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Differences between In-Vivo and In-Vitro (SHD)!
What are the main differences between In-Vivo and In-Vitro technique of Dr. Nigam's SHD (Stemcell Hair Doubling)?
Also what are the advantages of each and when to use?
Also what are the advantages of each and when to use?
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?? Both GC and Nigams just explained it to you in that other thread ? -
Bro Arashi, I have an idea about it as I'm going to get In vitro for my scar using my beard hair this April 26 with Dr. Nigam. I just wanted a thread that explains the differences well, the advantages and when to use which so other members benefit from it. As you know that Dr Nigam's Stemcell Hair Doubling is new and there isn't much info about it as Dr. Gho's HST technique has. So I felt like starting a thread about it. I hope Dr. Nigam would kindly answer it sufficiently.Comment
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It's easy. He either leaves part of the follicle behind in your head, just like Gho does, he calls that the In-Vivo. Or he extracts the whole graft and splits it under a microscope. It's easy to imagine the differences. If you want to extract the whole follicle, you'll need a bigger needle and thus you will get bigger scarring. Hence I would never use that for beard hair, like you're planning.Comment
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Man, Hariri, I'm getting the impression you're going to Nigams without having read much at all about everything and without having thought things through. If I were you I'd try to find out as much as possible. Most importantly for me would be: what exactly is he going to inject ? Growth factors ? Other cells ? Has that been approved ? By which authorities ? Were clinicial trials done to prove safety ?Comment
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HARIRI,
My In vivo hair doubling(bisection of follicle inside the scalp) is performed the following way as below---
1)Trimming of the donor scalp hair to 1guard.
2)Using .6mm hollow needle(for single and doublegrafts)and .7mm to extracttriple graft manually to extract partial follicle from the donor scalp,leaving the dermal papilla /root of the follicle intact with its blood supply intact at the donor and should grow backas donor regen 100%.
3)minimum 3mm of the follicle should be extracted, so that it has inherent bulge stemcells and a part of outer root sheath with its stemcells ,which has the capacity to develop into a complete follicle on implantation at the recipient.
4) With invivo technique, we do not go more than 1mm deep into the epidermis and than tweeze and pluck out the partial follicle.
Since scar forms only if we go deep to dermis like fue,hence no chance of any scar,or mark.
5)Advantage is donor regen is 100% guaranteed but disadvantage is recipient may not regenerate 100% as the partial follicle is without dermal papilla /the root.
6)thus in a session of a week(7days) ,we can extract 10000 plus grafts.And can repeat tis procedure after 2 to 3months.
Hence a nw7 can be cosmetically converted to nw2 in short time.
Invivo is like trimming your grass in your garden as against fut/due wherin there is relocation of grass from area to another,no net gain of follicles.
7)Now u must be thinking how will recipient bisected follicle without dermal papilla/root will repair and grow into full follicle.
This problem is overcomed by--
a) injecting dp cells isolated from body hair in dp culture medium and inject into the recipient .
b)Injecting autologous progenitor(active) stemcells of dermal and pithelial origin into both donor and recipient.
c)Injecting growth factors into the donor and recipient to boost the donor and recipient regeneration.
d)injecting extracellular matrix and prp for better healing and recovery.
You can come to your own conclusion regarding difference between ours and others invivo technique.
We have recently improved our invivo technique by giving eyes to it by use of ultrasound and fibrooptic camera guided bisection in vivo....so that now we can see and bisect at the right point rather than bisecting blindly.Hence better regeneration.
This is how invitro(outside scalp bisection of follicle under magnification)
1)Trimming of hair at the donor.
2)Extracting the graft by.6mm(single graft),0.7mm(double graft),.8mm(triple graft).with the root /dermal papilla.i.e a complete graft.
3)Even in this extraction there will be no scar although we are going upto dermis because of extracellular matrix .
4)Extracted graft is bisected at the dermal papilla level(at present transversely,shortly we can make three or four bisected graft by bisecting bith transversely and longitudnally).so that both the bisected part have some dermal component also.
5)Invitro will give much better yield as both the bisected follicle has some dermal component which has the capacity to form a complete follicle.Under magnification the bisection is more precise.(you must have seen in my 15graft patch test.....23 follicles have become 90 follicles by 18th day).
6)Disadvantage is that we have removed the dermal papilla/root of the follicle away from it's blood supply.
7)like invivo in this technique also we give following booster injections--
a) injecting dp cells isolated from body hair in dp culture medium and inject into the recipient .
b)Injecting autologous progenitor(active) stemcells of dermal and pithelial origin into both donor and recipient.
c)Injecting growth factors into the donor and recipient to boost the donor and recipient regeneration.
d)injecting extracellular matrix and prp for better healing and recovery.
In your case ,as per your request we are using beard hair for strip scar revision..invitro is better because the scar implantation anyway has lesser yield ..hence better to use the root/dermal papilla portion is important and will give better yield.no scar or mark..plus all the boosters as mentioned above.Your scar is 18.6sqcms ..
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Dr. Nigam, Thank you for the sufficient answer.
Arashi, I appreciate your advice but I really have nothing to lose. I'm just going to use my chest hair and some only of my beard hair under chin area. I wont risk with my head donor or beard along the jawline. It would be a bigger risk if I will go for strip scar revision. Also if I would go to Bisanga to use my beard hair into my scar it would be the same. The only thing different is I will manage to get hair doubling and create a better growth environment in my scar tissue area. There are many patients before me have tried it and nothing negative reported. It would be ONLY a scar job. My balding thinning areas wont be touched at all.
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Thank you for the time you put in to inform us Dr. Nigam!
What is the price per graft for these different methods?
Will injecting extracellular matrix and prp into the donor make scar less transplantations even with normal FUE procedures?Comment
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Ted ,
The policy of this forum does not allow to solicit any business on the forum.
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,
FDA has approved extracellular matrix for wound healing and scar reduction..I am surprised why others have not thought till now...
In my case as you may be aware the stemcells has a role in wound healing..hence no scar .
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extracellular matrix
Are you sure there wont be any white dots?Comment
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By Dr. Cole at HS:
"The Acell reduced the diameter of hypopigmentation and the degree of hypopigmentation, but Acell, did not eliminate hypopigmentation."
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".
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.Comment
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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.Comment
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Do you have any pictures of donors where you have used extracellular matrix in combination with normal FUE Dr. Nigam?Comment
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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.
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