Dr Nigam, my own experience

[One]

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[garethbale]

Dear,one i explained earlier...

Documentation took a lot of time,convincing tom not to lower hairline so much laterally took alot of time,ultimately had to agree with tom,it's is after his hairstyle which he loves..he is a fan of cristiano's hairline...

.

Whose hairline?

[Arashi]

Whose hairline?

Christiano Ronaldo

[drnigams]

One,
Answer to your specific question if i understood correctly...

Do you want to know..why i give local anesthetic and extract approx 200 grafts from donor when patient lies in prone position and turn the patient into supine position give local anesthesia and implant at the recipient....

This is because,i want to expose the grafts to minimum time, outside the scalp...as against extract all grafts and than implant after bisection..
This also consumes time...
Remember invitro doubling is not fue..there are multiple steps and 9/10 personnel team working together and not 2/3 as in fue..
With invitro ,i can implant 1500..to 2000G per day...provided all medical parameters are normal..

That's right, Dr Nigam I do not know if updates on the forum writes her or his secretary but often do not understand what it means.

Read a bunch of names (cells dp-prp, re-growth factors), numbers, bulbs cut, put some in the culture, other implanted confuses us a lot.


Moreover, often does not respond in a direct manner to the questions.

Mine is the following: Why do not you have innestat all grafts at once? Are you able to engage with a density of 40-50-60 cm2 grafts in a session?

[garethbale]

Christiano Ronaldo

oh yeah...pretty obvious!

[drnigams]

Invitro hairdoubling...equals 1500 doublings per day..which means ..in 4 days..approx.6000grafts doublings ..per session..repeat the same after 6 to 12 weeksr visit ..

Also, Dr Nigams, you were talking earlier about a max of 5000 grafts/session. But if approx 1000 grafts already take 3 days, does that mean that 5000 grafts equals 15 office days = 3 weeks ?!?!

[didi]

wow, nice dr nigam.

12 000 grafts in 2-3 months, no scarring/white dots+90% growth and donor regeneration?

[TO YOUNG TO RETIRE]

what is the waiting time Dr? i mean when is the next available free to book time?

Invitro hairdoubling...equals 1500 doublings per day..which means ..in 4 days..approx.6000grafts doublings ..per session..repeat the same after 6 to 12 weeksr visit ..

[didi]

this is Holy Grail, who cares abt HM..as far as im concerned this is a cure for HL.

Spencer, please organize an interview with Dr Nigam.

[TO YOUNG TO RETIRE]

and soooooooooooon please

this is Holy Grail, who cares abt HM..as far as im concerned this is a cure for HL.

Spencer, please organize an interview with Dr Nigam.

[drnigams]

I hope this will be clear now...

1)Total1475 extraction drills at the donor.

2)Out of these1475 drills.175grafts extracted for stemcells and 75 grafts extracted for dp culture and sent to lab.

3)106grafts extracted for dermal papilla cell isolation and than implanted back at the donor from where they were extracted without dermal papilla,these were not bisected.

4)1119 grafts left were bisected and double the number i.e 2238 grafts created by bisection.

5)1044 implanted at the recipient and 1194buiisected grafts were implanted at the donor...why we implant little more at the donor is to fill all extraction drills..

So ,if we get 1475-175-75=1225x2=2450-106(as they were not doubled,used for dpcell isolation)= 2344 grafts at donor and recipient combine is what we should get, for 100%regen in total at donor and recipient...anything less could be due to telogen/exogen(10%to15%),if at all you want to count them...anything less than this, means corresponding regeneration percent ...
I can understand..invitro is new..and the process is different from fut/fue/invivo doubling..hence please feel free to clarify...

I don't understand the numbers. How should we see them ? Total extracted grafts was 1119. 175 sent out for isolation, were these whole grafts (so before split ?). Same question for the 75 grafts for DP culture. Then the 106 grafts for DP isolation, were they split ?

You say 1044 halves were planted into recipient. How many went into donor ? And I don't understand this sentence "Most of the lower half of the grafts part hair bulb was implanted as the donor except approx 200 lower half injected most of the upper half of the follicle implanted approx 75 grafts were drilled but grafts not extracted from these 75 drills at donor"

Thanks

[drnigams]

didi,
If donor is poor,than 3rd visit will be required,it depends on donor density for example...
1)Someone has the safe donor area of avg. 38cms length)x avg 7.5cms width(6cms at sides and10cms at back of the scalp) from sides to back of the scalp,thus the donor available is 38x7.5= 285 sqcms.
If the donor has a density of 40...that means the patient has 11400 grafts at the donor.if donor density is 30..than the available donor grafts would be..8400..in that case ,one more sitting 6months from the day zero will be required...those with old fut scars..will have less available donor hence third session..
In two sittings we will extract 5000 and 6400 grafts ,with one sitting of 4/5 days on an avg.if patient is able to take local anesthesia,if not we will require third visit...remember,in two visit in this hypothetical case, we are not touching the same graft ...but virtually removing all the grafts at the donor...
If anyone feels not fully confident..i advice them..to undergo100/200 graft patch test ,see the donor and recipient regen and than go for mega session..
Practically speaking if nw7 has even poor donor ,which is the case most of the time..third visit will be required ...unless simultaneous hm injections also work..


QUOTE=didi;127537]wow, nice dr nigam.

12 000 grafts in 2-3 months, no scarring/white dots+90% growth and donor regeneration?[/QUOTE]

[didi]

in theory and practice nw7 should get covered in 6 months time with some 10 000+ grafts, that's very good.

if that's all true as you say than you shd start thinking about expanding your business, open more clinics to meet demand.

[Arashi]

I hope this will be clear now...

1)Total1475 extraction drills at the donor.

2)Out of these1475 drills.175grafts extracted for stemcells and 75 grafts extracted for dp culture and sent to lab.

3)106grafts extracted for dermal papilla cell isolation and than implanted back at the donor from where they were extracted without dermal papilla,these were not bisected.

4)1119 grafts left were bisected and double the number i.e 2238 grafts created by bisection.

5)1044 implanted at the recipient and 1194buiisected grafts were implanted at the donor...why we implant little more at the donor is to fill all extraction drills..

So ,if we get 1475-175-75=1225x2=2450-106(as they were not doubled,used for dpcell isolation)= 2344 grafts at donor and recipient combine is what we should get, for 100%regen in total at donor and recipient...anything less could be due to telogen/exogen(10%to15%),if at all you want to count them...anything less than this, means corresponding regeneration percent ...
I can understand..invitro is new..and the process is different from fut/fue/invivo doubling..hence please feel free to clarify...

I'm not sure I understand. When you say did 1475 extraction drills, does this mean that you extracted 1475 grafts ? Cause if that would be the case then if you'd want to attain 100% regrowth, you'd need to see 2950 grafts regenerate and not 2344 ?

[One]

Dr Nigam, even I don't understand.

Until now you said that with your technique in vitro you can choose to put half of the hair in the donor, and then have regeneration, or NOT put them both in the graft and recipient.

Now you said: "In two sittings we will extract 5000 and 6400 grafts, with one child of 4/5 days on an avg."

But if we extract 5000 or 6400 grafts and we want to regeneration in donor, we will have only half the recipient, that is 2500 + 3200 = 5700 or am I wrong?