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  1. #21
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    Quote Originally Posted by 35YrsAfter View Post

    Please feel free to call or email me with any questions. Ask for Chuck
    Is it allowed to ask a question ...


    ...concerning this ...hmmm... should I say "photo" or "photos" - if you understand what I mean with "photo vs. photos" ....

  2. #22
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    I think we can all thank many around us for some of the skills and good qualities that we have may possess. I always thank my dad for giving me such a strong work ethic and just general drive to want to excel at whatever I choose to do.

    Someone I think that is not given enough credit is Dr. Woods. Regardless of whether he chose to share information or not as I believe had I been in this same business knowing how many of the vultures in it operate I might have done the same. What I do really respect about him is that he is not afraid to be politically incorrect and state exactly how the industry along with the forums and some of their operatives work. For that it seems that he has had to pay a very hefty price at least that is the way it appears to me but I can respect a man with a set of balls.

    I think the biggest move forward in this industry will not be a new technique or process but when these handful of really talented doctors trying to do the right thing put any ego they have aside and decide they have had enough of what they see going on and form their own group. I would love to see this happen and have nothing to gain accept the satisfaction of seeing these wannabes but will neverbes out of business along with those that work in this industry and can only be described as snakes in the grass. I watch and hear what some of them do and it really turns my stomach because I was that young guy once. These young guys think they know but they really don't understand what is going on and it's not as easy as simply telling them.

    Maybe one day it will happen.

  3. #23
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    Very interesting, Topcat. Yes, we both agree. You have to want to be good at something. You have to have the talent. Then you have to get the experience. When Dr. Bisanga worked with me in his last year, we worked 7 days a week three weeks out of each month for one year. He got the time to become very good and he wanted to be good. He was a very hard worker and he helped me out when I needed his help the most. So did Dr. Mwamba, but Dr. Mwamba was with me through 2005. He got a ton of exposure to FUE. Both did everything I ever asked them to do and they never complained. They always put the patient and the result first. I always demand that of my staff, however. If they are sloppy in their work, they don't last long. Those that we keep are very dedicated to their work. They work tirelessly to produce the best possible result. I would never have succeeded without my wonderful staff over the years. I demand alot of them, but they always come through. My belief is that each patient's hair loss and restoration or repair situation is the most important thing in their life at that moment so we have the duty to give each case our absolute best. If my staff is ever having a problem in life, I always ask them to leave those problems at the door of the office and deliver their best effort for every patient. If a problem in life prohibits them from doing their best effort on any given day, they know that they have my blessing to stay home because nothing can interfere with the quality of work each day. I never had that issue with either Dr. Bisanga or Mwamba. They were both wonderful assistants and they have both become outstanding hair restoration surgeons.

    This is my best attempt to show the extraction sites. It is interesting that when i went back to the extraction site overlay, one of the sites i thought had nothing clearly had at least one hair. Often you can't see the difference between one hair and two hairs in a photo. I often prove this even under my 6X magnification by trying to extract a single hair unit only to find that almost all are at least two hairs. With a photo, you simply can't tell if it is one hair or two.

    The overlay did not fit perfect, but it is close. Size of the images is a little different.

    Also, one site I was certain had a hair probably does not.

    Remember that we had 5 hairs growing in 5 extraction sites at about 5 weeks. At about 3 weeks I put in the tattoos because it was getting hard to find the extraction sites because they were healing so well. The tattoos were not placed exactly like the 1 sq cm area that I harvested from. I placed them only so i could find them.

    The blue line represents the tattoo marks. All extractions were within these marks. The green circles represent definite regrowth sites. The purple represent the definite no regrowth sites. The red represent sites I'm not certain about. I am least certain about the red circle to the bottom left.
    Attached Thumbnails Attached Thumbnails Click image for larger version

Name:	3 month acell regeneration study .jpg

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ID:	21638  

  4. #24
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    Well I have been observing this industry for a very long time. I have spoken to many people over many years, listened and have taken notes along with having almost a photographic memory. I can easily draw back into my collection of information and pull out all kinds of facts but I will leave that for another day.

    I will say this from my own life experience. I have had many teachers along the way and I have developed many skills along the way. My practice of many of those skills can only be described as having passed those of many of my teachers . That is life sometimes and many of those teachers smile when they see me do my thing and that makes me feel good and I’m sure they feel the same.

    Thank you for the update. I can’t say I’m convinced but I say that with no agenda and only honesty. I will keep watching.

  5. #25
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    Well stated. Every teacher wants their students to advance. While teachers advance after students move on, one always hopes to learn from the student. There are so many ways left to advance this discipline. No one person can do it all on their own. A student that stands still is not advancing the discipline. There simply are too few who step out of the box and come up with improvements.

