration while reducing scarring and pain associated with inflammation so it does have benefit in donor sites in hair transplantation”.

A Cell on its own has not demonstrated hair regeneration; however, in combination with PRP reversal of thinning hair has been shown so the question is, “was it the PRP or A Cell that had the effect on hair growth”?

The Importance of an Extra Cellular Matrix (ECM) and PRP with Hair

2011-04-11T14:53:00.000-07:00

On May 30, 2008, in Rome, Italy I lectured on the importance of an extra cellular matrix ECM/PRP combination for hair regeneration at the ISHRS Workshop “Made in Italy”. In the March/April 2009 issue of the International Hair Transplant Forum International we published the importance of having an extra cellular matrix (ECM) with PRP to provide a “scaffold for cellular proliferation” in hair regeneration. On March 26th, 2009 I posted the photos on my blog of our patented natural protein matrix, OroGen Plus, developed by my partner, Robert Brandt that he has used in wound care, Orthopedic, Cardiovascular and Cosmetic surgery since 2001.   Three years later, after the ISHRS Boston Meeting in 2011, it was reported that the combination of an extra cellular matrix (ECM), A Cell, a matrix made from “pigs bladder” and PRP was used to help heal donor scars and help regenerate hair. Finally, physicians are getting what I lectured on three years ago.  Since 2008, we have demonstrated hair growth in Androgenic Alopecia (AGA), Alopecia Areata (AA) and now in Discoid Lupus (DL) with OroGen Plus, or a natural protein matrix ECM/PRP complex made from the patients own “protein” rich plasma. Since hair is made of protein does it not seem reasonable then an “ECM complex made of your own protein” entrapping growth factors would be a natural way to regenerate miniaturized hair? See Below.

We feel the success of this complex is a combination of the powerful anti-inflammatory effects of PRP in the autoimmune disease processes like AA and DL where the stem cells are dormant and can then be “turned on” with our GF/ECM complex. In light of recent excellent studies by Garza, et al, Journal of Clinical Investigation, 2011 demonstrating the existence of stem cells in the follicles of bald scalp in AGA (Male Pattern) patients, we also feel the ECM/PRP complex may be “turning on” stem cells for a period of time in these patients. 

PRP Treatment brings Back Hair in Discoid Lupus Patient

2011-03-19T19:35:00.000-07:00

Discoid lupus erythematosus is a skin disease that can cause scaring hair loss. It most often affects young adult women (aged 20 to 50), but children, the elderly, and males may be affected.

This patient suffered from Discoid Lupus and experienced over 15 areas hair loss throughout the top of her scalp. Additionally, she was developing a linear scar in her forehead, which also effect patients with this skin disease. The patient was treated with traditional therapy for 2 years with steroid injections, without results, prior to referral to our clinic. Her skin was becoming thinner and hair was not growing back.

The patient was treated with only one session of PRP and this was the result at 6 months after one session. In addition to hair growing in the previous areas of hair loss, the patient’s hair character improved and the linear line that was developing on her forehead resolved. This was the first time PRP has been used to successfully treat this scaring alopecia.

Email from a patient

2011-03-08T04:31:00.000-08:00

This was a recent email from a 30 year old male patient who has extensive knowledge regarding male pattern hair loss and therapies available. He was already on a DHT blocker (Avodart) but noticed a leveling off of therapy and decided to try PRP therapy. Please see his email below:

Dr. Greco,

I have had to patiently wait to write you a two week update and I have put serious consideration into how I wanted to lay out this email. I figure I will write a brief intro and follow with some questions.

Well here is the intro. This stuff is unbelievable! I can best describe it as massive proliferation. The frontal hairline has miniature hairs that I never thought would grow just exploding. From the frontal line then deep into the recessions all of the dying short and "whitish" hairs have all just begun to grow. Crown and vertex is just about completely thickened with no obvious thinning. It actually appears that these small hairs are fighting to get out. Interestingly as I see that you have mentioned this in previous postings there is a darkening of the hair and noticed this color change on my chest and abdominal hair as well.

As for the second portion these are rhetorical questions and I don't expect answers.

