Dr Nigam, my own experience

[drnigams]

Ted,
Good question,but i have answered this with 15 graft patch test bisected graft growth...2 months result,in that thread...which proves that 15 graft patch test was of bisected follicles..or else how could it show most of the follicles regrown ..both at recipient and donor..in 2 mont..although in that case ,i used a lot of dp cells..compared to toms..
Ted/Arashi,
In case of FUE/FUT..the whole extracted graft is implanted...in case of invitro bisection an injured/amputated graft is implanted.
In case of fue ,the graft goes through DYSTROPHY..and enters anagen after 60 days approx.
In case of amputated graft..it has to survive first..repair it's other half...and than go into dystrophy or shedding..an injured ..follicle repairs first..and grows initially faster and than sheds..these claims are supported by papers of kurt stenn,jahoda,koi et al..


QUOTE=Ted;126413]Would be great to know this[/QUOTE]

[drnigams]

yes.

Excellent, just to confirm, you have not yet tried a patient with BOTH HM and cultured DP am I right? The next step is HM and 3d Culture dp?

[garethbale]

Dr Nigam

Is there any specific type of hair loss your treatments work best on. I am not diffuse thinning, however I am around a norwood 2-2.5 and have a receding hairline. I am 28 years old and have been slowly losing hair for 10 years.

Would I be suitable for HM / doubling / DP ???

Also can it work on areas with no hair or do you need vellus hair to be there?

[Ted]

Ted,
Good question,but i have answered this with 15 graft patch test bisected graft growth...2 months result,in that thread...which proves that 15 graft patch test was of bisected follicles..or else how could it show most of the follicles regrown ..both at recipient and donor..in 2 mont..although in that case ,i used a lot of dp cells..compared to toms..
Ted/Arashi,
In case of FUE/FUT..the whole extracted graft is implanted...in case of invitro bisection an injured/amputated graft is implanted.
In case of fue ,the graft goes through DYSTROPHY..and enters anagen after 60 days approx.
In case of amputated graft..it has to survive first..repair it's other half...and than go into dystrophy or shedding..an injured ..follicle repairs first..and grows initially faster and than sheds..these claims are supported by papers of kurt stenn,jahoda,koi et al..


QUOTE=Ted;126413]Would be great to know this

[/QUOTE]
Thanks!

So the grafts in the 15 grafts patch test had not yet shed at 2 months? After how long time will the bisected grafts start shedding?

[534623]

Would I be suitable for HM / doubling / DP ???

hmmm, if I would consider your answers as multiple choice answers, I think I would make a cross next to "DP" - re-programmed DP's, of course, sprinkled onto "spheroids" and then implanted. Yeah, that's it.

[ccmethinning]

Ironman, I'm sorry you're under-appreciated here. Thank you for holding the unscrupulous HT doctors accountable.

[drnigams]

Approx 30% have shed after 1month...only difference is i used good dose of dp cells in 15graft test,and bisection point was different,and as you can see donor follicle thickness count and number is better than recipient follicle thickness and count..as it was slick bald.and donor had sorrounding hair and the donor is non AGA scalp....
I am confident of not just donor regen..but donor enhancement after 6 weeks inj of dp culture and multiplied stemcells..as in case of 15 graft patch test..


Thanks!

So the grafts in the 15 grafts patch test had not yet shed at 2 months? After how long time will the bisected grafts start shedding?[/QUOTE]

[drnigams]

Garethbale,,
My experience with HM inj is .. that ,definitely..
if there are sorrounding hair , and not slick bald saclp...HM results are much better...
but in case of lowering of hairline or bald temple... which has no surrounding hair...
May get results but success percent will be lower than the cases which have some surrounding hair around inj sites..hence early intervention is better ..before one becomes slick bald..


Females with less androgens..have still better results...

Tom met 4/5 patients of hm..all had got results..some early results..as few were 3/4 months post hm..and some excellent hm result..
Hairline..slick bald ...as on today ,may need combination of doubling with hm..for guaranteed result..
But,doubling is just an extension of HT...and without any doubt..with my 8/9months experience...and continuous improvement.....is guaranteed(i offer the same on stamp paper or return my fees)...
Doubling without stemcell,dp cell ,ecm, will not be as successful..

Skeptics... will need 5 more independent cases,in coming months to give verdict...but that's understandable...i have no issue with that..

Real challenge for all of us..is how much success percent can we improve with HM in coming months...HM is already a partial cure with aderans claiming 60% success rate ,and myself slightly lower...that means ,those scalps,who will respond to HM and dp culture..mpb cure is there for them..and those who do not respond...will have to wait still....

Now ,after showing 4/5 cases of pure HM, who had come for follow up..to..Tom the forum member(remember obi,nsn also saw few pure hm cases) ...he saw their pics,met them,spoke to them,saw my own hair with result...and if tom reports you directly..and skeptics still do not believe..it is their problem...and they will believe in coming months..as more and more cases are presented...(tom was saying..for skeptics ..They think it is too good to be true..)

