Are Robotic & Automated Hair Transplant Systems Better?

Trends in Hair Transplant Technology

Technology impacts every area of medicine, including hair restoration. Dr. Vories keeps up with the latest literature and participates in hair restoration surgery and medicine conferences worldwide.

At Carolina Hair Surgery, we believe that FUE or follicular unit excision is the best and most ethical surgical option for our patients. FUE is a minimally invasive surgical procedure that does not leave the patient with a linear donor scar like strip or FUT donor harvesting.

With FUE, the patient experiences less discomfort, heals quicker, and has more styling options after surgery because the donor region in the back and the sides of the head can be trimmed very close without any visible scarring.

The above being said, not all FUE hair transplants are the same. Dr. Vories was an early adopter of the NeoGraft automated hair transplant system. Although he succeeded with the device, there were limitations and potential pitfalls to the technology. For Dr. Vories, the primary negative of NeoGraft was the suction, which automated the harvesting of the grafts and could cause some damage to the delicate hair follicles and dry the grafts out – reducing hair graft survival.

The ARTAS Robotic Hair Transplant System is an amazing new technology.  Robotic technology may one day be the ultimate methodology for performing hair transplant but the technology cannot currently outperform the performance of a truly skilled hair transplant surgeon. In our opinion,  robotic hair transplantation can help level the field so that surgeons new to the field of hair transplantation have a reliable technology partner to assist with graft harvesting. The laser-assisted technology does not work on light or gray hair and requires patients to dye their hair black. There may be more scarring because the ARTAS uses a larger 1-1.2mm punch.  We feel that with the larger punch used by the ARTAS the scarring is unacceptable and defeats the goal of FUE, which should be little or no visible scarring. We have not seen results from the new iX technology for implanting grafts; this is one of the most critical aspects of hair transplantation and why Dr. Vories implants each graft to ensure that the graft placement and insertion angle mimics the original hair growth pattern.

In our practice, we believe the physician should be an integral part of every patient’s surgery. Our surgeons review the aesthetic design and hairline placement with the patient before surgery, extracting each graft (.7mm-.9mm average graft size). With the assistance of a highly trained technician, who loads each sorted hair graft into an implanter that protects the graft from physical trauma, the surgeon safely inserts each hair follicle in the appropriate place and direction for maximum hair growth and aesthetics.

In some practices, we have heard of physicians not performing any of the procedures and delegating the surgery to non-licensed technicians. See the consumer alert notice by the International Society of Hair Restoration Surgery. This unethical and non-patient-focused practice has been particularly prominent in providers offering NeoGraft hair transplant technology. This does not mean that all physicians using this technology abdicate their role in the surgery, but unfortunately, many physicians with little or no experience in hair restoration do delegate the surgery to unlicensed technicians.

Technology cannot be ignored and we are constantly improving equipment and methodology, but until the technology can equal or exceed a skilled hair transplant surgeon and his staff there is no advantage, and there may be disadvantages to the patient, in performing hair transplant surgery using an automated or robotic device.