Since the IHRS in October 2010, we've been brimming with hope that the era of unlimited donor has arrived via Acell and hair plucking. Indeed, you have both provided a handful of photographic evidence that the procedure can be successful.
However, much time has passed. You have treated many patients over the past two years with this procedure. I think I speak for many of us when I wonder aloud where the photos are of some of these patients.
For example: word has it, Dr. Cooley, that you have incorporated hair plucking sessions into your practice at least once or twice a week. Can you please show us pictures of results to support our hope that this is in fact a reliable procedure? As it stands, the IHRS presentation may come across as simply a demonstration of isolated incidents. We eagerly await the day we start seeing regular 'before and afters' of pure hair-plucking sessions in the "Clinic Results" section of this forum. Why not start now? Thanks.
Since the IHRS in October 2010, we've been brimming with hope that the era of unlimited donor has arrived via Acell and hair plucking. Indeed, you have both provided a handful of photographic evidence that the procedure can be successful.
However, much time has passed. You have treated many patients over the past two years with this procedure. I think I speak for many of us when I wonder aloud where the photos are of some of these patients.
For example: word has it, Dr. Cooley, that you have incorporated hair plucking sessions into your practice at least once or twice a week. Can you please show us pictures of results to support our hope that this is in fact a reliable procedure? As it stands, the IHRS presentation may come across as simply a demonstration of isolated incidents. We eagerly await the day we start seeing regular 'before and afters' of pure hair-plucking sessions in the "Clinic Results" section of this forum. Why not start now? Thanks.
Dear Wolvie
I understand that you, and many others, want more information about this procedure. I get that. Let me explain why such updates and photos have not been forthcoming (I can only speak for myself). I did mention this in a prior post but it may have been buried at the end of a thread somewhere.
I started testing the ‘autocloning’ procedure two years ago. At that time, I didn’t know anyone that gave any credence whatsoever to Dr. Hitzig’s description almost ten years ago of follicle regeneration from plucked grafts. So my first goal was simply to document whether or not this ever occurred. I did small tests of 100 grafts or less. It was slow going at first, as the procedure is much more difficult than it sounds. It was another 6-9 months before I was observing my first hairs growing. I continued to refine the process and our technique. After about a year, we were doing only slightly larger test areas of 200-300 grafts. So the public presentation last October, represented these small test cases with followup of 1 year or less. I was able to demonstrate beyond a shadow of a doubt using photographs and biopsies that this phenomenon was real.
Just prior to last October, we started doing increasingly larger cases. Most of these are only now reaching the 6 month mark. Since word of our technique spread, many of our patients are coming from long distances, so I am relying mostly on emails from these patients that they are starting to see hair growth. A few have been local so I have been able to document with closeup photography the early stages of growth, which in most take longer than standard transplants. These closeup photos look like the other photos I’ve already posted of hair growing; certainly not impressive from a distance, which we wouldn’t expect at 6 months. (see attached 6 month result, dark hairs are from plucked grafts and trimmed for the photo).
Given the uncertainty about the 1) %graft survival 2)ability of new hairs to cycle normally and 3)the question as to whether these new hairs will be androgen resistant, I have tried to be careful not to inflate expectations, even though I still consider this a clinical breakthrough. Demonstrating follicle regeneration as a documented fact means we are moving into a new era in our field but we have to go slowly.
Later this year, I will be presenting my accumulated experience with these larger cases. Presenting them together will allow better conclusions than posting them piecemeal along the way.
Its worth remembering that microscopic follicular unit grafting, the procedure that is now the accepted gold standard in our field, was developed in the late 1980’s by Dr Bobby Limmer and didn’t make into a medical journal until 5 years later, and another 5 years would pass before it gained widespread public acceptance. Perhaps I should have waited longer to go public, but I wanted to share these findings and spur my colleagues to try it as well, which they are now doing. We will know much more in the not too distant future.
Regards,
Dr Cooley
Jerry Cooley, MD
Member, International Alliance of Hair Restoration Surgeons
View my IAHRS Profile
Dr. Cooley, thank you very much for taking the time to respond. Your answer makes sense.. It's just good to hear a reaffirmation that this breakthrough - at least so far - isn't going off the rails and that you continue to see positive results.
Your response will likely prompt some questions (starting with some of my own!) -- I understand how busy you must be, but when you have a chance:
1. Have any patients so far reported a complete failure of any growth from hair plucking, or do the 6 month results appear consistent?
2. What percentage of regrowth would you say the patient whose photo you posted has experienced? (I know you're reticent to discuss percentages, and I realize it varies - but for curiosities sake, it would be nice to get an idea of the success rate you've seen so far).
3. Have you since tried plucking a regrown plucked hair to see if it cycles properly?
1. Have any patients so far reported a complete failure of any growth from hair plucking, or do the 6 month results appear consistent?
With this technique, I have observed new hair growing between the 6-12 month mark so I think that 1 year is the time point to make that judgement; I have not seen any complete failures at one year except in dense, wide scar tissue (which has been discussed).
2. What percentage of regrowth would you say the patient whose photo you posted has experienced? (I know you're reticent to discuss percentages, and I realize it varies - but for curiosities sake, it would be nice to get an idea of the success rate you've seen so far).
Again, that has to be judged at one year, and I will have a much more accurate idea when I analyze my larger cases later this year. Sorry, I don't want to just throw a number out there because that is misleading.
