Dr. Cole Reveals C2G Video Demonstration

This video demonstration was taken during live hair transplant surgery with one of Dr. Cole’s patients.  With strip harvesting or traditional FUE, the patients are very limited in their personal appearance and have difficulties getting back to normal daily activities because they are asked to shave their head.
Shaving the head allows the physician to have high visibility of the donor area which is necessary for donor hair extraction. With the new C2G technique, the patients are able to keep their normal hair style before and after the CIT technique!
Now patients can have the best of both worlds. They no longer have to put up with the pain associated with strip scars and they can still maintain their normal hair style.

 
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What Causes Shock Loss?

It is really unknown what causes shock loss.  Shock loss is hair loss resulting from a hair transplant procedure.  There are many theories, however.  Shock loss most likely is due to an inflammatory response as a result of physical trauma.  It is really quite uncommon in the donor area.  It is more common in the recipient area.  The density of incision sites may play a role as high density incision sites tend to produce shock loss more commshock loss Causesonly.  Shock loss will occur only in the area where the incisions are made.  It will not occur in adjacent regions.

Shock loss begins about 2 to 3 weeks after a procedure and it will continue over a period of a few weeks.  If you experience hair loss months after a procedure, it is not due to shock loss, but rather due to progression of hair loss or some other factor unrelated to the hair transplant procedure.

Some feel it is due to the injection of epinephrine, which is commonly added to the anesthetic.  This is most likely untrue as you will not see shock loss in areas where anesthesia is given, but rather only in areas where the incision sites were made.  You also more commonly see it in the recipient area while epinephrine is also given in the anesthetic given in the donor area during a hair transplant surgery.  Even though the same anesthetic with epinephrine is given in the donor area, you do not see shock loss in the donor area when it occurs in the recipient area.

The inflammation might result from physical trauma, but it also might be due to the free radicals that accumulate in tissue that continues to metabolize outside the body in an anaerobic state.  Free radical scavengers in the storage fluid along with cooling of the tissue outside the body might help reduce the amount of free radicals produced by the grafts.  One might also limit the free radical load by limiting the recipient area density during a hair transplant.

Shock loss is uncommon in the donor area with both strip harvesting and with FUE or FIT.

When shock loss occurs, the hair will generally begin to grow back after a hiatus of 3 months.  It is only the fine wispy baby like hair that seems most prone to remain dormant following shock loss.  This sort of baby fine, short, lightly pigmented hair produces the least amount of coverage, however, so it will not be missed as coarser, darker, longer terminal hairs will take their place when the hair transplantation produces new hair growth beginning three months after the hair transplant.

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Strip Scars Grafting and Camouflaging

What are the ways to camouflage strip hair restoration scars?

Camouflaging Strip Scars

Scars in the donor area from strip harvests may be problematic for many men. They may be short or run from ear to ear. Sometimes they widen over time, occasionally to more than two centimeters, which is deforming. This is usually due to an overly tight scalp, too low a placement, or poor surgical technique. They also change the direction of hair growth below the scar, relative to above the scar, which may cause a “shadow” of the linear scar to be evident even with the hair grown out somewhat.

IN order to minimize the appearance of scars, several strategies are available. There are cosmetics such as Dermatch, which may help disguise the scar. The hair may also be grown out fairly long to attempt coverage. This, of course, may not be an option for those with an over harvested donor region.

Surgical scar revision may be attempted, often without success. This consists of excising the scar and them suturing up the wound, hoping that the resultant scar will look better than the original one. This can work in some instances; however, if the condition that led to the scarring is not remedied, then even the best revision may fail.

Grafting into the scar is another option. Because yields tend to be lower in scars, this may take more than one surgical procedure over many months to have a significant cosmetic effect. Either body or scalp hair may be used; scalp hair is generally a better choice if it is available.

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Dr. Cole, What Is The C2G Stand For?

Dr. Cole, what is the C2G stand for?

C2G stands for the Cole Isolation technique to go or CIT to go. CIT is a proprietary method of harvesting individual follicular units one at a time such that there is no need for a strip harvest. Strip harvests leave linear scars and no one can predict how wide the scar will be or whether it will be pale white in color or red in color. Either way the strip harvest leaves you will a linear scar that obviates your capacity to wear your hair short and leaves you vulnerable to others suspecting you’ve had a hair transplant previously. Often patients are so concerned about their strip scar that they cease going to a barber or hair stylist for fear of exposure.

In an effort to overcome this social stigma we developed the CIT procedure. The single negative to this procedure has been the requirement for patients to shave the donor area. This can result in problems blending back into society or into one’s work place. The goal of C2G was to develop a procedure that allows patients to keep their hair long so that they can return to their normal social environment within a few days.

C2G is a procedure where only individual follicular units are trimmed and the resulting individual follicular units are then transferred to the top of the scalp after harvesting them via CIT. Only the individual follicular units are trimmed so that you have a normal appearing donor area from day one and you also have the advantage of avoiding the strip scar altogether. Now there is no reason to avoid taking advantage of all the long term benefits of CIT. This includes no linear strip scar, no prolonged strip scar pain, no prolonged strip scar tightness or numbness in the donor area, more hair per graft (more bang for you buck), and a lower follicular injury rate (transaction rate).

There was once a draw back to CIT. Now there is none. C2G is the future of hair restoration surgery.

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CIT VS Other Hair Transplant Techniques

What are the common used hair transplant techniques and how are they different from CIT?

Hair transplant surgery can be done using several different techniques, including old-style plugs, strip harvest, The Cole Isolation technique (CIT), and body hair transplantation (BHT). Plug harvesting is only mentioned for historical reasons; it is a very poor technique and should not be used in the modern era. Strip harvest using only two incisions became popular during the 1990’s, and is still widely used today. CIT is very new, having been used only the past 5 or 6 years, but is beginning to challenge strip surgery in some areas as a procedure with much less scarring. BHT is used mostly for adding hair to scalp hair surgeries, and in patients who have had much of their scalp donor hair removed. Scalp hair is always better, and BHT is seen as a complement to scalp hair.
Hair grows on the scalp in separate units, which are known as follicular groups or follicular units. They contain 1, 2, 3, 4, or rarely 5 or more hairs. During the CIT procedure, a special tool is used to take these hair groups out one at a time. The advantage is that no long incision or wound is made in the scalp, and therefore no long scar results. Also, there is very little pain after the surgery, and the hair grafts come out ready to place in the balding areas, with no trimming needed. Sometimes there are tiny white dots left where the hair s were taken out; these are very small and if the hair is more than ¼ inch long or so, the dots are invisible.
These hair grafts are then placed into tiny slits or holes made by the surgeon into the balding or thinning hair areas; in about 3 or 4 months the first of the “new” hairs begin to sprout and by the end of a year, the full result of the transplant will be seen!

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