Aragorn

Anche il Dr. Hasson passa alla FUE. Non c'è ormai dubbio che questo è il futuro! ____________________________________________ Thanks to those who have showed interest and to WWH who has encouraged me to perform FUE. We will be performing FUE as from May 1, 2003. We will only be performing small sessions (initially at least) limited to a few hundred grafts. The reasons for this are multiple, but most importantly I want to be sure of the final results and effect on the donor area. For those of you who are looking for large FUE sessions in the near future, I would recommend you to contact Dr. Jones and Dr. Cole – both excellent surgeons. I would like to take this opportunity to give my two cents worth with regard to FUE: The principle of FU grafting is based on the fact that the FU is the most compact type of graft – i.e.: It contains more follicles per unit area and is smaller in size than other grafts. This fact on its own does not make the graft inherently better aesthetically than any other type of graft. In fact, to the contrary – follicular unit grafts may appear pluggy – if too widely spaced. In addition the natural groupings of follicles in FU’s are only of real value if the grafts are placed in coronal slits. Regardless of the type of recipient sites used the FU’s must be relatively tightly packed in order to appear natural. This is the key factor! We must either use large number of grafts, or, if using fewer grafts, confine our transplants to a relatively small area. This is the reason that I perform mega-sessions. Using large numbers of FU’s I am able to both cover large areas and achieve a high degree of naturalness (through dense packing). The conventional strip method is currently the only technology which can achieve this end point – and usually in one surgery. The downside here is the inherent “invasiveness” of the strip excision and the possibility of scarring. The effect on the donor area of removing thousands of FU’s via FUE is largely unknown. There is virtually no change in scarring of multiple strip excisions if carefully planned and performed. With FUE the removal of each individual FU will result in increased scarring and I sincerely doubt that anyone will be able to have 9 – 13,000 FU’s removed via FUE as suggested by Dr. Cole. Mathematically the excision of 10,000 FU’s by FUE would result in approximately 31 linear meters of scarring versus 30cm via strip excision. This is 100X more scarring via FUE. Is this a method of diminishing returns? I will let time be the judge. In the meantime I will not be taking such risks with my patients. In the end it is the choice of the patient. Going with a surgeon with a good record using strip excision or rolling the FUE dice. (Un)fortunately I don’t gamble. Victor Hasson MD

Questo è il testo che invierei: ________________________________________ Hello Dr. Cole, I’m Shon and I have booked an appointment for a consultation the 29th of May in Athens. I’m a member of the discussion forum here in Italy (www.salusmaster.com) that has more than two thousand of subscriptions. We appreciate your passion, your honesty and integrity. Your revolutionary FIT technique and your fantastic results have created great expectations compared with the poor results that we have seen here in Italy in the last years. I’m hair transplant virgin and I’m seriously considering your FIT technique as a solution. I have many questions for you, but I would anticipate one before our meeting. I’ve seen one of your messages in the Hairsite Forum where you believe that the equipment for the transplants is far better in Atlanta than what you have in Greece. Can I have the confirmation that you have all the necessary equipment and the right assistant to guarantee the same transplant in Greece than in the USA? Thanks in advance for your response. See you soon in Athens. Best regards Shon ___________________________________________ Se vuoi sostituisci il tuo vero nome al nickname e inviala a: john@forhair.com Calcola che il doc è spesso in viaggio e quindi potrebbe non risponderti subito. Ciao

afiumi@dhi.gr

Cole sta testando anche la tecnica di Gho per constatare la ricrescita di due capelli da uno. Per chi non lo sapesse Gho sostiene che con la sua tecnica si ottiene una moderata ricrescita nei siti donatori. Le foto al link: http://www.hairsite4.com/dcforum/DCForumID6/462.html Questo è un'altro argomento che gli inviati potranno discutere con Cole in DHI. Finalmente qualcosa si muove anche in area trapianti !!!

Anche la mia mail è stata inviata cinque minuti fa a: afiumi@dhi.gr Shon fammi la cortesia di chiedere a Cole cosa pensa dell'utilizzo dei body hair. In bocca al lupo !!!!

