Experimental suggestions.

[S Foote.]

If this is what is happening, if you then transplant follicles from the normal donor area that are in the natural telogen phase, (miniaturised), these will `NOT' then grow in the male pattern baldness area because the matrix will be small and prevent this!

This would be an important test in my opinion, and i asked Dr Limmer who was interviewed on HairLossTalk.com if this had been tried. He said that as far as he was aware, this hadn't been studied.

I think it should be, because if these transplanted `normal' follicles in telogen `didn't' enlarge, the current theory would have yet another problem!

So what is the approximate success rate of transplanted hairs? Let's be clear about what I'm asking: what is the percentage of TOTAL hairs which, when transplanted into balding areas of scalp, continue to grow normally afterwards?

Here's some BAD NEWS for you, and it comes from Orentreich's original "autograph" study from 1959: he apparently had a higher success rate than the 90% predicted by your theory! :wink: He transplanted hairs in a total of 52 subjects with male pattern baldness (multiple graphs per subject), and here's what he says in the "Results" section (the emphasis in bold text in a couple of places is my own):

"Donor dominance was observed in all of the cases of alopecia prematura. 'Hair to hair' grew hair; 'hair to bald' grew hair; 'bald to bald' remained bald; and 'bald to bald' remained bald.

"The grafts containing hair continued to grow hair in the area of alopecia that was of the same texture and color and, apparently, at the same rate and with the same period of anagen that governed the nature of the hair of the donor site (after 2 1/2 years' follow-up it was still growing)...Moreover, the hair growth of the grafts appeared unimpaired."

How do you explain THAT, Stephen?? At any one time in normal non-balding subjects, about 10% of scalp hairs are in telogen (even HIGHER percentages of scalp hairs are in telogen in balding subjects), so several of the follicles that Orentreich transplanted MUST have been in telogen at the time! And yet he said that in EVERY CASE of the male pattern baldness grafts, full donor dominance was observed, with the grafts continuing to grow normally afterwards. If your theory were correct, several of them (the 10% or more which were in telogen at the time they were excised) would never have enlarged from the miniaturized condition they were in, while in that telogen phase!! I know, I know: you think that just from sheer luck, Orentreich excised only follicles that just happened to be in anagen, right? That would be the usual ad hoc explanation that you always come up with, wouldn't it? :wink:

It's "Strike 3" for your theory! YOU'RE OUT!!

You don't half talk some rubbish Bryan!

I asked you before but you didn't answer the question, so i'll try again!

What `SIZE' grafts did your hero Orentreich experiment with?????????????

The `modern' up to date research clearly shows a `NOW' accepted fact in transplantation, that the `MAJORITY' of follicles in grafts 3mm or over in size, do `NOT' survive in the long term.

This is an accepted fact that i can personally testify too! I really don't care what Orentreich `thought' 50 years ago, the latest research is refuting these `assumptions'!

If you want to believe the assumptions of 50 years ago, go get yourself some 4mm grafts in your bald area Bryan. Then get back to us about it!

S Foote.

 

[Bryan]

You don't half talk some rubbish Bryan!

I asked you before but you didn't answer the question, so i'll try again!

What `SIZE' grafts did your hero Orentreich experiment with????????

I don't recall your asking that question before, Stephen, but that information is not hard to come by. Here's another short excerpt from the study (the very first paragraph, in fact):

"Multiple transposition of skin punch free grafts was performed in order to study some factors in the pathogenesis of certain dermatological disorders, especially the alopecias. After local anesthesia, and appropriate surgical preparation of the skin, which included washing, shaving, and cleansing with alcohol, 4 full thickness circular excisions were made with punches of 6, 8, and 12 mm. diameter..."

The `modern' up to date research clearly shows a `NOW' accepted fact in transplantation, that the `MAJORITY' of follicles in grafts 3mm or over in size, do `NOT' survive in the long term.

Only one of the grafts didn't "take" in the short-term. Orentreich goes on to say later in the study in the "Results" section:

"Of a total of 284 punch grafts, only one of the grafts failed to take. This was in a patient with alopecia areata in whom a graft with hair fell out from the recipient alopecia site. This graft had been covered with collodion. Its loss was noticed the next day and it was replaced by a new hair graft that took without difficulty."