1. Why didn't I do this sooner?
2. Why did I respond the way I did? Age, current regimen, type of hair loss,
3. Will these hairs continue to grow and not recede in future? Are they immune from miniaturizing?
4. I understand there is a bell curve but is it best to treat again at 4 months, 6 months, 10 months, etc?
5. Once the bell curve peak is reached do future treatments maintain or have the potential to awaken new cells again?
Again, I'm not looking for answers and a number of these questions/concepts I'm sure you have already been working on and answered. I just know that this has worked beyond my wildest dreams. I really could not have ever expected anything that could have produced these types of results so quickly. Finally thanks again so much. If you ever need a guinea pig for anything else you are working on or for that matter a sales man I am your man. This is just so incredible.

Thanks,
Keith

First International Congress on State-Of-The-Art PRP and Growth Factors in Dermatology

2011-02-18T13:31:00.000-08:00

Joseph F. Greco, PhD, PA/C was a keynote speaker at the First International Congress on the State-of-The-Art PRP and Growth Factors in Dermatology meeting in Milan, Italy January 21-22, 2011. Over two hundred Dermatologists, Plastic Surgeons, Oral surgeons from Europe, the Middle East and Asia attended the conference that was sponsored The International Hair Foundation and Chairman Fabio Rinadi, MD of Milan.

Sixty participants came from abroad (from India, the USA, Turkey, Germany, Spain).
Of the speakers, 19 were from Italy, all of them remarkable researchers, while 4 were international experts (Joe Greco from the USA, Jorge Planas from Spain, Zlotogorsky from Israel, Eduardo Anitua from Spain, 27 scientific reports, 6 round-table discussions, 4 articles published in the most important media and 1 radio interview with Radio 24, 5 international congresses introduced by their own organizers

Dr Greco has pioneered Bio-enhanced surgical and non-surgical growth factor therapy in hair restoration, including patent pending cellular technology in hair multiplication. Dr Fabio Rinaldi, an internationally respected hair researcher and Dermatologist, presented case studies of his success in treating Alopecia Areata and Androgenic Alopecia non-surgically with PRP and Dr Gianfranco Schiavone, Director of Regenerative Medicine and Plastic Surgeon at the Vatican’s Dermatologic hospital in Rome, also demonstrated impressive results using PRP in non surgical hair regeneration and facial plastic surgery.

Dr Greco, Vice President of OroGen biosciences, Inc., a Biotechnical Research and Development company, also presented future patented and patent pending growth factor/ stem technology in veterinary and human medicine for wound care, soft tissue and bone regeneration. Cases studies demonstrating “bone regeneration” with Platelet Rich Plasma utilizing a new “stem cells catalyst”, developed by OroGen was also presented by Dr Greco.

Do bald men have the potential to grow hair from invisible miniaturized follicles?

2011-01-29T15:00:00.000-08:00

In a new study, published in the Journal of Clinical Investigation, a team at the University Of Pennsylvania School Of Medicine has found that stem cells play an unexpected role in explaining what happens in bald scalp.

Using cell samples from men undergoing hair transplants, the team compared follicles from bald scalp and non-bald scalp, and found that bald areas had the same number of stem cells as normal scalp in the same person. However, they did find that another, more mature cell type called a progenitor cell was markedly depleted in the follicles of bald scalp.

The researchers surmised that balding may arise from a problem with stem-cell activation rather than the numbers of stem cells in follicles. In male pattern balding, hair follicles actually shrink; they don't disappear. The hairs are essentially microscopic on the bald part of the scalp compared to other spots.

“Even when a follicle has become miniaturized beyond recognition by the naked eye, it still has the potential of retransformation and of generating hair shafts” Ralph Paus. If not, then how could Finasteride and Rogaine work to reverse miniaturized hair? This has been my mantra and reason for trying to understand cellular therapy.

At a the recent Congress on State of the Art PRP and Growth Factors in Dermatology I spoke at in Milan, Italy Dr Fabio Rinaldi presented a study on himself . He is a Type VII patient who counted 50 hairs on his head before his PRP treatments? After the treatments he counted over 800 hairs!

The body has a symbiotic relationship between GF's and stem cells. Today, peripheral blood is taken from humans and the CD34's (stem cells) are multiplied with specific growth factors and injected into myocardial tissue, lungs etc. Colleagues doing this tell me that some of their patient’s hair thickens and gets darker… like I have been noticing in a group of our patients.