Sono sulla tua stessa linea e mi auguro che si possa restare qui, altrimenti andremo a frequentare qualche altro sito tutti insieme. Ci sono molti aspetti di questo forum che mi piacciono, soprattutto le persone che lo frequentano e la loro competenza, ma non vorrei che la nuova anima commerciale di salusmaster.com portasse ad escludere contenuti di scarso interesse commerciale o aperture a medici e tecniche non sponsorizzate dal sito stesso. Io direi di restare qui, anche se temo che a stretto giro questo forum verrà chiuso. Comunque lasciamo in vista questo post per comunicare gli eventuali spostamenti. Grazie a Geronimo per l'iniziativa.

E' la situazione ideale per il trapianto se la situazione come dici dici si è realmente assestata. Il costo è variabile e dipende dalla tecnica utilizzata (strip o FUE/FIT). Se non ti sei mai sottoposto ad un trapianto la seconda è senz'altro preferibile in quanto non lascia cicatrici visibili. Per il chirurgo aspetta il report di Shon da Atene.

Molto interessante. Il dottore (john Cole) si sta preparando ad utilizzare un punch di 0,5 mm per l'estrazione dei peli. Se quanto mostrato da Woods si dimostrerà vero, si potrebbero aprire nuove frontiere per chi esegue e si sottopone ai trapianti. http://www.hairsite4.com/dcforum/DCForumID6/452.html

Nel weekend la invio anche io. Fatemi sapere se passate sull'altro forum. Purtroppo non ho avuto tempo di leggere tutti i threads in questi giorni.

Shon, volevo solo aggiungere una ultima informazione ringraziandoti fin da ora per la tua disponibilità. Cole opera con una sofistificata apparecchiatura e con una equipe collaudata negli States e pare che in Grecia queste non siano ancora disponibili. http://www.hairsite4.com/dcforum/DCForumID18/18.html Credo che tu abbia diritto di essere rassicurato dalla DHI o da Cole stesso. Il doc è assolutamente disponibile e risponde sia alla sua email che alla sezione esperti di Hairsite.

Non sono del tutto d'accordo con voi xxxxx (mi riferisco agli ottimi Geronimo e Linux). Se Shon ha una sufficiente zona donatrice e un discreto numero di euro da investire, potrà molto probabilmente avere un risultato apprezzabile. E' chiaro che questo non si potrà avere da una singola sessione, anche se devo ammettere che chirurghi come Cole hanno trapiantato anche 70 u.f. per cm2 per sessione. Le mie conoscenze mediche sono limitate alle vecchie tecniche e personalmente sono molto incuriosito dai risultati che possono essere ottenuti dalle nuove. Credo che il "carattere" di Shon lo porterà a scegliere il meglio e credo che se sceglierà Cole come sembra, la scelta sia molto vicina a questo risultato. Spero solo che voglia condividere con noi questa sua nuova esperienza, permettendo un reale confronto utile sia per i pazienti che per i medici. Sarebbe interessante se uno dei dottori volesse partecipare all'eventuale intervento per acquisire esperienza con la nuova tecnica. Credo che essere il primo chirurgo che pratica una tecnica esente da cicatrici visibili, possa essere un reale vantaggio competitivo dal punto di vista economico oltre che professionale. Concludo, augurando le migliori fortune a Shon per il suo futuro intervento e ringraziando Morselli per il suo approccio onesto e professionale nelle risposte.

Dottore, troverà interessanti le valutazioni di John Cole riguardo le incisioni e il relativo tessuto rimosso da un punch da 1 mm relativamente alla casa produttrice dello strumento impiegato. Se ne può dedurre che l'asserzione "punch da 1 mm." sia troppo generica. http://www.hairlosshelp.com/forums/message...&threadid=18499

A method of enhancing hair growth or treating alopecia in a subject uses topically administered estrogen receptor antagonists. Pharmaceutical formulations comprising estrogen receptor antagonists are described. http://patft.uspto.gov/netacgi/nph-Parser?...cles&RS=hair+AN D+follicles

Non è una pazzia ed è già stato fatto. Tecnicamente si chiama rotazione dei lembi. E' un intervento eccessivamente invasivo dalla discutibile riuscita e fortemente invalidante a livello cicatriziale. Era una delle soluzioni adottate negli anni '80 e credo che non venga più praticato da anni.