This is an accepted fact that i can personally testify too! I really don't care what Orentreich `thought' 50 years ago, the latest research is refuting these `assumptions'!

If you want to believe the assumptions of 50 years ago, go get yourself some 4mm grafts in your bald area Bryan. Then get back to us about it!

You know, Stephen, I'm not terribly surprised at this response from you. In your embarrassment at these findings which contradict your theory, your only recourse is to try to cast doubt on the general validity of Orentreich's study! :x

However, what you said doesn't really have anything to do with the central issue here, which is donor dominance. What you said about the general long-term survivability of large punch-graft transplants is undoubtedly true, but that has nothing to do with the GIGANTIC fact that his findings refute your assertion (and prediction) that transplanted follicles that are already in the telogen state will be unable to enlarge again at their new location! Stephen, if you have any intellectual honesty, you'll admit that this is a LARGE setback for your theory...

Oh BTW, I also replied to you in that thread over in the dutasteride forum on hairsite. I think I came up with that study that you asked me about a few days ago!

Bryan

 

[S Foote.]

You don't half talk some rubbish Bryan!

I asked you before but you didn't answer the question, so i'll try again!

What `SIZE' grafts did your hero Orentreich experiment with????????

I don't recall your asking that question before, Stephen, but that information is not hard to come by. Here's another short excerpt from the study (the very first paragraph, in fact):

"Multiple transposition of skin punch free grafts was performed in order to study some factors in the pathogenesis of certain dermatological disorders, especially the alopecias. After local anesthesia, and appropriate surgical preparation of the skin, which included washing, shaving, and cleansing with alcohol, 4 full thickness circular excisions were made with punches of 6, 8, and 12 mm. diameter..."

[quote="S Foote.":3ed1a]The `modern' up to date research clearly shows a `NOW' accepted fact in transplantation, that the `MAJORITY' of follicles in grafts 3mm or over in size, do `NOT' survive in the long term.

Only one of the grafts didn't "take" in the short-term. Orentreich goes on to say later in the study in the "Results" section:

"Of a total of 284 punch grafts, only one of the grafts failed to take. This was in a patient with alopecia areata in whom a graft with hair fell out from the recipient alopecia site. This graft had been covered with collodion. Its loss was noticed the next day and it was replaced by a new hair graft that took without difficulty."

This is an accepted fact that i can personally testify too! I really don't care what Orentreich `thought' 50 years ago, the latest research is refuting these `assumptions'!

If you want to believe the assumptions of 50 years ago, go get yourself some 4mm grafts in your bald area Bryan. Then get back to us about it!

You know, Stephen, I'm not terribly surprised at this response from you. In your embarrassment at these findings which contradict your theory, your only recourse is to try to cast doubt on the general validity of Orentreich's study! :x

However, what you said doesn't really have anything to do with the central issue here, which is donor dominance. What you said about the general long-term survivability of large punch-graft transplants is undoubtedly true, but that has nothing to do with the GIGANTIC fact that his findings refute your assertion (and prediction) that transplanted follicles that are already in the telogen state will be unable to enlarge again at their new location! Stephen, if you have any intellectual honesty, you'll admit that this is a LARGE setback for your theory...

Oh BTW, I also replied to you in that thread over in the dutasteride forum on hairsite. I think I came up with that study that you asked me about a few days ago!

Bryan[/quote:3ed1a]

But Bryan, you are reading into that particular study things that are not there!

Quote:
"Of a total of 284 punch grafts, only one of the grafts failed to take. This was in a patient with alopecia areata in whom a graft with hair fell out from the recipient alopecia site. This graft had been covered with collodion. Its loss was noticed the next day and it was replaced by a new hair graft that took without difficulty."

There is just no detail in this Bryan! Where does it say that `ALL' the folicles in these grafts grew normaly in the long term? Where does it say that the growth of transplanted follicles in the telogen phase was studied?

It `doesn't' make any reference to these factors, you are again just making assumptions Bryan!

We know `NOW' that the vast majority of transplanted follicles in the larger plug grafts don't survive long term! This `doughnutting' effect as it's called is well reported Bryan, do some research!

As i said before, the leading transplantation expert Dr Limmer has said that he knows of no specific research into the growth response of transplanted telogen follicles. I wish there was! but there isn't `yet'.

Who are we to believe Bryan, the modern transplantation experts or you?

S Foote.

