Category: FUE

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Will the FUE Robot Make Surgery Cheaper? – Balding Blog

Hi Dr.Rassman. If you were to incorporate one of those fue robots in your practice would it lower the cost of an fue session? I know time limit would be lessened. Which method of the fue session is most labor intensive, the extraction process or the implanting one? I heard you have an interest in the success of these robotic systems. Please educate the public docter.

RobotI am told the robot will cost about $250,000. I think that this has to be paid down and the result should be a more expensive hair transplant. At least initially. I am just speculating, though, as we don’t have the robot in our practice.

This may be an issue of quality, not cost alone. Don’t focus on costs. A poorly done FUE procedure will cause permanent loss of your donor hair (not uncommon) and that costs you much of your future hair supply. How does one put a price on quality?

Note: The robot at the right is not going to be doing the FUE procedure, though it would be kind of neat to see.




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Balding Forum - Hair Loss Discussion

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Hair Loss Information » Artas System by Restoration Robotics — Now With a Photo! – Balding Blog

Snippet from the article:

The FDA has approved a machine called the Artas System for use, according to manufacturers Restoration Robotics, Inc. The company describes Artas as “an interactive, computer assisted system utilizing image-guided robotics to enhance the quality of hair follicle harvesting” by combining “several features including an interactive, image-guided robotic arm, special imaging technologies, small dermal punches and a computer interface.” Artas can be used on patients with straight brown or black hair; blondes or redheads still have to face male pattern baldness without robotic assistance, at this stage.

Read the full text at Time.com — Now, Robots Can Save You from Baldness… As Long As You’re Not Blond

We posted about the FDA clearance of Restoration Robotics’ Artas System a couple weeks ago, but with all the emails I’ve gotten about it and more articles showing up in my Google Alerts daily emails, I figured at least some of you might like to see a press photo of the instrument (see below):

Artas

 

The FUE harvesting that this robot can do is just one step in the process for hair restoration. Some doctor must design the hairline and decide what has to be harvested. Plus, the management of the grafts is a strict science, and the placement of the grafts into the recipient area requires a team of specialized personnel. This is a good addition for instrumentation, but it is not the automation of the entire process.

While I mentioned before that we licensed the core optical technology for the robotic FUE technique and have a vested interest in seeing this instrument be successful, I realize how surreal this might seem. So with that said, feel free to post your cyborg/robot jokes in the comments section.

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Hair Loss InformationUsing SMP to Fill in the White FUE Dots? – Hair Loss Information – Balding Blog

Hello Doctor

Do you believe that with the advent of scalp micro-pigmentation, it is now feasible for transplants in younger patients / more aggressive transplants in general?

A patient could have a transplant to frame the face with a NW2 or so look, and if they cannot keep up with hair loss via meds + additional transplants, they may have the SMP procedure, (with the option of some hair transplanted to the regions), in order to obtain the close-cut stubble look.

Additionally, has there been any attempts to fill in the “white dot” scarring from FUE procedures?

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The answer is yes on all accounts. Scalp MicroPigmentation (SMP) works wonderfully in filling in the white dots from FUE harvesting. Combining SMP and transplants must be made individually by a person skilled in the art.

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Hair Loss InformationIn the News – FDA Clears Restoration Robotics Tech – Hair Loss Information – Balding Blog

Snippet from the article:

Medical device company Restoration Robotics Inc. said Thursday the Food & Drug Administration approved its system for treating hair loss.

Mountain View-based Restoration Robotics, which is privately held, said the system harvests hair follicles from the scalp in men diagnosed with male pattern hair loss with black or brown straight hair.

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Read the full story — FDA approves Restoration Robotics system for treating hair loss

Restoration RoboticsThis product has limited use, as it only performs the FUE (follicular unit extraction) harvesting, not the implantation of the grafts, which is by far the most challenging technical aspect of the hair transplant process. The learning curve for manual FUE takes a few months, but the learning curve for placing the grafts easily approaches one year. For the novice surgeon who never learned the manual FUE technique, it allows that person (with minimal training) to produce a high quality FUE process.

In our original article which introduced FUE to the hair transplant community a decade ago, we categorized patients in 5 categories to determine which were the best and the worst patients for FUE (Fox class 1 was the best and Fox class 5 was the worst). In that article, we reported the worst Fox class 5 patients reflected about 20% of the population. It remains to be seen whether the robot can produce the high quality grafts with minimal damage in the Fox class 5 patient. Today, I believe that only about 10% of patients would be classed by me as a Fox class 5.

