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Graft integrity out of the body, how long is too long?


#1

I’m intersted in hearing some thoughts on how long the grafts can stay out of the body??? There are some doctors that are performing all the work themselves. With FUE this is a very time intensive procedure. Sometimes if they start in the morning it can be late afternoon until the grafts are place back in the scalp. Other clinics have technicians that trim the removed grafts and others that place them back in the scalp as soon as they are ready (greatly reducing the time the graft stays out of the body away from a blood supply). I like the thought of a doctor doing all of the work, but could it be detrimental to the success of the procedure? It seems to me that the most critical part of the procedure is possibly the handling of the donor grafts and the speed at which they get replaced back into the recipient area. Any thoughts are appreciated. I have my own suspicions but I would like to hear from the knowledgable ones on this board. This is a great site and a wonderful exchange of knowledge.


#2

» I’m intersted in hearing some thoughts on how long the grafts can stay out
» of the body??? There are some doctors that are performing all the
» work themselves. With FUE this is a very time intensive procedure.
» Sometimes if they start in the morning it can be late afternoon until the
» grafts are place back in the scalp. Other clinics have technicians that
» trim the removed grafts and others that place them back in the scalp as
» soon as they are ready (greatly reducing the time the graft stays out of
» the body away from a blood supply). I like the thought of a doctor doing
» all of the work, but could it be detrimental to the success of the
» procedure? It seems to me that the most critical part of the procedure is
» possibly the handling of the donor grafts and the speed at which they get
» replaced back into the recipient area. Any thoughts are appreciated. I
» have my own suspicions but I would like to hear from the knowledgable ones
» on this board. This is a great site and a wonderful exchange of knowledge.

I remember a study that says it can stay as long as 4-6 hours out of the body.


#3

» I’m intersted in hearing some thoughts on how long the grafts can stay out
» of the body??? There are some doctors that are performing all the
» work themselves. With FUE this is a very time intensive procedure.
» Sometimes if they start in the morning it can be late afternoon until the
» grafts are place back in the scalp. Other clinics have technicians that
» trim the removed grafts and others that place them back in the scalp as
» soon as they are ready (greatly reducing the time the graft stays out of
» the body away from a blood supply). I like the thought of a doctor doing
» all of the work, but could it be detrimental to the success of the
» procedure? It seems to me that the most critical part of the procedure is
» possibly the handling of the donor grafts and the speed at which they get
» replaced back into the recipient area. Any thoughts are appreciated. I
» have my own suspicions but I would like to hear from the knowledgable ones
» on this board. This is a great site and a wonderful exchange of knowledge.

Dear Rooster,
My apologies for the delay in reply to your email.

I will answer the question here as this is an often asked one.

By itself, comparing a doctor doing all the work or a well trained technical team helping the doctor is a non issue.

There are many doctors who do all the work by themselves and still do a bad job of it.
There are also well trained technician teams who are very good at their work. They help their doctor or clinic get good results.

Hair transplant, more so follicular unit extraction and BHT, are equally about -

  1. Proper training (many untrained doctors doing all the work wreck havoc on unsuspecting patients),
  2. Physical skill (more than any other surgery, the laborious modern day HT requires specific hand eye coordination and skill that many need to be born with).

Patients seeking HT should look for results and consistency from the doctor/clinic first and foremost.

There are studies that claim that follicular unit grafts can stay out of the body for longer periods, but its my personal belief that keeping the grafts out for a longer duration is, at best, of no added benefit to the patient.
Its best to place them in as soon as possible.

Regards,
Dr. A

P.S. - Another thing to keep in mind is that its better to have relaxed well trained technicians placing the grafts securely, than an exhausted doctor who may have finished working long hours yesterday as well as today.
Fatigue has a predisposition for increasing mistakes.


#4

“Patients seeking HT should look for results and consistency from the doctor/clinic first and foremost” I agree with this statement 100%. As far as time out of body? I had long surgery days and it had no effect at all on my overall yield. But before I went for my surgery I contacted many ex-patients to talk and see the results myself. Please take your time and research all. Good luck.


#5

Therapy,
I have doubts on those 4-6 hours, what about sessions from top docs that start early morning and end at night… I dont need to name some of these docs. I think that the grafts after been removed they are kept in some sort of saline solution so to guarantee that they can withstand 5-8 hours after removal… Perhaps hairtech might have more details.

