Dr. Gorana Kuka-Epstein on Regenerative Medicine for Hair Loss

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In this video, Dr. Gorana Kuka Epstein talks about her journey in regenerative medicine. She was trained as a plastic surgeon in Serbia and although she now lives in Miami practicing in consultation with Dr. Jeffrey Epstein, she maintains an active practice in Belgrade, Serbia.

Her interest in regenerative medicine came about from the idea that the body’s own tissue could potentially help other tissues, preferable to the taking of medications. So, she started to apply fat grafting into scars prior to hair transplants which led to the realization that those grafted scars have better regrowth than non-grafted scars.  She thought that it was a great idea because scar is dense hypertrophic tissue with reduced blood circulation that can soften and develop new blood vessels with fat grafting. And that is when her journey of regenerative medicine and hair loss started. She hypothesized that if fat worked for the scars, it could possibly work for Androgenetic Alopecia, where there is also a loss of adipose tissue..

By recreating the subcutaneous layer in the scalp with fat grafting, the fat will not only induce angiogenesis providing more blood flow for the existing hair follicles as well as for any follicles that are to be transplanted with a hair transplant procedure, the fat also contains  regenerative cells or stem cells. Finally, fat has an anti-inflammatory effect, a process that is involved with Androgenic Alopecia.

Before and After Pictures

Her clinic was one of four sites that started research with adipose derived stem cells for Androgenic Alopecia and so far, the results from enriched fat have been good.

Who are Good Candidates for This Study?

Typically, the fat is obtained from the abdomen or hips by liposuction to get the fat out.  It is a minor procedure done under local anesthesia where 50 to 80 cc of fat is taken. In most patients, sufficient amount of fat can be obtained.

Once the fat is out, it is purified from contaminants such as white blood cells, lipids and oils.  Then that purified fat is injected into the scalp.

Candidates who can be treated include those who have Androgenic Alopecia, Frontal Fibrosing Alopecia, Scarring Alopecia, and in combination with hair transplantation.  For purposes of the study, only male and female patients with Androgenic Alopecia are enrolled.

When it comes to patients who have Androgenic Alopecia, it is advisable to treat patients in earlier stages of hair loss because if hair is completely lost, there is no effect with fat. However, if there is some hair that is thinning, that’s where fat can play a potential role and thicken the hairs and induce more hair growth. So early stages of hair loss and of course, women with Androgenic Alopecia are great candidates for this procedure.

From Dr. Kuka-Epstein’s clinical experience, she has seen this being effective for a year and a half to two years. It is also very convenient for patients since it is one injection and can have a prolonged effect with just one therapy, but likely needs to be repeated every year or two to maintain results.

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