Robotic FUE (ARTAS) Dallas
The ARTAS System is an interactive, computer-assisted medical robot utilizing an image-guided device to enhance the quality of hair follicle harvesting.A sophisticated image processing and various algorithms guide the physician in identifying and harvesting targeted follicular units. The follicular units are extracted, then stored for implantation according to the physician-designed restoration plan.The main advantage of the robot is that it can achieve rapid and accurate hair harvesting using highly sophisticated computer visualization technology and tireless repetition. With impressive technological gains, the computer software and hardware of the ARTAS robot provides one of the most efficient methods for FUE harvesting currently available. In spite of its advanced technology, the ARTAS has some limitations, such as harvesting from the lower portion of the scalp or body hair that must still be undertaken by hand. Using oftentimes a combination of hand and robotic technology can provide the best of both worlds and our team is skillful in both techniques offering the expertise that many clinics cannot match.
The ARTAS System is the creation of Restoration Robotics, Inc., the California-based medical device company specializing in hair transplantation technology. The development team is composed of innovators whose talents have pioneered other medical robotics instrumentation, including the daVinci Surgical System.In 2013, our hair transplant coordinator, EminaKaramanovski Vance, served as a Senior Director for Training and Professional Education helping develop the training program for the ARTAS users. Understanding medical robotics helps our team utilize the ARTAS system more effectively while exercising the best practice.
If you are considering an ARTAS FUE procedure, you need to plan that your entire donor area will be shaved to a length of 1mm (“high and tight” electric trimmer with no guard) in order for the robot’s vision system to accurately see the angles and direction of the hair.The donor and recipient areas will then have tiny scabs that heal within 7-10 days. In most people, the remaining hair grows out and covers signs of the procedure in the donor, and sometimes in the recipient, area within 10-12 days.
This patient underwent the ARTAS robotic hair transplant procedure to restore his lost hair. He is the perfect candidate for this procedure because he likes to wear his hair relatively shorter in style.
One size does not fit all and everyone has different needs, desires, and limitations that must be calibrated when embarking on any hairtransplant procedure.Dr. Lam and his team will discuss with you the best method or combination of methods that will be suitable for you as a prospective patient.
- Ideal candidate
- Men who have hair loss and are diagnosed with male-pattern hair loss
- Men whose hair-loss progression is relatively slow and stable
- Men who wear their hair very short, have very sparse donor hair, or have donor hair that grows at an obtuse angle (such as some Asian hair) in which the scar would not be well camouflaged
- Men who can comfortably shave their head for the procedure
- What to do
- Schedule your procedure and plan on one week for recovery during which you are functional but may not be socially presentable for 3 to 5 days.
- Cut your hair a day or two before the procedure; you should ask for a “high and tight” hair cut that leaves the top as long as you desire but the sides are cut to a “0” guard.
- If you are not already on any hair-loss management therapy and you have miniaturized hairs, you may be required to start one or several (such as finasteride, minoxidil, and/or laser) in preparation for the procedure. Depending on your unique situation, you may be required to be on a hair-loss management treatment for anywhere between 4 to 6 weeks in order to strengthen your hair and to minimize postoperative, temporary hair shock loss.
- If you are from out of town, you will be required to arrive the day before the procedure and will be allowed to travel the day after, staying in town for a total of two nights.
- What to expect
- You may have visible scabs around transplanted hairs and around harvested sites for about 7 days. You may have swelling of your forehead and around the eyes that may last 3 to 5 days.
- You can wear a hat immediately after the procedure, and you can wash your hair 24 hours after and resume most physical activities 48 hours afterward. You can travel the next day.
- You can wear hairstyling products 2 days after, camouflaging products 7 days after, and color your hair 15 days after the procedure.
- Transplanted hairs should oftentimes start growing 3 to 4 months post-procedure, achieve visible change in many cases at 5 to 6 months post-procedure, and continue improving in growth up to 12 months post-procedure or longer.
I understand that FUE is a scarless procedure. Is that true?
There is a misconception that FUE is a scarless procedure. It is worth mentioning that any surgical procedure leaves a scar, and most scars heal with less pigment than in normal surrounding skin (whiter in color). Consequently, even the scars from FUE procedures can be easily noticed as white dots if the scalp is completely shaved. In addition, over-harvesting, which may happen in a single or multiple procedures can result in thinning out the donor hair at the point of looking unnatural. For that reason, it is important to limit the number of grafts in a single session and the total number of grafts in multiple sessions, in order to properly space out the harvest sites and thereby protect the donor area from becoming unnaturally thin.
What are the limitations of an FUE procedure?
First, FUE grafts are not as hearty as FUT (strip) grafts because they are more fragile, thinner, and have less adnexa (surrounding support structures). Therefore, there is a slightly lower survival rate than FUT. Dr. Lam believes that the gentle handling he and his team perform on his grafts and the regenerative medicine techniques (PRP, ACell, ATP, and HypoThermosol), which he likes to explain as fertilizers, that he uses help to ensure that his FUE grafts grow better than elsewhere in the industry. He also minimizes the ex vivo time (time out of body) by staging transplantation (what is removed is then placed as quickly as possible), and the ARTAS robot, which allows more rapid harvesting, can further minimize ex vivo time of harvested grafts. Second, FUE cannot reasonably provide the same complete front-to-back coverage as FUT can achieve due to donor depletion (there are more total usable FUT grafts in the donor area). Over-harvesting in the donor area with FUE can lead to devastating patchy or moth-eaten scars that are virtually impossible to correct, and in Dr. Lam’s opinion can be far worse than linear strip scars in their appearance and the possibility to correct them.
How does Dr. Lam decide to use ARTAS robotic FUE versus a manual motorized or dull punch?
The ARTAS provides very precise, controlled harvesting that is also remarkably fast. However, the ARTAS at times has difficulty with certain hair types (very curly or very low angled) and in certain areas of the scalp (like the very low portion of head above the neck or the sides of the head above the ears), so Dr. Lam may supplement the harvest with handheld motorized techniques. For the beard and chest areas, the ARTAS cannot be used, so he harvests these areas with handheld FUE tool that is very accurate and is the only way to harvest from these areas.
FUE vs. FUT
|Procedure||Follicular Unit Extraction||Follicular Unit Transplant|
|Harvesting method||Small round punches||Linear Incision (Strip)|
|Ideal candidate||Men||Men and Women|
|Graft survival||Grafts fragile and easily injured; good survival||Grafts robust and resilient; great survival|
For more information, please watch our videos on Follicular Unit Extraction
Please click here for our Before and After photos
Please watch Dr. Lam’s SlideShare presentation on his philosophy, strategy, and design for crown hair transplantation.
Please watch Dr. Lam’s SlideShare presentation on the fundamentals of male hairline design.
Please watch Dr. Lam’s SlideShare presentation on recipient site design and distribution.