Con la FIT/FUE può essere fatto, così come possono essere utilizzati i peli per una maggiore densità. In Grecia solo Cole opera con tale tecnica, gli altri utilizzano ancora la convenzionale (strip). Credo che nel breve periodo saranno molti ad impiegare tale innovazione, dal momento che anche Cole ha ammesso di aver imparato da Woods e Rassman, ritenendo obsoleta la tecnica classica con cui operava. Ti allego la mail della DHI che formalizza tale novità: ____________________________________________ Dear DHI Clients, WE are very happy to inform you that the new NON STRIP method of hair transplantation is now available at the DHI CLINICS. DHI Medical Director Dr J COLE will be working at the DHI PLASTIC SURGERY HOSPITAL every month performing the new FOLLICULAR ISOLATION TRANSPLANT. This method is performed only by 3 Hair Surgeons world wide and has become the latest and most talked about invention in hair restoration. In the future we will see less and less the need of STRIP EXCISION says Dr J COLE, the inventor of the FIT procedure. With FIT there is NO VISIBLE SCAR in the donor area and we can transplant a greater number of grafts in just a few days. The placement is done with the DHI IMPLANTER - a new device that has replaced the OLD CHOI implanter. The new device uses a 21 cage needle and is another DHI invention. The procedure will be demonstared live from the Athens DHI-PHS PLASTIC SURGERY HOSPITAL VIA THE INTERNET. FOR DETAILS PLS VISIT OUR WEB SITE www.dhimedical.com. Live demonstration will also take place during the AEGEAN MASTERS MEETING on JUNE 1st in ATHENS where 45 MASTER HAIR SURGEONS FROM AROUND THE WORLD will be present. Dr J COLE, Dr MINOTAKIS, Dr DIM GRIGORIOY, Dr MANOS PANTELIDIS, Dr ALEX CABONI and Our Global Coordinator Carolina Salinas will be consulting in LONDON, PARIS, MILAN every week & MANCHESTER every other week. Consulting dates in these and other CITIES around the globe will also be posted in our site. If you wish to plan a consultation in the next weeks PLEASE email us at info@dhi.gr or phone our UK NUMBER 020 75840557. ADVANCED BOOKING IS ESSENTIAL. Kindest regards, DHI Medical Group read more news...

Per concludere volevo fornire un riferimento per comprendere quanto datate siano le informazioni riguardo tale tecnica. Woods utilizza strumenti operatori di 0.8 mm e 0.6 mm per l'inserzione delle u.f. Ne consegue che le stime fornite siano in questo caso totalmente errate sulla lunghezza totale delle incisioni. http://www.thewoodstechnique.com/default.a...D=164&Category=

Per Whybob, il riferimento a Gho è relativo alla pubblicazione: Kim JC, Choi, YC. Regrowth of grafted human scalp hair after removal of the bulb. Dermatol Surg 1995; 21:312-313 Non ho trovato la pubblicazione su web, ma puoi trovare interessante l'articolo che ne fa menzione: http://www.newhair.com/medical_publications/fue.asp Su Choi puoi trovare interessante anche l'articolo relativo all'implanter. http://togoclinic.co.kr/english_index.html#6 Personalmente però non sono convinto che Gho sia riuscito ad eliminare il rischio di "transection" che tale intervento comporta. Hai ragione su Cole, infatti egli stesso è il primo ad ammettere di essere passato alla tecnica ad estrazione monobulbare solo da un anno. E' chiaro che Woods ha portato una sostanziale novità nel campo dei trapianti e a meno di cure rivoluzionarie la FIT/FUE sarà il futuro della chirurgia della calvizie per i prossimi 5-10 anni. Tutti i chirurghi dovranno necessariamente aggiornarsi in un lasso più o meno lungo di tempo.

L'articolo è interessante ma piuttosto datato. Attualmente nessuno dei chirurghi che pratica la FIT/FUE utilizza il punch da 1 mm. La zona di prelievo risulta inferiore di almeno 1/3. Almeno così è per Cole e Jones. Gho attua una tecnica parzialmente diversa basandosi su quanto riportato in uno studio di Choi.

