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Hair Loss Forum - COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

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drnigam

28.02.2013, 16:22
 

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS (Hair Multiplication & Stem Cells Treatment)

COMPARING DR. NIGAM & DR. GHO’s DONOR / HAIR DOUBLING FOR / BY HT DOCTORS & MEMBERS

This post is for the comparison between Dr. Nigam’s and Dr. Gho’s technique for the forum members & HT Doctors for the critical discussion and sharing of experiences for mutual benefit of all. This is a professional, healthy discussion post and is not for any personal criticism against any one, would appreciate if Dr. Gho and other Hair transplant Doctors participate in this thread, specially inviting Dr. Cole, Dr. Ziering, Dr. Bernstein, Dr. Umar, Dr. Arvind, Dr. Gho and many more respected colleagues including Ironman, GC, Neversay, Didi, Boldy, Freddie and the other forum members.

As you know it took 10 years for 50 % of Doctors to move from Strip method to FUE and FUE itself is 10 years old, now it’s time to move to Hair Doubling with activated Stem Cells and Isolated Dermal Papilla cells and newer ideas which will be coming through esteemed colleagues and forum members.

I wish to present my studies in San Francisco, USA in OCT 2013. Hopefully there I will be meeting all the above mentioned doctors and other respected colleague from Hair Transplant industry.

LET US COMPARE THE ONLY TWO HAIR CLINIC IN THE WORLD FOR HOUR DOUBLING / DONOR DOUBLING –


Our friend Dr. Gho’s - Donor doubling & Dr. Nigam Hair Doubling with activated Stem Cells and DP cells:-


1G. Dr. Gho bisects the follicular unit and not single follicle longitudinally in Vivo (when the follicle already exist in the scalp), hence it is a blind technique. (As per Dr. Gho’s published paper he himself mentioned there are unsuitable or damaged grafts at the donor area. He bisects using a inner diameter, 0.6 mm triple waved tipped partially blunt FUE punch (he calls it triple wave punch). Since Dermal Papilla is embedded in sub-cutaneous fat cells hence it is unlikely Dermal Papilla cells would be present in the extracted bisected follicular unit or maybe he is able to extract part of Dermal Papilla. As per Dr. Cole’s website Dr. Gho tries to bisect the follicle at the line of Auber which he found difficult and was worried about loss or damage caused to the grafts. Although even if 1/3 proximal that is a root with outer root sheath and 2/3 distal which contains bulge stem cell and part of outer root sheath stem cells, generate hair up to 60% to 70% which has been shown in the earlier studies of Toscani, Rossi, Erjin, Jahoda, Roy and Micali. This also shows that if there is such a partial FUE or transacted FUE with proximal and distal stem cells it can still grow both the bisected follicles. Although the character and diameter of the hair may differ. Remember Dr. Gho is not cutting follicle unit into two but a folliclular unit(refer to his histo slide in his paper and not the picture mentioned in his paper) into two. Kindly refer his article donor hair follicle preservation by partial follicular unit extraction a method to optimize hair transplantation.

1N. Dr. Nigam bisects the hair follicle / follicular unit transversely in vitro under 50x magnification with special fine blades and also collects the spilled out approximately 1000 to 1200 DP cells and injects it back in to the bisected follicles along with autologus activated epithelial and dermal papilla cells, outer root sheath, stem cells through 25 to 50 separately extracted follicular units in Vitro (when the follicle is not existing in the scalp but the cutting is done under microscope with full vision hence there is no chance for unsuitable or damaged grafts). The bisection is done at the particular level on the follicle wherein the Dermal Papilla cells & outer root sheath cells are present in both the bisected parts of the follicle. Due to patent pending neither Dr. Nigam nor Dr. Gho has not mentioned that at what level they bisect the follicle.

2G. Dr. Gho’s technique utilized only preservative media which does not have stem cell or isolated stem cell for boosting and survival of bisected follicle & no growth factor, no stem cells were utilized. Dr. Gho claims in his website that stem cell is been extracted from the donor area and implanted in the recipient area which is false and misleading because bisected follicle unit is extracted and implanted in the recipient area.

2N. Dr. Nigam’s technique involves addition of isolated activated stem cells with growth factors isolated Dermal Papilla cells injections extra cellular matrix and 250 arterial PRP, Epidermal growth factor, follistation,, KGF, FGF and other (can’t disclose all as patent is under process)

3G. Dr. Gho claims that since he keeps the bisected follicular unit in the preservative medium (The medium is composed of the following ingredients: sodium chloride, potassium chloride, magnesium sulphate, sodium phosphate, calcium chloride, glucose, sodium bicarbonate, sodium lactate, sodium pyruvate, human serum albumin, insulin, bis(maltolato)oxovanadium (BMOV) and
a-tocopherol (vitamin E)) of nutritional factors hence this technique should not be claimed as stem cell hair transplant (Because no isolation of stem cell is done in a regenerative lab, hence the technique cannot claim any manipulation of stem cells. Although it is true even in a normal hair fall when a new hair grows it is because of the inherent multiplication of the stem cell present in the hair follicle. Any isolation or multiplication of stem cell is possible only in a FDA or European authority certified lab which our friend Dr. Gho does not have at present.

3N. Since Dr. Nigam has his own Lab he can extract few grafts from the body or from the donor area and isolate stem cell from the grafts, Dermal Papilla and Dermal Sheath cells, plus isolate and cultured with inducible Dermal Papilla cells and inject the solution into both the bisected units so that they are nourished with the required nutrition to develop.

4G. Unfortunately regulation in Europe are very strict for isolation, multiplication, activation of even adult stem cells not to mention embryonic stem cell or allogeneic stem cell, the use of which is legally 25 years away. Hence our dear Dr. Gho has shifted his lab and opened one unit in Indonesia to catch up fast and may be introduced activated stem cells into his present techniques.

4N. Luckily in India for Dr. Nigam research and therapy on adult autologus stem cell with minimal manipulation is legal and cleared by 3 regulatory authorities in India (Dr. Nigam has a clearance from these 3 authorities in India) and since he utilizes the activated stem cells in his medical procedure with monthly follow up with his all patients with a special consent form. Dr. Nigam’s technique is only be legal in few countries as on today across the globe including India.

5G. Dr. Gho has patented his process of longitudinally bisection of donor hair follicle, preservation by partial follicular unit extraction a method to optimize hair transplantation (kindly confirm the same with the patent authority and through his published paper in journal of Dermatological Treatment, 2010, 21:337-349. Since Dr. Gho himself calls his technique partial follicular extraction it is misleading to named it as stem cell hair transplant. This nomenclature of stem cell hair transplant is not usually objected by patent authorities but can be objected very well by European authorities of stem cells because claiming of stem cells therapy or its used is not legal in Europe. The word stem cell for hair transplant can only be used if it is isolated in FDA certified regenerative lab and / or activated and then injected back into the scalp. Unfortunately this is not the case of in Dr. Gho. Hence if this will come to the notice of Stem Cells authority they might take action against it but patent authority will not object for the same. Infact it is the inherent property of the existing stem cells in a hair follicle to denovo on its own to get activated and multiply to regenerate a bisected hair follicle if all the different type of stem cells is present in the bisected the follicle to regenerate a new hair follicle. Dr. Gho bisected graft are minimal outside the scalp by 4 to 5 hrs including 2 hrs in the preservative medium.

5N. Since Dr. Nigam has his own FDA licensed regenerative Lab in Mumbai (the license is already posted on the forum) Dr. Nigam’s Bio-Techs first isolate the adult hair stem cells present in a hair follicle, sorted out by magnetic beading system and then they activate (not multiplied which takes one and half a month) with serum free growth factors within 4 hrs of time and then they inject it into the bisected follicles. This hair doubling has been trademarked in India and Patent application is under process. We believe this is a actual stem cell Hair Doubling. At Dr. Nigam’s we do not keep the follicles outside the scalp for more than 50 min in any of the hair transplant procedure including Hair Doubling.
We make Patient lie-down in a lateral position and one Doctor extract and other Doctor implants the grafts simultaneously (most of the transplant elsewhere are done in supine or prone position where the surgeon has to first extract the graft which takes few hours and then implant the grafts except in DHI technique. We use PRP growth factor and extra cellular matrix to increase the graft survival. We make recipient incisions prior to the extraction of grafts to promote granulation of tissues and minimizing scalp.

6G. Dr. Gho’s technique of Donor Doubling or preservation can transform the NW7 to NW2 in 2 years of time and that also at a very high cost because on an average 1500 grafts can be replicated only after 6 to 7 months.

6N. Dr. Nigam’s technique of Donor Doubling or Hair Doubling are effective because in this technique both the bisected part of the grafts can be implanted at the recipient area hence through this technique NW7 can be transformed to NW2 in 10 – 15 days from the procedure.

7G. The cost and time to transform NW7 to NW2 (10000 grafts) through Dr. Gho’s technique will cost very high (approximately USD $13000 for 2000 Grafts which means US $50000 for 10000 Grafts) and this transformation will take atleast 5 years.

7N. The cost for 10000 Grafts with Dr. Nigam’s Hair Doubling technique for 2000 Grafts in one day is USD $5000 and USD $10000 (All Inclusive) for 10000 Grafts. The total time period required for 10000 Grafts is 10 – 15 days.
You must be wondering that the NW7 patient can donate only 2000 to 3000 follicular unit maximum. We can extract 3000 follicular unit from NW7 and we can double it to 6000 follicular units and can be implanted into the recipient scalp. The Balance 2000 / 3000 grafts can be taken from the body or beard and similarly can be doubled to 4000 /6000 grafts as body hair are single follicular Graft.

8G. Both Dr. Gho is using surrounding tissues with the bisected follicular unit

8N. Dr. Nigam is also using surrounding tissues with the bisected follicle

9G. Dr. Gho is using 0.6 mm inner diameter which means 0.7 mm FUE punch of outer diameter. Although his punch is triple waved tipped, which is partially blunt.

9N. Dr. Nigam uses the same 0.6 mm inner diameter which means 0.7 mm FUE punch.

10G. Blindly longitudinal bisection in vivo has a disadvantage since the hair follicles angles at the skin surface is different from the placement angles of the bottom part of the hair follicle with the root. Hence higher number of transected or unsuitable grafts are possible and it’s a time consuming process

10N. Since at Dr. Nigam’s the bisection of follicle / follicular unit is done under high magnification in vitro which is outside the scalp, negligible chances of transected or unsuitable grafts. Kindly go through Dr. Cole explanation of the same in his post on the forum

11G. Healing of the donor area with Dr. Gho’s technique is also better than traditional FUE.

11N. Healing of the donor area is exceptionally fast in Dr. Nigam’s technique due to the use of activated stem cells, growth factors, isolated DP cells, extra-cellular matrix and PRP. Some of the forum member has already commented that they have not seen such exceptionally fast healing of both donor as well as recipient area with complete healing bring the scalp to the normal state without dot marks.

Challenges for both Dr. Gho & Dr. Nigam:-
Dr. Gho and Dr. Nigam both have to get their documentation of Donor Doubling / Hair Doubling atleast on 5 patients independently by informed and computer skilled consumer or by a independent hair transplant Doctor and / or by independent editor of top credible hair loss forum. Dr. Nigam has already agreed for the above procedure for free of cost in Mumbai and similar response from Dr. Gho is awaited. Both these techniques are promising and can change the hair loss industry in better way before the real Hair Multiplication, Dermal Papilla implantation or macro follicle Organoid hair implantation becomes a reality in next 1 to 5 years as it is the next and may be the final breakthrough in the HT industry for MPB. Neither of their technique can claim multiplication but it can be classified as Donor Doubling & Hair Doubling respectively.



drnigam has 1 Personal Journal(s). Click here to view
drnigam is located in [NA] and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

drnigam

28.02.2013, 16:39

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Dr. Nigam's 1st case study of 2013 on Hair Doubling

Mr. Dhanesh Makwana, Age : 24

Hair Doubling Day 0

(11th Jan, 2013)

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drnigam has 1 Personal Journal(s). Click here to view
drnigam is located in [NA] and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

Noyznarcos

28.02.2013, 21:16

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Thank you, doctor you're giving me confidence for the future.

questions:

1) When do we see cases from NW 7 to NW 2?

