Many believe donor doubling, or unlimited donor supply, procedures represent the next evolution in hair transplant surgery. Donor doubling refers to the ability to create a unlimited number of follicular unit grafts to use in hair transplantation by splitting a hair follicle into its two regions of known stem cell activity: the bulge region and the dermal papilla. Studies show that each of these regions is capable of forming a fully functional hair follicle on its own; so dividing the follicle and implanting one portion of stem cells in the recipient scalp and one portion in the donor region creates new growth in both areas. In other words, one hair follicle is split and “doubled” into two fully functional follicles.
Recently, Coalition hair transplant surgeon and follicular unit extraction (FUE) expert Dr. Patrick Mwamba announced that he was integrating donor doubling into his hair restoration practice. Dr. Mwamba is currently researching and testing a specific type of doubling called in vitro donor doubling. During this method, a hair follicle is removed using a regular FUE technique, bisected (split in two) into the two regions of stem cell activity under a microscope, and then one half is implanted into the recipient scalp and the other half is reimplanted back into the donor region.
After learning about his new venture, we asked Dr. Mwamba to share his thoughts and experience related to donor doubling and how he plans on integrating this experimental technique into his practice. According to Dr. Mwamba:
I have been following and reading about hair regeneration technology, partial longitudinal follicular unit extraction techniques, Coalition hair transplant surgeon Dr Jerry Cooley‘s work with ACell, and Dr Nigam’s (the first to use the in vitro donor doubling technique) work with donor doubling for quite some time. Throughout this time, I was experimenting with donor doubling techniques and ACell myself as well.
However, with my technique , I was not able to completely erase the small white scars created in the donor region with FUE. I also achieved donor regeneration of around 10 to 30% , but was not satisfied with this level of scarring or donor doubling.
I continued reading and investigating physicians who were claiming to get above 60 % regeneration in the donor region and good recipient growth with donor doubling techniques. At this point in time, one of Dr Nigam’s representatives contacted me and suggested that I meet him. Dr. Nigam was using the in vitro bisection method and said he was willing to openly share his technique with me. I accepted his invitation under one condition: after teaching me the technique, he would perform his technique on one of my own patients so I could monitor and assess the results myself. He agreed, so I bought a plane ticket and traveled to his practice in India.
After I arrived, we spoke and slightly modified our plan. We decided that I will perform surgery on one of Dr. Nigam’s patients with my FUE technique and then apply some of the growth factors he uses to regenerate the donor region during in vitro doubling, and he would still perform his technique on my own patient. I then agreed to follow up both patients in my clinic in Brussels (as they both live in Europe).
During my visit, I was pleasantly surprised by Dr. Nigam’s passion and his clear explanation of the science behind his techniques. I also reviewed a patient who previously underwent donor doubling hair transplantation with Dr. Nigam, and it was clear that he experienced growth from the procedure. I now had proof that I could not deny. I won’t generalize and say every patient will achieve this type of result, but this patient inspired me to learn and practice the in vitro bisection donor doubling technique.
Dr. Nigam then taught me how to perform his technique so I can start offering it in my clinic in Brussels. This will help me determine if it is something I want to permanently integrate into my practice. One of the most important aspects of proving the scientific validity of a technique is reproducing the same protocol in a different environment and achieving similar results. Therefore, I am choosing to apply Dr Nigam’s technique in another environment ( my clinic ) to prove the validity of his concept.
In the meantime , I am following up the two patients who traveled with me in India ( Dr Nigam’s patient and my patient ), and I will also go back to India for more donor doubling training. It is my hope that the in vitro bisection donor doubling technique will create a new way to help those suffering from hair loss. I will keep you updated on my findings.
Blake – aka Future_HT_Doc
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