Senior Member Drnigam Posted April 11, 2013 Senior Member Share Posted April 11, 2013 Dear All, 15 G patch test for in-Vitro donor doubling on this MPB case on 28th March 2013. Below are the Before Pictures for 15 grafts patch test including one short video. 6 tattoos have been made on the recipient and 6 tattoos have been made on the donor shaved scalp. Before Pictures click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/01.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/02.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/03.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/04.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/05.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/06.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/07.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/08.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/09.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/10.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/11.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/12.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/13.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/rtn/large/14.jpg Video Link :- Day 0 20130330170528 - YouTube Day 3 Procedure Video - 15 Grafts In-Vitro Hair Doubling procedure Below are the pictures of Day 0 and Day 3 of recipient and donor regeneration. Also find video of the procedure on Day 0 including pictures of graft bisection. click the below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day03/Large/01.jpg click the below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day03/Large/02.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/large/33.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/large/34.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/large/35.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/large/36.jpg click link below to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/large/37.jpg Kindly find below 1. Before picture of every extraction and recipient 12th Day picture of every extraction and recipient microscopic large & zoomed picture. Now we can easily follow the case by keeping an eye on the surrounding hair. We have started with 15 G extraction at the donor area (6 Single, 8 Doubling & 1 Triple follicle) total 23 follicles in between 6 tattoo marks. Believe it or not, it is surprise to me too that we can see on 12th day 46 growing follicle at Donor and 34 growing follicles at recipient, regenerating themselves with additions of new follicles formation. Total 80 follicles re-grown from 23 follicles extracted. Remember we have also injected stem cells, dp cells, dp growth factor, ECM + PRP. Hence new follicle regeneration also as a part of our stem cells hair multiplication therapy. In the months to come we will follow the rate of growth and also the thickness of the follicles. Donor Area Day 0 picture for reference click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/donor.jpg Donor extraction Day 12 Microscopic pictures click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/1.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/2.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/3.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/4.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/5.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/6.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/7.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/8.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/9.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/10.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/11.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/12.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/13.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/14.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Donor/15.jpg Recipient Area click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/ricipient.jpg Recipient extraction Day 12 Microscopic pictures click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/1.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/2.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/3.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/4.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/5.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/6.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/7.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/8.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/9.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/10.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/11.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/12.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/13.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/14.jpg click below link to see enlarged close up of the above pic http://www.drnigams.net/images/RTN/Day12/Large/Ricipient/15.jpg Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted April 12, 2013 Senior Member Share Posted April 12, 2013 Dr. Nigams, Great presentation! A few questions: 1. What type of magnification are you using with the bisection? 2. What type of blade are you using to dissect? 3. What anatomical landmarks (on the follicle itself) are you using for the bisection? Do you simply bisect above the bulb? "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted April 12, 2013 Author Senior Member Share Posted April 12, 2013 Blake, 1)50x magnification Dr. Nigams, 2)we use opthalmic blades which are the finest. 3)Regarding the level where i bisect ,i will share later,but its very interesting..just to give an idea both the bisected follicle should have dermal papilla or dermal cup sheath cells,thus dermal papilla can be created in both. plus the dp culture and dp cell injection helps to counter the missing dp in one bisected part. I am developing fibrooptic vision possibilty of attaching to the extracter ..with a german comapany..should be ready in a month,wherein i these fine fibres will be inside the hollow extracter and i can see everyting on tv monitor ...and thus i can bisect as i desire even in vivo ..when there will be no need of vitro and atleast the root of the follicle need not be removed from its blood supply as in vitro. I hope this fibropoyic vision will be used by normal strip.fue docs in future ..this gives EYES to HAIR TRANSPLANT. Great presentation! A few questions: 1. What type of magnification are you using with the bisection? 2. What type of blade are you using to dissect? 3. What anatomical landmarks (on the follicle itself) are you using for the bisection? Do you simply bisect above the bulb? Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted April 12, 2013 Author Senior Member Share Posted April 12, 2013 Blake, 1)50x magnification Dr. Nigams, 2)we use opthalmic blades which are the finest. 3)Regarding the level where i bisect ,i will share later,but its very interesting..just to give an idea both the bisected follicle should have dermal papilla or dermal cup sheath cells,thus dermal papilla can be created in both. plus the dp culture and dp cell injection helps to counter the missing dp in one bisected part. I am developing fibrooptic vision possibilty of attaching to the extracter ..with a german comapany..should be ready in a month,wherein i these fine fibres will be inside the hollow extracter and i can see everyting on tv monitor ...and thus i can bisect as i desire even in vivo ..when there will be no need of vitro and atleast the root of the follicle need not be removed from its blood supply as in vitro. I hope this fibrooptic vision will be used by normal strip/fue docs in future ..this gives EYES to HAIR TRANSPLANT. Great presentation! A few questions: 1. What type of magnification are you using with the bisection? 2. What type of blade are you using to dissect? 3. What anatomical landmarks (on the follicle itself) are you using for the bisection? Do you simply bisect above the bulb? Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted April 15, 2013 Author Senior Member Share Posted April 15, 2013 Day 18 - 15 Grafts Patch Test of In-Vitro Hair Doubling @ Dr. Nigam's. Please find below the pictures including comb-over video of Day 18. We can see the regeneration of 90 follicles from 23 follicles Recipient - 38 Follicles (F) Donor - 52 Follicles (F) Recipient Area:- Day 0 & Day 18 Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/Recipient.jpg We can see the Recipient regeneration of Recipient Videoscope Image Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/1.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/2.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/3.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/4.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/5.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/6.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/7.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/8.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/9.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/10.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/11.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/12.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/13.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/14.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Recipient/Large/15.jpg Donor Area Day 0 & Day 18 The surrounding hairs were trimmed for better view of the donor regeneration area. Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/Donor.jpg Recipient Videoscope Image Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/1.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/2.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/3.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/4.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/5.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/6.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/7.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/8.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/9.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/10.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/11.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/12.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/13.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/14.jpg Please click on the link below for the larger view http://www.drnigams.net/images/RTN/Day18/Donor/Large/15.jpg Video Link: Comb-Over Video - Day 18 Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted May 24, 2013 Author Senior Member Share Posted May 24, 2013 Day 53 Update In-Vitro Doubling of 15 G patch test @Dr. Nigam's Dear friends, Kindly find Day 53 update of donor and recipient of 15 graft patch test of in-vitro hair doubling along with tattoos marks and one shot video. results Donor - On Day 0 total 23 follicles were extracted from 15 grafts (Single - 8, Double - 6 & Triple - 1) On Day 53 by Videoscopic & Macro images of Donor shows - 37 follicles as against 52 follicles on Day 18 may be some must have gone into shedding or some may have not regenerated. Although still better than 23 follicles which were extracted from the donor which mean the gain of 14 follicles at the donor which means as on today (Day 53) regeneration is 160%, may become less or more, actual donor regeneration will come to know in 6 to 9 months. You must be wondering how come more than 100% regeneration that is becuase of stem cells, dp cell, growth factor were injected into the donor and recipient. You can clearly see even after using large punch to extract the graft from the donor like in FUE...... THERE IS NO WHITE DOT OR SCAR MARK. This proves if FUE doctors start using ECM, concentrated PRP and / or growth factor, stem cells, DP cells, visible FUE scar can be avoided. As the above have important role in wound healing. Hence no white dot or scare. Recipient shows 23 follicles as against 38 follicles on Day 18 but still 100% recipient regeneration as 23 bisected follicle were implanted at the recipient, may be the 15 follicles is not seen on Day 53. May be they must have gone into shedding or they must have not regenerated. Actual recipient regeneration will be known after 6 to 8 month. observe the pigmentation and thickness of Donor and Recipient re-growth to analyze the diameter of new hair. WCHR 2013, Edinburgh, UK, had 2 paper presentation on unlimited hair transplant. One Japanese paper were shown which was earlier confirmed by Jahoda that ........ Freshly isolated DP cells which is trichogenic, if implanted at the base of upper half of the amputated / bisected follicles, new dermal papilla or new follicle with similar characteristic of the donor will be created. Another study confirm that upper half of the hair follicle if amputed and extracted with outer root sheath stem cells minimum and great if extracted with matrix stem cells can create it's own dermal papilla. The study also confirmed that the lower dermal papilla when imputed from its upper half of the follicle can create it's own shaft and rest of the follicle. Cotsarelis had published one paper called "De-Differentiation of stem cells" in which bulge stem cells (epidermal) can become matrix germ stem cells and dermal stem cells and similarly dermal stem cells can become epidermal stem cells if required, this is called stem cell De-Differentiation. With my experience of 4 to 5 month of in-vitro and in-vivo technique, as on today I come to conclusion that in-vitro hair doubling or donor doubling will give higher donor & recipient regeneration with better quality of hair than in-vivo donor doubling. since in in-vivo donor doubling the major issues is that its a blind technique and not one can bisect the follicle at the matrix germ cells level or dermal cup sheath level. In-vivo technique has disadvantages.... 