» » I’m intersted in hearing some thoughts on how long the grafts can stay
» out
» » of the body??? There are some doctors that are performing all
» the
» » work themselves. With FUE this is a very time intensive procedure.
» » Sometimes if they start in the morning it can be late afternoon until
» the
» » grafts are place back in the scalp. Other clinics have technicians that
» » trim the removed grafts and others that place them back in the scalp as
» » soon as they are ready (greatly reducing the time the graft stays out
» of
» » the body away from a blood supply). I like the thought of a doctor
» doing
» » all of the work, but could it be detrimental to the success of the
» » procedure? It seems to me that the most critical part of the procedure
» is
» » possibly the handling of the donor grafts and the speed at which they
» get
» » replaced back into the recipient area. Any thoughts are appreciated. I
» » have my own suspicions but I would like to hear from the knowledgable
» ones
» » on this board. This is a great site and a wonderful exchange of
» knowledge.
»
» I remember a study that says it can stay as long as 4-6 hours out of the
» body.


#6

» “Patients seeking HT should look for results and consistency from the
» doctor/clinic first and foremost” I agree with this statement 100%. As far
» as time out of body? I had long surgery days and it had no effect at all on
» my overall yield. But before I went for my surgery I contacted many
» ex-patients to talk and see the results myself. Please take your time and
» research all. Good luck.

I have wondered about this question myself. I would say that it would have to be atleast 8 hours. I have heard of some surgeries going to 11-12 at night.


#7

» » “Patients seeking HT should look for results and consistency from the
» » doctor/clinic first and foremost” I agree with this statement 100%. As
» far
» » as time out of body? I had long surgery days and it had no effect at all
» on
» » my overall yield. But before I went for my surgery I contacted many
» » ex-patients to talk and see the results myself. Please take your time
» and
» » research all. Good luck.
»
» I have wondered about this question myself. I would say that it would have
» to be atleast 8 hours. I have heard of some surgeries going to 11-12 at
» night.

JohnnyE you are correct some surgeries last until the wee hours of the morning and the grafts have been out of the body for over 10 hours. I know at Dr. Cole’s office he keeps the storage medium a constant temperature and changes the medium every hour. This is very smart in my opinion. Graft storage after extraction to me seems extremely important.


#8

As Dr. A points out there are many factors that can affect the survival of a graft. There has been considerable debate regarding storage time and chilling grafts over the years and it has been studied. Bobby Limmer did a study in the early 90s where he left grafts out of the body for up to 48 hours. He did chill the grafts in Normal Saline. He found that the survival rate diminished as a function of time. This was a single patient study and was not scientifically significant. Most studies have looked at survivals up to 5 to 6 hours. Dr. Kim’s work suggested that it is not necessary to chill grafts at all as long as you place them within 5 hours. After 5 hours, the survival rate decreased if the grafts were not chilled. Again, this study was not scientifically significant.

The problem with all these studies is they have not looked at dense packing thousands of grafts and we do not know if there efforts in general produced the optimal yield. The goal must remain to achieve the optimal yield.

More recent studies have looked at storage mediums and temperature. Some storage mediums can actually be quite harmful to tissue and cause cell bursting if the tissue is chilled in them. For instance, the two most common mediums (ringer’s lactate and normal saline) can actually cause cell bursting due to an uptake of fluid into the cell if the cells are chilled. This has led to the production and study of storage mediums designed specifically for cold storage.

I think the question really is not so much about whether time out of body is an important component in cell survival. The better question is how we can improve cell survival. How can we improve yields? The alternative question is what factors have the potential to reduce yields.