The cost of the robot, I believe, will be very high (significantly more than $100,000)… so the market will be small. There are many alternative approaches to the FUE technology, as there must be more than a dozen extraction devices produced. Some work, but many do not. Despite the automation of the extraction process, I doubt that this robot will become today’s ‘Standard of Care’. There is no doubt that the FUE technique has been well defined and proven today with the various techniques, but there are still a number of doctors who perform the technique very poorly. I have unfortunately seen too many of their failures in my office. At least with the robot, I would expect that the patient will be confident that what he is paying for and what he is going to get is what he expects he will get, and that alone should help the patient make a decision about their surgeon (if there are any doubts as to their chosen surgeon’s competency).

I must reveal here that we have a vested interest in the success of this particular robot, as we licensed the core optical technology for the robotic FUE technique many years ago. Seeing that the product finally has come to the market is very satisfying to us. We have also developed comparable hardware technology for placing grafts and obtained US patents in this arena, so when and if Restoration Robotics moves into graft placing, we can finally say that the automation process is complete.

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If FUE Doesn’t Satisfy My Hair Needs, Can I Then Have a Strip Surgery? – Hair Loss Information – Balding Blog

Im a 58 year male who is seriously considering transplant surgery to restore my frontal hairline area. Im interested in the FUE procedure. My question is if Im not satisfied with the results can I still undergo strip harvesting in the future

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I realize your question is very limited and I don’t know anything about your hair loss, but based on what you are asking I think you are going about this completely wrong. First, you need a Master Plan for your hair loss.

Follicular unit extraction (FUE) is a great surgery, but it has limitations. One of the main reasons you should have an FUE procedure is because you want to cut your hair short in the back without seeing a linear scar. If you don’t mind the linear scar (which I assume to be the case if you’re considering the strip procedure), I’m not sure why you’d want to go with FUE to start with. There’s a list you might find to be an interesting read — The Pros and Cons for FUE / Strip Harvesting.

So while the short answer to your question is “yes”, I think you should seek a good hair transplant surgeon to discuss your overall goals and expectations.

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Hair Loss InformationFUE for the Front, SMP for the Back – Hair Loss Information – Balding Blog

Dr. Rassman,

With the advent of the Scalp Micro-pigmentation procedure, I’m wondering if it actually allows for more FUE harvesting from the donor area. What I mean to say is that one could only have a certain level of FUE grafting before you depleted the donor and left noticable empty spot in the back of the head.

I’m now wondering (if one so chose to)if you can in theory remove more grafts of real hair and simply fill-in the depleted donor area? This of course is assuming the patient wanted a low-cropped/shaved hair style. However, I’m not crazy about the shiny razor-shaved look. I prefer some natural looking stubble on top.

I understand you may think grafting hair on top of your head and shaving it might defeat the purpose, but that’s the look I like. Thanks for your time.

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We have had one patient get follicular unit extraction (FUE) on top of the pigmented balding scalp to produce the feeling and appearance of stubble. It works.

You indicated you aren’t far from our Los Angeles office, so if you’re interested in setting up an appointment for a consultation, you can call our office at 310-553-9113… or attend one of our free monthly open house events. The next open house is coming up on Saturday, April 9th.

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Hair Loss InformationHistamine Positive Skin and Hair Transplantation – Hair Loss Information – Balding Blog

Hi,
I would first like to thank you for this very informative site. My question has to do with post operational side effects. Specifically, I had FUE/FUT 1.5 months ago. Unfortunately I have something my doctor called histamine positive skin. As a result there is redness in the recipient area. My first question is related to that.

How long would it take for such redness to fade away and what can I do to reduce that amount of time? Additionally, in the donor area, there is a significant amount of redness and the hair growth appears limited. Is this to be expected? And what is the time frame for full recovery of the donor area? My doctor is quick to say it will all be fine in a few months but I wanted a second opinion as well as anything I should keep an eye on to better facilitate the recovery of that area.

This was my first surgery and I only had 1000 grafts transplanted.

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If your doctor was helpful enough to explain a histamine reaction to you, how is it possible that you were not told how long it would last? I often do a scratch test to the scalp or forehead to preselect those patients who are histamine positive. In general, every patient is different and the redness can last several weeks to months. 1 to 2 months would seem on the long side.

Unfortunately this is not a place for second opinions as I do not know what you are really experiencing. All hair transplants are not the same, especially FUE, as there are many variables such as size of punch, techniques of extraction, the drugs you take, the allergies you have, etc, etc.

