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NEEDHAIRASAP,
1)In invitro hairdoubling is extraction of single follicle FU by.4mm inner diametre punch,and double or triple follicle graft with.5 or.6 or .7mm inner diametre punch from the donor scalp.
The FU is further bisected at the point just above the dermal papilla.In our subsequent case we will bisect just at the level of dermal cup sheath as we recieve our new high resolution microscope.As you are awre the dp can regenerate itself to a complete follicle.The other bisected part with part of dermal cup sheath (which can regenerate dermal papilla cells), intact outer root sheath with it's stemcells and intact mid follicle stemcell bulge should be able to develop to a full follicle.These bisected parts are further boosted by addition of epithelia,dermal(mesenchymal) stemcell sourced fro donor scalp or body hair,dp cells separately sourced from the body hair,extracellular matrix like acell,prp,growth factors like FGF,VEGF,KGF,FOLLISTATIN,ANGIOGENESIS GROWTH FACTORS etc.The follicle s should regenerate except certain bisected follicles wherin our bisection is not correct due to human error by the technicians or the doctor.
2)Answering your next point.Please understand when HST says they use.5mm or .6mm punch or needle they are talking of inner diametre and they are actually .6mm and .7mm outer diamtre needle or punch.So both of us use similar needle or punch.Yes HST uses triple wave punch or needle as they are not into invitro but invivo bisection,this triple wave helps them manipulate the bisection.
Regarding the white dots of FUE ex traction compared to normalfue or HST,there is very less chance of white dots of extraction in our technique because a)we use extracellular matrix like dr hitzig,dr cole uses acell ecm for his patients even in fue with much less chances of white dots.In fact acell/extracellular matrix is cleared by FDA USA for the claim of reducing or healing of fut strip scar mark.Acell is commonly used by different types of surgeons in USA to reduce marks post surgeries and for quick and quality of wound healing.
b)We are the only clinic in the world which also use activated or progenitor stem cells,growth factors at both donor and recipient which also plays a significant role in wound healing,imagine if FDA approved acell plus stemcells plus dp cells...i am confident there won.t be any white dots.Even i would suggest all the fut strip HT surgeons to use the above ,the fut sca will reduce by 80%.
Now let me answer your question regarding comparision with DR gho's technique-
a)Recently i have also starting performing HST like technique with much improvement because certain patients like neversay and few other's want to do invivo bisection so that they can avoid a fue punch required for extraction of graft.I personally feel invitro technique is much better since it is not blin technique but under magnification,and will have much higher regeneration at recipient.
HST extract with triple wave needle or punch a part of follicular unit with sorrounding tissue(although they say they extract stemcells from the needle,which is totally untrue,any one can come forward and prove me wrong,
You can confirm the same from their histological slide(shown in their published paper) after extraction of graft from the donor which does not show bisection longitudnally of the hair fibre,
but they bisect follicular unit with sorrounding tissue, as against totally different claim in their representative drawn pictures shown by them in which they show longitudnal bisection of the hair fibre?).Then they claim that since they preserve the extracted FU part in their preservation medium which they said to a forum member in an email that this preservation medium is the real secret like the cococola formula and they cannot disclose the same.As per their patent and published paper kindly review yourself--Below is the excerpt from their patent paper---
(WO2007061291) METHOD FOR IN VIVO MULTIPLICATION OF HAIR byHST/DR GHO
It is the object of this invention to overcome one or more of the above-mentioned problems, and thus to provide a method for the reproduction of human hair in which a long culturing time is not required. Extracellular matrix is produced by the (support) cells around the hair follicle. From our own research it is apparent that this Extracellular Matrix is essential for hair growth. In this invention the hairs are no longer cultured in a keratinocyte culture medium but are simply immersed for a short time in a medium which contains extracellular matrix or substitutes therefor. The hair is then put back. With this technique several hairs can grow as a result of putting back a single hair. The method according to the invention is moreover patient-friendly, because only plucked hairs can be used and no invasive method or anaesthesia is necessary, the patient does not have to come back for a second treatment after culturing in order to have the hairs implanted after culturing. A further advantage is that the donor area is left intact.