We all know that removal of cells from the body deprives them of oxygen, which is an essential component in the production of cellular energy. Cells do not cease to metabolize when removed from the body. They continue to utilize energy for metabolism. Without oxygen cells must now begin to produce energy aerobically. This leads to the production of free radicals, superoxide, hydrogen peroxide, and eventually a hydroxyl free radical, the most reactive of all. The latter can be quite harmful to normal tissue and will oxidize any organic molecule almost instantaneously. In fact, an interruption of blood flow temporarily to the brain is not as harmful and may not cause injury, but after reperfusion such tissues show marked and occasionally severe damage that is thought due to the free radicals that gorge the brain when oxygenated blood flow is restored. This is called ischemia reperfusion injury or IRI. Of course free radicals are not the only proposed mechanisms of IRI, but they remain under intensive investigation. Other possible mechanisms besides cell derived free radicals include actions and products of inflammatory cells in the blood ( especially neutrophils and platelets), effects of intracellular calcium accumulation (calcium paradox), and loss of membrane phospholipids. Small quantities of free oxygen radicals produced during a cell’s normal metabolism are detoxified by the enzyme superoxide dismutase. This protective enzyme occurs in all aerobic tissue but is found in substantial quantities only inside the cell. Oxygen derived free radicals are also detoxified by the naturally occurring enzymes catalase and peroxidase. During ischemia the production of hypoxanthine is greatly increased as a result of the catabolism of ATP. In the absence of oxygen, the enzyme xanthine dehydrogenase is converted to xanthine oxidase, which converts hypoxanthine to xanthine and this reaction also involves calcium (the end component in cell death). During reperfusion when the ischemic tissue is again exposed to oxygen, xanthine oxidase catalyzes the generation of superoxide radicals. Some tissues such as the heart have defense mechanisms against superoxide-mediated ischemic injury in the form of scavenging enzymes These may be antioxidants such as glutathione peroxidase and catalase or chain breaking antioxidants such as super oxide dismutase, ascorbate (vit C), alpha tocopherol (from vitamin E). The emerging role of oxygen derived free radicals in ischemia injury has raised the question as to whether or not injury ascribed to ischemia is in fact reperfusion injury that is initiated by ischemia, but precipitated by reperfusion. The end result o prolonged ischemia is cell death. The culmination of the cascade of interactive ischemic events is a tissue that is unable to resume its normal function upon restoration of its blood supply. The sequence of processes advances at such a rate that irreversible damage is sustained by most organs within one hour of ischemia at 37 degrees Celsius and much shorter times in highly metabolic tissues such as cardiac muscle. Therefore, one should consider the role of low temperatures in protecting against ischemic injury and providing a means for preserving tissues.

The optimal temperature will depend on a number of factors involving the interaction of the hypothermia, the nature the cell, and the chemical composition of its environment, as well as the strategy adopted to effect maximum protection.

In mammalian systems there is an approximate 50% decrease in oxygen consumption for each 10 degrees Celsius reduction in temperature. Oxygen consumption of a cell at 5 degrees Celsius is approximately 6% when compared to 37 degrees Celsius or 98.6 Fahrenheit. Kidneys can tolerate only 45 minutes of warm ischemia before incurring irreversible injury. Tolerance can be extended to 2 hours at 15 to 25 degrees Celsius and 6 to 7 hours at 5 to 15 degrees Celsius. Ischemic tolerance of organs is not only a function of temperature reduction, but is also maximized by manipulation of the extracelluar environment of the component cells in terms of the chemical composition of the perfusate. The optimal temperature for tissue storage will depend on the nature of the cell. For instance, cardiac muscle preservation is felt to best achieved at a range of 10 to 20 degrees Celsius. For Kidneys 5 degrees Celsius has been shown to be better than 0.5 degrees Celsius and 10 degrees better than 5 degrees. Then again, the storage medium itself may affect the optimal storage temperature.

As you can see, the subject is quite complex and not without multiple factors. We know cells do not like fluctuation in temperature. Therefore, we attempt to maintain a constant temperature. We use a very expensive storage medium that is specifically designed for cold storage. One liter has a cost of 220.00 compared to about 2.00 for Normal saline. Normal Saline should not be used when chilling tissue, however as it can cause cell bursting. Also, if you are going to expose tissue to prolonged storage, you should chill it to reduce oxygen consumption. We know that cold storage is better than warm storage based on multiple studies of tissue other than hair grafts. What we are not currently sure of is the optimal temperature and the optimal medium.