2) When do we see cases of megassession, to see how it works?

3) I am a person with a little beard and a few hairs in the body, is that a problem?

thank you very much




Noyznarcos is located in [NA] and he is available to meet: NO

Faker

28.02.2013, 22:53

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Why do you want to include other doctors? Are you trying to spread this out and make it widely available? Will other doctors just be able to start doing this procedure?

You state you are one of the limited clinics with a full lab at your disposal, and this is a necessary element for success. So other doctors will have to invest in full on site laboratories? What other countries could realistically have this available in the very near future?

I have diffuse thinning will you be able to help me? I would be willing to be a test subject.

Your pictures are not loading properly and are taking a really long time to load. I like how you taped a sticker with the words "Growth Factor" on a syringe!!!! It reminds me of a cheesy 80s SciFi movie!

Dr Nigam I was completely skeptical of you when you showed up. You are beginning to grow on me a bit. I hope you are the "won" but I wont get excited as of yet.




Faker is located in [NA] and he is available to meet: NO

Freddie555

01.03.2013, 05:51

@ Faker

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

I don't have a comment as I have not yet gone through the details posted above.

But at least one thing is looking better - his documentation process. Photographs are taken well and pictures are clearly labelled. Prior to this, it looked chaotic from the messy website on down.

The holy grail however is a top/crown view of 5 guys who've transitioned from NW6 to NW2. The first doctor/researcher to post those set of pictures will have created the first multi-billion (possibly trillion) dollar industry of the early 21st century.

Keep going with the research Dr. Nigam.




Freddie555 is located in [NA] and he is available to meet: NO

---
"When true Hair Multiplication comes, it will arise out of the East." - John The Revelator, Feb. 18, 2001

Mr. Z

01.03.2013, 06:27

@ Freddie555

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

agreed - his documentation is improving quite a bit. Be curious to see what happens in this test case.

If this works, i would imagine that the technique could provide pretty high densities, as the trauma doesn't seem too severe.

This is worth keeping an eye on...




Mr. Z is located in [NA] and he is available to meet: NO

GoneWithTheHair

Australia,
01.03.2013, 07:32

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Thankyou for the great indepth post dr nigam. Your pictures have improved greatly and are much easier to follow. We all appreciate the fact that you are keeping us informed of what's happening. I hope we can see some nw7 to 2 in the future. I also think dr gho is too expensive for the average person so if you can provide at the prices you quoted that's great for everyone. Keep up the good work.




GoneWithTheHair is located in AUSTRALIA and he is available to meet: NO

James Bond

02.03.2013, 10:16

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» 1G. Since Dermal Papilla is embedded in sub-cutaneous fat cells hence it is unlikely Dermal Papilla cells would be present in the extracted bisected follicular unit or maybe he is able to extract part of Dermal Papilla.

Gho does extract part of the DP, but his primary regeneration cell type is of epithelial original.

» As per Dr. Cole’s website Dr. Gho tries to bisect the follicle at the line of Auber which he found difficult and was worried about loss or damage caused to the grafts.

You are referring to Gho’s old FM technique, which is still peformed at The Gho Clinic. Gho is no longer associated with this clinic but they still perform the technique. FM attempts to transect transversely at the line of Auber while the follicles are still in the scalp. An independent study performed by an Italian HT group showed 72% of follicles transected in this manner regrew hair in the donor of normal thickness and rate. The regrowth rate would have been higher if it wasn’t for the “blind technique.” If you remove too much tissue, the donor will not regenerate, but you will still be left with a viable graft to transplant in the recipient area, so the 28% of grafts that don’t regenerate in the donor still result in a 1 for 1 technique similar to traditional HT.

» Dr. Nigam bisects the hair follicle / follicular unit transversely in vitro under 50x magnification with special fine blades and also collects the spilled out approximately 1000 to 1200 DP cells and injects it back in to the bisected follicles along with autologus activated epithelial and dermal papilla cells, outer root sheath, stem cells through 25 to 50 separately extracted follicular units in Vitro (when the follicle is not existing in the scalp but the cutting is done under microscope with full vision hence there is no chance for unsuitable or damaged grafts). The bisection is done at the particular level on the follicle wherein the Dermal Papilla cells & outer root sheath cells are present in both the bisected parts of the follicle. Due to patent pending neither Dr. Nigam nor Dr. Gho has not mentioned that at what level they bisect the follicle.

Once again, Dr. Gho no longer bisects the follicle at a particular level, he removes a core with enough tissue to rejuvenate in the recipient and leaves enough stromal tissue to rejuvenate in the donor. As far as proper bisection level of transverse transections, Kim, Jahoda, et al showed the lower third to result in the best success rate.

» 2G. Dr. Gho’s technique utilized only preservative media which does not have stem cell or isolated stem cell for boosting and survival of bisected follicle & no growth factor, no stem cells were utilized. Dr. Gho claims in his website that stem cell is been extracted from the donor area and implanted in the recipient area which is false and misleading because bisected follicle unit is extracted and implanted in the recipient area.

Gho’s HST, stem cells are extracted from the donor area and transplanted to the recipient area. These stem cells are present in the extracted and implanted tissue, and it is these stem cells that perform the 2 for 1 work. In fact, Jahoda used a similar technique, which resulted in growing hair in his wife’s arm by using cells from hair follicles on his head. IMO, there is nothing misleading in his statement.

But you are correct in stating that your technique of injecting stem cells at the site of transplant is novel. Early on, Dr. Gho developed a technique quite similar to your own, but he soaked the transected grafts in culture solution prior to reimplantation of both halves. You can look at the progression of this technique as Kim transacting at the line of Auber and reimplanting both halfs in the scalp. This resulted in an inconsistent regrowth. Gho added soaking the grafts in cuture solution, but it still resulted in inconsistent regrowth. Now you are attempting a similar approach, but you are reinjecting stem cells into the tissue in an attempt to kick start the grafts. This is a good approach because it allows for direct interaction with the body’s cell signaling environment. However, I believe it’s important for you to also soak the grafts in this solution prior to implantation in the scalp. An addition to the technique would be to inject the patient’s cultured DP and ORS cells into the recipient area post transplant.

» 2N. Dr. Nigam’s technique involves addition of isolated activated stem cells with growth factors isolated Dermal Papilla cells injections extra cellular matrix and 250 arterial PRP, Epidermal growth factor, follistation,, KGF, FGF and other (can’t disclose all as patent is under process)

Considering both Jahoda and Gho have shown DP cells are of limited value in human hair multiplication, I would use DS or ORS cells before I used DP cells. IMO, you will have much better success using these cell types. However, from your description of the process, I suspect you are using off-the-shelf cultured DP cells and lack the facilities to culture the patient’s own cells. IMO, this is a potential short-fall of your method.

» 3G. Dr. Gho claims that since he keeps the bisected follicular unit in the preservative medium (The medium is composed of the following ingredients: sodium chloride, potassium chloride, magnesium sulphate, sodium phosphate, calcium chloride, glucose, sodium bicarbonate, sodium lactate, sodium pyruvate, human serum albumin, insulin, bis(maltolato)oxovanadium (BMOV) and
» a-tocopherol (vitamin E)) of nutritional factors hence this technique should not be claimed as stem cell hair transplant (Because no isolation of stem cell is done in a regenerative lab, hence the technique cannot claim any manipulation of stem cells. Although it is true even in a normal hair fall when a new hair grows it is because of the inherent multiplication of the stem cell present in the hair follicle. Any isolation or multiplication of stem cell is possible only in a FDA or European authority certified lab which our friend Dr. Gho does not have at present.

Dr. Gho has performed studies in his lab in Holland using human cultured epithelial stem cells. I’ve seen and read the regulatory approval papers that allowed him to do this. It appears to me, the approval process is not as difficult as you say. However, I agree gaining approval for such processes in Holland is more difficult than gaining approval in India.

» 5G. Dr. Gho has patented his process of longitudinally bisection of donor hair follicle,

IMO, you are being far too critical in your attack on the naming of Gho’s procedure. The word “stem cell” implies a 2 for 1 technique and differentiates it from tradition 1 for 1 HT. Let’s face it, he got there at least a decade before you even considered a 2 for 1 technique possible, and without his pioneering effort, you’d be doing 1 for 1 transplant techniques to this day. IMO, a little appreciate is in order. I say that, not to take away from the good work you are doing, but to remind you of whose shoulders you are standing on while doing this work.

» 5N. Since Dr. Nigam has his own FDA licensed regenerative Lab in Mumbai (the license is already posted on the forum) Dr. Nigam’s Bio-Techs first isolate the adult hair stem cells present in a hair follicle, sorted out by magnetic beading system and then they activate (not multiplied which takes one and half a month) with serum free growth factors within 4 hrs of time and then they inject it into the bisected follicles.

In truth, your procedure is closer to a true stem-cell technique than HST, but it still runs shy of what we typically think of as a full-blown stem cell technique.

» 6G. Dr. Gho’s technique of Donor Doubling or preservation can transform the NW7 to NW2 in 2 years of time and that also at a very high cost because on an average 1500 grafts can be replicated only after 6 to 7 months.

I don’t believe this statement is true. It would take much longer than 2 years to transform a NW7 to a NW2 using HST. But I do agree about the high cost.

» 6N. Dr. Nigam’s technique of Donor Doubling or Hair Doubling are effective because in this technique both the bisected part of the grafts can be implanted at the recipient area hence through this technique NW7 can be transformed to NW2 in 10 – 15 days from the procedure.

This claim is highly exaggerated. You cannot transform a NW7 to a NW2 in 10 to 15 days. Such claims make me very suspicious of the rest of your claims. My advice is to only make claims you can back up with experimental results. Your reputation will be much stronger this way.

» 7G. The cost and time to transform NW7 to NW2 (10000 grafts) through Dr. Gho’s technique will cost very high (approximately USD $13000 for 2000 Grafts which means US $50000 for 10000 Grafts) and this transformation will take atleast 5 years.

A minute ago, you said 2 years. Now you are saying a more realistic 5.

» 7N. The cost for 10000 Grafts with Dr. Nigam’s Hair Doubling technique for 2000 Grafts in one day is USD $5000 and USD $10000 (All Inclusive) for 10000 Grafts. The total time period required for 10000 Grafts is 10 – 15 days.

I’ll believe this when I see it.

» 10G. Blindly longitudinal bisection in vivo has a disadvantage since the hair follicles angles at the skin surface is different from the placement angles of the bottom part of the hair follicle with the root. Hence higher number of transected or unsuitable grafts are possible and it’s a time consuming process

You fail to mention HST has an advantage in that it can harvest the same donor follicles multiple times, and therefore does not rely on the use of body hair in order to fully restore a NW7 to a NW2. This is a major advantage over your technique.

» 10N. Since at Dr. Nigam’s the bisection of follicle / follicular unit is done under high magnification in vitro which is outside the scalp, negligible chances of transected or unsuitable grafts. Kindly go through Dr. Cole explanation of the same in his post on the forum

Yes, but so far, no researchers have been able to transect outside the scalp and get consistent regrowth of both follicle parts. If you have managed to do this, then you should provide peer reviewed studies that show your regeneration rate is better than Gho’s prior to making such claims.