    When I first started in this field we had plugs and mini grafts. They looked terrible. A handful stepped out of the box in an effort to create a more natural result. The vast majority of physicians were much slower to adapt, but over time they adapt. One always wonders whether this adaption is based on aesthetics or patient demand for a more optimal outcome, however. The good ones keep advancing and always stay a step ahead of the vast majority. It is the little things that make the greatest difference.

  6. #26
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    Sure nothing wrong with advancement but patients who know very little need to be better informed and extremely cautious. If we were to believe in each and every advancement we would all be tattooing our heads, having robotic or endoscopic fue or who knows what else. The majority of the advancements over the years are gone because they were in fact crap and were only meant to advance the numbers forward in someone’s bank account. So of course one needs to always move forward with extreme caution when listening to many of the carnival barkers in this industry.

  7. #27
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    That's true. If you have been in the field long enough, you know when it sounds too good to be true. With anything new, you need to exercise a degree of caution. I know from experience with body hair that I didn't believe it would work. Then I tried it and the first few cases were great successes. Then I had some major failures. One needs repeated success to pass judgment.

    Many probably have some application such as the tattoo. Tattooing has limited use, but then again we really need to follow it a long time to make sure that it does indeed fade with the newer pigments. I can't imagine someone will be happy with blue dots once their hair turns white. Then there are those that rarely if ever have any benefit such as scalp reductions, plugs, minigrafts, flaps, and balloon expansion. Even body hair works well in about 25% of the patients. Beard hair works well, but it sometimes looks like beard hair and that can be an issue for many. Come to think of it, even hair transplants aren't the best idea for all patients. Strip scars can create long term problems for many. FUE does not work optimally for all. I thought of endoscopy a long time ago to replace strips, but who wants a bald zone in the donor area. I think it is worth seeing what happens long term with this method to replace FUE. I'm glad people are innovating. We all want a better aesthetic result. The one thing we can't do is replenish a donor supply. That's why I'm hoping for continued success with Acell and hopefully stem cell therapy later on. Stem cells have not worked out yet. With the Acell bandage we apply, there will be issues coating a larger area and it is costly to apply. It is a cost I will have to eat for now and in limited trials. One trial certainly does not suggest future positive results. Also, we might be replacing three hairs with one hair in some sites as only a handful of sites appear to have multiple hair growing.

    Next we will have to do one box without Acell and one box with Acell to evaluate if there is any firm improvement with Acell as opposed to placebo. We will also try to do a better job with photographs going forward as we learned a great deal about their importance in this single patient trial.

  8. #28
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    Stem cells in my opinion are a long way off. I have watched Geron for about 20 years and the FDA has a way of crushing anyone regardless of the amount of data they provide or money spent if it is a threat to the status quo. It is only when the status quo benefits that it will come to market and as of now the money is being made in current treatments not cures. Although they were working with patients suffering spinal cord injuries it still poses a threat to the greater market. Sometimes we can see the same in hair transplantation when something that is actually better comes along it becomes a threat to the status quo, thankfully they don’t wield much power.

    Acell experimentation is not even on the FDA’s radar as long as you are not trying to cure cancer you are safe. If no harm comes to the patient then it just becomes a matter of proving something of which I have not seen much.

    Advancements come in many ways. I had an interaction recently and without going into great detail I was so impressed with this person I had to let them know. We conversed briefly and he passed on the title of a book he gave his daughter when she was 12 and it made a huge difference in who she became as a person. I in turn purchased that book and also passed on another book to this same person that I regularly keep several copies of as I believe it is one of those types of books of which there are many that can advance someone as a person so I tend to hand out a copy here in there for people I think are special in some way. We both advanced as people during that interaction which can sometimes be more important than advancing in the engineering of ideas.

    I read a book by Daniel Golman it must have been almost 20 years ago. There was a short story in it that I always remember and it can relate to hair transplantation as it is a team effort and as a patient I want the whole team to not only be great at what they do but happy that they are doing it. So as I have written advancements come in many ways. I will cut and paste the story below from “Emotional Intelligence” as I’m sure many can learn from it.

    In his book, Goleman relates the story of Melburn McBroom, who was a domineering leader, with a bad temper. The problem with this combination of emotional deficiencies was that he also happened to be an airline pilot. In 1978 as McBroom’s plane was approaching Portland, Oregon to land, he noticed a problem with the landing gear. He decided to maintain a holding pattern as he obsessed about the landing gear. His co-pilots watched as the fuel gauges approached empty, but they were so fearful of their leader’s wrath that they said nothing. The plane crashed, killing ten people. This story is told in training courses to enforce the need for teamwork, open communication, cooperation, listening, which leaders with high emotional intelligence foster.

    Don’t want to get to far off topic so I look forward to further updates.