Today we graft thousands of follicular unit to the scalp. It is my belief that these vast quantities can overwhelm the bodies own natural anti-oxidants if the density is to high or the quantity of grafts too great. We have all seen cases that do not meet the lofty expectations we had for them. Might it be that we simply overwhelmed the bodies’ defense mechanisms to IRI. Body hair may be even more sensitive to the affects of IRI and this may be the reason high densities of body hair simply do not produce an acceptable yield in a high percentage of patients. With other individuals, high densities and high graft counts with scalp hair may affect the resulting yield. Since we cannot predict the outcome in high density grafting for all individuals, I think that we must remain cautious in our attempts to place grafts at a high density and we simply must exercise caution any time we consider grafting more than 5000 grafts in a single procedure. We also must remember that warm storage is going to increase the production of free radicals and reduce the survival time. I think it is highly important that we continue to explore this very complex subject and attempt to derive an optimal medium and temperature in order to insure the highest yield. Higher densities and higher graft counts may produce a more optimal yield with hypothermic storage in the proper medium. Hair is not a self replicating structure. It is of finite supply. Prolonged storage greater than 6 to 7 hours cannot have a positive affect on yield. It could be that 5 hours is too much. One should be cautious until more scientific data is available.


#9

» I’m intersted in hearing some thoughts on how long the grafts can stay out
» of the body??? There are some doctors that are performing all the
» work themselves. With FUE this is a very time intensive procedure.
» Sometimes if they start in the morning it can be late afternoon until the
» grafts are place back in the scalp. Other clinics have technicians that
» trim the removed grafts and others that place them back in the scalp as
» soon as they are ready (greatly reducing the time the graft stays out of
» the body away from a blood supply). I like the thought of a doctor doing
» all of the work, but could it be detrimental to the success of the
» procedure? It seems to me that the most critical part of the procedure is
» possibly the handling of the donor grafts and the speed at which they get
» replaced back into the recipient area. Any thoughts are appreciated. I
» have my own suspicions but I would like to hear from the knowledgable ones
» on this board. This is a great site and a wonderful exchange of knowledge.

Raposio found that saline solution is not the best graft soaking solution but that it is adequate. He also showed that keratinocyte cell culturing solution enhanced the survival of the grafts. The following study shows that the donor site can be harvested and then regrow the harvested grafts.

http://www.tmsacnakli.com/download/Result_2004_Follicular_Unit_Multiplikation.doc

The author’s cite two problems with reusing donor grafts.

  1. The upper follicles have low survivability and often result in thin hairs.

  2. The lower follicles are difficult to re-extract for reuse as the surrounding tissue loses integrity when the upper 2/3 graft is removed.

To address 1) Gho found that using a keratinocyte cell culturing solution as a soaking medium similar to that of Raposio, the upper 2/3 grafts regenerate with HT quality and consistency.

To address 2) Kim found that it takes a year or more before the transected follicle fully repairs itself; thus, one should not attempt to re-use it before that time has expired.

Right now, we are very close to discovering a solution that could help most men get their hair back. This solution is quite superior to BHT + FUE. Unfortunately, most HT docs do not have the necessary experience in cell science to pursue this area of research. I recall Cole stating a few years ago that he would like to work with Gho toward creating a better hair treatment. It is unfortunate that this never gelled because I think mixing Cole’s placement expertise with Gho’s scientific expertise would rapidly lead to a hairloss treatment that would cosmetically cure most patients and revolutionize the hairloss world.

Many would argue that it is a waste of time to develop the above technique because HM will be here soon. In truth, there are no guarantees in this game. Gho stated for years that leaving the lower third in the skin would result in regrowth of the donor. People argued and pissed around with that statement for the better part of 5 years before an unbiased clinic finally proved the statement to be true. How many more years will be wasted before hair restoration specialists finally begin to pursue this promising area of research? I can only cross my fingers and wonder.