Il trapianto rappresenta attualmente l'unica soluzione che restituisce una percentuale dei capelli originariamente persi. E' anche l'unico campo nel quale sono stati fatti dei passi in avanti notevoli negli ultimi venti anni, cambiando la tecnica adottata. Non altrettanto si può dire delle cure farmacologiche dal momento che siamo fermi a minoxidil + fina, farmaci esistenti da venti anni che comunque nel migliore dei casi mantengono l'originale numero di capelli. E' chiaro che nei casi di calvizie molto avanzate anche il trapianto non può rappresentare una soluzione definitiva a meno che l'implementazione di Woods con l'utilizzo dei peli nei siti riceventi non si dimostri effettivamente reale. Purtroppo in Italia siamo ancora all'età della pietra, ma questo avveniva anche negli anni '90 con l'introduzione della tecnica monobulbare.

Come ad esempio questo intervento di Cole . Settanta u.f. per cm. quadrato !!!! http://www.hairlosshelp.com/forums/message...&threadid=19535

Per Cheveux. Se non te ne fossi accorto, David ha pubblicato le tue foto: http://www.hairsite4.com/dcforum/DCForumID7/4.html

Grande Under, potrai finalmente dare un parere competente rispetto alle vecchie tecniche a cui sei stato sottoposto. Cole a mio parere è un'ottima scelta ed è l'unico chirurgo di FUE/FIT che opera in Europa insieme a Gho. Le migliori fortune a Katetzu per l'intervento.