1. since it's a blind technique, precise bisection which we want cannot happen 2. Becuase precise bisection cannot happen some extraction cannot suitable hence multiple extraction need to be done 3. Because it is blind technique hence it will be more expensive 4. The hair re-growth at the recipient will be much lesser than the in-vitro technique because only part of upper follicle is being extracted hence hair at the recipient could be thinner. Both In-vitro and in-vivo technique will be scarless but the role of injecting stem cells, dp cells, growth factor, ECM, as per my observation is very important for donor and recipient re-growth and thickness of hair. I remember what Washneik said that in the 1st phase hair multiplication will be used as a adjunct to the hair transplant. This is what I feel too, by the time in coming months we will get consistent result when we will add 3d spheroidal aggregated capsulated, growth factor secretarine trichogenic, good dose of dp cells and / or what Dr. Gerd and Tsuji Lab did that is co-culturing of epithelial stem cells and trichogenic dp cells to create proto hair or micro follicle as named by Gerd for real CELLULAR HAIR IMPLANT or if Histogen succeeds and as believed by Ralf Paus of UK as he told to me in WCHR 2013 that dormant 100000 hair follicles lying also in the slick bald scalp in Telogen phase with partial fibrosis can be activated with stem cells, DP cells, Growth factors, Noggin, WNT7A, etc. in-vivo. I would advice all the patient of AGA doing or not doing hair transplant, doubling or HM should start with mast cells supressor (Oral or topical) OC-03-01, anti-androgen preferably topical will come in the market, antioxydent like melatonin. Oral good dose of antioxidents and smoker should start L-Cystine and biotin in good doses orally and / or topically to counter the follicle damage of nicotine. By next month I will have topical vascular endothelial growth factor FGF and others which can be applied topically for the medical AGA prescription but these topical gels are not available to the patient directly but only to the bio-tech labs. For prevention of AGA I am working on how to reduce on micro inflammation due to multiplication at and around hair follicle and androgenic TGF - Beta-catenine topical or injectible to reduce mast cell released histamines. Reducing DHT concentration on scalp, countering prostaglandin, interlukine 1 & 6 concentration on scalp and products to up regulate PGE2, insulin growth factor, products to prevent apoptosis of stem cells, products to convert dormant stem cells to progenitor stem cells in-vivo through ioantophoresis, electoporation, nano particulate transdermal targetted delivery, chitosan, etc capsulated vehicle. These medical prescription will also helps my HM results if patient starts this medical prescription, same for the regular transplant. If I had movable photon microscope costing US $1 million, my HM result would have increase significantly. Since with movable photon microscope applied on patient scalp. I can see telogen follicles on the human scalp and inject the stem cells directly into it specially when they are fibrosed, partially or totally, normal stem cells injection could be difficult to them. In movable photo microscope, I can see cells of epidermis and dermis and also upward & downward movement of stem cells. As you remember I had mentioned the use of photon micro-scope in cellular regeneration micro imaging study, same was highlighted by 2 presenters with their paper titled "Imaging in hair generative therapies" Elian Fuchs in her paper presentation "Stem cells in silence and in action" showed upward & downward descent video of moving stem cells in a hair follicle in-vivo Hope fully I have to do some research in Gerd lab in Berlin which is having fixed photon microscope and bio-reactors, etc to find the answer that why HM doesn't response on all the scalp? and we know HM respond on some scalp and in these responding scalp the results are really good and acceptable. Donor Count line Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/Donor-countline.jpg Recipient IMG Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/Recipient.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/1.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/2.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/3.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/4.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/5.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/6.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/7.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/8.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/9.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/10.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/11.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/12.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/13.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/14.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Recipient/15.jpg Donor IMG Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/Donor.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/1.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/2.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/3.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/4.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/5.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/6.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/7.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/8.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/9.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/10.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/11.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/12.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/13.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/14.jpg Click the below link for enlarge image http://www.drnigams.net/images/RTN/Day53/Large/Donor/15.jpg Day 53: video link Link to comment Share on other sites More sharing options...
Senior Member JustOne Posted May 25, 2013 Senior Member Share Posted May 25, 2013 nice write up and update , looks like the donor area had 90% regeneration. looking forward to my visit . Link to comment Share on other sites More sharing options...