» Challenges for both Dr. Gho & Dr. Nigam:-
» Dr. Gho and Dr. Nigam both have to get their documentation of Donor Doubling / Hair Doubling atleast on 5 patients independently by informed and computer skilled consumer or by a independent hair transplant Doctor and / or by independent editor of top credible hair loss forum.

Dr. Gho has already had his HST regrowth numbers published in a peer reviewed journal, which is a far more credible approach than simply posting photos and claims on a hairloss forum. The study he performed was in conjunction with a major university with a well known and respected co-researcher. He is way ahead of you. It is now up to you to catch up.




James Bond is located in [NA] and he is available to meet: NO

James Bond

02.03.2013, 10:32

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» [image]

This description applies to pure cellular hair multiplication, which is quite different than what you are doing.




James Bond is located in [NA] and he is available to meet: NO

roger_that

MARYLAND,
02.03.2013, 19:57
(edited by roger_that, 02.03.2013, 20:23)

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

James -- great information, very enlightening. Thank you. Just have a few comments and questions.

» In fact, Jahoda used a similar technique, which resulted in growing hair in
» his wife’s arm by using cells from hair follicles on his head. IMO, there
» is nothing misleading in his statement.

I thought it was the other way around, his wife's cells into Jahoda's arm... Either way though the point is the same.

»
» I don’t believe this statement is true. It would take much longer than 2
» years to transform a NW7 to a NW2 using HST. But I do agree about the high
» cost.

James -- do you have a reason it should take so long? Why not 2 years? Is there a clear-cut, plausible, easy-to-explain reason why it should take much longer than that?

So far I haven't heard one.

Nor have I heard a clear or believable explanation from Dr. Gho as to why he doesn't set out trying to convert NW7's into NW2's.

Gho says he advises patients not to do this.

I am going to paraphrase a remark that Dr. Gho made in an interview (on TBT):

He said that he specifically advises ALL patients NOT to seek full heads of hair, no matter how long it would take, because when a man is 45, he shouldn't have a 20 year-old head of hair, it looks unnatural, and the patient will regret it.

To me, it's inconceivable that he would say this. What if a patient really wants full hair restoration back to his original hairline and density? Assuming this is theoretically possible with Gho's HST procedure, then why should Gho refuse such a request? According to Gho, he would deny this. In fact, he forbids it.

To me, this SOUNDS LIKE a cop-out. It SOUNDS like Gho is trying to decrease expectations because in reality, he cannot deliver this kind of result no matter how hard he tries, because of a limitation of his procedure.

I want to think I'm wrong here.

I want very much to trust and believe in Dr. Gho.




roger_that is located in MARYLAND and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

James Bond

02.03.2013, 22:18
(edited by James Bond, 02.03.2013, 22:52)

@ roger_that

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» I thought it was the other way around, his wife's cells into Jahoda's
» arm... Either way though the point is the same.

You have it backwards. A few hundred of Jahoda's DS cells were transplanted into his wifes arm. This resulted in new follicles that were a genetic cross between both people. In a later experiment they transplanted a different guy's DS cells into her arm and achieved similar results.

Currently, McElwee is attempting to culture DS cells and transplant them into the balding scalp. Conceivably, if he uses WNT to keep the cells from degrading through several passages, it's a cure. But we'll have to wait and see if he can get it to work in a cosmetically meaningful manner. IMO, this will take a while, so don't hold your breath.

The most interesting thing about Jahoda's experiment is, there was no evidence of donor rejection. Thus, people with really crappy donor hair can conceivably upgrade there hair-type by breeding their cells with that of those with much better hair.

» James -- do you have a reason it should take so long? Why not 2 years?
» Is there a clear-cut, plausible, easy-to-explain reason why it should take
» much longer than that?

If I understand Gho's reasoning, you don't want to overharvest the donor too much at once, or it can lead to excessive trauma. Thinking about this, I can't say for certain overharvesting would be necessarily be bad. It could actually be good, as it would load the skin with wound-signals that could interact with the left over follicular tissue and help it to rebuild. Then again, there is probably a good reason Gho doesn't like to take too much at once. One would have to do the experiments to know for certain.

Also, it can take a year or more for a transected follicle to fully reassemble itself. Taking a second harvest before this process occurs could lead to less than good results. This puts a limitation on how fast Gho can restore a patient's hair.

» Nor have I heard a clear or believable explanation from Dr. Gho as to why
» he doesn't set out trying to convert NW7's into NW2's.

I agree with that. If I were doing what he claims, that would be one of my first priorities.

» He said that he specifically advises ALL patients NOT to seek
» full heads of hair, no matter how long it would take, because when a man is
» 45, he shouldn't have a 20 year-old head of hair, it looks unnatural, and
» the patient will regret it.

Teenage hairlines on adults in no way look freakish if they are built naturally. I have several friends without any signs of hairloss that have better hairlines than I did when I was a teenager (and I had no sign of hairloss until I was about 30). By contrast, my father had a naturally receding adult hairline (no signs of MPB) at 52 and he looked like a movie star. IMO, natural receding adult hairlines looks great, and so do adult teenage hairlines. What doesn't look good is hair that has thinned out due to MPB.

» To me, this SOUNDS LIKE a cop-out. It SOUNDS like Gho is
» trying to decrease expectations because in reality, he cannot deliver this
» kind of result no matter how hard he tries, because of a limitation of his
» procedure.

I don't know the limitations of Gho's procedure. Since he had a small study, and we have no idea what methods he used to choose his patients, we don't know the true consistency-level of the procedure. Also, there could be a limit to the amount of times you can harvest a particular follicle unit. This could certainly limit the amount of restoration a patient could receive. But I would expect 10K FU's would go a long way's toward giving any person a decent head of hair, so long as the donor hair is of high quality.

» I want very much to trust and believe in Dr. Gho.

IMO, you will do well to keep an open mind either way. We would all like to trust and believe that there's a procedure out there right now that can restore a NW7 to a NW1. IMO, no such procedure exists. Even the best donor doubling procedure out there right now has limitations. If it weren't the case, there would be no reason, other than cost, to limit the amount of grafts placed into the recipient site.

True cellular hair multiplication is not what we all thought it would be. Early on, Gho was very enthusiastic, as was Intercytex, ARI, etc. While the promise of HM is great, the reality is, it's extraordinarily difficult to get it to work consistently in all patients. IMO, the first incarnation of HM will be an adjunct to HT. If it weren't the case, it wouldn't have taken 15 years and many $millions to not be much further along than where we all began this journey.

HM has proven to be very difficult to figure out and get right.




James Bond is located in [NA] and he is available to meet: NO

Freddie555

03.03.2013, 05:34
(edited by Freddie555, 03.03.2013, 05:51)

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

> James Bond wrote :
> Currently, McElwee is attempting to culture DS cells and transplant them
> into the balding scalp. Conceivably, if he uses WNT to keep the cells from
> degrading through several passages, it's a cure. But we'll have to wait and
> see if he can get it to work in a cosmetically meaningful manner. IMO, this
> will take a while, so don't hold your breath.

I got 2 questions for you :

1) You say McElwee (of Replicel) is attempting to do the above. Are you
talking about Replicel's Phase II trials or something McElwee is trying
outside of Replicel's Phase II trials? I don't see how the FDA would let him
inject WNT into patients in Phase II when it hasn't been done in Phase I.

2) Why is it Jahoda made the discovery of DP cells creating chimeric hairs
and hasn't done JACK for almost 20 years since? Do these researchers just
make a discovery and then take a nap making absolutely zero progress? What
has he been doing since his discovery - i presume nothing.

Dr. Nigam needs to get his hair germ experiment up & running. If he can find
a way to create & implant hair germs and have them successfully sprout, we
are on our way to a cure. But seeing how Aderans has poured 150+ million
into their venture creating hair patch assays, scaffolds and all kinds of
stuff early on in their development ..and still can't figure it out, it will
be a miracle if Dr. Nigam pulls this off.




Freddie555 is located in [NA] and he is available to meet: NO

---
"When true Hair Multiplication comes, it will arise out of the East." - John The Revelator, Feb. 18, 2001

James Bond

03.03.2013, 09:03

@ Freddie555

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» 1) You say McElwee (of Replicel) is attempting to do the above.

I'm saying he is attempting to culture DS cells and inject them back into the scalp in a manner that meaningfully restores hair. The addition of WNT to the culture medium is something that I discussed with Kurt Stenn some years back as a way to keep dermal stem cells in their embryonic state through multiple passages. I'm not saying McElwee is using WNT or that he plans to use it. My point is, in order to get HM to work consistently, it's imperative to find a safe and effective way to keep multiple passage cells' genetic expression exactly the same as fresh non-passaged cells.

The problem with removing cells from the body prior to transplantation is, the longer they are out of your body, the less chance they have of working. So you have to find a way to keep them from degrading.

A case in point is, leaving the lower third of a donor follicle in the scalp will cause the follicle to rejuvinate 100% of the time if the follicle is perfectly transected.

But taking it out of the body, transecting it perfectly, and putting it back in the body will lead to inconsistent results unless other factors are introduced to strengthen the tissue and aid the signaling environment.

As you can see in the Jahoda experiment, the DS cells were not out of the body long, and they were not cultured (degraded). This allowed neogenesis to occur. But if these same cells had been cultured prior to implantation, chances are, the results would not have been as good (note that Jahoda also implanted cultured DP cells and had no success).

» 2) Why is it Jahoda made the discovery of DP cells creating chimeric hairs
» and hasn't done JACK for almost 20 years since? Do these researchers just
» make a discovery and then take a nap making absolutely zero progress?
» What
» has he been doing since his discovery - i presume nothing.

You are pretty much correct. Jahoda is an academic, and has no interest in developing a cure for hairloss. His role is to spawn ideas for others to follow up upon.

» Dr. Nigam needs to get his hair germ experiment up & running. If he can
» find
» a way to create & implant hair germs and have them successfully sprout, we
» are on our way to a cure. But seeing how Aderans has poured 150+ million
» into their venture creating hair patch assays, scaffolds and all kinds of
» stuff early on in their development ..and still can't figure it out, it
» will
» be a miracle if Dr. Nigam pulls this off.

Interestingly, the approach Nigam is taking is similar to the approach I recommended about a decade ago.

If I recall correctly, my reasoning was, in Bisection of Hair Follicles: An in Vitro Study (1999), Raposio showed that removing the follicles and transecting them outside the body and placing them in culture medium lead to thick hairs emerging from the lower 3rd and thinner hairs emerging from the upper 2/3.

Gho claims he figured out how to remove the upper 2/3, soak it in a specific medium, re implant it, and consistently get thick hair growth. But when he removed the lower third, he had trouble getting it to reform. He found leaving it in the scalp led to better results. But this meant he had to perform the transections blindly, so he had inconsistent results.

IOW, the only outstanding thing remaining to bring about a 2 for 1 was to figure out how to treat the lower 3rd prior to implantation. I'm surprised nobody has came along prior to Nigam and given it an honest attempt. Truthfully, I thought this would be solved by now.




James Bond is located in [NA] and he is available to meet: NO

roger_that

MARYLAND,
03.03.2013, 14:55

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

James,

So what you're saying is, the most we can hope for is 2:1 replacement (and even then, that would be tricky and based on bathing parts of follicles in different triggering factors like Wnt)...?

The whole issue of Wnt is complicated because it's an exceedingly complex set of pathways. It's also something that's been linked to promotion of tumors and cancers. Moreover there are several different kinds of Wnt, as certain posters here never cease to remind me.