Interessantissimo articolo di Cole. -------------------------------------------- I would like to thank Dr. Hasson for several things. First, I appreciate his kind words and his recommendation on our clinic for follicular extraction. Second, I want to thank him for giving me something interesting to do while taking the 6:40 am flight to Chicago. There is nothing more compelling than the opportunity to debate intelligent people you respect. Long before Dr. Hasson began performing the lateral slit (coronal incision) for his patients many physicians such as Bob Bernstein, Ron Shapiro, Brad Wolf, Bobby Limmer, and myself were achieving outstanding results for their patients using a variety of instruments and incisions. The belief that the coronal incision is mandatory to achieve natural results is complete rubbish. There are no studies or statistics to verify this belief. There is only a growing popularity for this marketing ploy on the internet. Furthermore, we will show in due course that it is completely false. This is the danger of jumping on a marketing tool and over promoting it. Second, the term follicular unit is incorrect. This is a histological term. The clusters of hairs which exit the scalp often are composed of more than one follicular unit. This is my primary objection to the term follicular unit extraction. It is inherently incorrect. The term follicular unit was first used by J. T. Headington in 1984. He used the term to describe the pilosebaceous unit as disclosed at the mid-dermal level while looking at skin sections from the crown region of the scalp that was stained with hemataxolin and eosin. It was resurrected from dr. headington’s paper by Bob Bernstein, who has given its name a new meaning based on gross anatomical observations that are often incorrect. Making all your incisions in a coronal fashion creates a very unnatural pattern or distribution that violates the chaotic fractals that nature intends. It could be compared to stacking chairs in linear rows in an auditorium. It appears too man made or artificial. Dr. Hasson’s transplants work because he uses natural clusters of hairs that I call follicular groups. I had the opportunity to watch dr. Hasson in Arkansas. He is methodical, careful, and precise in his work. I was impressed. I noted that he changed his incisions from coronal to essentially a 45 degree angle as he approached the hairline. In other words, he began to mimic nature’s true angles as he created the hairline. Dr. Hasson has an excellent aesthetic sense and a compulsion for detail work. He creates natural hairlines, but his belief that this can only be done with true coronal incisions is inaccurate. I cannot say for certainty that Dr. Hasson always changes his incision angles, but I can say that he did change them in the patient I observed him treat. I believe he showed some photographs during his presentation in which he did not change from a true coronal incision to one somewhere between sagital and coronal and his results did appear very natural. What this implies to me is that you can create very natural results and still violate nature’s true angles. The question remains, can you make it better by more closely following nature’s true angles. I can say that he makes his incisions in two planes (Y and Z). hairs do not exit the scalp naturally in two planes. They exit in three planes (X, Y, and Z). Therefore, I will not apply his technique to my procedure for reasons that are obvious to me. What is the coronal plane and what is sagital. Coronal is the plane from the left to the right side of the body. A true coronal incision would be parallel to the line drawn form the opening of one ear up, across, and down to the opening of the other side of the ear. sagital is the line from the front of the head to the back of the head. A true sagital incision would be perpendicular to a coronal incision. Lining up all the hairs in one plane like chairs in a row completely violates nature’s intent. If you don’t believe this, take a look at one of the Hasson and wong post op photos of the shaved head (I see no reason to shave the recipient area). It mimics troops in formation rather than a natural pattern. The rationale for the coronal incision needs refinement also. There are several types of grafts. If you look at my website <a href="http://www.forhair.com";>www.forhair.com</a> you will notice that there are three types of three hair grafts. In one type all the hairs exit from a single follicular canal, in type two two hairs exit from one canal and a single hair exits from a separate canal, and in the third type all the hairs exit from separate canals. The proportion of thes three types vary from one individual to another. If someone still fails to recognize the fact that some individuals do not have a large percentage of hairs that exit from a single follicular canal despite multiple attempts to open their eyes to this fact, I cannot help it or them. I would encorage them to sit down and cut 1000 grafts on several consecutive cases like I have rather than focusing on strip removal and recipeint site preparation. The rationale I have always heard from dr. hasson for his lateral slit is that the slit allows the hair to spread out so the coverage will be better. Well, this would be true if you were looking at the person only from the front and the majority of the hairs exited from the different canals, but if the viewer moved the side, all the hairs would be spread out in the anterior posterior plane (fonrt to back) and the see through visibility would be increased when looking at the side of the patient. If the person has a majority of hairs that exii from a single canal, then the rationale for their argument is complety destroyed. The fact is that it is time for art to meet science. DaVinci would be appalled by the cosmetic approach taken by hair restoration surgeons in general. Is dr. hasson and wong on to something speacil and exciting with their lateral slit? The answer is a resounding, YES!. However they need to take their thinking a step further and begin to understand that natural follows multiple logarythmic spirals rather than coronal and sagital planes. It is our belief that typcially the follicular group exits perpindicular to the tangent of “n” radians from the point of origin of the spiral, which is defined by the formula Ө = rk The angle of growth (β is equal at all tangents 2 π radians from this point. It is time for hair rstoration surgeons to accept the philosophy of Descartes, who believed that in life many problems can be solved mathematically throught application of formulas. Man made does not work. God did not create this world in systematic and sterile fashion. His logic was much more complex that simply stacking chairs in rows. I implore dr. Hasson to open his mind to new ideas rather than remaining in a rut that has him fixated on the lateral slit. He should be commended for opening the door to new concepts in the preparation of the recipient area, but I believe he needs to continue the process by expanding his level of understanding. I can honestly say