This invention thus relates to a method for the reproduction of hair, which method comprises the following steps:
(a) removing hair in the anagen phase from one or more donor areas in such a way that the hair stem cells which are responsible for hair growth are still attached to the hair removed; and
(b) bringing the hair removed into contact with a medium which contains extracellular matrix components or substitutes therefor; and
(c) implanting the hair of step b) in the scalp.
According to this invention it is thus not necessary to culture the hair follicle cells; merely immersing the hair in the medium which contains extracellular matrix components or substitutes therefor is sufficient. The hair is then put back in the scalp, after which several hairs grow out of this one hair.
In step a) of the method according to this invention hair in the anagen phase is removed from one or more donor areas in such a way that the hair stem cells which are responsible for hair growth are still attached to the hair removed.
As has already been stated above, hair growth comprises three phases: an anagen, catagen and telogen phase. Only hairs which are in the anagen phase are suitable for the method according to the invention. Compared with hairs in the catagen and telogen phase such hairs in the anagen phase are characterized in that they have a bulbus - often pigmented - with a shape that is characteristic of hairs in the anagen phase, on the underside of the hair. This is generally known and a hair in the anagen phase is therefore immediately recognizable for an experienced eye by the shape of the bulbus. Use of a microscope can give a definitive answer in cases of doubt. The removal of hair in the anagen phase can be effected in various ways, provided that the bulbus which is characteristic of hair in the anagen phase is still attached to the hair removed.
Since the difference between hairs in the different growth phases is very clearly visible when the hairs have been removed, the hairs are for example removed from the donor area by plucking hair from the donor area and selecting the hairs plucked in the anagen phase.
Tweezers are for example highly suitable for plucking hair from the donor area. The hair can also be plucked from the scalp by hand, however.
In step b) of the method according to the invention the hair removed is brought into contact with a medium which contains extracellular matrix components or substitutes therefor.
To this end a plucked hair can for example be immersed for a short time, e.g. 2 seconds, in the medium which contains extracellular matrix components or substitutes therefor. A longer contact time between the hair removed and the medium which contains extracellular matrix components or substitutes therefor is of course also possible but is not required. The culturing step which is described in European patent application 0 971 679 is thus not needed.
The term "extracellular matrix components" is a term known to all in the art. Substitutes therefor are also known in the art. Examples of Extracellular Matrix components are collagen, laminin, etc. These components are already available for cell culture. Examples thereof are Collagen I to IV inclusive, from Sigma/Aldrich, or Alminin, from Merck.
It is not necessary for the whole hair to be immersed in the medium which contains extracellular matrix components or substitutes therefor. Immersing the part of the hair to which the stem cells are attached is sufficient for the reproduction of hair by the method according to this invention.
In the last step c) the hair of step b) is implanted in the scalp. This hair - or at least the part of the hair to which the stem cells are attached - has been in contact with a medium which contains extracellular matrix components or substitutes therefor, and probably as a consequence of this the hair stem cells which are located in that part have been 'activated1, so that they too can develop into hairs. As a consequence of this the implantation of the single hair of step b) results in the growth of one or several hairs .
The medium which contains extracellular matrix components or substitutes therefor preferably has a viscous consistency (e.g. a hydrogel) . As used here, the term "medium" refers to a substance which contains important nutritional components, such as growth factors and trace elements .
As has already been discussed above, it is preferable that hair in the anagen phase is removed by plucking the hair from one or more donor areas, followed by selection of suitable hairs in the anagen phase .
The invention furthermore relates to the application of extracellular matrix components or substitutes therefor for the reproduction of hair. Such an application of extracellular matrix components has not been described previously.