What do you think the prospects are that the FDA will allow use of Wnt in prospective HM treatments (whether follicle transection or cell culture based)?

I think the chances of swift approval of this kind of thing by the FDA are almost nil.

Even if a form of Wnt is used that hasn't been implicated in cancer is used, I think the FDA will set such an application aside just because it involves putting exogenous Wnt into the body. I don't think they're going to differentiate between different types of Wnt, whether or not they've been directly linked to cancer, because there is so much we don't know about the whole set of interlinked Wnt pathways that the FDA is unlikely to agree to such a risk.

The practical consequence of this will that such an application will be mired in a very extended approval process, probably around 10 years.

Which isn't a practical answer for many of us right now.

Are you saying that without addition of such chemical factors, "HM" as we have understood it may be impossible?

I have another theory about why cell-based HM experiments aren't working consistently. It may be related to your theory, but it's more focused on the need to have injected cells physically adhere to one another and form a cystic proto-follicle in the tissue.

My contention is that when injected, cultured stromal or somatic cells (e.g. DP cells) from the follicle have no natural tendency to adhere to one another and that is exactly the problem.

The second you inject them, the cells start drifting apart and thus the yield of viable proto-follicles per set of injections is low, and based on "luck" -- the relatively low chance that, say, out of 100 injections, maybe 5-10 will by pure statistical happenstance result in a proto-follicle because enough cells just happened to stick together to form a viable cyst.

This would explain why consistency is very low and why yields are very low.

Anything that would promote the injected cells adhering together once injected would, in my opinion, vastly increase yield.

However this approach was tried with mini biodegradable or removable scaffolds, I believe, and gave questionable results, which to my knowledge were never specifically reported.

What do you think?




roger_that is located in MARYLAND and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

HMorHT

03.03.2013, 22:54

@ roger_that

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» However this approach was tried with mini biodegradable or removable
» scaffolds, I believe, and gave questionable results, which to my knowledge
» were never specifically reported.
»
» What do you think?
- poster 'roger_that'

Don't write this off just yet, you are right, I think Aderans was the first who talked about using scaffolds, they have been working on this for many years already, maybe they will have a scaffold system that works in the near future.




HMorHT is located in [NA] and he is available to meet: NO

drnigam

04.03.2013, 12:05

@ Noyznarcos

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Noyznarcos,
You can count your hair yield per sqcm at the donor and also give me the measurement in sqcms of the recipient scalp area to be covered.
If you have poor body or beard hair count,we will have to take the help of HM with hair doubling.
Megassesion cases are in progress will document next month.
» Thank you, doctor you're giving me confidence for the future.
»
» questions:
»
» 1) When do we see cases from NW 7 to NW 2?
»
» 2) When do we see cases of megassession, to see how it works?
»
» 3) I am a person with a little beard and a few hairs in the body, is
» that a problem?
»
» thank you very much
- poster 'Noyznarcos'



drnigam has 1 Personal Journal(s). Click here to view
drnigam is located in [NA] and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

drnigam

04.03.2013, 12:10

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

James Bond ,
You are right these pics are part of my hair multiplication procedure not hair doubling.You may not be aware my major applied research work is in the field of autolous solution of hair stemcell injections,inducible dermal papilla implant and proto hair implant.
» » [image]
»
» This description applies to pure cellular hair multiplication, which is
» quite different than what you are doing.
- poster 'James Bond'James Bond,



drnigam has 1 Personal Journal(s). Click here to view
drnigam is located in [NA] and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

drnigam

04.03.2013, 13:22

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

James Bond,
Dr.Nigam bisects the hair follicle / follicular unit transversely in
» vitro under 50x magnification with special fine blades and also collects
» the spilled out approximately 1000 to 1200 DP cells and injects it back in
» to the bisected follicles along with autologus activated epithelial and
» dermal papilla cells, outer root sheath, stem cells through 25 to 50
» separately extracted follicular units in Vitro (when the follicle is not
» existing in the scalp but the cutting is done under microscope with full
» vision hence there is no chance for unsuitable or damaged grafts). The
» bisection is done at the particular level on the follicle wherein the
» Dermal Papilla cells & outer root sheath cells are present in both the
» bisected parts of the follicle. Due to patent pending neither Dr. Nigam nor
» Dr. Gho has mentioned that at what level they bisect the follicle.
»
» Once again, Dr. Gho no longer bisects the follicle at a particular level,
» he removes a core with enough tissue to rejuvenate in the recipient and
» leaves enough stromal tissue to rejuvenate in the donor. As far as proper
» bisection level of transverse transections, Kim, Jahoda, et al showed the
» lower third to result in the best success rate.
James,If removing a core tissue of FU for the recipient and stromal tissue at the donor,than all the transected FU'S of the traditional FUE should generate hair follicles,as in FUE also some grafts are transected or damaged, that is a part of the graft is extracted without the root or stromal tissue.
We bisecte at the level of dermal papilla, as it is shown that dermal papilla alone can regenerate a complete follicle, if not it is compensated by epithelial stem cell injection into it.The other half have both a part of dermal papilla and ofcourse complete epithelial follicle with stem cells.

» » 2G. Dr. Gho’s technique utilized only preservative media which does not
» have stem cell or isolated stem cell for boosting and survival of bisected
» follicle & no growth factor, no stem cells were utilized. Dr. Gho claims in
» his website that stem cell is been extracted from the donor area and
» implanted in the recipient area which is false and misleading because
» bisected follicle unit is extracted and implanted in the recipient area.
»
» Gho’s HST, stem cells are extracted from the donor area and transplanted to
» the recipient area. These stem cells are present in the extracted and
» implanted tissue, and it is these stem cells that perform the 2 for 1 work.
» In fact, Jahoda used a similar technique, which resulted in growing hair in
» his wife’s arm by using cells from hair follicles on his head. IMO, there
» is nothing misleading in his statement.
James,As you are aware, Stemcells are inherently present in a hair follicle,But are inactive in MPB hence they need to be isolated ,sort out by magnetic beading syatem etc.all other tissue including the rest of the tissue of hair follicle has to be discarded before one can isolate stemcell for activation and reuse, before that one cannot just remove stemcellsfrom the donor area in vivo and implant into the recipient.If they could have perform the 2 for 1 work they could have performed even 10 for 1 work in theory.2for 1 work is due to 2 bisected parts from 1.
Jahoda also grew hair by bisection not any direct intervention to the inherent hair stemcells in the follicle.Even in normal course when a hair falls and new grows it is because of inherent stemcell activity, will you cal this stemcell hair fall and regrowth treatment with a patent process.I had performed lower 1/3rd bisection but found bisection at the dermal papilla more effective both theoritically and practically with much better results.
» But you are correct in stating that your technique of injecting stem cells
» at the site of transplant is novel. Early on, Dr. Gho developed a technique
» quite similar to your own, but he soaked the transected grafts in culture
» solution prior to reimplantation of both halves. You can look at the
» progression of this technique as Kim transacting at the line of Auber and
» reimplanting both halfs in the scalp. This resulted in an inconsistent
» regrowth. Gho added soaking the grafts in cuture solution, but it still
» resulted in inconsistent regrowth. Now you are attempting a similar
» approach, but you are reinjecting stem cells into the tissue in an attempt
» to kick start the grafts. This is a good approach because it allows for
» direct interaction with the body’s cell signaling environment. However, I
» believe it’s important for you to also soak the grafts in this solution
» prior to implantation in the scalp. An addition to the technique would be
» to inject the patient’s cultured DP and ORS cells into the recipient area
» post transplant.
As you correctly said ,our next step is dp inducible culture which will be followed with proto hair created in vitro implantation.But can you clarify how does preservation medium of dr gho help(i have listed the ingredients of his preservation medium).I do sok them in a solution of growth factors, prp,ecm antibiotics and nutritional factors.I appreciate your knowledge in this field.Keep suggesting.What do you think if a follicle is divided into 4 by bisecting at the dermal papilla into 2 and bulge into 2 and injection of at present dp cells and epithelial stem cells and later also with dp culture.Each part will act as proto hair in part,As you are aware it is easier to create a new follicle with stem cells if we have some part of hair follicle for stemcells and dp cells to improve induction and cross talk.
»
» » 2N. Dr. Nigam’s technique involves addition of isolated activated stem
» cells with growth factors isolated Dermal Papilla cells injections extra
» cellular matrix and 250 arterial PRP, Epidermal growth factor,
» follistation,, KGF, FGF and other (can’t disclose all as patent is under
» process)
»
» Considering both Jahoda and Gho have shown DP cells are of limited value in
» human hair multiplication, I would use DS or ORS cells before I used DP
» cells. IMO, you will have much better success using these cell types.
» However, from your description of the process, I suspect you are using
» off-the-shelf cultured DP cells and lack the facilities to culture the
» patient’s own cells. IMO, this is a potential short-fall of your method.
» We are not using off the shelf dp cells but isolate dp cells from 10 separate follicles which are also reimplanted and not wasted.We are not yet ready with cultured inducible dp cells.
DP cells and dermal sheath cells can give rise to cells for either reciprocally after disection.We do use stemcells isolated from ds,outer root sheath,bulge stemcells,resident epidermal stemcells.We have a FDA certified biotech lab with CO2 incubator with different flasks, cytoflow meter,inverted microscope,Microbiology section and a full fledged lab for stemcells culture with full time biotechs and cell biologist.We are working with chang media,enriched with vitd3 media for versican and phospahtase positive dp culture.
» » 3G. Dr. Gho claims that since he keeps the bisected follicular unit in
» the preservative medium (The medium is composed of the following
» ingredients: sodium chloride, potassium chloride, magnesium sulphate,
» sodium phosphate, calcium chloride, glucose, sodium bicarbonate, sodium
» lactate, sodium pyruvate, human serum albumin, insulin,
» bis(maltolato)oxovanadium (BMOV) and
» » a-tocopherol (vitamin E)) of nutritional factors hence this technique
» should not be claimed as stem cell hair transplant (Because no isolation of
» stem cell is done in a regenerative lab, hence the technique cannot claim
» any manipulation of stem cells. Although it is true even in a normal hair
» fall when a new hair grows it is because of the inherent multiplication of
» the stem cell present in the hair follicle. Any isolation or multiplication
» of stem cell is possible only in a FDA or European authority certified lab
» which our friend Dr. Gho does not have at present.
»
» Dr. Gho has performed studies in his lab in Holland using human cultured
» epithelial stem cells. I’ve seen and read the regulatory approval papers
» that allowed him to do this. It appears to me, the approval process is not
» as difficult as you say. However, I agree gaining approval for such
» processes in Holland is more difficult than gaining approval in India.
The paper you are referring is the one where he has indentified presence of stemcells in a hair follicle which has been reported earlier in much detail by others biotechs.Indentification of stemcells and isolating the stemcells for implantation is different.Can you detail a bit about the european stemcellreasearch and therapy approval process you have mentioned,which allowed him to do so.May be than i can open a clinic in europe.
» » 5G. Dr. Gho has patented his process of longitudinally bisection of donor
» hair follicle,
»
» IMO, you are being far too critical in your attack on the naming of Gho’s
» procedure. The word “stem cell” implies a 2 for 1 technique and
» differentiates it from tradition 1 for 1 HT. Let’s face it, he got there at
» least a decade before you even considered a 2 for 1 technique possible, and
» without his pioneering effort, you’d be doing 1 for 1 transplant techniques
» to this day. IMO, a little appreciate is in order. I say that, not to take
» away from the good work you are doing, but to remind you of whose shoulders
» you are standing on while doing this work.
I do appreciate dr gho and all others who's work has helped me to better my work.
We are here to question technical aspects to further our research work and nothing personal.I take criticism,questions or suggestions in a positive way to improve and do not take it as personal.
»
» » 5N. Since Dr. Nigam has his own FDA licensed regenerative Lab in Mumbai
» (the license is already posted on the forum) Dr. Nigam’s Bio-Techs first
» isolate the adult hair stem cells present in a hair follicle, sorted out by
» magnetic beading system and then they activate (not multiplied which takes
» one and half a month) with serum free growth factors within 4 hrs of time
» and then they inject it into the bisected follicles.
»
» In truth, your procedure is closer to a true stem-cell technique than HST,
» but it still runs shy of what we typically think of as a full-blown stem
» cell technique.
»
» » 6G. Dr. Gho’s technique of Donor Doubling or preservation can transform
» the NW7 to NW2 in 2 years of time and that also at a very high cost because
» on an average 1500 grafts can be replicated only after 6 to 7 months.
»
» I don’t believe this statement is true. It would take much longer than 2
» years to transform a NW7 to a NW2 using HST. But I do agree about the high
» cost.
»
» » 6N. Dr. Nigam’s technique of Donor Doubling or Hair Doubling are
» effective because in this technique both the bisected part of the grafts
» can be implanted at the recipient area hence through this technique NW7 can
» be transformed to NW2 in 10 – 15 days from the procedure.
»
» This claim is highly exaggerated. You cannot transform a NW7 to a NW2 in 10
» to 15 days. Such claims make me very suspicious of the rest of your claims.
» My advice is to only make claims you can back up with experimental results.
» Your reputation will be much stronger this way.
I claimed the transition from nw7 to nw 2 in 15 days with for example 3500 from the donor scalp and doubling it to 7000 grafts and rest 3000 from the beard and body.If the donor of nw7 can give me 4000 to 5000 grafts ,nothing like it but is normally not the case.

