The “magic sauce” that I talked about in my previous blog involved platelet rich plasma (PRP) and Acell. The question though is whether adding Acell, a porcine bladder matrix, does anything? I know many physicians who only use PRP and think Acell is redundant. Having now done several cases with Acell, I would beg to differ. A respected colleague of mine has spoken with me during a lunchtime conversation at the ISHRS meeting and he is convinced that Acell is “anti-scarring”, i.e., it decreases inflammation of the hair follicle and along the donor incision and thereby promotes a better result. In what way exactly? In my opinion finer and more elegant looking grafts is perhaps the biggest way. I also believe that it adds to the overall potential for uniform growth in a synergistic fashion when used with PRP. My staff is the world’s best. In fact, Emina has won the prestigious Surgical Assistant of the Year Award, given once a year (and not every year) to the best assistant in the world. I would not disagree with that assessment of her. Despite that, sometimes grafts may not grow perfectly as fine as possible. Since using Acell in the past 2 years, I have seen almost uniformly fine grafts grow, and I attribute that fact both to excellent work on the part of my assistants who handle the grafts as well as to the use of Acell during my procedure. At this time, I am convinced that PRP and Acell are fundamentally important to achieve the results that I want with the prerequisite that excellent work is always ensured by the surgeon (myself) and the staff.