Conclusions Thus, CK19 ⁄ Bcl-2-positive and Bax-negative cells can be obtained from cells derived
from plucked hair and are retained in cultures made from these cells. If this phenotype represents
follicular stem cells, our finding endorses the assumption that stem cells are located in the bulge
area of the hair follicle, as we did not find them in or near the dermal papilla.
Claims
Cosmetic method for the reproduction of hair, which method comprises the following steps:
(1) removal of hair in the anagen phase from one or more donor regions in such a way that the bulb characteristic of hair in the anagen phase is still attached to the hair removed,
(2) culture of hair follicle cells from the hair removed, under circumstances such that the hair follicle cells are able to multiply, and
(3) implantation of the cultured hair follicle cells in the receptor regions,
wherein:
the hair in the anagen phase is removed by plucking hair out of the donor region or the donor regions, followed by selection of suitable hairs in the anagen phase,
the hair follicle cells are cultured in a culture medium which is optionally supplemented with (a) at least one human mast cell line and/or autologous (cultured) CD34+ cells, or (b) one or more extracts of the human mast cell line(s) and/or of the CD34+ cells and/or (c) growth-stimulating agents, and
the cultured follicular hair cells and/or the autologous (cultured) CD34+ cells are implanted in the pores of the receptor
Now you can see for yourself that HST is saying cd34stemcells present in the midfollicle bulge of the follicle is important to activate or multiply hair.I wonder how can they get cd34 isolated and activated to progenitor stemcells in dosage or numbers in millions to be effective.Unless they are using stemcells from human cell lines which are allogenic and only used for research which niether HST or we can use in therapy.
In contrast we have a FDA licensed lab with biotech with our clinic wherin we isolate not just cd34,k19,cd200,mesenchymal stemcells,and all the possible stemcells in the hair follicle and sorrounding epithelial and dermal stemcells,activate them and inject with the bisected grafts.Addition of growth factors and ecm is mentioned previously.And multiplied into millions stemcells after 6 weeks.
Give it a thought if adearans,dr nigam,replicell,histogen,costarelis of follica are not getting consistent result with autologous solution of stemcells with multiple injection,even if HST is able to isolate and activate the cd34 stemcells(which are derived from only one part of follicle the bulge)it will not except in few cases create multiple hair as HST claims.Hst may claim that injury or wound to the follicle can activate stemcells for repair,which is fair enough,but that can happen also in transected fue,in vivo or invitro doubling.Culturing of cd34 and other stemcells requires at least 45days for good dosage to be effective as mentioned in thier own patent paper explanation.
Our invitro technique is new,our invivo technique is improvement on HST.I hope HST improves on my technique further.
At world's 7th congress on stemcell hair research at scotland in may 2013 ,i will be discussing with jahoda,costaralis and others on lpuked hair and stemcell activation techniques apart from dp culture and dp implant.
This post is a little technical, but i hope GC,didi,IRONMAN,ARASHI,NEVERSANEVER,BOLDY, and many senior members can understand the point i want to communicate discuss.
QUOTE=NeedHairASAP;111989]Couple Questions Doctor,
1. by hair doubling-- you mean taking an extracted follicular, cutting it into two, and then putting one half back in the donor and one half back in the recipient?
To me, this seems to be exactly what gho is doing, albeit less efficient, as Gho's happens all in one swipe, where you must chop a thousand grafts one-by-one in a petri dish and then implant.
2. Second, how can you have less scaring than gho if you are using larger needles than him?
thank you for your time
ASAP[/QUOTE]Comment
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Dr. Nigam, with all respect, but without proofs nobody would care what you personally feel.