If members agree on mumbai patients, as case studies..i can load the forum with multiple cases,as the documentation becomes easy..as i can call mumbai patients for follow up...




QUOTE=garethbale;126738]Dr Nigam

Is there any specific type of hair loss your treatments work best on. I am not diffuse thinning, however I am around a norwood 2-2.5 and have a receding hairline. I am 28 years old and have been slowly losing hair for 10 years.

Would I be suitable for HM / doubling / DP ???

Also can it work on areas with no hair or do you need vellus hair to be there?[/QUOTE]

[Ginkgo]

Hello Dr Nigam,
Is there any progress with your accommodation in the UK? I'm wondering if you would be able to offer the doubling procedure without the cultured injections (as these don't have European approval), or would this not produce good results? If this stand alone procedure proved satisfactory, surely this could be an alternative to HASCI?

[One]

Dr. Nigam sorry,

I did not understand that the procedure used by Tom. It would be appropriate that she should specify, so as to make it clearer to all users who read (old and new).

Thanks!

[drnigams]

Ginkgo,ONE,
My surgeon is in uk till 6th june,taking consultations.

Regards opening clinics outside mumbai...
I can offer doubling with progenitor stemcells and dpcells..without dp culture and multiplied stemcells...and it will give similar results...ofcourse better with the injections after 6 weeks.
But the problem is manpower cost.

You can confirm from tom..

In case of invitro doubling this is how the process goes...blood test,preoperative profile,checking of equipments,medicine trolley,consent form,fumigation etc...

step1)30minutes to plan a hairline,minimal shaving as per the number of grafts required,testing for every medicine like local anesthetic for any allergy.
Applying emla,ice and than for safety7 i v line.
Very slowly local anesthetic is given with help of ice,dermajet,ouchless needles etc.to avoid pain this process consumes a lot of time.

2)Patient lies on prone position,we(2docs) extract the grafts from the either side,Normally we send 75 grafts to lab,outside mumbai,i will have to extract stemcells and activate without multiplication,this is known as same day minimal manipulation process in a special minilab section at the clinic.(1technician will do this).


3)we will extract 2000/300 grafts for dp cells,one technician will isolate dp cellsand the doc will implant the follicle back at donor.

4)Now we will extract 200 grafts from the donor and one technician or doc will bisect under special 50x magnification at precise point,he will also check for any transected extraction and warn the doctor.

5)now the patient will turn to supine position and local anesthesia will be given and as per patients preference,we will inject the tiny dp lower of the graft with 21 number needle or to make sure the angles are perfect we would have create incisions in the beginning of the procedure..to avoid bleed or propping out or loss of visibilty due to blood..as pre incision method 3/4 hours before,is critical for density ,as there is no blood,incision is sticky and it takes grafts smoothly.In the process through out a nurse applies ice all over ..for pain management,helps in reducing swelling,and minimal bleed and clear field to work.

6) After implantation of these 200 grafts,patient turns back to prone position,where we implant the upper half of the grafts at the donor.
The same steps are repeated.
You must have noticed we do not keep grafts out of scalp for longer than few few minutes,to improve survival,in typical fue,one takes out all the grafts and than implants all back,and the graft is out of scalp for few hours ,same is in fut.
The initial process also involves making of tumescent anesthesia ,we add triamcelone to it which reduces 90% swelling possibility,TOM have deranged clotting time,as he did not stop his natural supplements and had very thin blood..other ht surgeon might have delayed his procedure,but because of triamcelone acetate in anesthesia and ice application..he did not have any swelling .
Not to forget one nurse is supposed to maintain the patients record regards what has gone in,,number of grafts ,single,doubles,triples..atleast 30 minutes are lost inbetween ,as the patient discusses the final hairline,,and majority of time he/she wants lowering and we have to convince with x number of grafts available,if you lower further ,the density will be less)

7)The dpcell injection,progenitor stemcells and prp injection is given allover the donor and recipient after again local anesthesia,ecm paste is applied all over the donor and recipient,and finally area is cleaned,no bandage but a bandana is worn to avoid swelling.

8(The doctor explains the follow up procedure gives medicines,and his number,gives a special spray ****tail of certain products with antibiotic..for grafts survival as it takes 8/9 days for blood supply to resume totally.
We keep the grafts in same medium we use for culture of dpcells and stemcells..this media does not do anything to stemcells but extraordinarily prevents grafts from injury or apoptosis.
Not to mention the pre ,during and after procedure videoscopy,macro pics.Food/juice breaks...Of course we can avoid the massesuer for relaxation of patient and doctor for better ergonomics and concentration which is offered at mumbai..
Patient receives his follow up kit bag,thankyou card and a flower bouquet..and leaves

FUE REQUIRE2/3 PROFESSIONAL AND INVITRO DOUBLING REQUIRES 8/9 PROFESSIONAL..AS MANPOWER COST IN INDIA, IS ONE FOURTH THE COST OF USA,UK..the procedure will become expensive...
Thats why i feel as of now...FLY BALD ..FLY MUMBAI IS BETTER..till i finalize my partnership in TOP cities across the globe with the local HT surgeon..i can't run around the globe...At ISHRS..i may have a bussines counter for new partners with drnigams doubling technique..and meetings..in october 2013..at San Fransisco.
Believe me ,we will get the doubling to various cities across the globe in next 2years..it is only about ht docs getting confidence after having a look on their patients with small patch test ,and finalization of financial agreements..