3. Have you since tried plucking a regrown plucked hair to see if it cycles properly?
Funny you mention that. One of my local patients, whose 6 month result I did post before, just came in at the ten month point and there seems to be even more hair growing (see attached). I thought he would be the perfect candidate to do the replucking. When I asked him, he looked at me like I was crazy. It seems that no one wants to part with their new hair, but I'm still trying. Ideally I would have a little spot tattooed on their scalp and to repluck that area....but hardly anyone wants a spot tattooed on their scalp either. This isn't typical pharmaceutical sponsored clinical research, and my patients are like anyone else, they just want hair, and once they have it, they want to keep it. These questions will take time, years probably, which is frustrating to everyone, myself included.
Jerry Cooley, MD
Member, International Alliance of Hair Restoration Surgeons
View my IAHRS Profile
3. Have you since tried plucking a regrown plucked hair to see if it cycles properly?
Funny you mention that. One of my local patients, whose 6 month result I did post before, just came in at the ten month point and there seems to be even more hair growing (see attached). I thought he would be the perfect candidate to do the replucking. When I asked him, he looked at me like I was crazy. It seems that no one wants to part with their new hair, but I'm still trying. Ideally I would have a little spot tattooed on their scalp and to repluck that area....but hardly anyone wants a spot tattooed on their scalp either. This isn't typical pharmaceutical sponsored clinical research, and my patients are like anyone else, they just want hair, and once they have it, they want to keep it. These questions will take time, years probably, which is frustrating to everyone, myself included.
Those results are very promising.
Just to be in the clear, what exactly did this patient suffer from? The hypopigmentation suggests some kind of scarring, but, yet, there is hair growing pre-transplantion. If it indeed is scarring, these results are in stark contrast to the results that ejj had from plucking. Do you have any theories why that may be? Also, from the picture, it seems impossible to tell the plucked hair from the native. Would you say that it is a fair assessment that the plucked hair have retained its donor characteristics in terms of thickness etc (even though transplanting to scar tissue would imply less than optimal blood flow and, as has been discussed previously, possibly a lesser concentration of mesenchymal cells)?
it seems you are getting better and better. But come on this picturs, this is transplanted hair not plucked right :-) if its plucked hairs i would say thats impossible and amazing in the same way.
Oh ad dont batter yourself up about going public so far, i think a lot of hairloss suffering people owe you one because with your findings you keep em away from doing something bad or hasty.
Regarding point three on your answer here. Maybe you should ask those patients, that you will fill their "tattooed" spot with grafts after that for hals the price or so (even if its not your style and i get it that you also want to earn money thats absolutely ok but it would help us all in the long term, even those who dont wanna get their hair plucked)
And Dr Cooley its really not about bombarding us with informations or so, but we are all glad even if we see some pictures from time to time. We all know that we dont have to hold our breath for a full NW6 to NW1 plucking transformation ( who knows if you wanna do this to shock us all :-)
But you know the drill, people are getting crazy if there are no updates for a long period of time and all i can say is, that your results with all due respect are in fact awesome (even you personally think they suck), because
1) The hair characteristics are identical to native hair (impresive)
2) The fear of never getting hair again is a thing from the past (yes i know you guys speak about expanding donor, but i say its infinite donor :-) sometimes you have to be ****y ^^
3) Its also a backup plan to a certain degree for repair patients
And to be honest, i think you are a smart guy, so if all the concerns about cycling and dht resistance would be true, you wouldnt pursue this further :-) so i think you play it a little low to not jinx something here :-)
And i have another personal hope, i hope that the price will be affordable in the future
Nevertheless keep up the awesome work.
Btw did you ever contacted Gho ? Just out of curiosity
Just to be in the clear, what exactly did this patient suffer from? The hypopigmentation suggests some kind of scarring, but, yet, there is hair growing pre-transplantion. If it indeed is scarring, these results are in stark contrast to the results that ejj had from plucking. Do you have any theories why that may be? Also, from the picture, it seems impossible to tell the plucked hair from the native. Would you say that it is a fair assessment that the plucked hair have retained its donor characteristics in terms of thickness etc (even though transplanting to scar tissue would imply less than optimal blood flow and, as has been discussed previously, possibly a lesser concentration of mesenchymal cells)?
This patient has typical male pattern hair loss AND extensive sun damage. The small areas of mottled scarring you notice are where his dermatologist scraped and/or burned off cancers and pre-cancers. I did a transplant on him 7 years ago and saw him from time to time since; most of the hairs in the top part of the before photo are transplants. His scalp was tight as a drum, and hence he was only a candidate for FUE but quite frankly he didn't care to do anything. These are plucked grafts, not standard grafts. He was also the earliest grower I've yet had and I don't know why. Tight scalp, scarring, prior transplants....I would assume that the circulation would not be that good yet he got great results. Most virgin cases have not come in at the rate his has, which just shows that there are factors we don't understand.
Regarding the patient you mention, I think the explanation is that the extensive, thick and wide scarring prevented successful graft survival and regeneration. I have had success in other cases of scarring when the area is relatively narrow (normal skin nearby) and not hypertrophic. I am trying different ways to improve success in scarring.
Jerry Cooley, MD
Member, International Alliance of Hair Restoration Surgeons
View my IAHRS Profile
I see, many thanks for your reply! As a scar sufferer with no real treatment option (the scar being in my eyebrow), I'm always very happy to see these kind of successes. These findings could make a huge difference for people who have lost hair without any outlook to recover it by current means. Best of luck with your continued research! :-)
An Appeal to Dr. Cooley and Dr. Hitzig
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Originally Posted by wolvie1985
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