Differences between In-Vivo and In-Vitro (SHD)!

[HARIRI]

I also asked Dr. Nigam about the difference between Dr. Gho's HST In-Vivo and his SHD In-vivo, he answered me the following:-

HST invivo extracts complete follicle with bulb, as can be seen in their Petri dish of 200 grafts sample, Dr. Nigam's In-Vivo does not extracts complete follicle but partial follicle without bulb as per the pics of his partial follicle extracted in Vivo are posted on his thread of NW7 case in TBT.

HST claims that they break the stemcell portion at the donor and because they soak their extracted follicle in preservation medium they claim that they can multiply follice, which he doubts is true.

At Dr. Nigam's, he extracts partial follicle at the level of dermal papilla so that even the partial follicle has some portion of dermal papilla, which has capacity to regenerate into a complete follicle

At Dr. Nigam's, he has access to progenitor stemcells from lab,growth factors to boost the partial follicle growth.

Also why he modified the technique to In-Vivo from In-Vitro is to avoid total extraction of graft. They both have their role depends on case to case

However both great techniques of Gho's HST and Nigam's SHD are scarless. There is no wastage of grafts with Dr. Nigam's SHD..as you can see with HST 200 grafts test they had to throw away 50 grafts.

HST claims donor regeneration of 80% while Dr. Nigam's claims regeneration of 100%. However recipient regeneration claim by both is same. Also the price is cheaper due to the location probably.

Finally unfortunately Dr. Umar, Dr. Rassman and Dr Rahal doubt HST saying that they extract one follicle out of 2 follicles and implant at the recipient.

After all I respect both surgeons Dr. Gho and Dr. Nigam and believe that they are trying hard to bring FUE and Hair doubling to another level. Im just a messenger guys so take it easy on me.

[drnigams]

GC,UK,
The scar is seen because of alignment of collagen in a different pattern than normal skin and also because of contracting effect.
These are few things by which no white dots will occur...
1)ECM has to be filled in with prp(areterial from 200ml blood for good concentration of growth factors for healing and not 10 ml venous blood used by majority) and growth factors for wound healing and scar prevention immediately after extraction before the clot is formed and the filler should be in semisolid or gel form.ECM is full of collagen.
The most important part to handle is activation of haparin sulfate,which will make sure no scarring.
2)Of course i have the advantage of adding epidermal and dermal stemcells ,which as u are aware has an important role in wound healing.
3)As drcole suggested ,do not go upto 4mm deep to extract graft in fue,as you go deeper into dermis ,chances of injury to more and more of dermis increases.Hence dr cole also utilizes the technique of tweezing and easing out follicle without going deep into the dermis.Injuring epidermis will not lead to visible scarring,as more and more deep you go into dermis ,the chances of white dot and scarring increases.
I have presented 4 cases till now..and u can watch the quick healing without any mark(look at nsn birth mark,where we have used manual fue punch)
By the way there are two papers on wound healing and regrowth to be presented by 2 scientists at international investigative dermatology conference from 8th to 11th MAY,2013 at edinburgh.

So what is the difference here with Dr Nigams ECM and the Acell ECM that Cole was using?

If there is such a difference, how is it Dr Nigam has success with 0% white dot scarring it and Dr Cole hasn't come close? Seems almost unbelievable doesn't it?

Perhaps Dr Nigam should extract 1000's of grafts from one of his patients/volunteers head, shave down to a zero and show us no white spots.

That would be worthwhile.

[drnigams]

UK,
Yes we are waiting for dr wesley's disclosure of his hair harvesting technique for scarless procedure .
Specially after reading his quote....
(PiloFocus) has developed a new technology that is so simple, that it would take a true visionary to imagine it."

"When (I learned) about the procedure I (thought) why hasn't this been thought of before?! But like all other inventions throughout history...once you hear about something that improves something, you always say to yourself why didn't I think of that?! This technique proves that theory.".

