Trends in Hair Transplant Technology

Robotic Hair Transplant System

Technology has an impact in every area of medicine including hair restoration. Dr’s Vories and Hughes keep up with the latest literature and participate in hair restoration surgery and medicine conferences around the world.

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 there is less discomfort for the patient, they heal quicker and FUE provides the patient with 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 had success with the device there were limitations and protentional pitfalls to the technology. For Dr. Vories the primary negatives to 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. During FDA testing the robot had higher transection rates (hair follicles being cut and damaged) and the skilled physician outperformed the robot in speed and quantity of hair that can be transplanted in a given session. 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 that scarring is unacceptable and defeats the goal of FUE which should be little or no visible scarring. Also, contrary to some information online, the robot is not able to make recipient sites and implant the grafts.

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

Actual patient. Top view, before, immediately post-op and 6 months post-op

In some practices we have heard of physicians not performing any of the procedure 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 or ARTAS Robotic 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.