» » 10G. Blindly longitudinal bisection in vivo has a disadvantage since the
» hair follicles angles at the skin surface is different from the placement
» angles of the bottom part of the hair follicle with the root. Hence higher
» number of transected or unsuitable grafts are possible and it’s a time
» consuming process
»
» You fail to mention HST has an advantage in that it can harvest the same
» donor follicles multiple times, and therefore does not rely on the use of
» body hair in order to fully restore a NW7 to a NW2. This is a major
» advantage over your technique.
We can easily implant a bisected part into the donor from where it was removed and the other at the recipient.Hence our technique can be called hair doubling at the recipient and also donor doubling at the donor as per the choice of the patient.
Since at Dr. Nigam’s the bisection of follicle / follicular unit is
» done under high magnification in vitro which is outside the scalp,
» negligible chances of transected or unsuitable grafts. Kindly go through
» Dr. Cole explanation of the same in his post on the forum
»
» Yes, but so far, no researchers have been able to transect outside the
» scalp and get consistent regrowth of both follicle parts. If you have
» managed to do this, then you should provide peer reviewed studies that show
» your regeneration rate is better than Gho’s prior to making such claims.
Sure i will provide peer review studies in the months to come,as it can easily be copied or replicated once all the steps are disclosed and proved in a peer review journal.It is not a difficult task to publish in a peer reviewed jounal especially the journals are always looking out for newer studies.But i do not understimate the intellect of some forum members who have been helping me improve my technique since last 3 and a half month i joined this forum.You are one of them.



drnigam has 1 Personal Journal(s). Click here to view
drnigam is located in [NA] and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

moopookoo

04.03.2013, 13:58

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Dr Umars response



http://www.hairsite.com/hair-loss/board_entry-id-90628-page-0-order-time-category-0.html


If you review this thread (click above) I posted in 2007, you will see it depicts a patient I transplanted in 2006, during the earlier stages of my FUE technique (SFET). You can see how pristine the donor looks. Smaller size punches (~0.6mm) were used to extract this patient's grafts, but smaller punches have limitations. A smaller size punch cannot extract an entire follicular unit containing 3 or more follicles if the hairs exit the skin in a dispersed fashion. I cannot extract them because the diameter of the hairs’ exit points exceeds the diameter of the punch. In such a scenario, one is left with 2 options: Leave such FUs alone or extract 1 of 3 or 2 of the 3 hairs in the follicle. In the later scenario, if the follicles left in the donor survive, it may appear that the donor has regenerated, but it hasn't. You have made 2 follicles out of one follicular unit by dividing it, but the sum total number of hairs remains the same.

Donor area: Primarily because the small sized punch produces smaller wounds, the healing is faster, and scarring even less. Because less hair is moved the donor area appears pristine, but not regenerated, as the "regenerated" follicle is nothing more than a portion of a follicular unit that was not extracted.

Recipient area: As a consequence of the recipient area receiving more singles and doubles than in typical HTs, density tends to be less by comparison. Some patients prefer this, some are okay with it, but it cannot be represented to them that we have multiplied hair. We would have split their follicular units into 2 different surviving follicles, but the number of hairs has not been multiplied.


needhairasap,

There will be no retraction from me. The comments I made and the opinions I offered are based on medical science, as it exists in the year 2011, and the many years I have spent studying and working with skin and hair. If hair multiplication were a reality, it would be easy to provide convincing proof of its success. I feel comfortable in saying a lawsuit will not be filed, because a lawsuit against me would require evidence.

I welcome Dr. Gho's input on this thread. Since you (needhairasap) are not in a position to provide 1st hand proof either way, going on would raise the question of promoting a clinic blindly




moopookoo is located in [NA] and he is available to meet: NO

thehairman

04.03.2013, 17:02

@ moopookoo

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» Dr Umars response

Who cares what dr. Umar says ? Dr. Umar simply wants nothing to work so that ppl go for BHT which he does best!!




thehairman is located in [NA] and he is available to meet: NO

---
AKA Aim4hair

Shooter

05.03.2013, 06:03

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Hi Dr. Nigam,

I have a quick question (my apologies if this has been covered before).

Does your Hair Doubling technique actually double hair follicles, or just split them?

For example, after your process does a two-hair graft yield two separate hairs? Or does it ultimately yield four hairs?

Thanks,
Shooter




Shooter is located in [NA] and he is available to meet: NO

drnigam

05.03.2013, 08:36

@ Shooter

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Shooter,
2hair grafts yield 4hair.

» Hi Dr. Nigam,
»
» I have a quick question (my apologies if this has been covered before).
»
» Does your Hair Doubling technique actually double hair follicles, or just
» split them?
»
» For example, after your process does a two-hair graft yield two separate
» hairs? Or does it ultimately yield four hairs?
»
» Thanks,
» Shooter
- poster 'Shooter'



drnigam has 1 Personal Journal(s). Click here to view
drnigam is located in [NA] and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

James Bond

05.03.2013, 09:21

@ roger_that

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» What do you think the prospects are that the FDA will allow use of Wnt in
» prospective HM treatments (whether follicle transection or cell culture
» based)?

The main thing here is untreated DP cells start turning into cells that resemble other tissues than hair cells when they are passaged. When you add the WNT into the culture, cDNA micro-array analysis shows that the cells no longer degrade to the degree they otherwise would. If WNT is a problem, the cells can be isolated from the culture prior to injection.

» Are you saying that without addition of such chemical factors, "HM" as we
» have understood it may be impossible?

Not at all. At the time, I spoke with Stenn (many years ago now), he felt WNT could be used in the culture medium, it would not slow down the regulatory process, and it would circumvent the problem with high passaged cells morphing into blood cells. He pointed me to certain studies that seemed to back up his beliefs. It's possible things changed since then, and he found another way, or his initial beliefs did not hold up over time.


» I have another theory about why cell-based HM experiments aren't working
» consistently. It may be related to your theory, but it's more focused on
» the need to have injected cells physically adhere to one another and form a
» cystic proto-follicle in the tissue.

Certainly Jahoda showed dermal cells work best when they clump in culture. And the clumped cells create a more robust cell-signaling environment than single cells, which would allow them to better migrate to the follicle bases. But I'm not sure it explains why the same cellular injections that work well in mice do not work well in humans. This would have to do more with signaling deficiencies, which I think is still the main holdup with HM.

Fortunately, if injections are a problem, then the cells can be delivered through small slits in the skin, as with the hair Jahoda grew in his wife's arm (due to the cells being targeted at the dermal/epidermal junction). The biggest issue, of course, with Jahoda's method is the hair emerged from the skin at multiple angles.

» However this approach was tried with mini biodegradable or removable
» scaffolds, I believe, and gave questionable results, which to my knowledge
» were never specifically reported.

That was Barrows (ala BioAmide) original idea. It certainly is interesting that it seems to have been shelved for the time being. As was` neogenesis, slit delivery etc.




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James Bond

05.03.2013, 10:58

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» James,If removing a core tissue of FU for the recipient and stromal tissue
» at the donor,than all the transected FU'S of the traditional FUE should
» generate hair follicles,as in FUE also some grafts are transected or
» damaged, that is a part of the graft is extracted without the root or
» stromal tissue.

In my opinion, while it might appear the two techniques are similar, removing the core leaves both dermal and epidermal follicular cells in the area of wound signal. Transection during FUE, due to the blind nature of the lower follicle extraction, tends to only leave the dermal component. So I think FUE transections will result in some regrowth, but only for the small portion of follicles transected at or above the lower third. HST has the potential for a much higher rate of regrowth than FUE.

» We bisecte at the level of dermal papilla, as it is shown that dermal
» papilla alone can regenerate a complete follicle, if not it is compensated
» by epithelial stem cell injection into it.The other half have both a part
» of dermal papilla and ofcourse complete epithelial follicle with stem
» cells.

That makes sense. But, even though the upper portion has both a dermal an epithelial component, it does not always grow thick hair. So it too needs a kick start. The key here is to perform the transection as accurately as possible in order to ensure both parts have adequate tissue to regenerate on their own. Then the addition of stem cell and growth factor boosters provide the best chance to work. But I suspect you are well aware of this, and it is a key to your technique.

» James,As you are aware, Stemcells are inherently present in a hair
» follicle,But are inactive in MPB hence they need to be isolated ,sort out
» by magnetic beading syatem etc.all other tissue including the rest of the
» tissue of hair follicle has to be discarded before one can isolate stemcell
» for activation and reuse, before that one cannot just remove stemcellsfrom
» the donor area in vivo and implant into the recipient.If they could have
» perform the 2 for 1 work they could have performed even 10 for 1 work in
» theory.2for 1 work is due to 2 bisected parts from 1.

Yes, I agree, 2 for 1 is due to both parts retaining adequate tissue and cells for regeneration. But the key in the 2 for 1, IMO is, the wound signal switches on the dormant MPB stem cells and calls them into action. I recall some of Jahoda's (Oliver's) work showing this to be the case, but can't think of it specifically at the moment.

The key with Gho's technique is ensuring the upper components are handled in such a way as to ensure they will consistently regenerate. From the looks of his grafts, he accomplishes this by removing adequate tissue. The real magic with HST appears to be in what's left behind in the donor where the stem cells are triggered into action by the wound signal.

» Jahoda also grew hair by bisection not any direct intervention to the
» inherent hair stemcells in the follicle.Even in normal course when a hair
» falls and new grows it is because of inherent stemcell activity, will you
» cal this stemcell hair fall and regrowth treatment with a patent process.I
» had performed lower 1/3rd bisection but found bisection at the dermal
» papilla more effective both theoritically and practically with much better
» results.

That's an extremely interesting finding.