"The handful of patients participating in the phase one clinical trial would help determine if the two theoretical benefits of this surgical technique were, in fact, true: 1) the donor area from which the hair follicle was harvested would show no evidence of scarring (not even the punctate scarring pattern seen in FUE), and 2) the survival and growth of the transplanted hair follicles using this technique would be as good as “strip harvest” or follicular unit transplantation (FUT) and as good, if not better than follicular unit extraction (FUE). Currently there are no additional agents (e.g. PRP, ACell, etc.) being factored in to enhance one method over another."[/QUOTE]

[UK Boy]

Yes TED,show this to the critics...at least if dr cole says they would believe it.
And its my prediction ,it may be proved wrong...that dr wesleys fue scarless technique will be about special equipmentation to avoid scar and use of such biological material to avoid scars in fue..
By the way ,i like dr cole...he is also an innovator and communicates freely.

Not sure if you're right about Dr. Wesley's procedure Dr. Nigam. Back in Jan he answered some people's questions here on the Bald Truth forums, I took the info below from that thread.

"The handful of patients participating in the phase one clinical trial would help determine if the two theoretical benefits of this surgical technique were, in fact, true: 1) the donor area from which the hair follicle was harvested would show no evidence of scarring (not even the punctate scarring pattern seen in FUE), and 2) the survival and growth of the transplanted hair follicles using this technique would be as good as “strip harvest” or follicular unit transplantation (FUT) and as good, if not better than follicular unit extraction (FUE). Currently there are no additional agents (e.g. PRP, ACell, etc.) being factored in to enhance one method over another."

[gc83uk]

Google >Dr. Cole on ACell - “That’s not science.”<

...and you will find more details about Dr. Cole's spicy ACell-science.

So what is the difference here with Dr Nigams ECM and the Acell ECM that Cole was using?

If there is such a difference, how is it Dr Nigam has success with 0% white dot scarring it and Dr Cole hasn't come close? Seems almost unbelievable doesn't it?

Perhaps Dr Nigam should extract 1000's of grafts from one of his patients/volunteers head, shave down to a zero and show us no white spots.

That would be worthwhile.

[534623]

Here is what dr.cole experienced with ecm and fue marks.

Google >Dr. Cole on ACell - “That’s not science.”<

...and you will find more details about Dr. Cole's spicy ACell-science.

[drnigams]

Here is what dr.cole experienced with ecm and fue marks.(a pointed out by TED)

Healing with CIT FUE Hair Transplant and Acell

Posted by John P. Cole, MD on Wednesday, January 26, 2011
Review of: ACEll

Product by:
John Cole, MD

Reviewed by: John P. Cole, MD

Rating:
5 Stars

On January 26, 2011
Last modified:May 22, 2012
Summary:

More Details


I find this interesting. This is another FUE extraction site treated with ACEll in a hyaluronic acid mixture after 5 weeks. It is still too early to tell if the hair might regrow in the extraction site though I have seen this. It does appear that a single hair is forming in the extraction site, which appear as a black nub. What is interesting is the appearance of a capillary in the skin. These are usually missing following FUE and help lead to the loss of pigment in the extraction site. I’ve done enough FUE to spot extraction sites anytime I look at a donor area even when no hypopigmentation occurs. It is an observation based on experience with FUE. With this donor area, I could not find any evidence that FUE was performed. The red circle is where I would expect a follicular unit to be. The entire donor area looked like this. The black circle is 10 sq mm. I had the dermlite people make this reticule for me.

The long hair after 5 weeks is a result of a completely non-shaven procedure of 1464 grafts. I call this C2G. It is still to early to say for sure because I need more results, but this is an example of what I have seen in donor areas treated fully with ACELL with my method of FUE where I use minimal depth control. The initial problem was treating all the extraction sites with a powder. I overcame this with mixing it in a viscous hyaluronic acid. More recently I have been mixing in a more viscous cellulose. I have a few comparative examples where I am looking at powder, hyaluronic acid, and cellulose. Time will hopefully tell. I think the minimal depth incision technique along with Acell may result in better healing than a full depth incision. Maybe we will see more hair regrowth over time. Maybe not. Still no one could comb through this donor area and find any evidence that a hair transplant had been done. It appears that we really are coming full circle today. Not only have we produced optimal results in the recipient area such that you cannot tell that a hair transplant has been done. Even the trained eye cannot see evidence that a hair transplant was done in the recipient area.