that his visions and those of dr. wong have opened my mind to new ideas and I hope he will take a look at some of my new ideas and at least give them an educated and intense review. I will present these concepts a the Aegean Meeting. I will also put them on my website, but I will not present them at any International Society of Hair Restoration Surgery sponsored meeting because this society does not enforce it code of ethics or protect its membership from the ruthless assault by those who violate their code of ethics. The belief that a single follicular group separated by a large distance form another follicular group will lead to PLUGGYNES, is completely false as is the statement that grafts must be tightly packed to appear natural. What is hair loss? It is a progressive miniaturization of the hairs. Some of the hairs seem to be unaffected by the hair loss process though. these hairs survive and remain on the scalp as isolated islands of hairs. What would look unnatural? An employment of hairs and groups of hairs in geometric patterns that violate nature’s patterns would look unnatural. One method that violates natures geometry is to plant clusters of hairs in groups larger than a natural follicular group. We all recognize the plugginess that results from the employment of full size plugs and mini-grafts. Another very unnatural pattern is to plant all your grafts in rows, a sagital plane or in the coronal plane. Therefore, I would like to rephrase dr. hasson’s statement with my own modification. “In order for a transplant that is created with grafts placed entirely in the coronal plane, the grafts must be densely packed and the hair must be grown to a style able length so that the unnatural geometric pattern is completely concealed from the view of others.” Now I will dissect his comments on follicular extraction. Once again, I do not like the term follicular unit. It is just plane wrong. Dr. woods was the first to popularize this methodology. Inaba mentioned a version of it in his text published in 1996. Dr. Woods has been reportedly doing the surgery much longer than anyone else though and his mention of it pre-dates Inaba’s text. We may never know for sure though since dr. inaba is now dead. Certainly, it was dr. woods that popularized the method. He should receive the platinum follicle from the international society of hair restoration surgery for his contribution, which he should promptly return (I can assure you that if I had been awarded one, I would have donated it to a local garage sale). When I first head about dr. wood’s work, I too thought it was ludicrous. I used the same logic as dr. Hasson is describing the surgical margins (scar). Dr. Rassman began his own method, which he inappropriately named follicular unit extraction (a term that NHI continues to eternalize). Dr. Rassman was very secretive about his work and technique. . I tried removing follicular clusters individually myself with only limited success, and continued my pursuit of strip harvesting as my primary focus. I was repeatedly influence dby Spencer Kobren during this time about the fabulous results that Dr. Woods was achieving. Dr. woods began to grow in fame and reputation. It became apparent to me that he should have an opportunity to present his ideas and work at the Chicago meeting of the ISHRS. As program chair I attempted to bring him to this meeting and was prepared to pay his way myself. Spencer did everything he could to facilitate bringing dr. woods to the chicago meeting. Members of the hierarchy within the ISHRS, however, thwarted these attempts and in doing so alienated Dr. Woods further. Spencer Kobren told me of a new physician I’d never heard of before named Rob Jones. He told me that Rob had begun doing follicular extractions after speaking with Spencer. As I recall, Dr. jones had approached Spencer about a recommendation by the IAHRS. Spencer told him that he’d have to review his results, but encouraged him to take a look at Dr. Woods. Spencer told me that Dr. Jones had started doing follicular extractions and encouraged me to look at them further. Spencer then told me about a patient named timetested (I apologize if I am wrong about his handle), I believe, but am not certain. He told me that this patient had been disfigured many years ago and that he had been to another physician for corrective work without a significant improvement. Spencer went on to explain that this patient had approached Spencer about a referral. Spencer referred him to a number of different very recognized physicians. None of his initial referrals had a good plan to correct his disfigured appearance. His donor area was too depleted and too scarred. He asked spencer once again for a referral. Spencer told him of a physician in Australia named Dr. Woods. According to Spencer the patient went to dr. woods, had corrective work, had body hair moved to the top, and had a marvelous result. It literally changed the person’s life. That was all it took for me. I was sold on the concept. The next step was to learn the procedure. From a rational point of view, Dr. Hasson’s argument about potential meters of scarring from follicular extraction is accurate based on a 1mm punch. Decreasing the size of the punch to 0.75 mm reduces the meters of scar to 23.5 meters. He misses the key points though and this is where he remains in the dark ages. In the early 1990s I began ascribing to a philosophy of leaving a single scar in the donor region. I found that the first procedure typically left an acceptable single scar that was generally 1 to 2 mm in width. The second strip that removed the first strip created a wider scar, however. In an effort to reduce this I began employing a second layer of suture that was deep to the surface layer. What I learned was that this additional layer helped to reduce the width of he second scar. It did not always prevent some degree of widening in the range of 3 to 5 mm in all patients. I presented my findings opening in Rome in 1997. Not one member within this group acknowledged that a second incision that removed the original scar resulted in a wider scar and more importantly they did not offer any means of preventing this. Well it does occur, but appears to be something that has been noted by many others only after 1997. Another thing happens when you removed a donor strip. You increase the tension, you reduce the surrounding follicular density, you create scar, and you absolutely destroy the natural anatomy of the donor region. You inhibit a person from being able to shave their donor region without having a visible scar. Subsequent surgeries almost invariably are more limited in total width and the follicular yield is necessarily reduced. The defect must be closed. This requires stretching the remaining follicular units so that they cover the area they once covered in addition to the area that was removed. The density has no choice except to go down. Graft cutting is more difficult and more pain staking on subsequent harvests because the scar tissue is much harder (like leather) and distorts the natural growth angles of