» As you correctly said ,our next step is dp inducible culture which will be
» followed with proto hair created in vitro implantation.But can you clarify
» how does preservation medium of dr gho help(i have listed the ingredients
» of his preservation medium).I do sok them in a solution of growth factors,
» prp,ecm antibiotics and nutritional factors.I appreciate your knowledge in
» this field.Keep suggesting.What do you think if a follicle is divided into
» 4 by bisecting at the dermal papilla into 2 and bulge into 2 and injection
» of at present dp cells and epithelial stem cells and later also with dp
» culture.Each part will act as proto hair in part,As you are aware it is
» easier to create a new follicle with stem cells if we have some part of
» hair follicle for stemcells and dp cells to improve induction and cross
» talk.

Paul Kemp's team performed work in this area, but I'm not familiar with the exact work he did. Here is an article explaining the basics:

http://files.investis.com/icx/pdfs/hair_morphogenesis.pdf

Gho's growth medium is a sticking point for me, because in the past he told me he was using HM-growth factors similar to his culture medium to soak the grafts in prior to implantation, and this helped the upper follicles to consistently regenerate. But he has since seemed to have dropped this requirement. Looking closely at the amount of tissue he removes, it would appear he might not need this extra soaking. But that does indeed make the tissue left behind appear to be magical. Especially since he would theoretically need to leave a slight nub, where the hair is soft and easily breakable, right at the base in order to regenerate in the manner that appears to be occurring.

Gho's technique is well documented in his study. Can you perform a small scale experiment and confirm his technique works as advertised as far as regeneration in the donor is concerned? The donor regeneration with FM was independently confirmed, but so far, nobody has independently confirmed HST.

» The paper you are referring is the one where he has indentified presence of
» stemcells in a hair follicle which has been reported earlier in much detail
» by others biotechs.Indentification of stemcells and isolating the stemcells
» for implantation is different.Can you detail a bit about the european
» stemcellreasearch and therapy approval process you have mentioned,which
» allowed him to do so.May be than i can open a clinic in europe.

I'm not sure you are aware of this, but Gho started with true stem cell hair multiplication long before he invented HST. The reason he began to perform HST is because he failed in his attempt at true stem-cell based hair multiplication.

Years ago, a person emailed me copies of the legal paperwork that allowed Gho to perform cell-based hair multiplication on human in Holland. These studies preceded Dr. Gho's current HST technique and are well known. The method he used in those studies is well documented in a patent that is freely available. Keep in mind, the regulations could have become much more strict since that time.

» We can easily implant a bisected part into the donor from where it was
» removed and the other at the recipient.Hence our technique can be called
» hair doubling at the recipient and also donor doubling at the donor as per
» the choice of the patient.

Yes, you are correct. But using that method is much more invasive and is less elegant of a solution than Gho's. Don't get me wrong, if you can get your technique to work, it will be amazing. But correct me if I am wrong, you're still in the preliminary stages of your procedure.

» But i do not understimate the intellect of some forum members who
» have been helping me improve my technique since last 3 and a half month i
» joined this forum.You are one of them.

Thanks, I want you to succeed and wish you the best. I'm sorry, I haven't followed your research so far, as I am involved in other fields of study and have not paid much attention to this one for several years. Have you performed enough fundamental research to gain an idea of the consistency rate of your 2-for-1 technique so far in growing normal-sized hair from both follicle parts?




James Bond is located in [NA] and he is available to meet: NO

James Bond

05.03.2013, 11:04

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» » I have another theory about why cell-based HM experiments aren't working
» » consistently. It may be related to your theory, but it's more focused
» on
» » the need to have injected cells physically adhere to one another and form
» a
» » cystic proto-follicle in the tissue.
»

I thought about this a bit more, and my previous response to it was not accurate. I believe your theory is right. The most important thing remaining to be solved is the delivery mechanism. The fact that ARI strayed from Barrow's research is a big concern, given their phase II rejuvination results are not all that exciting.




James Bond is located in [NA] and he is available to meet: NO

roger_that

MARYLAND,
05.03.2013, 13:39
(edited by roger_that, 05.03.2013, 14:06)

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» I thought about this a bit more, and my previous response to it was not
» accurate. I believe your theory is right. The most important thing
» remaining to be solved is the delivery mechanism. The fact that ARI strayed
» from Barrow's research is a big concern, given their phase II rejuvination
» results are not all that exciting.

What I would add is that you're right that a scaffold or something similar might help, but I think that short of that, varying the means of delivery (e.g., implantation via a slit vs. injections) isn't going to do the trick. The problem is an inherent one about the cells. These cells simply do not want to "hold together" in a clump once inserted, no matter what the means of insertion. (Inserting cells may be a bit better, but I would argue much more difficult and complicated to do logistically and much more traumatic to the patient on a large scale.)

I think from observation of the results of HM experiments, this conclusion is reached by inductive reasoning.

Consistency ALWAYS seems to be a major problem. Of X injections, only X/n are producing hair, and that's usually quite a small number compared to X. But no one seems able to predict when an injection will produce hairs. Therefore this speaks of a random phenomenon.

When these cells are injected, the facts that (1) almost always sprout some hairs, but the yield of hairs produced is low compared to the number of injections (2) the outcome is random, i.e., unpredictable. This suggests a randomized statistical phenomenon, such as the following:

Injecting DP cells into the skin is analogous to throwing a handful of beads to your friend, who is standing 5 feet away, to catch. Invariably as soon as you release the beads into the air, they splay out from the clump in your hand and fly all over the place. They have no inherent tendency to stay together and remain in a clump. This is an inherent property of the beads (cultured cells) since they lack whatever signaling or chemical factors are required to keep them together.

A critical mass of cells need to remain clumped together in order for the cells to form a cystic mass (proto-follicle in neogenesis) or inductive mass of cells (capable of influencing nearby miniaturized follicles).

In most HM experiments, we see these very low yields and unpredictable outcomes precisely because what starts out as an ordered phenomenon (the cell culture, going into the syringe), becomes a much more random one (cells quickly drifting apart in the skin) and that makes most of the injections essentially useless.




roger_that is located in MARYLAND and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

Mr. Z

05.03.2013, 16:21

@ roger_that

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

»
» A critical mass of cells need to remain clumped together in order for the
» cells to form a cystic mass (proto-follicle in neogenesis) or inductive
» mass of cells (capable of influencing nearby miniaturized follicles).
»
» In most HM experiments, we see these very low yields and unpredictable
» outcomes precisely because what starts out as an ordered phenomenon (the
» cell culture, going into the syringe), becomes a much more random one
» (cells quickly drifting apart in the skin) and that makes most of the
» injections essentially useless.
- poster 'roger_that'


Perhaps they can get around this issue with a more directed application of the cells. I'm talking about a very fine needle that is injected/targeted at specific hair follicles. As opposed to random injections over the scalp, some of which, due to randomness, will fall very far (relatively speaking) from the follicle. In which case, the cells spread and diffuse out over a much larger skin volume, diluting their effect before they hit a follicle.

Of course, targeted injections would be labor intensive. But, i would be curious to see if it works first. If so, perhaps some technologies could be developed to make it a less labor intensive process.




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albardmark

UK,
05.03.2013, 19:01

@ Mr. Z

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

This nomenclature of control mobile locks surgery is not usually objected by certain regulators but can be objected very well by Western regulators of control tissues because declaring of control tissues treatment or its used is not lawful in Western countries. The phrase control mobile for locks surgery can only be used if it is separated in FDA qualified restorative lab and / or triggered and then treated returning into the head. Unfortunately this is not the situation of in Dr. Gho. Hence if this will come to the observe of Stem Cells power they might take activity against it but certain power will not item for the same. Actually it is the natural residence of the current control tissues in a locks string to denovo on its own to get triggered and increase to replenish a bisected locks string if all the different kind of control tissues is existing in the bisected the string to replenish a new locks string. Dr. Gho bisected graft are little outside the head by 4 to 5 hrs such as 2 hrs in the additive method.




albardmark is located in UK and he is available to meet: NO

---
Hair transplant is a surgical technique that moves individual hair follicles from a part of the body.

roger_that

MARYLAND,
06.03.2013, 02:23

@ albardmark

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

albardmark,

Are you using an online language translation program to translate some other language into English when making your posts?

Because phrases like "nomenclature of control mobile locks surgery" mean absolutely nothing to us here.

It must be a very bad online translation program.



» This nomenclature of control mobile locks surgery is not usually objected
» by certain regulators but can be objected very well by Western regulators
» of control tissues because declaring of control tissues treatment or its
» used is not lawful in Western countries. The phrase control mobile for
» locks surgery can only be used if it is separated in FDA qualified
» restorative lab and / or triggered and then treated returning into the
» head. Unfortunately this is not the situation of in Dr. Gho. Hence if this
» will come to the observe of Stem Cells power they might take activity
» against it but certain power will not item for the same. Actually it is the
» natural residence of the current control tissues in a locks string to
» denovo on its own to get triggered and increase to replenish a bisected
» locks string if all the different kind of control tissues is existing in
» the bisected the string to replenish a new locks string. Dr. Gho bisected
» graft are little outside the head by 4 to 5 hrs such as 2 hrs in the
» additive method.




roger_that is located in MARYLAND and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

James Bond

06.03.2013, 07:38

@ roger_that

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» What I would add is that you're right that a scaffold or something similar
» might help, but I think that short of that, varying the means of delivery
» (e.g., implantation via a slit vs. injections) isn't going to do the trick.
» The problem is an inherent one about the cells. These cells simply do
» not want to "hold together" in a clump once inserted, no matter what the
» means of insertion. (Inserting cells may be a bit better, but I would argue
» much more difficult and complicated to do logistically and much more
» traumatic to the patient on a large scale.)

I think the slit delivery holds potential because it's a way to target the dermal-epidermal connection placing the cells at this exact location to trigger neogenesis. It's traumatic to the scalp, but no more so than HT. And IMO, the trauma is additive to the process, because it results in a wound signal environment.

IMO,the biggest problem with dense-packing the slit is, it takes too many cells per hair grown to be a viable cure. Thus, the need for keeping the cells from degrading while multiplying very large quantities. IMO, if follicle stem cells did not degrade at all in culture, and they were of unlimited quantity, we would have the cure.




James Bond is located in [NA] and he is available to meet: NO

roger_that

MARYLAND,
06.03.2013, 14:11

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

James, what's your opinion of the role of progenitor cells? Aren't they critical to the growth of terminal hair follicles?

In one study, Dr. Cotsarelis showed that MPB patients had the same amount of hair follicle stem cells present in the scalp; the difference was that these stem cells were not converting into progenitor cells, and therefore no progenitor cells were present.




roger_that is located in MARYLAND and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

johndoe888

07.03.2013, 01:52

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

James Bond,

You are one of the most educational posters on this forum. If I can make one request it would be for you to keep interacting with Dr. Nigam and trading info. Being able to exchange information and having Dr. Nigam be able to implement different "tweaks" in his procedure would be more productive than any back and forth "what ifs" any of us posters can debate about.

Thanx in advance:ok:




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RickH

07.03.2013, 03:25

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Following up on Shooter's question, Dr Nigam, if hair doubling takes a single two-hair follicle and (essentially) creates a second two-hair follicle from it, does anything keep you from going back to that same donor follicle sometime in the future (let's say a couple of years) and doubling it again?




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RickH

07.03.2013, 03:49

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Dr Nigam, you wrote,

"7N. The cost for 10000 Grafts with Dr. Nigam’s Hair Doubling technique for 2000 Grafts in one day is USD $5000 and USD $10000 (All Inclusive) for 10000 Grafts."