 

[Bryan]

There is just no detail in this Bryan! Where does it say that `ALL' the folicles in these grafts grew normaly in the long term? Where does it say that the growth of transplanted follicles in the telogen phase was studied?

If you're not going to give me a serious reply, then all I'll say is that I've already explained all that to you. Go back and re-read what I said before.

Bryan

 

[michael barry]

New Idea?????
Could perhaps a plug FUE be taken from the FRONT of a guys head where it was indeed ALREADY miniaturizing in an area that was going to be bald in just a few years, perhaps a couple of triple-follicle FUE's, and simply be moved over or up near the hairline to see if the miniaturized follicles grew back to normal size?

If they did, would it not prove that the matrix around them upon reimplantation caused them to survive? If not, would it not prove that they were just anagen sensitive and "sentenced to death" anyway?

I wonder if there is a curious surgeon with a willing patient willing to try it. They could electrolysis the plug back out later...............

 

[S Foote.]

There is just no detail in this Bryan! Where does it say that `ALL' the folicles in these grafts grew normaly in the long term? Where does it say that the growth of transplanted follicles in the telogen phase was studied?

If you're not going to give me a serious reply, then all I'll say is that I've already explained all that to you. Go back and re-read what I said before.

Bryan

That was a serious reply Bryan, please explain why you think it wasn't?

I'll put it another way.

You seem to be claiming from that 40 odd year old study, that `ALL' the follicles in those large grafts studied, survived `normally' long term. That seems to be what you are claiming, and the text by Orentreich seems to say that.

BUT!!!

Modern research has `proved' otherwise! The now accepted effect of `doughnutting' in the larger grafts, was obviously `missed' by Orentreich!!

http://www.hairtransplantadviser.org/fallacies.htm

Orentreich has been proven wrong Bryan, simple!

I have no problem with the survival or normal cycling of transplanted large anagen follicles at the `edges' of these large grafts, this is my own experience.

BUT!!

There is again no reference to any note being made of follicles in telogen in Orentreich's study, or any note of their growth `after' transplantation!!

So how can you possibly `assume' that these follicles grew normally?

S Foote.

 

[S Foote.]

New Idea?????
Could perhaps a plug FUE be taken from the FRONT of a guys head where it was indeed ALREADY miniaturizing in an area that was going to be bald in just a few years, perhaps a couple of triple-follicle FUE's, and simply be moved over or up near the hairline to see if the miniaturized follicles grew back to normal size?

If they did, would it not prove that the matrix around them upon reimplantation caused them to survive? If not, would it not prove that they were just anagen sensitive and "sentenced to death" anyway?

I wonder if there is a curious surgeon with a willing patient willing to try it. They could electrolysis the plug back out later...............

I agree, there are a number of experiments like your suggestion that would resolve this question.

The problem has always been that transplantation has not been studied well outside of the transplantation industry.

It's really been a matter of vested interests!

S Foote.

 

[Bryan]

http://www.hairtransplantadviser.org/fallacies.htm[/url]

I don't give a flying you-know-what about "doughnutting". The issue here is DONOR DOMINANCE, and you damned-well know it.

There is again no reference to any note being made of follicles in telogen in Orentreich's study, or any note of their growth `after' transplantation!!

Don't waste my time with your damned stalling tactics. I explained to you in PLAIN ENGLISH that several of those follicles MUST have been in telogen.

So how can you possibly `assume' that these follicles grew normally?

Because Orentreich said in PLAIN ENGLISH that they did. For 2 1/2 years. That's long enough to prove the concept of donor dominance, and that even transplanted telogen follicles continue to grow normally.

Stop your stalling and nitpicking. It's embarrassing.

Bryan

 

[S Foote.]

http://www.hairtransplantadviser.org/fallacies.htm[/url]

I don't give a flying you-know-what about "doughnutting". The issue here is DONOR DOMINANCE, and you damned-well know it.

Your damm right i know the issue is donor dominance Bryan! 8)

Lets see, your concept of `donor dominance' is that the transplanted follicles are resistent to balding. But the follicles in the larger plug grafts start `balding' from the centre and outwards over time. The `nickname this effect has been given is `doughnutting'. But the `actual' effect is a `BALDING' process in these larger grafts.

Your donor doninance idea is that these follicles are `NOT' supposed to bald, but they `DO' Bryan!