Regular Member Gary1911A1 Posted May 25, 2013 Regular Member Share Posted May 25, 2013 Looks promising. I hope you can provide us with a follow up to the patient improvement in 4 more months. Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted May 26, 2013 Senior Member Share Posted May 26, 2013 Dr. Nigams, Thank you for the update. It looks like the donor doubling is moving along nicely! Also, I'm curious: have you been measuring the diameter of the hair shafts to note if you are seeing any reduction is size of the actual shaft with the regrowth from the bisected graft? I think surgeons who have used in vivo partial longitudinal follicular unit extraction noted decreased width in the new growth in the past. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Regular Member krishonkrush Posted June 10, 2013 Regular Member Share Posted June 10, 2013 Dr. Nigam... wats ur comment on futurehtdoc's question? Dr. Nigams, Thank you for the update. It looks like the donor doubling is moving along nicely! Also, I'm curious: have you been measuring the diameter of the hair shafts to note if you are seeing any reduction is size of the actual shaft with the regrowth from the bisected graft? I think surgeons who have used in vivo partial longitudinal follicular unit extraction noted decreased width in the new growth in the past. Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted June 10, 2013 Author Senior Member Share Posted June 10, 2013 Good question,Future-HT-Doc, We started,offering donor doubling to patients 8/9 months ago..after observing the hair growth at donor and recipient..in a miniclinical trials at our clinic. As you must have observed,we are constantly working to improve the same. My observation is.. At the donor scalp which is an non aga scalp,the effect of implanting bisected grafts with progenitor and multiplied stemcells with dp cells and dp culture...is excellent,with additional hair follicles than what we started before the procedure.. in contrast to invivo , which is just bisection and implantation..we have the advantage of injecting activated stemcells.dp cells and dp culture...to repair the bisected follicle.. Yes, the recipient,is comparitively thinner to donor regenerated hair..initially ,specially if the recipient is slick bald(not so in thinning scalp), but by 5/6 months the diametre of recipient hair matches the fue implanted hair, may be because of addition of multiplied stemcells injections after 6 weeks.. With my new technique and the level of bisection ..i am confident..results would improve ..significantly.. I would also introduce shortly..a medical prescription..to be followed for 3 months window period..when a person goes for a doubling ,to reduce androgens and microinflammatory fibrosing irritants at the recipient aga scalp...so that the new grafts get better environment to grow..during early phase of repair.. Newer things to come in coming months is world's first high frequency ultrasound to give eyes to HT/doubling.. Implantation by injections in the recipient, to avoid incisions at the recipient..thus adding lot of benefits like..higher density,less trauma,hardly any microscarring,no swelling,and the implantations will be injections..as the smaller fragmnt of bisected graft, is tiny enough..to be placed in a specially designed needle..with syringe.. But my real focus is pure hm and dp cultured injections...CELLULAR HAIR IMPLANTS...doubling is an extension of ht..but yes it is a significant step forward..to overcome the limited donor problem.. as pure hm gets support from fragments of hair follicle in doubling..rather than forming a denovo hair follicle in pure hm.. Dr. Nigams, Thank you for the update. It looks like the donor doubling is moving along nicely! Also, I'm curious: have you been measuring the diameter of the hair shafts to note if you are seeing any reduction is size of the actual shaft with the regrowth from the bisected graft? I think surgeons who have used in vivo partial longitudinal follicular unit extraction noted decreased width in the new growth in the past. Link to comment Share on other sites More sharing options...
Noah Posted June 13, 2013 Share Posted June 13, 2013 Dr nigam, with regards to your donor doubling technique I just have a couple of quick questions. 1 how long do people have to wait betwix these surgerys 2. Presumably if you say donor regenerates 100% of the time surley you can give any one 100k or more hairs even if they are nw7 and give them a hair line just above there eyebrows, do you have any photos of your hair lines that you restored looking toward to a reply noah Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted June 13, 2013 Author Senior Member Share Posted June 13, 2013 Noah, 1)The waiting period ,between the donor doubling surgeries,depends on case to case. For example,if you are a nw6/7,with the number of available grafts at donor scalp(back and sides),arel approx.8000 .... we can remove 4000 grafts in one session of 4 days . in the next session after 6weeks,we will extract the other remaining 4000 grafts( not the regrown grafts of the 1st session). We can repeat this process after 6 months ..to extract 4000 more graft from the regrown grafts of the1st session, at the donor. Regen rate may vary between approx. 5 to 10% at recipient, but will be consistent at the donor since the donor is a non aga scalp. Thus in 6 months a case of nw6/7 can potentially get new 12000 grafts at the recipient and same at the donor. The data ,i am providing you is of my 8/9 months experience with doubling... since we started offering doubling to our patients at our clinic... after small test procedures. We are documenting and following up... three recent cases... of nw7 for doubling of 12000 grafts at the recipient,will update the status of these cases on HRN shortly.. As the doubling has considerably improved in technique, since we started ...i can give you more data on the result with new protocol, in 6months to 1year. NW5/4/3 will need lesser sessions...but i always prefer two sessions for density..as anyway the person has to take multiplied stemcells and dp culture after 6 weeks... 2)I have not yet done a case what you are mentioning.. you have also to take into consideration.... patients overall health status,tolerance to local anesthesia.. .physical/ mental preparedness to do 3/4 sessions by a nw7. I will post what i have posted on other forum...a case of hairline and temples by donor doubling...the patient is an independent member of the forum.. For hairline design and density...we have the new protocol without recipient incisions..but graft implantation with special needle and syringe...thus less trauma,less swelling,hence more density and better survival of the grafts.. We will launch ..world's first image guided hair transplant...with follicle ultrasound..thus all techniques of HT will receive EYES.as you are aware fue is a blind procedure and fut is also partial blind procedure.. Dr nigam, with regards to your donor doubling technique I just have a couple of quick questions. 1 how long do people have to wait betwix these surgerys 2. Presumably if you say donor regenerates 100% of the time surley you can give any one 100k or more hairs even if they are nw7 and give them a hair line just above there eyebrows, do you have any photos of your hair lines that you restored looking toward to a reply noah Link to comment Share on other sites More sharing options...