    If you get a chance take a look at my posting in the "off topic rants" section. " Leadership in the HT industry. I thought it was worth posting but unfortunately I think most will miss it.

  9. #29
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    That is a good story. One could also theorize that with a problematic landing gear in certain circumstances, it was more prudent to hold the course looking for a solution than to put the plane down especially in cross winds and down shears. Who lived to tell the whole truth? As you suggest, a team approach is of benefit unless the rest of the team has a sure death option. In which case, a more cautious approach might have been optimal provided that the fuel gauges were accurate, which they often are not. I owed a plane for many years and I know that small things make a huge difference between life and death. One time I was flying from Charlotte to Atlanta in the rear of an 8 seat plane. I looked out the left side and noted that the left side engine had stopped soon after take off. I made my way down the aisle to the ****pit and told the captain that the left engine had stopped. He was the most gracious person you could ever expect to know. He turned around and told me to sit down and shut up. He worked for me, but I could tell in his tone that he was aware of the situation, the situation was serious, and he needed to focus on landing a twin engine with one engine working. A twin with one engine wants to turn in circles. He did not need teamwork. He needed focus. He landed the plane and we all survived. Sometimes those on the team think they are of help, but they are not really. Do you honestly think that those about to die because there was no fuel simply shut their mouths so they could be the focus of someone’s book? I don’t. I think they noted it, they were scared to death, they froze, and somehow they must have lived to tell the tale. No one dies because they are afraid to say the fuel is empty when the alternative is to live and say there is no fuel.
    Let me tell you another plane story. I was in the ****pit one night flying into weather. My pilot had us on course to land without visibility or Instrument Flight Rules (IFR). Suddenly, the ****pit came alive from the tower asking us to say position. My pilot stated his position and the tower came back to pull up immediately because we were 7 miles off course. Still we continued to descend. Finally, I turned to the pilot and said “they said to pull up because we are off course” He did. We came back on the IFR and landed safely. My pilot upon landing told me he was “shitting kittens”. Don’t suggest to me that someone about to die is not going to take corrective action because they are afraid of persecution over death.

    People express concerns out of fear that the actions will result in serious negative consequences such as death. They do not express concern because they are not sure that their beliefs are potentially disastrous. One does not express concern when they are not certain. One does express concern when they are certain. One does express an opinion when one has an idea based on experience that an action will result in a negative consequence. If one does not have such experience, one is not likely to express a concern.
    Then there is the gentleman approach where you do not say anything because you want to be pleasantly professional. This is an approach common in medicine where someone disagrees, but they don’t say anything out of professionalism. Actually, they do say something, but only under their breath, but never to the guilty party. This is pretty common in medicine.


    In my clinic, I am tough. I expect miracles. My staff knows what I expect. They respond. When I make a slight mistake, they correct me. Does that sound funny? I’m that really tough airline pilot, yet should I make a single mistake, my staff knows and they let me know. That is what you are talking about. Teamwork. My staff knows that my expectations are so high that they will not allow me to make a mistake however so slight. We watch out for one another, but they are so compelled because I am so compelled. While I cannot imagine a team allowing a plane to crash as they watch the instrument gauge run to no fuel, I can imagine a compulsive team making certain that no one makes a single mistake. Humans do make mistakes. A well greased team prohibits even the slightest error even by their leader. My job is to make sure they know what is right and what is wrong. We watch each other’s back, but ultimately, the quality control is in my hands. They know I don’t tolerate mistakes and they have the same perception of my work.

    Topcat, I think you are a work of art and a breath of fresh air. You are right. i need to look at your writings because I am certain they are full of wonderful insights and analogies. I think they could very well make us all better people. You have made me think and perhaps I need to think deeper. Deep thought is never a hinderance when your work holds the welfare and happiness of others in your oh so limited human hands. Thank you for your comments. My rebuttal is simply off the cuff and could change as i continue to contemplate your valuable lessons.

  10. #30
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    Well I laughed at your response as it was very good and very interesting. Some of it I would disagree with but we all base on views on different experiences.

    I have spoken to countless repair patients as I’m sure you have. Something some of us have in common and is kind of unique is that same fear of authority that kept us from taking appropriate action to save ourselves before it was too late. One story in particular from a patient relating his experience during a flap procedure struck a nerve for me and was especially eerie.

    When I sat in that chair 28 years ago and caught my first glimpse of Puig I knew with no doubt I was in extreme danger but I was frozen by the fear of what I perceived as authority so you see sometime this does happen as I remember it very well like it was yesterday. I guess there are always two sides to the coin and I am aware of that also through other personal experiences but I will spare you the stories.

    Even today when I hear from the patients who got switched over to strip at the last minute because the doctor told them they were not a candidate for fue I understand what they must be feeling when it happens and I despise a doctor that would do this to a young man or a rep that would represent him.

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