Your website says the charge for Hair Doubling is U.S $4.18 per graft, which comes to $8360 for 2000 grafts ($4.18 x 2000 = $8360) and $20,900 for 5000 grafts ($4.18 x 5000 = $20,900).

What am I misunderstanding?




RickH is located in [NA] and he is available to meet: NO

Shooter

07.03.2013, 03:55

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Hey JB,

I've been following this forum for quite a long time now, and I trust your opinion and experience.

I'm intrigued by Dr. Nigam's statements, but I also have a lot of reservations.

Could you give a really quick summary about your opinion on Dr. Nigam's research for those of us who aren't able to understand exactly what's going on? Is this something we should be excited about? Do you think there is merit to his claims? Is it a treatment you would consider for yourself? What evidence do you think should we be looking for before we make a determination on the efficacy of this approach? Etc.

Thanks for all your input to this forum,

Shooter




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Faker

07.03.2013, 04:35

@ RickH

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

His website looks surprisingly similar to that crook Dr. Bazan's website that was offering hair multiplication. I sure hope we dont have the same results here.




Faker is located in [NA] and he is available to meet: NO

drnigam

07.03.2013, 07:42

@ RickH

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

RickH,
When the number of grafts required are less i.e 2000 ,we calculate the charges on total bisected grafts which means 1000 grafts doubled to 2000 grafts (4.18x2000=8360 US$).
5000 US$ is the reduced price for forum members from outside mumbai to coverup their traveling and staying expenses to make our price competitive.
When the number of grafts are more i.e 5000 grafts doubled to 10000 grafts ,the charges are further reduced to 10000 US$ instead of 5000x4.18=20,900.For higher number of grafts we charge only for increased grafts i.e 5000 grafts and not for 10000grafts.
Service tax 12.32% plus activated progenitor stemcell injection per day cost of 500US$ is extra.
Above charges include in vitro bisection of grafts,implantation,activated progenitor stemcells,DPcell injection(notdp culture).
ECM plus PRP for faster healing is also included in the package.
You can get implanted all the bisected grafts into the recipient or 50% at the donor for future extraction and the other 50% at the recipient.
If all the grafts are implanted at the recipient,you can get body hair implanted at the donor for density.
There is no white dot of FUE because of stemcell and ecm injection at the donor.Procedure is virtually painless as we have fulltime pain management expert dr.arora with us.


» Dr Nigam, you wrote,
»
» "7N. The cost for 10000 Grafts with Dr. Nigam’s Hair Doubling technique
» for 2000 Grafts in one day is USD $5000 and USD $10000 (All Inclusive) for
» 10000 Grafts."

»
» Your website says the charge for Hair Doubling is U.S $4.18 per graft,
» which comes to $8360 for 2000 grafts ($4.18 x 2000 = $8360) and $20,900 for
» 5000 grafts ($4.18 x 5000 = $20,900).
»
» What am I misunderstanding?
- poster 'RickH'



drnigam has 1 Personal Journal(s). Click here to view
drnigam is located in [NA] and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

drnigam

07.03.2013, 09:13

@ roger_that

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» what's your opinion of the role of progenitor cells? Aren't they
» critical to the growth of terminal hair follicles?
»
» In one study, Dr. Cotsarelis showed that MPB patients had the same amount
» of hair follicle stem cells present in the scalp; the difference was that
» these stem cells were not converting into progenitor cells, and therefore
» no progenitor cells were present.
Roger,
As you are aware, adult stem cells are already inherently present in a hair follicle,
although as suggested by Dr.Cotsarelis and others that these stem cells are inactive specially in follicles of thinning and bald scalp of MPB. Even in fibrosed vellus follicles of the bald scalp, these inactive stem cells are still present.
They are separated in the lab in totally aseptic conditions. In the lab these stemcells are isolated or sorted out from the surrounding tissue including the other cells of hair follicles.
The moment they are sorted out with or without addition of growth factors or DMEM etc, they are now called activated or pro-genitor stem cells.
Only thing is that to activate inactive stem cells in dormant vellus follicles, you need progenitor stem cells dosage in millions which happens in around six weeks of culture as explained by James Bond, only then these dormant follicles can probably be activated, especially since we inject these activated and multiplied pro-genitor stem cells with magnification loop directly into the dormant vellus hair or thinning hair at the dermis sub-cutaneous fat junction of the skin so that the cells are close to the dermal papilla for easier induction.
Similarly, isolated dermal papilla cells on day zero and potent dermal papilla cultured cells after 2 passages after 6 weeks are injected into the epidermis - dermis junction where they have access to the epithelial stem cells induction.
A question to James Bond. As per myself, Dr. Costarelis study and statement of any biotech existing on planet earth, we state that Dr.Gho's statement that he takes out stem cells from the donor with his partial longitudinal extraction of follicular unit by triple wave needle or punch and implants it into the recipient scalp with the bisected follicular unit is false and misleading.
How can one extract pro-genitor stem cells or even inactive stem-cells by a needle in-vivo from the donor scalp and transfer it to recipient scalp.
As you are aware and must have understood by now that we need FBS or serum free media and DMEM etc in totally aseptic conditions in a biotech lab with magnetic beading filtering system etc.to isolate adult stem cells, not just merely by a needle as claimed by dr gho.
Although dear James Bond, you have mentioned that the principal of Dr.Gho may be, the injury to the follicular unit creates the scenario of wound healing, hence may be, the stem-cell gest activated to pro-genitor cells.
In that case, transected FUE or FUT are also injured follicular units, hence they would also create wound healing scenario and hence they should also be called Stem Cell Hair Transplant and should be able to give rise to 1:3 or more follicles but unfortunately, it is is not seen in practice.
Hence, as per Dr.Costarelis study, myself and biotechs, Dr.Gho's claim is unscientific, totally untrue and misleading. His technique can only perform 1:2 bisection donor doubling with maybe 60% success as proved by other studies of Jahoda etc 10 yrs. back.
Some members are excited that dr gho has some secret in his preservation medium tosoak the grafts.
Dr.Gho, in his own published paper have only mentioned nutritional and ph factors are used in his preservation medium which can only help survival of graft and little bit boosting in quality
of grafts but nowhere multiplying.
In our preservation medium, we use growth factors in any transplantation technique plus antibiotics plus nutritional factor plus ph factors plus extracellular matrix plus PRP.
I am amazed how learned members in the forum missing the most important point mentioned on my post regarding Dr.Gho's technique. Dr.Gho's technique is wrongly proclaimed as donor doubling with utilisation of stem cells and hair multiplication 1:3 or more.
As per the question of publishing the paper, 99% hair-growth products are fake in the hair restoration market worldwide and we all know about it. Many of these fake products have published their scientific papers even in American dermatology and American Hair Restoration Journals claiming hair-regrowth results.
Had the publishing of papers, the final world for efficacy of a product or process, then we would have found the cure of baldness by now. In no way, I am undermining the importance of published scientific papers but one should also keep in mind, published scientific paper is not the final stamp on efficacy.

Regards,
Dr.Nigam



drnigam has 1 Personal Journal(s). Click here to view
drnigam is located in [NA] and he is available to meet: YES
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James Bond

07.03.2013, 09:18

@ roger_that

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» James, what's your opinion of the role of progenitor cells? Aren't they
» critical to the growth of terminal hair follicles?
»
» In one study, Dr. Cotsarelis showed that MPB patients had the same amount
» of hair follicle stem cells present in the scalp; the difference was that
» these stem cells were not converting into progenitor cells, and therefore
» no progenitor cells were present.

I'm not familiar with the study. I would have to read it in order to be able to provide any useful comments about it. Without reading the context of the term progenitor, I'll assume he means the daughter cells born from bulge stem cells.

As far as progenitor cells needing to be naturally present in order to grow terminal hair follicles, it can be misleading. Stem cells typically hang around doing very little until the body provides signals to perform repair work. When signaled to do so, stem cells release transit-amplifying cells, which further differentiate into the type of cells the body needs to perform repair.

In the case of MPB, the signals are absent that tell the bulge (keratinocyte) stem cells to make progenitor cells (TA cells, which further differentiate) that travel down and remodel the shrunken lower end bulb and grow thick hair. The MPB scalp has a normal amount of stem cells present and an abnormally low level of progenitor cells. It's the progenitor cells that do the actual remodeling work. Since the bulge stem cells' role is to manufacture the progenitor cells, this equates to a scalp environment with everything necessary to grow thick hair except for the signals that tell the machinery to do the work. So I don't really think of MPB as a lack of progenitor cells. I think of it as a breakdown in the signaling pathway.

The beauty of wounding is, it triggers the entire process to work, including manufacturing the progenitor cells and telling them where to go, where to remain, and what to do. By contrast, simply injecting stem cells into the scalp can be inefficient, because the follicles that need the progenitor cells are not emitting the necessary signals to get them to come over, hang out, and do the work. So an attempt is made to load the injection with growth factors and cytokines that make up for this. But the problem is, these signals are free-floating in the blood instead of emanating from the follicle base.

I think this is where Nigam's method has promise. IMO, he loses a portion of the signaling environment when he removes the base from the scalp. But he gains the ability to perform an exact transection. He can then inject growth factors/cytokines (signals) and additional progenitor cells into the follicle itself. In addition, the follicle emits a wound signal, as does the recipient hole. It's crude, but it holds potential.




James Bond is located in [NA] and he is available to meet: NO

drnigam

07.03.2013, 09:36

@ RickH

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

RickH,Cost for smaller number of grafts is different form the cost of larger number of grafts for hair doubling.
For smaller number of grafts ,we calculate the cost of total grafts bisectedand implantedi.e we charge 5000US$ for doubling of 1000 grafts to 2000gtafts.2000x4.18=8630US$.
8630$ is reduced to 5000$ for outside mumbai patients to cover up for their travelling and staying expenses at mumbai.This makes us highly competitive in the international market.
For larger number of grafts i.e5000 grafts doubled to 10000 grafts ,we calculate the cost only for increased grafts i.e5000x4.18=20900$.This cost is also reduced to 10000$ for outside mumbai patients to cover up for their travelling and extra stay at mumbai.
Definately charges will be increased in september by50% also for outside mumbai patient as our capacity to handle more patients increase with extra trained staff.
» Dr Nigam, you wrote,
»
» "7N. The cost for 10000 Grafts with Dr. Nigam’s Hair Doubling technique
» for 2000 Grafts in one day is USD $5000 and USD $10000 (All Inclusive) for
» 10000 Grafts."

»
» Your website says the charge for Hair Doubling is U.S $4.18 per graft,
» which comes to $8360 for 2000 grafts ($4.18 x 2000 = $8360) and $20,900 for
» 5000 grafts ($4.18 x 5000 = $20,900).
»
» What am I misunderstanding?
- poster 'RickH'



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James Bond

07.03.2013, 09:50

@ Shooter

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

Hi Shooter:

It's late, so I won't go into a lot of detail at the moment. My above post touches on why Nigam's method has promise. In fact, I suggested a similar method about 10 years ago based on several researchers having performed relevant experiments prior to that time.

It's true that if the follicle is transected perfectly, both portions will grow hair. The problem is, the follicles don't always survive. When they do, the lower portions tend to generate thick hair, and the upper portions tend to generate thin hair. This is why you need to add growth factors, cytokines, and stem cells to have a chance of making it work consistently. Unfortunately, getting the correct mix is more difficult than it appears at the outset.

I don't know Dr. Nigam, and I have no idea how legitimate his attempts are. I only know that his stated method holds promise, and although he appears to be quite knowledgeable, he also appears to me to be in the very early stages of his research.