the hair. Cutting dulls sharp blades faster due to the scar and more force must be used to cut through the tissue. This can be likened to cutting your steak. When you hit a piece of tough fiberous connective tissue (some call this gristle), you must exert greater force downward and sawing in nature to cut through the harder tissue. All these factors increase the probability that you will damage or destroy a hair follicle. If you have a tight scalp you will have the capacity to create far fewer total grafts than if you have a loose scalp and you will be able to take far fewer strips. My experience is that you can leave a patient with a single scar that is typically 2 to 3 mm wide scar (general worst width 0.5cm) while removing 6000 to 8000 grafts from patients in three to seven total surgeries. Once you pass through 8000 grafts, you will often find that a new surgical scar is required. Of course you can take wider amounts if you undermine and maintain a single scar, but this process exacerbates scarring and should be discouraged. After removing a total of 6000 to 8000 grafts you will definitely have a visible scar if you shave the donor region. Dr. Hasson is wrong about the number of cm of surgical scar from strip harvesting. Strip harvesting has two margins. Each is 30 cm. When the two edges are approximated by surturing or stapelling (by the way there is no data to sugest that the method dr. Hasson prefers – staples- offers any advantage to sutures) the resulting line is 30 cm long. Each side of the wound forms scar though and the scar expands over time. If you take a deep incision into the fat, as many strippers do, and especially if you undermine, the scarring beneath the surface of the skin mushrooms like a nuclear explosion. You can’t see it, but I can when I cut into the donor region when these mostly lazy and ill advised techniques are employed. As the scar expands it forms at least double the number of sq. cm of scar that dr. Hasson incorrectly reports. He also fails to describe the steps which must be employed subsequent to removal of a strip excised by one or (god preclude) multiple bladed knives. The next step is to toss the strip to your assistant, who if you don’t monitor, don’t use current technology, and don’t have an understanding of the donor regon, might destroy up to 30 or 40% of the removed strip. Some physicians use microscopes to cut their grafts. As far as I’m concerned those that use a Mantas microscopes are using toys disguised as microscopes. To them I say, get a real microscope and join the big leagues. Study the donor area. Learn what your techs should be producing and insure they meet your expectations. If you sliver he strip, use adequate maginification, and insure your staff captures the intact follicular groups, your destruction rate will approach 2 to 5%. Single blade harvesting always results in transaction at a an average rate of 2%. The rate of transaction on the second cut is always double that of the first cut. Accoring to dr. woods, his transaction rate from his technique is between 2 and 5% so we must assume that proper application of this technique will generally produce a higher yield. Now lets talk about he destruction of the anatomical features of the donor region. You obliterate the spiral nature of the follicular clusters. You can never get this back. We will document this in print very soon. The formation of the linear scar is an attempt for the donor region to restore its natural follicular distribution, but it cannot because you mutilated it with your strip harvest. Follicular extraction does not mutilate the donor region. The size of the scars is so small that they are imperceptible to the naked eye. So, I ask, if you have 31 cm of scar, who cares, if you can’t see it. I’d rather have 50 cm of invisible scar than 60 or 90 cm of blatantly obvious stripper scar or scars in the back of my head. Follicular extraction does not violate natures natural geometry. Rather it approximates natural and irregular follicular loss through disease, senescence, drug, or hormonal (androgenic alopecia) influence. Don’t kid yourself or the public. Strippers and their ill advised pursuit of ease and high capitol return are doomed in due course. Practice improves results in time with follicular extraction, but you must be married to this discipline. A cavalier attitude toward it, or an effort to market yourself by saying you perform the procedure will not produce success. You will ultimately fail and you will harm your patients. You must be convinced that this procedure works and you must be married to it. Angela Woods, Ray Woods, Rob Jones, and myself are committed to this technology. The woods have more experience and as such are the best at this procedure. Rob jones has more experience than me and is probably better than me. I’m coming along though and there is no question that we are getting fantastic results with low transaction rates even on patients that we previously felt were poor candidates. Those that perform the procedure as a side thought, as an experiment, or as a free service will not acquire the skill necessary to convert patients into success stories. This is a very tedious, time consuming, difficult procedure that only those with committed resolve will learn given current technology and tools. The more you work at it, the faster you become and the better your results will be. If you think you canone day turn the water on and it is hot, you are wrong. You have to pay your dues. You are not going to start doing this surgery cold turkey and suddenly be a major league star. Forget it. Don’t kid yourself. Either make the commitment or don’t get started. You’ll do more harm than good and risk destroying the momentum we are building by saying you tried it and it didn’t work or it can’t work. It can’t work if you aren’t committed and by your comment I feel you are not committed and you will fail unless you select a perfect candidate for this procedure (only 25% of all patients are ideal candidates). You say you don’t gamble, well 25% probability is a huge roll of the dice. I recognize the popularity of this procedure, but be very careful. It is not a procedure that you can make money as a physician that does hair transplant surgery until you get very good at it. You will loose money by offering it. Those who offer it now are either doing so as a marketing tool or they are doing it because they feel it has virtues that far exceed the capacity of the strip to provide. They believe that strip removal without informed consent in the 26 year old or younger patient is malpractice. They believe there is a far better solution to donor harvesting than stripping your patient so they work tirelessly to learn and excel at this new technology. We have gotten so good at this procedure, that we are dropping our prices and actively marketing ourselves for patients. For us the future is now. It is my hope that Dr. Hasson will work with me to better treat our patients and help accelerate the combination of art and science. John P. Cole, MD Atlanta, GA 800 368 4247 http://www.forhair.com