So far all you are doing is using complicated technical words full of bold claims without any proof, not even a proof for the safety of all the things you inject into ppl scalps.Comment
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Dr Nigam -
You previously said and showed that you are doing a procedure where you PLUCK a hair, and then bisect the hair and use both halves in the recipient area. It seems as though this is what you did with Neversaynever in some of the pictures. What percentages of plucked hairs regrow? And how can the top half of the plucked hair even have a chance to regrow? It seems from the pictures like their was no tissue attached to any of the plucked hair. Does the donor area regrow after plucking it? This is quite a feat if its possible. That means you can triple 1 hair. I have never seen any studies confirming this. We all know how the "autocloning" ACell and plucked hair thing went with Dr. Hitzig. And he was implanting the bulb. How is yours any different?Comment
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Aim4higher,
Kindly go through my two other thread showinga) 5000 grafts doubling at the recipient on an ht doctorb) hair doubling of 6 single follicle by invitro technique at the recipient scalp, under cutting edge/future treatments. Our patients have options to choose the growth factors which are optional injection in the procedure of hair doubling.
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Then what is stopping you from doing a FUT , then harvesting the hairs under microscope so that you can split them in half, thus doubling the amount of grafts as they both will 'regenerate' right?
You dont need to do a FUE to do this procedure.Comment
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DR Nigams,-
I am very interested to see if a plucked hair (not half removed by a needle only plucked) can be implanted in a bald scalp and grow. Dr Hitzig had some success with beard hair but not with scalp hair. He said the plucked beard hair had more stem cells.
With your new DP cell solution from Europe could you try implanting a small patch of plucked hairs after you have cultured the DP cells for 30 days. You could did the plucked hair in the DP cells. The DP solution could make up for the needed dermal papilla material missing from the plucked hair and the plucked hair could act like a hair germ.
Here are some advantages of using plucked hairs.
-The plucked hair has some stem cells that could be used as a hair germ cell.
-The hair would grow in the right direction
-The recipient holes could be smaller than for implanting a FUE follicle-the plucked hair has a smaller diameter,
-The plucked hairs can be implanted closer together
-All the donor hair will grow back with no white dots or scaring—no need to cut the follicle into two.
-Thousands of hairs can be plucked in a few hours with no need to cut into the donor area
Thanks for your time.Comment
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Youngin,
At present we offer 3 techniques
1)injections of autologous stemcell(extracted from the donor scalp or body hair) solution like aderans with addition of dp cells isolated from body hair in injection form.This will be followed with DP culture in 3 months and dp implant by dec2013.
2)Invitro hair doubling wherein the bisection of the follicle is done under magnification outside the scalp and the graft survival boosted by activated stemcells,dp cells frpm body and growth factors.
3)In vivo donor doubling whrein we pluck the graft after loosening it with hollow needle.This partial plucked graft which has to contain mid follicular bulge with ir's stemcells and outer root sheath with it's inherent stemcells.This is what we did in case of neversaynever.
I preMy reaaeer invitro hair doubling wherein you have 2 options a)implant all the bisected follicles/follicular unit at the recipient or 1 at recipient and the other at the donor .In case of invitro that is outside scalp doubling we can accurately bisect at the dermal papilla or more specifically at the dermal cup sheath.You can google and search many studies which confirms that a bisected dermal papilla can regrow,the other bisected follicular unit with the stemcells at follicular bulge which is located at 1mm to 1.8mm from skin surface with outer root sheath can grow upto 60%(this is confirmed by studies of jahoda ,the famous UK researcher).
Adding activated stemcells both of epithelial and dermal origin, does significantly help improve the regeneration percent to 80% at the recipient.The other part with dermal papilla should regenerate upto90%.
In case of neversaynever we used plucking the partial follicle from the donor.In this case the dermal papilla with dermal cup sheath is intact with it's blood and nerve supply,the donor in this case should theoriticall grow 100%.When a women plucks her eyebrow,her donor eyebrow grows approx.100%(unless accidentally we pluck out the follicle from it's root).Yes the recipient will grow between 70 to 80% depends how good the doctor is, when plucking the partial graft I have never claimed like acell (orHST) which is an extracellular matrix that it can stimulate stemcells or grow hair,niether has FD AUSA approved acells claim that it can activate stemcells.FDA have only approved ACELL claim of superior wound healing.