James Bond is located in [NA] and he is available to meet: NO

James Bond

07.03.2013, 11:03

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» Although dear James Bond, you have mentioned that the principal of
» Dr.Gho may be, the injury to the follicular unit creates the scenario of
» wound healing, hence may be, the stem-cell gest activated to pro-genitor
» cells.
» In that case, transected FUE or FUT are also injured follicular units,
» hence they would also create wound healing scenario and hence they should
» also be called Stem Cell Hair Transplant and should be able to give rise to
» 1:3 or more follicles but unfortunately, it is is not seen in practice.

I disagree with your assertion.

When healthy follicles cycle, the end bulb shrinks up in the skin and can no longer support hair. A signal is then given that tells the stem cells to create daughter cells, which travel down and remodel the bulb, which journeys back down in the skin and supports thick hair again. All hair multiplication procedures are an attempt to mimic, manipulate, and exploit this naturally occurring process.

Simply removing an entire follicle and inserting it elsewhere, such as with FUE has no relationship to follicular morphogenesis. It is the simple exchange of a whole part to grow in a different region in the skin.

By contrast, Gho's HST method is a multiplication procedure. In his method, the stem cells and signaling environment are manipulated and coaxed in a manner to multiply the follicles.

In short, FUE = no manipulation of stem cells; thus, no follicle multiplication occurs. HST = manipulation of stem cells; thus, follicle multiplication occurs.


» Hence, as per Dr.Costarelis study, myself and biotechs, Dr.Gho's
» claim is unscientific, totally untrue and misleading. His technique can
» only perform 1:2 bisection donor doubling with maybe 60% success as proved
» by other studies of Jahoda etc 10 yrs. back.

Gho's transection method is very different than Jahoda's. Your transection technique is very similar to Jahoda's. Yes, you add growth factors etc, but so far, we only have your word to go on and a few unclear pictures of 5-hair transplants that don't prove anything.

» I am amazed how learned members in the forum missing the most important
» point mentioned on my post regarding Dr.Gho's technique. Dr.Gho's technique
» is wrongly proclaimed as donor doubling with utilisation of stem cells and
» hair multiplication 1:3 or more.

No it isn't. If you follow the math provided in the paper, it is proclaimed as less than 1:2. Where did you get this 1:3 figure? It appears to me to be something you are simply making up out of thin air.

» As per the question of publishing the paper, 99% hair-growth products
» are fake in the hair restoration market worldwide and we all know about it.
» Many of these fake products have published their scientific papers even in
» American dermatology and American Hair Restoration Journals claiming
» hair-regrowth results.

Can you link some of these papers so we can verify your claims?

If we all know anything, it's that 100% of Internet websites claiming to have a cure for baldness, with no published research to back up their claims are fake. While not perfect, the best we have to go on is scientific papers. This allows other research groups to independently repeat the methodology and verify the results.

» Had the publishing of papers, the final world for efficacy of a product or
» process, then we would have found the cure of baldness by now. In no way, I
» am undermining the importance of published scientific papers but one should
» also keep in mind, published scientific paper is not the final stamp on
» efficacy.

You seem to be missing the importance of publishing scientific papers in peer reviewed journals. Publishing these papers is the first, but extremely necessary, step toward validation of the procedure. The final stamp on efficacy is achieved when other research teams independently duplicate the research methods and either verify or contradict the results.

In all seriousness in this matter, your Internet website claims are nowhere near as believable or credible as Dr. Gho's research papers featuring well-known and respected co-authors associated with a highly respected research university. I find it downright strange that you are criticizing his credibility given the position you are currently in.




James Bond is located in [NA] and he is available to meet: NO

Noyznarcos

07.03.2013, 11:53

@ drnigam

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» Definately charges will be increased in september by50% also for outside
» mumbai patient as our capacity to handle more patients increase with extra
» trained staff.


I'm sorry doctor, but never any occidental man will be India for a little-known technique for to pay 20,000, $ 30,000

This is money that normal people do not have but if we have them we might as well go from gho, which is closer.




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RickH

08.03.2013, 01:04

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

James, you wrote, "You are referring to Gho’s old FM technique, which is still performed at The Gho Clinic. Gho is no longer associated with this clinic but they still perform the technique. FM attempts to transect transversely at the line of Auber while the follicles are still in the scalp. An independent study performed by an Italian HT group showed 72% of follicles transected in this manner regrew hair in the donor of normal thickness and rate. The regrowth rate would have been higher if it wasn’t for the 'blind technique.'”

Does Dr Gho bisect the hair in vitro now? Is that why you are contrasting his current technique with the earlier FM "blind technique"?

The reason I ask is that I have some old Bosley work from the early 90s that is terrible, so "multiplying" those hairs but leaving them in their current location and arrangement is not what I need. I need those grafts removed and replaced properly. If Dr Gho could also double the hair follicles in those grafts, that would be ideal. So, for those particular hairs I need an in vitro approach that works.




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RickH

08.03.2013, 01:29

@ drnigam

The Danger of WANTING This to Be True

I read Dr Nigam's post with great interest and I found it impressive that he has come here and is openly attempting to engage of respected doctors in a dialogue about what he claims to be doing. That didn't strike me as standard behavior for a charlatan. So, I'll admit, my hopes that this is all true rose.

But, then I went to his website and it just doesn't correspond with the impression Dr Nigam gives here.

It isn't just that his photos aren't very good and that almost all of them can be summed up by saying, "That patient's hair is longer", although that is troubling.

It isn't that there aren't many of even those kinds of poor photos, although that is troubling.

It isn't even that there isn't a single bald guy who was turned into a Norwood 2 through Hair Doubling, as Dr Nigam claims he can do...although, that is incredibly troubling because isn't that the FIRST thing you would do if you were a doctor who had really discovered a way to do that?? I would find 5 bald men and give them their hair back and show those pictures on my webpage! Dr Nigam doesn't do that, and that's troubling.

But, for me, the most troubling thing about Dr Nigam's site is that he offers "Bio Medical Hair Fibre." That's right, he will implant fake hair into your scalp. Why would a reputable doctor do that?? Especially a doctor who has discovered a process of "hair doubling" that can turn a NW7 into a NW2 in a couple of weeks?? That isn't just troubling, that is beyond belief.

I want what Dr Nigam claims he can do to be true. But, I titled this post "The Danger of WANTING This to Be True" because I want to warn guys who are so desperate for this to be true (and I share that desperation) that they would leap headlong into a procedure. Dr Nigam has a long, LONG way to go to prove his claimms AND to explain things like his acceptance of the implantation of plastic hair into human scalps.




RickH is located in [NA] and he is available to meet: NO

Faker

08.03.2013, 04:54

@ RickH

The Danger of WANTING This to Be True

BINGO! At this point we will just have to wait and we will know very soon what Dr. Nigam is made of! Either we will see proof and a very well documented case soon, or he will disappear into the woodwork!

Time and time again this forum falls for hopes and dreams because of WANTING to believe. The problem and trend here is basically anybody can come here and make bold statements and this forum will accept it as gospel for a little while.

I remember when the headline on this page about 10 years ago read like this... "BREAKTHROUGH HAIRSWITCH PEPTIDE REACTIVATES ALL YOUR HAIR FOLLICLES!" This wasn't a post it was actually posted on this page as a headline and we all know how that turned out to be! Then we were all waiting for Gho, then Bazan, then Intercytex, then aderans and countless more. It can be disputed that some of these were professional outlets but we still have not seen much from them. Some of them were just flat out liars like Bazan and we put faith behind him like he was legitimate! Anyone remember the "hairdot" guy????

My point is lets not get caught up in this again. Lets wait for good proof and I will be the first on a plane there!




Faker is located in [NA] and he is available to meet: NO

James Bond

08.03.2013, 05:35

@ RickH

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» Does Dr Gho bisect the hair in vitro now? Is that why you are contrasting
» his current technique with the earlier FM "blind technique"?

Rick:

Dr. Gho bisects the follicle vertically and in vivo. I contrasted the FM blind technique just to show that independent researchers found that 72% of the donor follicles regrew thick healthy hair when they attempted to transect the follicles horizontally in the scalp. They felt the regrowth rate would have been higher if the transections weren't blind. Unfortunately, the researchers soaked the grafts in normal saline solution prior to implantation into the recipient site, which will always result in poor results. Due to the poor results in the recipient, they didn't pursue the technique further.

» The reason I ask is that I have some old Bosley work from the early 90s
» that is terrible, so "multiplying" those hairs but leaving them in their
» current location and arrangement is not what I need. I need those grafts
» removed and replaced properly. If Dr Gho could also double the hair
» follicles in those grafts, that would be ideal. So, for those particular
» hairs I need an in vitro approach that works.

As far as I know, a working in vitro approach does not exist. If the grafts are in the hairline, you would be better off going to a hairline expert and getting a 1:1 repair job for these particular grafts. Artistry is everything when it comes to graft placement in the hairline.




James Bond is located in [NA] and he is available to meet: NO

roger_that

MARYLAND,
08.03.2013, 13:03
(edited by roger_that, 08.03.2013, 13:21)

@ James Bond

COMPARING DR.NIGAM's & DR.GHO’s DONOR/HAIR DOUBLING FOR/BY HT DOCTORS & MEMBERS

» Dr. Gho bisects the follicle vertically and in vivo.

Thanks for the info. A while back on this forum, I stated Dr. Gho bisects the follicle vertically and in vivo and people here (even some people who otherwise seemed quite well informed) ridiculed me and said I didn't know what I was talking about.




roger_that is located in MARYLAND and he is available to meet: YES
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roger_that

MARYLAND,
08.03.2013, 13:58

@ RickH

The Danger of WANTING This to Be True

I'm not advocating implanting fake hair fibres in the human scalp, but we shouldn't look at this from a purely US perspective. This procedure is legal in many countries, including, I believe, Russia and Japan, and obviously, from Dr. Nigam's website, India. It's not legal in the US, and I believe that's because the FDA has determined it's prone to causing scalp infections. I would think the rate of infections is much higher in India, but somehow it's legal over there. My point is that many countries have deemed this an acceptable procedure.

It's possible that Dr. Nigam had been selling these fibre implants at his office for a while before he developed his new hair-doubling procedure. Just because he's developed a new procedure which can multiply hairs (assuming he has), doesn't mean he would instantly take these ads off his website. There may be all kinds of reasons why a patient would want this. What about a patient who has little or no donor hair? This might be the only acceptable option for such a patient. Again, I'm definitely not advocating it, I realize the risks involved, and I wouldn't get it done myself.

I don't think that this alone is proof one way or the other whether Dr. Nigam has developed something significant here.




roger_that is located in MARYLAND and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

Aleluia

08.03.2013, 15:06

@ roger_that

The Danger of WANTING This to Be True

Dr. nigam should transform a NW7 patient in NW1, using only this technique, to show everyone that his procedure really works. If he does that he will be very very rich.
BTW... i´ve never believe in Dr. gho




Aleluia is located in [NA] and he is available to meet: NO

moopookoo

08.03.2013, 15:49

@ Aleluia

The Danger of WANTING This to Be True

Dr Gho has been offering HST since 2005, 8 years, and we havent seen single nw6-nw2 transformation,

Dr Nigams been doing hair doubling for the last 5 months, he hasnt provided nothing of substance, only talk and rhetoric


IMO and that is the opinion of most HT surgeons is that Dr Gho splits follicles, he perfected it, his FUE looks clean and pristinie but he does not create new hair follicles, it is just clever and misleadin marketing..it is still a good technique since theres no scarring but you get low density since most of growing grafts are single hairs

His HST training with fully equiped studio cost only 60 000 dollars,
I think Dr Nigam should send one of his doctors to do HST training and open clinic in India at low price, it only taked 9 months to complete




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