There is again no reference to any note being made of follicles in telogen in Orentreich's study, or any note of their growth `after' transplantation!!

Don't waste my time with your damned stalling tactics. I explained to you in PLAIN ENGLISH that several of those follicles MUST have been in telogen.

[quote="S Foote.":c6bee]So how can you possibly `assume' that these follicles grew normally?

Because Orentreich said in PLAIN ENGLISH that they did. For 2 1/2 years. That's long enough to prove the concept of donor dominance, and that even transplanted telogen follicles continue to grow normally.

Stop your stalling and nitpicking. It's embarrassing.[/quote:c6bee]

NO no no Bryan!

Like i said before, i have no problem with follicles transplanted in anagen cycling normally. and `continuing' to produce hair! But there is `NO' reference in Orentreich's study to normal cycling of the follicles transplanted in telogen! Did Orentreich spot tattoo the telogen follicles before they were transplanted, to track their progress Bryan?

I don't think so!!

You are just `assuming' that these `particular' follicles `re-grew'! As far as i am aware, no one, including Orentreich has `SPECIFICALY' studied the transplantation of follicles in telogen. Dr Limmer couldn't refer me to any such study! So if you are still convinced of this, show me a study???

I must say i have been thinking about this study and my own experience, along with the later finding of `doughnutting' in these larger grafts.

With hindsight, it took some time for the central `balding' of the 4mm grafts i had, probably around 3-4 years. So at 2 1/2 years Orentreich would not necessarily have seen this effect!

This `doughnutting' is claimed to be due to hypoxia (A lack of oxygen in the centre of larger grafts). But if this was due to a growth restriction induced by hypoxia, the follicles wouldn't survive any longer than months, or even weeks?

If it is taking a few years for the balding in these grafts to develop, it is in line with the Hydraulic theory, not hypoxia!

I have said before that an increase in fluid pressure around follicles, only effects the growing anagen follicle through contact inhibition, `NOT' those follicles already in anagen! So this `mini' version of male pattern baldness in the large plug grafts over time, is consistent with the anagen period of a few years, and the slow building of pressure (weeks or months after healing), in the grafts!!

Thanks Bryan for posting Orentreich's study, which adds further credibility to my theory!

S Foote.

 

[MidnightFlyer]

We know `NOW' that the vast majority of transplanted follicles in the larger plug grafts don't survive long term! This `doughnutting' effect as it's called is well reported Bryan, do some research!

I've had multiple "thousands" of grafts, starting in 1975. They are the large kind that Bosley did. None have donutted in that time. Not one. Am I lucky, or an anomaly?

either that or they're "all" donutted, and I just can't tell the difference. 8)

 

[S Foote.]

We know `NOW' that the vast majority of transplanted follicles in the larger plug grafts don't survive long term! This `doughnutting' effect as it's called is well reported Bryan, do some research!

I've had multiple "thousands" of grafts, starting in 1975. They are the large kind that Bosley did. None have donutted in that time. Not one. Am I lucky, or an anomaly?

either that or they're "all" donutted, and I just can't tell the difference. 8)

My 4mm frontal grafts i had in the early 80', have all `doughnutted' as it is called. The hair around the edges survives in the long term.

This is a recognised thing in grafts of 3mm and larger.

http://www.hairlosstalk.com/surgicalops/ht11.htm

http://www.hairtransplantadviser.org/repair.htm

http://www.newhair.com/resources/mp-199 ... afting.asp (good one).

S Foote.

 

[elguapo]

Foote, I am intrigued by this thread. Very interesting stuff and a lot of science to hair trasnplants that I just never looked at before. I still have yet to read all the material contained in the links provided, but good stuff. Thanks.

I don't know if I fully understand your point, though, being the first message that started this thread. Could you elaborate a bit on what you think should be studied?

Some questions and input of my own, might or might not be related to the topic:

1) You've presented a few studies regarding hair transplants of terminal occipital hairs to the leg, and vellus hairs to an immunodefficient mouse. First of all, was that vellus hair to the mouse also occipital? Or is it fair to assume that "(balding)" indicates that it is from the balding scalp?

2) I asked this before on this site: Has there ever been a study/experiment in which a balding vellus hair has been transplanted to another part of the body (leg, for example), to monitor its growth?

