The 50 Graft Test Procedure

[Arashi]

That's the frustrating thing though. If they had just followed our instructions and did the test properly, none of this would be a big deal and we'd be focusing on the results.

By performing the test the way they did, they just added infinitely more confusion.

I agree mate. I've forwarded your instructions and they've read them before the surgery. They decided to go for 200 grafts, for whatever reason, I don't know. Maybe they figured it added more statistical significance, which it does, but it's only manageable with good photo's ...

Anyway, I still do have some hope they have some good photo's.

[JJJJrS]

For sure, will do that. If anything, this case might finally be proof of the whole 'failed extraction' thing But if this ends here, then it will only look worse for HASCI then it did before: like JJJJRS said, real regrowth might even be lower because of the transected hairs and the failed extraction. I just cant imagine it all ends here. I'm very confident they're straight people at HASCI, they want to proof what they can do and if this specific test fails here, I'm hopeful we can set up something better.

That's the frustrating thing though. If they had just followed our instructions and did the test properly, none of this would be a big deal and we'd be focusing on the results.

By performing the test the way they did, they just added infinitely more confusion.

[Arashi]

Seeing as your firing emails back and to with Kristel, I don't think it would do much harm to email her that we have all counted over 300 extractions, but only 203 grafts were extracted, so why the extra 100 holes in the donor?

For sure, will do that. If anything, this case might finally be proof of the whole 'failed extraction' thing But if this ends here, then it will only look worse for HASCI then it did before: like JJJJRS said, real regrowth might even be lower because of the transected hairs and the failed extraction. I just cant imagine it all ends here. I'm very confident they're straight people at HASCI, they want to proof what they can do and if this specific test fails here, I'm hopeful we can set up something better.

[gc83uk]

Hang on a minute, I've had an epiphany.

The local local anesthetic. How many times do they shove that big ****ing needle in your donor? That would cause plenty of holes/bloody spots right?

[gc83uk]

Anyway, unfortunately this all means that if we don't get a good pre-op picture, then this just all ends here. Because due to the discrepancy between the number of grafts and the extraction sites, we have no way of telling what was in the 'failed extraction' sites and the puzzle just can't be solved anymore.

Seeing as your firing emails back and to with Kristel, I don't think it would do much harm to email her that we have all counted over 300 extractions, but only 203 grafts were extracted, so why the extra 100 holes in the donor?

[gc83uk]

Well, I think your case IS very different. Remember when we talked about the failed extraction thing ? We now see that James has quite a few. I had many as well. Then, you said you were going to count, which you did, and concluded that in your case there were almost no failed extraction. If I remember correctly they even showed you the failed ones, right ?

Correct, there was just 1 graft unusable from memory.

BUT

I counted more drills then extractions. I put this down to a multitude of reasons. Pressing the drill right before actually drilling etc, but I do think some drills are made where nothing comes out, just a bloody mess and the graft stays in the donor. This is just my take anyway.

[JJJJrS]

My only hope here is that each case differs dramatically and with my hairs being thinner I had less transections.

The most important thing is the final aesthetic outcome. In your case, your donor looks in great shape and things are starting to fill up in the recipient. So I really wouldn't worry about it.

I'm just focusing on it from a statistical and technical standpoint.

We counted around 400-450 hairs in the petri dish. Add another 50 grafts corresponding to the failed extractions, which probably means adding ~100 hairs to the total hair count, and you have an enormous influence on the perceived donor regeneration rate.

All of these hairs by the way, were just to extract 250 usable hairs!

[Arashi]

Anyway, unfortunately this all means that if we don't get a good pre-op picture, then this just all ends here. Because due to the discrepancy between the number of grafts and the extraction sites, we have no way of telling what was in the 'failed extraction' sites and the puzzle just can't be solved anymore.

[Arashi]

My only hope here is that each case differs dramatically and with my hairs being thinner I had less transections.

Well, I think your case IS very different. Remember when we talked about the failed extraction thing ? We now see that James has quite a few. I had many as well. Then, you said you were going to count, which you did, and concluded that in your case there were almost no failed extraction. If I remember correctly they even showed you the failed ones, right ?

[gc83uk]

Yes, exactly.

I tried to stress how important this was before the procedure.

Based on all this, my conclusion now is that gc's regeneration rate is significantly lower than ~65% I came up with, which didn't take any of this into account. If they're getting this many transections/failed extractions with a simple, proof-of-concept procedure, I imagine it must be even higher for standard procedures where time is an issue.

My only hope here is that each case differs dramatically and with my hairs being thinner I had less transections.

[JJJJrS]

Because, really, a good pre-op picture is all we really need. Then the failed extractions dont even matter, cause they're supposed to grow back anyway.

Yes, exactly.

I tried to stress how important this was before the procedure.

Based on all this, my conclusion now is that gc's regeneration rate is significantly lower than ~65% I came up with, which didn't take any of this into account. If they're getting this many transections/failed extractions with a simple, proof-of-concept procedure, I imagine it must be even higher for standard procedures where time is an issue.

[gc83uk]

I think most of those are failed extractions (i.e., transections) and they simply discarded those grafts.

Overall, I think HASCI made things far more complicated by extracting so many. The whole point of this procedure was to give us a proof of concept but honestly, after everything I've seen so far, I have absolutely no idea how they expected this was going to prove anything. It's especially frustrating when we gave them detailed instructions and they proceeded to ignore practically all of these points.

Precisely!

When these completely transected FUs regrow in the donor, there will be at least 50 of them. Again this is another reason which skews the results badly.

When we originally thought we only had to count the number of hairs in the petri dish, how wrong!!! We also need to know how many hairs were in these 50 completely transected grafts.

Or even better the before photo where we can physically count all the hairs in those 300+ extraction sites. That will be almost impossible unfortunately.

But I would bet there is 400 hairs in the petri and about 100 hairs that were extracted and simply not used at all.

Put it another way, if we get 250 hairs regrowing out of those 300 extraction sites, then we have 0% regrowth, agree?

[JJJJrS]

Especially combined with what indeed must be failed extractions and we don't even know if there were 1's or 2's, which ones were failed and which ones are not, it's going to be next to impossible.

Of course, IF they got us a good pre-op picture, then there would still be hope, albeit it's going to be a hell of a job. So although I totally agree to what you just said, I'm not going to give up just yet, there is still some hope.

I'll wait to see if james or HASCI can provide any more pictures. After that, I'll review all the evidence and see what I can come up with. I'll try my best but at this point, it doesn't look promising.

james photos aren't even that bad but there's just way too many extraction points spread over too large of an area. It makes it really hard to capture everything one photo and just as hard to analyze. It doesn't even look like we have a good before photo.

[Arashi]

But unfortunately it will also mean that if we don't get a good pre-op picture, then this just all ends here. Because due to the discrepancy between the number of grafts and the extraction sites, we have no way of telling what was in the 'failed extraction' sites and the puzzle just can't be solved anymore.

[Arashi]

Because, really, a good pre-op picture is all we really need. Then the failed extractions dont even matter, cause they're supposed to grow back anyway.