PDGF and VEGF are growth factors vital for hair biology found in PRP and numerous independent studies conclude VEGF increases hair size. I think what we are doing with PRP in Alopecia Areata (AA) is reducing inflammation and also stimulating the follicular stems cells, which was demonstrated in our Alopecia Areata research grant. Sixty percent of the AA patient grew hair. Additionally, I feel we are also stimulating the follicular stem cells in Androgenic Alopecia (AGA), if not, how did Dr Rinaldi increase his hair count after PRP injections?

Round Two - My Second PRP Hair Loss Treatment With Dr. Joseph Greco

2010-04-06T19:37:00.001-07:00

Unlike male-pattern baldness, where patches of hair fall out over time, female hair loss means a reduction in hair volume, making transplantation extremely difficult for those experiencing miniaturization. While medical treatment options are limited for females, we have been having some very encouraging results with PRP cellular therapy.

Here's an article written by one of our female patients about her experience with PRP:

Hello Everyone!

Recently I ventured back to Florida to have another PRP (platelet rich plasma) hair loss treatment with Dr. Joseph Greco. I went back at the 4 month mark, which is before the time usually recommended to patients. I did so because I was quite pleased with the results I saw, and I wanted to make sure I kept my hair in that happy state it seems to be in. After 10 years of hair loss, when you find something that helps, you pretty much jump all over it… or at least I do.

So round two begins….ding ding.

I arrived at the hotel the day before my appointment, ready, excited and pumped with anticipation to have this treatment done again. I had a lot less apprehension because I pretty much knew what to except. As some of you will recall, a big point of anxiety for me during the last trip, was exactly how much pain was involved in this process. Well thankfully that anxiety didn’t exist because I had already experienced the process and knew it was not that big a deal.

I slept like a baby, no nerves whatsoever, part of that may be attributed to the wine I drank that evening. Gotta love wine! I awoke the following morning and stepped outside on the balcony with my cup of coffee and was just in awe of how beautiful it was. It was an incredibly gorgeous day so I just soaked it all in.

An hour before I was to depart, I dialed the front desk to ask for a cab to pick me up. Before I knew it I was being whisked away by some crazy driver who seriously needs to re-evaluate her profession. I’ve never in my life had a cab ride quite like that before. I found myself bracing at every turn and frantically clutching on to the seat for dear life. And to make matters worse, she didn’t take credit cards! Every cab pretty much takes credit cards nowadays, but her machine was getting serviced (uh huh). So now I had to rummage through my purse (something resembling a black hole) to pull out dollars and quarters. Shockingly I had the cash. Yay for spare change!

I walk into the office and am warmly greeted by the receptionist. I re-sign some forms and take my place in the waiting room chair. Not much waiting time before Dr. Greco appears and welcomes me back. I say my hellos to Val, his awesome assistant, and shortly after I’m in the chair getting my blood drawn. Like I mentioned in my first post, Val is a pro at drawing blood and there was no real discomfort there at all.

The doctor and Val then disappear into the other room to prepare the injection of platelet rich plasma. That process involves spinning it in a centrifuge and also using his protein matrix to get the most yumminess (isn’t that the technical term?) out of my blood. I venture to say that process takes about 15 minutes, I’m not really sure, I was watching Law and Order on the television, while reclined in my dentist like chair.

I was really quite relaxed and had surprisingly had no apprehension about what was about to take place. I didn’t get very far in my Law and Order episode before Dr. Greco and his assistant returned with the platelet rich plasma.

The process was the same as the last time. Dr. Greco started with examining my hair, pushing it in all different directions, at which point he says, “You had a lot of miniaturized hair before, and it doesn’t seem that you have as much miniaturized hair.” To which I replied, “Oh, you say that to all the girls.” ha! His words truly were really echoing what I already felt about my current state of hair loss improvement, so that was great. The process started off with injections to numb my head, then Dr. Greco used a microneedle roller on the scalp, and then comes time for the yumminess - the PRP injections. Pop pop pop (what the injections sound like in my head) and the hardest part is over. Lastly, the doctor and Val massage the PRP in, and clean up my scalp a tad. When they finished and shut the overhead light off, I said “Is that all?” I was really surprised it had gone by so fast and it just seemed so much easier than the last time.