#10

th» » I’m intersted in hearing some thoughts on how long the grafts can stay
» out
» » of the body??? There are some doctors that are performing all
» the
» » work themselves. With FUE this is a very time intensive procedure.
» » Sometimes if they start in the morning it can be late afternoon until
» the
» » grafts are place back in the scalp. Other clinics have technicians that
» » trim the removed grafts and others that place them back in the scalp as
» » soon as they are ready (greatly reducing the time the graft stays out
» of
» » the body away from a blood supply). I like the thought of a doctor
» doing
» » all of the work, but could it be detrimental to the success of the
» » procedure? It seems to me that the most critical part of the procedure
» is
» » possibly the handling of the donor grafts and the speed at which they
» get
» » replaced back into the recipient area. Any thoughts are appreciated. I
» » have my own suspicions but I would like to hear from the knowledgable
» ones
» » on this board. This is a great site and a wonderful exchange of
» knowledge.
»
» Raposio found that saline solution is not the best graft soaking solution
» but that it is adequate. He also showed that keratinocyte cell culturing
» solution enhanced the survival of the grafts. The following study shows
» that the donor site can be harvested and then regrow the harvested grafts.
»
»
» http://www.tmsacnakli.com/download/Result_2004_Follicular_Unit_Multiplikation.doc
»
» The author’s cite two problems with reusing donor grafts.
»
» 1) The upper follicles have low survivability and often result in thin
» hairs.
»
» 2) The lower follicles are difficult to re-extract for reuse as the
» surrounding tissue loses integrity when the upper 2/3 graft is removed.
»
» To address 1) Gho found that using a keratinocyte cell culturing solution
» as a soaking medium similar to that of Raposio, the upper 2/3 grafts
» regenerate with HT quality and consistency.
»
» To address 2) Kim found that it takes a year or more before the transected
» follicle fully repairs itself; thus, one should not attempt to re-use it
» before that time has expired.
»
» Right now, we are very close to discovering a solution that could help
» most men get their hair back. This solution is quite superior to BHT +
» FUE. Unfortunately, most HT docs do not have the necessary experience in
» cell science to pursue this area of research. I recall Cole stating a few
» years ago that he would like to work with Gho toward creating a better
» hair treatment. It is unfortunate that this never gelled because I think
» mixing Cole’s placement expertise with Gho’s scientific expertise would
» rapidly lead to a hairloss treatment that would cosmetically cure most
» patients and revolutionize the hairloss world.
»
» Many would argue that it is a waste of time to develop the above technique
» because HM will be here soon. In truth, there are no guarantees in this
» game. Gho stated for years that leaving the lower third in the skin would
» result in regrowth of the donor. People argued and pissed around with that
» statement for the better part of 5 years before an unbiased clinic finally
» proved the statement to be true. How many more years will be wasted before
» hair restoration specialists finally begin to pursue this promising area of
» research? I can only cross my fingers and wonder.

Amazing stuff. Keep me posted on the progres.


#11

» Amazing stuff. Keep me posted on the progres.

Okay, but after seeing your results currently being featured by hairsite, I might have to stop by your clinic for an FUE first. Keep up the good work. You really did a fantastic job on that patient. :slight_smile:


#12

Hi Dr. Cole:

Please excuse my laziness if this information appears elsewhere but my curiosity is peaked. As I alluded to in the above post, I am quite impressed with the work you did in the featured video of the front page. That is certainly one of the most if not the most natural results I have seen.

How many grafts did you place in the hairline and at what density did you place them?

How many grafts and at what density were require in the crown?

Did you place the grafts thicker at the very edge of the hairline than you did immediately behind it?

And finally, what is the realistic chance of a random patient with a similar degree of loss achieving a similar result in your clinic. IOW, same loss, different hair texture, strand thickness, etc.?

Thanks for your time and expertise,

jb


#13

I’m glad to hear that you do not use saline solution to soak the grafts. But with your desire to achieve the highest quality HT that you can, it doesn’t surprise me that you ditched the saline and turned to a more expensive medium. Truthfully, one of the big reasons that doctors who have attempted to transplant upper 2/3rds transected follicles have failed is because they used saline solution to soak the grafts before implanting them. That is a big no-no because the saline solution promotes early cell death in the amputated grafts.

I found the following study of interest.

" BACKGROUND: When performing hair transplantation procedures, it is of the foremost importance to try to obtain the maximum survival rate possible of transplanted micrografts. OBJECTIVE: Aim of this study was to evaluate, in an in vitro model, the effects of preserving micrografts, for five hours, in an enriched storage medium in order to enhance the survival rate of hair micrografts. METHODS: A total of 200 human anagen hair follicles was obtained from ten male patients. Follicles were thus randomly assigned to one of the following group: Group A (control; n = 100 follicles), preserved for five hours in saline, and Group B (experimental; n = 100 follicles), preserved for five hours in a storage medium, containing adenosine triphosphate-magnesium chloride and deferoxamine mesylate. Isolated hair follicles from both Groups were then cultured for 10 days. RESULTS: A statistically significant difference was found between the survival rate of experimental (98%) and control follicles (87%). CONCLUSION: In our opinion, a “metabolic preconditioning” of micrografts by means of storing them for 5 hours in the described medium may be of some utility in augmenting the survival rate of hair grafts when performing hair transplantation surgery."


