What is Melanocyte transplant surgery?
Dr Vivekananda Bhat
Lavelle road, Bengaluru Feb 9, 2017
This is the next procedure in evolution of surgical treatment for vitiligo.We have been performing Melanocyte transplants in India since 1996, as it was new at that time and only three doctors including myself worldwide were doing this procedure it was ridiculed as being unsafe by most of the other dermatologists, and these same doctors today are trying to do this procedure unfortunately through trial and error method, it took as a long time to convince people that this procedure works, there are papers on Melanocyte transplant done by noble clinic featured in top international dermatological journals which vouch for the safety and efficacy of this method of treatment.
I am grateful to my mentors for having done this hard job without which noble clinic would have failed to survive and a huge number of successful patients we have had subsequently would have missed the opportunity to recover through this excellent procedure.
What is Melanocyte transplant surgery?
It is a procedure where in a 10 percent graft size yields cells which can cover an area of white patch ten times the size of the graft.
Due to technical reasons one sitting is restricted to 100 square centimeters and to cover this area about 10 square centimeter of skin is removed.
As previously explained a small thin piece of skin is removed roughly about 10 square centimeters in size we then treat this skin with enzymes to separate the dermis from epidermis, the epidermis is rich in melanocytes and kerayinocytes, these cells are harvested, kept alive and then transplanted over the white patches which are dermabraded to a level where the cells originally were prior to the destruction.
- A small piece of skin yields enough melanocytes to treat large areas of white patches.( 1:10 ratio)
- The cosmetic results are far superior to that of older treatments as we replace cells and not pieces of skin, hence if we remove cells from skin of thigh and transplant it over the lip the color we get is closer to lip color and not the thigh color as melanocytes in the lips are genetically programmed to lay down a specific shade of color.
- Pigmenation starts of in 3-6 weeks,and it takes 2-3 months for it to end.
- Day care treatment.
- Can be done under local /regional/or general anesthesia.
- Excellent results in focal and segmental vitiligo, good results in generalized vitiligo, but results in acrofacial vitiligo can’t be predicted.
Limitations of Surgical Treatment
- Huge areas of the body can’t be taken up for cure.
- A very small percentage of patients can develop white patches on areas where the skin is removed-this can be
treated subsequently with medicine and surgery if required.
- A very small percentage of patients develop what is called Koebners phenomenon where in the border areas of
white patches can depigment after the procedure, this can be corrected with further medical /surgical treatments if required.
- None of the surgical treatments are permanent cure for vitiligo, hence there is a chance you may develop a new
patch in future which requires additional treatments.
- There is a chance of failure of the procedure.
Melanocyte transplant is safe and effective to a large extent to treat vitiligo, however there is a chance it may fail to yield color and patients should psychologically be prepared to accept good results as well as failures, ultimately it the disease that kills the transplanted cells and at present there is no laboratory test which predicts whether the patch is really stable or not, we do go by history of the duration since when the patches have stopped spreading to determine stability and operate on patients, so good results can be expected in most patients, however in some rare cases we have been caught by surprise when even excellent patches can fail and extremely difficult patches can get cured, such is the nature of this harmless disease.
I hope there is sufficient information here which can help you to choose wisely, if you have any other clarifications feel free to mail me at firstname.lastname@example.org.