During my last treatment I had some discomfort post treatment when the numbing medication wore off, so this time I decided to take Tylenol before, immediately after and another 4 hours later after that. I think that was the super special recipe for myself, because I didn’t really experience any post treatment pain or discomfort, and I didn’t even have head swelling. Of course me being ME, I start to think, “well something has to be off, will it work the same?” It couldn’t possibly be the wonder magic of Tylenol, could it? I emailed the doctor with my concern regarding lack of pain (I know that’s funny) and he wrote back letting me know that it will indeed work as well as the last time. From time to time, my mind still reflects on that, as though I HAVE to have pain to see results. I know, I know that’s just plain nutty, welcome to my world

So I return back to the hotel, kicked off my shoes and ordered up a little self prescribed aftercare… a bottle of Robert Mondavi chardonnay. That evening I actually felt good enough to go out to eat for dinner (with my hat on of course), so my fiance and I ventured out for some good eating. The next morning I showered and lightly shampooed my scalp, rinsing it clean and then it was off to the airport.

That was pretty much my visit in a nutshell. I have received so many questions and emails about this new treatment and I think many women (and likely men) remain skeptical about whether or not PRP actually works. I can completely understand that, I am probably more skeptical than anyone when it comes to hair loss treatments. The internet is filled with so much bogus garbage for products and services, that when something real comes along it is hard to believe it will actually work. I honestly do not know if everyone will respond to this treatment in the same manner as I have, I can only attest to what it has done for me - which is to really help lessen my shedding, spur a little regrowth and make the overall quality of my hair a lot better. My hair now has visibly more fullness and the color seems more vibrant as well, enough so that even my hair dresser acknowledged it without any prompting. Which is a pretty amazing thing.

Realistic expectations… I really can’t stress this enough. If you are going into having this treatment with the notion that this will cure your hair loss, and that all your hair will return back to it’s normal state, then you will very likely be disappointed. This isn’t a cure, but it’s been my little miracle. I’ve reached a point in my hair loss life, that I don’t need everything back. I simply want enough to get by, and really just to keep what I have left, which is a mere fraction of what I started with. I’ve already been there and done that, with the wanting and praying for everything to return, that time has thankfully passed for me many years ago. When this nightmare first began I really felt like I didn’t know how I would live my life if ALL my hair didn’t come back. I was riddled with constant sadness, crying and depression. But, amazingly we adapt, we learn to live with less and we gain a greater acceptance of how we are today. My hair is still shedding, and I still have visible thinness, but so what, if it can stay like this, I’ll be one heck of a happy camper.

One last thing, I want to address a frequently asked question, which is “Why did you go all the way to Florida to have this done with Dr. Greco?” I realize many places are popping up like Starbucks offering PRP treatments in their practice, but since Dr. Greco was the pioneer in using this therapy for treating hair loss, and since he is currently the only one using his self-engineered protein matrix, I feel most comfortable there. I got results there and so that is where I’ll go for this treatment. I have heard several reports from some women that there was a doctor in Canada who was performing this treatment, and has since stopped offering it, due to what he says is “lack of results.” Well, I’m not sure what he was doing and if he was doing it correctly. I can only go by my own experience, which was quite a positive one.

I have to say many thanks to Dr. Joesph Greco and staff, they always make me feel very welcomed, comfortable and put my mind at ease. But don’t think I’m not still wondering if the lack of pain during this last treatment will be indicative of lack of results! ha. What’s the saying? “No pain, no gain.” :) I have already confessed to everyone I suffer with a bit of OCPD right? Yes, it’s OCPD, not OCD, it wasn’t a typo.

Bio Cellular Hair Restoration Surgery

2010-01-06T18:43:00.000-08:00

The combination of a patients Platelet Rich Plasma and various Growth Factors, along with hair restoration surgery has multiple advantages. Numerous independent studies demonstrate that growth factors promote wound healing and tissue regeneration, decrease scar collegian, increase wound tensile strength. In addition, when leukocytes (white blood cells that fight infection ) are increased , as occurs in PRP, the incidence of infection decreases so application of PRP in donor sites (strip or FUE) is advantageous.

Other studies indicate basting follicular units in concentrated PRP may increase follicular yield and produces less crusting post operative. Injecting concentrated amounts of of growth factors, specifically (VEGF) promote increased circulation to the follicle and five independent studies demonstrate the follicle will get bigger so it has advantages with non transplanted hair.

This author has been doing hair restoration surgery 27 years and noticed faster healing, and more mature growth sooner when a combination of GF's and surgery are used. The patient in the video had Bio Cellular therapy and "one" hair restoration procedure or 2,000 FU's and these are his results in less than one year.