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Hair Loss InformationI Am a Bad Scar Former – Would FUE Be an Option? – Hair Loss Information – Balding Blog

I have hypertrophic scars from numerous cutaneous surgeries, and even under modest tension my scars tend to spread quit a bit. None of them have an adequate cosmetic result in my mind for a hair bearing region. As a result, harvesting grafts with a strip is something I am not considering. Given my propensity for making ugly scars, am I likely to have abnormally visible scarring from follicular unit extraction at the harvest or transplant site, or are these so small that hypertrophy and spreading are of little concern?

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Nobody wants a bad scar, but for hair transplant surgery (or any surgery on the scalp), the scar should always be hidden under the hair if you keep it at a normal length (more than 2 inches). Even a bad scar can still be hidden after a haircut with a #3 clipper most of the time. I also realize many men would like to cut their hair very short in the back where the scar may be visible, and that’s when follicular unit extraction (FUE) may be a better option. However, if you have a tendency to have hypertrophic scars, then even the FUE may leave you with hundreds of noticeable dots.

As with everything in life, you need to have some perspective on what you are doing and what you are willing to give up. Nothing is perfect. There is no such thing as scar-less surgery. There are men who choose to have hair in the front and top, but sacrificing the gain with a scar in the back of their head. There are men who do not want any scars on the back of the head (linear or otherwise), and for them surgery is simply not an option. There has to be some give and take that you have to be comfortable with.

Think about cosmetic surgery on women: Women who want larger breasts will sacrifice their gain in cup size with a scar under the breast, around the areola, in the armpit, or in their belly button. Women who want a face lift will sacrifice a youthful face for a scar along the back of their ear and behind their front hairline.

Remember, keeping your hair very short after a hair transplant will not give you the best cosmetic results no matter how many grafts you transplant. A very short hair style will look much thinner than a longer hair style, which covers more of your head. This is because the surgeon is working with a limited number of grafts to cover a big area.

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Removing Only Part of the Follicle – Hair Loss Information – Balding Blog

Hello Doctor

There is a dutch clinic that advertizes the following method

“The most significant difference between the HST method and traditional hair tr*nspl*nt techniques is that with HST, only a tiny part of the hair follicle is removed, leaving the majority of it in the donor area where it will produce a new hair. This preserves the donor area for future treatments, which is why this technique should actually be referred to as hair multiplication, rather than tr*nspl*ntation.”

A very famous dutch soccer player ( Snejder ) supposedly undergone this procedure . Anyone who saw the Bayern Munich – Inter Milan game this week definately noticed the difference on his head

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I’m not sure why “transplant” is censored on that clinic’s site…

I know who you’re referring to and I have heard this doctor speak on the subject of partial unit extraction. One of the problems — there was never any physicians actually looking at what he was doing, and as such, there is no peer review or comments by other qualified academic doctors that could back up the claims that he actually has growth of full healthy hairs from fragments of hairs. This very subject has been extensively studied by other physicians and the ability to grow full, healthy normal hairs is clearly not possible. I do not believe that what this doctor is reporting is real.

Past posts about this here and here.

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Auditing a Hair Transplant? – Hair Loss Information – Balding Blog

Hey Doc,
I had an FUE procedure last week of 2400 grafts. The procedure lasted 9 hours (10 if you include lunch, etc.).

My question is as follows: How can one verify that the doctor (a well respected FUE doctor)actually gave you the number of grafts that you paid for? The work seems fine, but it just doesn’t seem like there are 2400 scabs on my head representing the number of grafts, and im now skeptical that i really got that amount. I do not have much of a way to verify my hunch as its too difficult to count.

I know the obvious answer is to pick an honest surgeon. But beyond that — any thoughts, tricks or advice for those of us whose eyeballs seem to underestimate the number of grafts on our heads? Is it tpically more or less than it looks like to the human eye?

Thanks!

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Magnifying glassIf you feel the need to verify that you got what you paid for or what the doctor represented to you in regard to the follicular unit extraction (FUE) transplant, then you can get a second opinion. I have done that on a number of patients, but if the transplant was more than a week old, my accuracy in counting them is compromised. What I do is count the wounds (holes) on the back of your head.

If you had 2400 grafts, then you should have 2400 holes reflecting the FUE extraction sites. If the doctor charged by the number of follicular units, sometimes a single FUE site can have more than one unit if the doctor used a large punch or if your density is very high. Or maybe less than 2400 were taken, but the grafts were split (see here for more on that). I am not saying this is what happened, but I am giving you a skeptic’s point of view, reflecting your uncertainty.

Finally, if you trust the doctor ask for your surgical records and count sheets, which may show the doctor’s actual numbers (where the technicians keep track of all the “successful” FUE grafts pulled out and all the “unsuccessful” FUE grafts pulled out). This is what we do on every FUE case.