You say the scalp reduction hairs ended up receding back to the receding line that you feel was well established before the procedure. How certain are you? Not doubting you, but how much time went by after that line was established? That part of your story sort of fits my personal "hypothesis" that balding is caused by the combination of follicles and the surrounding skin/area of the head.

Sorry this isn't entirely coherent, but I'd like to discuss this with you further. I'll try to catch up on all that was said on the other pages of the thread. Interesting.

 

[S Foote.]

Foote, I am intrigued by this thread. Very interesting stuff and a lot of science to hair trasnplants that I just never looked at before. I still have yet to read all the material contained in the links provided, but good stuff. Thanks.

I don't know if I fully understand your point, though, being the first message that started this thread. Could you elaborate a bit on what you think should be studied?

Some questions and input of my own, might or might not be related to the topic:

1) You've presented a few studies regarding hair transplants of terminal occipital hairs to the leg, and vellus hairs to an immunodefficient mouse. First of all, was that vellus hair to the mouse also occipital? Or is it fair to assume that "(balding)" indicates that it is from the balding scalp?

2) I asked this before on this site: Has there ever been a study/experiment in which a balding vellus hair has been transplanted to another part of the body (leg, for example), to monitor its growth?

You say the scalp reduction hairs ended up receding back to the receding line that you feel was well established before the procedure. How certain are you? Not doubting you, but how much time went by after that line was established? That part of your story sort of fits my personal "hypothesis" that balding is caused by the combination of follicles and the surrounding skin/area of the head.

Sorry this isn't entirely coherent, but I'd like to discuss this with you further. I'll try to catch up on all that was said on the other pages of the thread. Interesting.

Hi.

I think the basic problem we have here, is that after the initial independent experiments, the long term results of the various procedures have not been scientificaly followed up. This is because of the vested interests of the transplantation industry in my opinion!

Because of the historical vested interest, i dont think the vellous hair experiments you refer too have been done yet?

Without looking it up again, i think the `mouse' transplantation study just noted that `balding' human follicles `recovered' when transplanted to mice in this experiment.

My views on scalp reduction are based on my own personal experience of four such procedures. The time line of the recession back after these procedures, was around 3 to 4 years. This seemed to match the time line of my `original' recession. Apart from my own experience, the very fact that scalp reduction has now been `dropped' by the industry, must ring the alarm bells??

You have to remember that scalp reduction was hailed as a major breakthrough when first introduced!

It seems to me that unless a healing process has taken place imediately around the transplanted follicles, these `bald' at around the same time frame as the original follicles.

This senario also fits with the `conclusion' the transplant industry has reached in the modern use of `micro' plug grafts.

I think there are any number of further experiments regarding transplantation we can suggest, but it needs people in a position to do these to show some interest!

S Foote.

 

[elguapo]

With the "doughnut effect" of grafts, do the hairs in the center die off as they do with male pattern baldness, growing in thinner and thinner until they cease to grow, or do they die off in another way?

 

[S Foote.]

With the "doughnut effect" of grafts, do the hairs in the center die off as they do with male pattern baldness, growing in thinner and thinner until they cease to grow, or do they die off in another way?

In my opinion the follicles in the larger grafts `bald', because of the same process that caused the original balding.

This thinning over time of the central follicles, is `claimed' to be caused by hypoxia (a lack of oxygen). But i think this is just an assumption. The actual studies refute this assumption!

Firstly, it has been shown in a study Bryan refers to occasionaly, that induced hypoxia in the balding scalp, `actually' improves follicle condition and hair growth.

http://www.geocities.com/bryan50001/artery_ligature.htm

Secondly, it was recorded by Orentreich's original study, that there was no noticable `thinning' in the larger grafts he used, over a period of 2 to 2 1/2 years.

We know that thinning and loss `does' happen eventually in these grafts, but if this `doughnutting' was because of hypoxia, this would happen a lot sooner!

I think the evidence shows that the thinning and balding of the central follicles in larger grafts, follows the same kind of time frame as the normal balding process.

I suggest that the thinning and balding period is related to the time it takes in the individual for an increased pressure to build around the follicles, and the length of the anagen growth period.

According to my theory, the increased pressure around follicles only effects their size when these are enlarging at the start of anagen, not those follicles already in full anagen.

The anagen period in humans can last up to 10 years! So an extended period of thinning and balding, is in line with my theory.

S Foote.