Joseph Greco, PhD, PA/C

News Release

2009-12-03T16:07:00.000-08:00

IDI Vatican's Hospital in Rome to Collaborate on PRP studies for Hair and Chronic wounds in Jan 2010.

My PRP (Platelet Rich Plasma) Therapy Experience

2009-11-16T08:03:00.000-08:00

Dr. Greco was featured in the larges Women's website regarding PRP Treatment.
CLICK HERE to view it.

Fall News

2009-10-30T18:18:00.000-07:00

View this video of OrthoBiologic injections of a patient shoulder’s with Platelet Rich Plasma. This patient had surgery to repair a torn rotator cuff and was suffering with pain eight months post-surgery. He also had a partial tear in the opposite shoulder and did not want to undergo another surgery.

After just two injections in both shoulders the patient avoided surgery and is now working out with weights and swimming!

Click on this link to read a study regarding PRP injections and Rotator cuff tears

PRP Bio Facial Skin Rejuvenation

2009-09-19T08:55:00.000-07:00

Click on the video below to view a PRP Bio Facial Skin Rejuvenation Procedure.

PRP Hair Procedure

2009-09-14T11:00:00.000-07:00

Click on the video below to view a PRP Hair Procedure.

The Science of PRP and Hair

2009-09-03T14:39:00.000-07:00

Click play on the video below to view a presentation explaining the Science of PRP and Hair.

PRP and the FDA

2009-08-04T17:46:00.000-07:00

“Platelet rich plasma (PRP) and fibrin matrix (PRFM), or autologous ( same donor same recipient) platelet derived growth factors, are proposed as an adjunct to standard treatment for a number of indications including wound care for the treatment of diabetic ulcers and venous stasis ulcers, bone augmentation and fusion, tendonitis, and plantar fasciitis.

Administration of PRP is a procedure and is, therefore, not subject to regulation by the Food and Drug Administration (FDA). However, the devices used to prepare PRP are regulated by the FDA premarket approval process. Several centrifuge devices have been approved by the FDA for preparation of PRP.” (1)

In other words since PRP is an autologus blood product and “not a drug” it is considered a “procedure” and the method of use i.e. spraying, injecting etc. is not regulated by the FDA only the preparation equipment is and requires 510 K approval.

(1)PLATELET RICH PLASMA/PLATELET RICH FIBRIN MATRIX
Effective Date: July 18, 2008 Review Dates: 6/08, 6/09
Date Of Origin: June 2008

Stop the Fall Out!

2009-08-04T16:26:00.000-07:00

Hair loss has a cyclical pattern so generally humans experience more hair loss in the Fall (October, November) and less hair loss in the Spring months.

If you are experiencing more hair loss we now have multiple options that work, including FDA approved medicines such as Rogaine, Propecia (Finasteride 1 mg), and our own BioFin ( Finasteride 1mg and Biotin 5mg).

Additionally, PRP cellular therapy, which has become extremely popular, can be used in addition to other therapies because it has a different mechanism of action.

Females have few options regarding therapy for maintaining their hair so PRP has been safe and effective treatment for those patients we have treated. See photos below of a female patient 6 months after PRP treatment.

Can PRP cause Neoplasm? No

2009-07-20T16:28:00.000-07:00

In medicine, one can “never say never”, but science demonstrates that PRP does not cause tumors.

The secreted growth factors immediately bind to the external surface of the cell membranes of cells in the graft, flap, or wound via transmembrane receptors. Studies have shown that adult mesenchymal stem cells, osteoblasts, fibroblasts, endothelial cells and epidermal cells express the cell membrane receptors to growth factors in PRP (Marx, RE 1998) These transmembrane receptors in turn induce and activation of an endogenous internal signal protein, which causes the expression (unlocks) of a normal gene sequence of the cell such as cellular proliferation, matrix formation, osteoid production, collagen synthesis, etc.  

The importance of this is that the PRP growth factors never enter the cell or its nucleus, they are not mutagenic, and they act through the stimulation of normal healing, just much faster. Therefore, PRP has no ability to induce tumor formation and has never done so." (Marx, RE, 2001), (Schmitz, et al, 2001)

Can PRP cause Infections? NO!

2009-06-23T21:17:00.000-07:00

PRP is actually bactericidal (a substance that kills bacteria). While platelets are increased in PRP processing so are leukocytes (white cells that fight infection) over 6 to 8 times. This is one reason why PRP is so effective in wound healing.