#14

This provides a better breakdown of the supercharged medium vs. saline solution.

http://www.plasticsurgery.org/public/e-posters06/htmswf/100806_Poster_10657_Ottaviano_Vincenzo_v1.swf

Of interest, the study also shows that graft survival can be improved upon by soaking in specific mediums. IOW, you can supercharge the grafts so that they have a better chance of survival than immediately implanting them upon excision from the skin. Thus, the breakdown in saline solution isn’t the only thing that should be considered. Even direct implantation is not the optimum methodology.

Of further interest, the study provides yet another example of the problem with 2 for 1 HT’s not being with regrowing the donor (as many people suppose) but with figuring out how to supercharge the upper 2/3 grafts so that they perform as well as a non-transected grafts. It makes sense that a non-supercharged upper 2/3rds follicle won’t grow very well without supercharging it because it no longer possesses the hair growth factory. So the trick is to stimulate the graft to repair itself and grow a new end bulb. While that might seem tricky, in truth, Oliver was accomplishing this (in somewhat archaic fashion) as far back as the 1960’s. So the science here is not as far out as it might at first appear. That being said, it isn’t exactly straight forward either.

One way to supercharge an amputated graft is to pack it’s end with specific types of follicular cells that possess embryonic/clonogenic properties. Another way is to soak the grafts in keratinocyte growth factors etc.


#15

Thank you Dr. Cole. It was very informative.


#16

JB, why are you thinking of getting a HT now? You know something about Intercytex not being able to deliver HM? is that why ?


#17

» JB, why are you thinking of getting a HT now? You know something about
» Intercytex not being able to deliver HM? is that why ?

Well, actually I am paying respect to Dr. Cole for all of his hard work and accomplishments. I highly doubt I would go for HT this year and was kind of punning about stopping by his office. I don’t have the money, I’m skiddish about the procedure, etc.

But, since I am a low NW level with stabilized hairloss, 2500 grafts would probably cure me until HM arrives (if all else fails I could get HST later, which is a good donor stingy filler procedure). The truth is, the technology already exists to cure me. I’m bald by choice. For how much longer, I can’t say.

I am curious about the questions I asked Dr. Cole. I don’t see many comments about his patient, but to me, the work is outstanding. I see his affiliate also has done some work recently that looks terrific. I don’t pay much attention to HT. Is FUE starting to mature as a technology? The hairlines look better than I’ve seen in the fairly recent past.