Lott, questo è ancora più impressionante: http://www.hairlosshelp.com/hair_loss_trea...llery_jose1.cfm Una densità simile non l'avevo mai vista in una singola sessione!

Questa la risposta di Cole riguardo l'utilizzo dei peli corporei a fini trapianto. --------------------------------------------- One of the most exciting advancements to the field of hair restoration surgery is the use of body hair. Dr. Ray Woods and Dr. Angela Campbell were the first to show that body hair can assume a character more like that of scalp hair when move to the scalp. This makes sense. Jung Chul Kim, MD and his team of researchers in Taegu, Korea showed that when scalp hair is move to the leg or other extremity, the hair will not grow as fast or as long. They did not always note a change in hair diameter. Therefore, it makes sense that hair from an extremity might grow longer when transferred to the scalp. One of the problems we encounter is that hair from body parts has a different curl or wave than typical scalp hair. Also it might be finer or coarser than scalp hair. We are also worried about the sebaceous glands and the sweat glands from the donor sources. For instance the sweat glands in the ears produce a was like substance while the glands in the pubic area produce a different type of secretion. Sweat glands are not assoiciated with hairs, but they are microscopic and not seen on typical dissection even with a dissecting surgery microscope up to 45X. therefore, it is possible that some of the sweat glands might be transplanted to the scalp. Then the question arises of whether they will maintain their same secretory function. Some feel the odor form the under arm might be transplanted to the scalp. The truth is that we do not know about this, but feel that odor may not be a problem. We have a considerable amount of research left to do so bear with us as we work out the details. Currently, Ray Woods and Angela Campbell are the world’s foremost experts in the field of body hair transplantation. We are working with body hair, but we consider our efforts in this area in the beginning stages. One of the things I’ve found about body hair is that it exist the skin at a very acute angle, but it does not rest beneath the skin at this acute angle. Since the source of each hair is deeper in the subcutaneous fat, we must assume that the hair begins its journey externally at a less acute angle and then turns more acutely just before exiting the skin surface. Enclosed is a photo comparing a back hair to the scalp hair. Both were removed using FIT. You will notice the back hair is coarser and has a large sebaceous gland. The scalp hair rests deeper in the dermis and the sebaceous glands are not as well delineated following FIT extraction. Also notice that we often employ a suturing technique to body hair in an effort to minimize the scar. John P. Cole, MD 75 14th St. Suite 3260 Atlanta, GA 30308 Cell 540 520 9999 Global 011306944627050 Office 800 368 4247 ====================== www.forhair.com