Not only do the increased levels of leukocytes enable the body to fight off infection they have a duel purpose. After platelets initially release their growth factors, leukocytes produce a secondary release or growth factors to promote healing.

In 2007 a study published in the British Journal of Bone and Joint Surgery demonstrated that, “Platelet-rich gel inhibited the growth of Staphylococcus aureus and was also active against Escherichia coli”.

T. M. Bielecki, MD, PhD, Orthopaedic Surgeon1; T. S. Gazdzik, MD, PhD, Professor1; J. Arendt, MD, PhD, Professor2; T. Szczepanski, MD, PhD, Pediatrician3; W. Król, MD, PhD, Professor4; and T. Wielkoszynski, MD, PhD, Senior Researcher, Antibacterial effect of autologous platelet gel enriched with growth factors and other active substances, British Journal of Bone and Joint Surgery, Vol 89-B, Issue 3, 417-420.

Benefits of PRP in Hair Transplantation

2009-05-27T12:42:00.000-07:00

Numerous independent studies demonstrate promising positive effects of growth factors on transplanted hairs, such as, (1) decreased erythema
(Redness), (2) crusting and (3) patient discomfort (Perez-Meza, 2006), (4) accelerated hair growth, (5) increased follicular unit size, and (6) accelerated revascularization of follicles utilizing VGF (Rinaldi, 2007)

When bathed in activated PRP, growth factors attach to the stem cells in the bulge area of the dissected follicular unit, thus increasing the yield of newly transplanted follicles 15.1 percent (Uebel, 2004).

In Fig 1, above, the follicular units are dissected and bathed in activated PRP gel (PRP can be activated with human thrombin, human recombinant thrombin, calcium chloride/ thrombin or fibrinogen and becomes a gel like substance) prior to implantation.
There is an increasing amount of consistently positive evidence among multiple investigators suggesting that PRP provides significant advantages for routine use in modern hair transplant surgery. In the future, the addition of PRP may be considered the new “gold standard” in hair transplant care”. (Reese, 2008)

Perez Meza, D. Presented at the ISHRS Annual Meeting in San Diego, Ca. October 18-22, 2006.
Rinaldi, F. et al. Improving the revascularization of transplanted hair follicles through up-regulation of angiogenic growth factors. Hair Transplant Forum International, 2007.
Uebel,C.O. Presented at the Annual Scientific Meeting of the American Society of Plastic Surgeons, in Philadelphia, Pennsylvania, Oct 9th through 13th, 2004.
Reese, R, A single-blinded, randomized controlled study of the use of autologus platelet rich plasma (PRP) as a medium to reduce scalp hair transplant adverse effects. International Hair Transplant Forum, March/April 2008.

Benefits of PRP in Donor Sites

2009-05-10T18:15:00.000-07:00

It has been objectively established that wounds, both acute and chronic, treated with PRP heal sooner, with less scar collagen and with a higher tensile strength. The goal in Hair Transplantation harvesting, Strip or FUE, is to decrease scaring and this study below demonstrates why PRP is advantageous when used in the donor site.

The above photo by (Carter et al, 2003) is a biopsy comparison of a wound, the left side is the non treated control side and the right side is the PRP treated side at day 79. Notice the bottom right PRP treated slide has a more orderly deposition of cells when compared to the bottom left non treated side demonstrating the above mentioned benefits.

Carter, C.A., Jolly, D.G., Worden, C.E., Hendren, D.G., Kane, C.J.M., Plate-rich plasma gel promotes differentiation and regeneration during wound healing Experimental and Molecular Pathology, 74, (2003), 244-255.

Back To the Future!

2009-04-17T21:02:00.000-07:00

Utilizing PRP cellular therapy in Hair Transplantation

While utilizing growth factors/extracellular matrix/stem cell/cultured hair cells complexes may be the future of hair multiplication, the current “State of the Art”, is and will be for quite some time, surgical hair restoration. There is no other cosmetic surgical procedure that can change your look more or make a person look younger than hair restoration.

A combined approach suited for the patient needs and expectations should encompass all options including surgical, medical, cellular, herbal and nutritional.

The utilization of cellular PRP therapy with hair restoration surgery has many advantages.