We all know HT collegues are resistant to change easily,except the new,younger ones...it is 10 years now.. when fue was introduced..and still only 40 to 45 % work of ht is done by fue rest by fut still..!

Already had a meeting with two top usa surgeons,uk surgeons ,canada and ireland surgeons at WCHR..i will not keep it to myself..would love to focus on pure HM..

Hello Dr Nigam,
Is there any progress with your accommodation in the UK? I'm wondering if you would be able to offer the doubling procedure without the cultured injections (as these don't have European approval), or would this not produce good results? If this stand alone procedure proved satisfactory, surely this could be an alternative to HASCI?

[drnigams]

ONE,
Numbering of the grafts are in process,will post tmr.
Briefly,

Tom( it is HE and not SHE) wanted to lower his hairline and temples including a different style i.e forwarding of his ...lateral locks...

Total sqcms of ... hairless area at temples ,hairline.. to be filled was..approx 40sqcms(tom is sending me the exact measurement tmr)

Available grafts of doubling were approx 1000(exact number tmr,with singles,double,triples count..as i am out of mumbai today) ,as he enrolled for the same and will do a similar 1000 grafts at the same hairline and temples in his next visit after 6 weeks,when he takes multiplied stemcells and dp culture injections.

We drilled approx1300/1400holes(exact tmr) at his donor,for extraction for doubling,extraction for stemcell isolation for the lab,extractions for dp cell isolation(after dp cell isolation the grafts are reimplanted at the donor from where it was extracted),Extraction for dpculture...few were unsuitable drills(graft was not extracted but drill was made).

These extracted grafts were bisected in such a way under magnification,so that upper part contains epidermal and few dermal stemcells and lower part contains dermal stemcells with a part of dermal papilla...

Incisions (with very fine blade, as lateral slits)are made at the recipient in consultation with the patient after hairline is drawn at the beginning of the extractions from the donor.
After the implantations and extractions are over...all the recipient and donor site is injected with injections of..
1)trichogenic dp cells
2)progenitor stemcells
3)growth factors
4)extracellular matrix and prp

After this procedure a paste of culture media with ecm is applied at recipient and donor holes,for zero scar process externally..which tom is provided also for home use for 7 days along with a special spray for graft survival.

We should get 100% donor regen and 100% recipient regen..thus no graft should be lost..and we can theoretically have many such sessions..even if we have a weak donor..

This technique is much superior to invivo technique..where a partial follicular unit is bisected blindly..and cannot,bisect the follicle at the hair bulb level..and specially if progenitor stemcells,dp cells are not used to support the graft repair or regrowth...!

The upper half of the bisected follicle may be missing a complete dermal papilla ,dermal cup sheath will make these cells and dp cell and dp cultured cells(after 6 weeks) injected will compensate and help in new dermal papilla formation.

Similarly the lower half of the follicle is a part of dermal papilla ,it is missing the bulge stemcells,hair shaft etc

The injection of progenitor bulge cd200 cells with all other epidermal and dermal stemcells of the follicle with trichogenic dp cells will help create a new follicle from a fragment of the follicle,6 weeks later multiplied epidermal /dermal stemcells and dermal culture will further strengthen both the bisected parts...

By the end of 2nd session he will have a density of 60/70 G per sqcms at hairline..which is approx.30 in the first session..and we hope to thicken his rest of the scalp hair with HM treatment and our medical prescription will counter androgens and micronflammation..
Thus without depleting any follicle at the donor ..we should get similar number of extracted hair as bonus..which are used at hairline...

Dr. Nigam sorry,

I did not understand that the procedure used by Tom. It would be appropriate that she should specify, so as to make it clearer to all users who read (old and new).

Thanks!

[Arashi]

ONE,
We should get 100% donor regen and 100% recipient regen..thus no graft should be lost..and we can theoretically have many such sessions..even if we have a weak donor..

If this would be true, you would have created unlimited hair, right ? And thus solved the hairloss problem. Forum can close down, nothing more to talk about

[drnigams]

Arashi,forums should continue..how do people like you and me meet...

We will miss our friend im.

If this would be true, you would have created unlimited hair, right ? And thus solved the hairloss problem. Forum can close down, nothing more to talk about

[garethbale]

If this would be true, you would have created unlimited hair, right ? And thus solved the hairloss problem. Forum can close down, nothing more to talk about

Haha, problem solved. No need for Replicel, Aderans, Histogen...we can all go home

Can't see 100% being achieved but would love to be proved wrong