#18

» th» » I’m intersted in hearing some thoughts on how long the grafts can
» stay
» » out
» » » of the body??? There are some doctors that are performing all
» » the
» » » work themselves. With FUE this is a very time intensive procedure.
» » » Sometimes if they start in the morning it can be late afternoon until
» » the
» » » grafts are place back in the scalp. Other clinics have technicians
» that
» » » trim the removed grafts and others that place them back in the scalp
» as
» » » soon as they are ready (greatly reducing the time the graft stays out
» » of
» » » the body away from a blood supply). I like the thought of a doctor
» » doing
» » » all of the work, but could it be detrimental to the success of the
» » » procedure? It seems to me that the most critical part of the
» procedure
» » is
» » » possibly the handling of the donor grafts and the speed at which they
» » get
» » » replaced back into the recipient area. Any thoughts are appreciated.
» I
» » » have my own suspicions but I would like to hear from the knowledgable
» » ones
» » » on this board. This is a great site and a wonderful exchange of
» » knowledge.
» »
» » Raposio found that saline solution is not the best graft soaking
» solution
» » but that it is adequate. He also showed that keratinocyte cell
» culturing
» » solution enhanced the survival of the grafts. The following study shows
» » that the donor site can be harvested and then regrow the harvested
» grafts.
» »
» »
» »
» http://www.tmsacnakli.com/download/Result_2004_Follicular_Unit_Multiplikation.doc
» »
» » The author’s cite two problems with reusing donor grafts.
» »
» » 1) The upper follicles have low survivability and often result in thin
» » hairs.
» »
» » 2) The lower follicles are difficult to re-extract for reuse as the
» » surrounding tissue loses integrity when the upper 2/3 graft is removed.
» »
» » To address 1) Gho found that using a keratinocyte cell culturing
» solution
» » as a soaking medium similar to that of Raposio, the upper 2/3 grafts
» » regenerate with HT quality and consistency.
» »
» » To address 2) Kim found that it takes a year or more before the
» transected
» » follicle fully repairs itself; thus, one should not attempt to re-use
» it
» » before that time has expired.
» »
» » Right now, we are very close to discovering a solution that could help
» » most men get their hair back. This solution is quite superior to BHT +
» » FUE. Unfortunately, most HT docs do not have the necessary experience
» in
» » cell science to pursue this area of research. I recall Cole stating a
» few
» » years ago that he would like to work with Gho toward creating a better
» » hair treatment. It is unfortunate that this never gelled because I
» think
» » mixing Cole’s placement expertise with Gho’s scientific expertise would
» » rapidly lead to a hairloss treatment that would cosmetically cure most
» » patients and revolutionize the hairloss world.
» »
» » Many would argue that it is a waste of time to develop the above
» technique
» » because HM will be here soon. In truth, there are no guarantees in this
» » game. Gho stated for years that leaving the lower third in the skin
» would
» » result in regrowth of the donor. People argued and pissed around with
» that
» » statement for the better part of 5 years before an unbiased clinic
» finally
» » proved the statement to be true. How many more years will be wasted
» before
» » hair restoration specialists finally begin to pursue this promising area
» of
» » research? I can only cross my fingers and wonder.
»
» Amazing stuff. Keep me posted on the progres.

This cat in Italy says cooling not necessary. I don’t subscribe to this AT ALL.
http://www.blackwell-synergy.com/doi/abs/10.1046/j.1524-4725.1999.98287.x


#19

» This cat in Italy says cooling not necessary. I don’t subscribe to this AT
» ALL.
» http://www.blackwell-synergy.com/doi/abs/10.1046/j.1524-4725.1999.98287.x

Raposio and his colleague Santi have performed a lot of research in this field, and their work is cited in numerous hair-related research papers and patents. So the work does carry a certain amount of weight. I found the result of this study interesting as well.

However, this is not to say that cold storage does not make a difference to survival rates in a typical HT. For instance, it could have more of an influence for grafts stored longer than 5 hours and/or there could be differences between in vivo and in vitro growth. Another possibility is that Raposio never soaked the grafts in a medium while cold storing them, so soaking them could influence the outcome of result as the temperature could influence the relationship between the soaking medium and the grafts. Non the less, the outcome here is intriguing and seems to indicate that choice of storage mediums is much more important than the temperature at which the grafts are stored. If you have links to studies with conflicting outcomes, I would appreciate that you post the links.

Here is a link to a more detailed presentation of Raposio’s results.

http://www.plasticsurgery.org/public/e-posters06/htmswf/100806_Poster_10657_Ottaviano_Vincenzo_v1.swf

thanks :slight_smile:


#20

»http://www.plasticsurgery.org/public/e-posters06/htmswf/100806_Poster_10657_Ottaviano_Vincenzo_v1.swf
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Interestingly, this study is another example showing that transected lower third grafts will continue to grow at the same rate as non-transected grafts. In fact, Raposio first demonstrated this phenomenon in a 1997 paper. That’s why I have always been so astounded that the community reacted so strongly to Dr. Gho’s claims throughout the years that donor regrowth would take place if you leave the lower third in the skin. The reason why Gho’s old FM procedure was inconsistent is because it is very difficult to know how deep to make the transection. Gho’s explanation at the time was that if you cut too deeply, you won’t get donor regrowth, but the upper follicle will regenerate. If you cut too shallow, the upper won’t regenerate but the donor will regrow. Getting the technique to work consistently proved to be quite problematic because the follicles grow to varying depths in the skin depending on how long they have been in the anagen state making it quite difficult to know how deep to cut (i.e. human follicles cycle independently from one another).

Thus, I would have been less surprised of criticism of Gho’s technique that the upper 2/3rd follicles would not grow properly because this would have fit the existing research better. But that level of criticism was seldom the case as the recipient grafts always appeared to grow well. Although they tend to sprout surplus hairs on many occasions.