Click on this link to see how it is utilized in hair transplantation

Greco, J., Brandt, R., Our Experience Utilizing Autologous Platelet Rich Plasma in all Phases of Hair Transplant Surgery, Hair Transplant Forum International, July-Aug, 2007. Pp131-132.

PRP Hair Miniaturization Study

2009-04-08T11:56:00.000-07:00

Research Grant Report
This research grant, "The Effects of Autologus Platelet Rich Plasma and Various Growth Factors on Non-transplanted Miniaturized Hair", was awarded to Joseph F. Greco and Robert Brandt by the International Society of Hair Restoration in 2007 and the results were published in the International Hair Transplant Forum Vol 19, Number 2 March/ April Issue 2009.

Utilizing platelet rich plasma and various growth factors in hair surgery led to the study and was not intended to replace approved FDA protocols for hair miniaturization. It may be utilized in certain individuals in combination with these therapies or in individuals who have had side effects to those medications or patients who have not responded to traditional therapy.

CLICK HERE to read the study.

The Second Generation PRP

2009-03-26T14:42:00.000-07:00

Orogen Plus (PRP with a “protein matrix”)

What is the importance of a “matrix”? Think of a matrix as a “scaffold”. The scaffold entraps growth factors allowing the healing capable cells to multiply and remold the area of injury.
Figure 1(above left) is an electron microscope image of the matrix while Figure 2(above right) is a view deep inside the matrix illustrating how the protein entraps the growth factors. Since it takes the body longer to break down protein, the growth factors and healing capable cells remain over the treatment area longer allowing more new cells to attach promoting healing.

Independent studies conclude that, “GF–ECM complexes may well be the most effective and efficient method to stimulate cell proliferation, as well as tissue healing or regeneration”.

1-Clark, R et al. Synergistic Signaling from Extra cellular Matrix–Growth Factor Complexes. Journal of Investigative Dermatology (2008) 128, 1354–1355. doi:10.1038/jid.2008.75

What are the Healing Cells in PRP?

2009-03-12T10:10:00.000-07:00

(Platelets contain Proteins or Growth Factors)

When platelets become activated they change shape (Fig 2) and emit growth factors that send chemical signals like emails and faxes to other growth factors to come back to the injured area where angiogenesis (formation of new blood circulation) and mitogenesis (formation of new cells) occurs and healing begins.

Alpha granules are storage units within platelets, which contain pre-packaged growth factors in an inactive form (see Fig 1). The main growth factors contained in these granules are transforming growth factor beta (TGFbeta), vascular endothelial growth factor (VEGF) platelet-derived growth factor (PDGF), and epithelial growth factor (EGF)

Click on the video below to view the PRP Treatment on ABC News

What is PRP? (Platelet Rich Plasma)

2009-03-06T13:44:00.000-08:00

Plasma is the liquid component of blood, made mostly of water and acts as a transporter for cells. Plasma also contains fibrinogen, a protein that acts like a net and catches platelets at a wound site to form a clot.

Blood contains plasma, red blood cells (RBC), which help pick up oxygen from the lungs and delivers it to other body cells, while removing carbon dioxide.

White blood cells (WBC) are cell’s that fights infection, kills germs, and carries off dead blood cells, and platelets.

Platelets are responsible for hemostasis, construction of new connective tissue, and revascularization.
“Typically a blood specimen contains 93% RBC, 6% Platelets, and 1% WBC The rationale for PRP benefit lies in reversing the blood ratio by decreasing RBC to 5%, which are less useful in the healing process, and increasing platelets to 94% to stimulate recovery”.

Reversing Male Pattern Baldness

2009-02-20T12:36:00.000-08:00

Can Infusion of Platelet Rich Plasma (PRP) Reverse Miniaturization of Non-Transplanted Hair? YES!

Case Study

This 26 year old patient was unable to take finasteride (Propecia™) do to side effects. Hair transplantation was done in the anterior hair line and the posterior crown was traumatized with a 1 mm micro needling roller (Clinical Resolutions, Inc, Beverly Hills) and platelet rich plasma (PRP) concentration was injected. Fig 1 below was before and Fig 2 was the patient 8 months later.

This photo illustrates that mild trauma and the infusion of high concentrations of Platelet Rich Plasma "PRP" reversed miniaturization of this patient’s hair in eight months.