I found this:
http://www.hairlosspress.com/418/hea...ant-and-acell/

[Arashi]

Anyway, Ironman already summed it up above:

"The Acell reduced the diameter of hypopigmentation and the degree of hypopigmentation, but Acell, did not eliminate hypopigmentation."

Anyway, my last post in this thread, I just can't take this anymore.

[Arashi]

wikepedia.....In terms of injury repair and tissue engineering, the extracellular matrix serves two main purposes. First, it prevents the immune system from triggering from the injury and responding with inflammation and scar tissue. Next, it facilitates the surrounding cells to repair the tissue instead of forming scar tissue.

Hmmm... what would that 'citation needed' exactly mean, following this quote on wikipedia ? Wouldn't that mean that someone added this to the wikipedia without referring to ANY clinical proof at all ? Can you instead link us to a scientific article/clinical study that shows us that extracellular matrix indeed results in completely scarless healing ?

[drnigams]

Yes TED,show this to the critics...at least if dr cole says they would believe it.
And its my prediction ,it may be proved wrong...that dr wesleys fue scarless technique will be about special equipmentation to avoid scar and use of such biological material to avoid scars in fue..
By the way ,i like dr cole...he is also an innovator and communicates freely.

I found this:
http://www.hairlosspress.com/418/hea...ant-and-acell/

[drnigams]

wikepedia.....In terms of injury repair and tissue engineering, the extracellular matrix serves two main purposes. First, it prevents the immune system from triggering from the injury and responding with inflammation and scar tissue. Next, it facilitates the surrounding cells to repair the tissue instead of forming scar tissue.
One has to understand the scar tissue formation after an injury at the wound site.
Go through the contents of ecm(as per wikepedia ..not just me)
2.1 Proteoglycans
2.1.1 Heparan sulfate
2.1.2 Chondroitin sulfate
2.1.3 Keratan sulfate
2.2 Non-proteoglycan polysaccharide
2.2.1 Hyaluronic acid
2.3 Fibers
2.3.1 Collagen
2.3.2 Elastin
2.4 Other
2.4.1 Fibronectin
2.4.2 Laminin

3 Cell adhesion to the ECM
4 Cell types involved in ECM formation

5 Medical applications

it is a long explanation,will explain one day.
Will also show you wound healing of FUE extraction with no white dots with a patch test.
Yes my ecm also has stemcells with boosters to give better results.
ECM is commonly used by plastic surgeons in cases of burns.
I am not talking of just acell.
Now i will talk about OUCHLESS NEEDLES...available in usa and fda approved,used by many surgeons..but not by all.
Just google ouchless needle.
I use it, if the patient pays for it..you won't have pain ,even of a prick.

extracellular matrix


Are you sure there wont be any white dots?

[Ted]

I found this:

http://www.hairlosspress.com/418/healing-with-cit-fue-hair-transplant-and-acell/

[Ted]

Do you have any pictures of donors where you have used extracellular matrix in combination with normal FUE Dr. Nigam?

[Arashi]

And concerning your previous long post - sorry, it's too tiresome to comment such a load of bold and incompetent claims.

LOL. Amazing that you're even responding man. If Extracellular matrix, that's been studied for decades, could COMPLETELY eliminate scar tissue formation, then why is there no such thing as scarless cosmetic surgery ?

I'm not going to respond to the rest of all the claims, in fact, I had said I would never even respond to anything Dr Nigams claims at all, which probably is best.

[534623]

Yes just tell your doctor in your city to use extracellular matrix which is easily available,there will not be any white dots even in fue ...

By Dr. Cole at HS:
"The Acell reduced the diameter of hypopigmentation and the degree of hypopigmentation, but Acell, did not eliminate hypopigmentation."

FDA has approved extracellular matrix for wound healing and scar reduction..I am surprised why others have not thought till now...

Just to let you know:
A few doctors play with "ACell" since around 2008 and lots of HT docs out there play with ACell since around 2010 - with "MIXED RESULTS".

In my case as you may be aware the stemcells has a role in wound healing..hence no scar .

That is basically true - but that doesn't mean that your patients CAN get scars.

And concerning your previous long post - sorry, it's too tiresome to comment such a load of bold claims.