In our autologous stemcell solution injection like aderans we are missing a proto hair,we are working to develop dermal papilla implant by dec2013.This dermal papilla implant is important for autologous stemcell injection as than it will have a ready structure of the follicle to talk,communicate or interact.Till that time i am using dermal papilla of body hair and injecting by syringe.Similarly these bisected follicles are acting as proto hair for my hair multiplication autologous solution to communicate with or repair these bisected follicles.
No we do not triple hair in this technique but double it.
I will be starting hair tripling trial on two patients next weekas my new ultra magnification microscope arrives wherein i will invitro bisect the hair at dermal cup sheath and above outer root sheath sparing mid follicle stemcell bulge with the third bisected part of the follicle.Studies have shown even outer root sheath alone have potential to regenerate.My real goal is to implant dermal papilla created in the lab and injection of multiplied epidermal and dermal stemcells in the hair follicle,thesee methods are for the patients to have best possible results as on today.Hairtransplant should be considered history even now since it is just relocation of hair from donor scalp to the recipient.Doubling of hair is the best option today till HAIR MULTIPLICATION IN THE LAB and injection/ implantation becomes more efficient in coming tears.
QUOTE=youngin;112187]Dr Nigam -
You previously said and showed that you are doing a procedure where you PLUCK a hair, and then bisect the hair and use both halves in the recipient area. It seems as though this is what you did with Neversaynever in some of the pictures. What percentages of plucked hairs regrow? And how can the top half of the plucked hair even have a chance to regrow? It seems from the pictures like their was no tissue attached to any of the plucked hair. Does the donor area regrow after plucking it? This is quite a feat if its possible. That means you can triple 1 hair. I have never seen any studies confirming this. We all know how the "autocloning" ACell and plucked hair thing went with Dr. Hitzig. And he was implanting the bulb. How is yours any different?[/QUOTE]Comment
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drybone,
Ofcourse strip docs should do this.Yes you are correct DOUBLING by FUT will be no different,but as you may be aware not many people want that strip scar or stitches.
The stemcells plus dp cell addition is very important to increase regeneration percentage which unfortunately restricted in the western world at present unless aderans and others complete their clinical trials in coming years.
In US many of the ht docs are using ECM to reduce FUT scar.
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Also Dr Nigam,
You are an expert in the field, there is no doubt of that, but I must say it's difficult to read your posts. Please paragraph your comments to make them more readable.Comment
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Just to be clear, when using invitro bisecting outside the scalp, if you extract a 2 hair FU and bisect it outside the scalp and put one half back in the donor and one half in the recipient...
You end up with a 2 hair FU growing in the recipient and a 2 hair growing the donor, correct?
Assuming I have this correct, can you tell me the percentages of this being successful each time? I'm also assuming it's 100% or close to it?Comment
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GC,
Regarding your query that 2FU would grow at the recipient and the 2FU at the donor after bisection outside the scalp ,you are correct.
Regarding the % regeneration, theoretically it should be around100%.
But as in traditional FUE/FUT where there is 90 to 98% regeneration , depending on the skill of the surgeon and how the respective scalp takes up the graft.
In vitro hair doubling will have the similar regeneration.
Another advantage is if , you have a stemcell responsive scalp you may get the benefit of additional new hairs or activation of vellous hair secondary to stemcellinjection.
I always prefer patients to take atleast 1 injection of multiplied stemcells after 6 weeks.
Jahoda and few other researchers have shown that with bisection of FU outside the scalp ( 1/4th proximal FU and 3/4th distal FU),the regeneration is upto 60%.
But in our case, with the addition of epithelial and dermal stemcells and growth factors we are able to provide the missing link for higher regeneration.
And also the fact that we will be bisecting from next week at the level of dermal cup sheath,hence our both the bisected parts will have epithelial and dermal components of the follicle to increase the regeneration potential further.
I am waiting for the dp culture to get ready in next 2 months at our lab, when the results should further improve.
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