1.Greco, J.F., Brandt, R. The Effects of Autologus Platelet Rich Plasma and Various Growth Factors on Non-Transplanted Miniaturized Hair. Hair Transplant Forum International, March April, 2009,

Can Infusion of Growth Factors “wake-up” Dormant Follicular Stem Cells? YES!

2009-02-15T17:00:00.000-08:00

Case Study (Alopecia Areata)

Alopecia Areata is an organ specific autoimmune disease where patients loose spots of hair in various places on the body. The follicular stem cells are not destroyed but rather go into a dormant stage.

This female patient presented to a Dermatologist 6 month earlier and when she was referred to our clinic the area of hair loss had expanded outward. While cortisone injections are traditionally used, the medicine can cause side effects. This patient did not want cortisone so follicular biologic injections were elected.

One month after one treatment she began to grow hair and her results are illustrated below.

Do Growth Factors Effect the Development of Hair? YES!

2009-02-12T07:07:00.000-08:00

While some growth factors are known to inhibit hair growth such as TGF beta, the majority of growth factors like platelet derived growth factor PDGF are essential to epidermis-follicle interaction and the dermal mechenchyme interaction required for hair canal formation and growth of the dermal mesenchyme. Additionally, vascular endothelial growth factor VEGF improves follicle visualization promoting hair growth and increases follicle and hair size. Below is a drawing of Vascular Endothelial Growth Factor.

1 - Takakura, N., Yoshida, H.,Kunisada, T., Nishikawa, S. and Shin-Ich. Involvement of Platelet Derived Growth Factor Receptor-a in Hair Canal Formation. Journal of Investigative Dermatology. (1996) 107,770-777.
2 - Yano, K., Brown, L. and Detmar, M... Control of hair growth and follicle size by VEGF-mediated angiogenesis. J Clin Invest, Feb 2001, Volume 107, Number 4, 409-417

Follicular Biologics: In Surgical Hair Transplantation and Non-Surgical Hair Restoration Therapy

2009-02-10T13:32:00.000-08:00

The ability to safely heal damaged tissue and regenerate new tissue with one’s own cells is the future of Regenerative Medicine. It is now possible to restore damaged cells in humans and animals by simply taking their own blood, processing it to increase the bodies healing capable cells and when those undifferentiated healing cells are applied to an injured area, new cells proliferate and regenerate damaged tendons, ligaments, muscle, bone, skin and hair cells.

While in its infancy, follicular biologic therapy has many advantages in surgical hair transplantation as well as non-surgical hair restoration. It may be utilized in surgery to enhance donor scar healing, decrease donor scaring, increase tensile strength for donor wounds, used as a graft storage medium to enhance graft survival. Because it is bactericidal, it can be utilized to decrease the incidence of infection.

It may also be utilized as an adjunctive treatment, especially in younger patients, to reverse follicular miniaturization in conjunction with other approved FDA therapies or utilized when other therapies have failed or patients have side effects to traditional therapies.

Welcome to Our New Blog

2009-02-10T13:00:00.000-08:00

Our Philosophy

My Philosophy is quite simple, “treat everyone as you would like to be treated and achieve the best possible results for every patient”.

Having grown up in a medically oriented family my father, Joseph F. Greco, MD, had a tremendous positive influence in that my two brothers Jeffrey M. Greco MD, Jonathan P. Greco, MD, my son, Joseph F Greco III, MD and nine first cousins became physicians.

We were taught to treat patients, “first and foremost” and to “treat all patients as a family member”.

Philosophy of Hair Restoration

I believe the State of the Art in hair restoration should be to create naturalness in one session, be it a facial framing or a posterior crown restoration, so that it does not take more than one session to achieve naturalness. Ask the patients what their goals are and partner with each patient to achieve those goals.

A conservative approach is the utmost importance because not all patients need or are candidates for hair restoration surgery. The blending of Artistic Design, surgical techniques, the latest equipment and safest non surgical therapies are essential for both a short term solution and long term treatment plan.

Background

Our family has been involved in hair restoration since 1960 when my father, Joseph F. Greco, MD, began as one of the early pioneers in hair transplantation. I assisted and learned the basics of hair restoration from my father in 1983 and have been involved in hair restoration the past 25 years. Today I am proud to say that my son, Joseph F. Greco, III, MD, a Dermatologic Surgeon, is a third generation hair restoration surgeon and the Co Director of the Cosmetic Surgery Department at UCLA in Los Angeles.