Noah Posted June 13, 2013 Share Posted June 13, 2013 thank you for your swift reply doc, can i just clarify one thing, you said regen at recipient is 5 to 10 %? Do you mean that out of a 4000 graft session only 5 to 10% will grow? Link to comment Share on other sites More sharing options...
Noah Posted June 13, 2013 Share Posted June 13, 2013 also can you repeat the donor doubling treatment as many times as you want if the donor regens every six months, assuming the patient is right for it Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted June 13, 2013 Senior Member Share Posted June 13, 2013 Dr. Nigams, Thank you for addressing my questions. Look forward to more results! "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted June 13, 2013 Author Senior Member Share Posted June 13, 2013 also can you repeat the donor doubling treatment as many times as you want if the donor regens every six months, assuming the patient is right for it I think you misunderstood,the recipient regen is not 5 to 10%,.... the recipient regeneration is between 90-100% as on today and would vary case to case by approximately 5-10%. As on today, I can speak only about my 8/9 months results which I have seen,... as the time will pass, I can confirm is it possible to repeat donor doubling for how many repeat procedures. theoritically repeat extraction of a regrown follicle of the donor should not have any problem for at least 2-3 times which will solve our problem of NW7. and as months and years pass, we will have documented outcome of the procedures, for us to review and analyze better. as per thickness of the follicle is considered, I don't see any difference from the FUE implanted grafts, the reason being the added stem cells, dp cells, dp culture to repair the bisected follicle quickly and to its original diameter. Link to comment Share on other sites More sharing options...
Noah Posted June 13, 2013 Share Posted June 13, 2013 doctor thank you for your replies, keep fighting the good fight Link to comment Share on other sites More sharing options...
Noah Posted June 14, 2013 Share Posted June 14, 2013 doctor you say regeneration At the recipient is 90 to 100% is this the case for 100% of people treated even on the second harvest of an area Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted June 14, 2013 Author Senior Member Share Posted June 14, 2013 Noah, As on today..i have only harvested a particular graft twice..and yes i see approx.90% regen on the second harvest... Kindly review the invivo and invitro doubling pics again.. http://www.drnigams.net/images/RTN/Day53/Large/Donor/Donor-countline.jpg http://www.drnigams.net/images/RTN/Day53/Large/Recipient/Recipient.jpg Pics on the left are of 15graft patch test with invitro hair doubling and pics on the right are of invivo donor doubling around birthmark.... Link to comment Share on other sites More sharing options...
Noah Posted June 14, 2013 Share Posted June 14, 2013 thank you Dr it seems very promising, can I take it from your case study of the Malaysian gentleman with thin donor that you are presenting that almost any one would be a candidate for this type of surgery noah Link to comment Share on other sites More sharing options...
Senior Member Drnigam Posted June 14, 2013 Author Senior Member Share Posted June 14, 2013 Theoretically... yes...but can confirm only as the time pass and we follow ..more and more cases.. thank you Dr it seems very promising, can I take it from your case study of the Malaysian gentleman with thin donor that you are presenting that almost any one would be a candidate for this type of surgery noah Link to comment Share on other sites More sharing options...
Senior Member Spanker Posted June 15, 2013 Senior Member Share Posted June 15, 2013 I think that the ultimate challenge would be to completely restore this mans hair through duplication. It would make you the most famous man in hair restoration and possibly of all elective surgeons. My question would be to ask if this process is too time consuming to be practical for large procedures? I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians. View Dr. Konior's Website View Spanker's Website I am not a medical professional and my opinions should not be taken as medical advice. Link to comment Share on other sites More sharing options...
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