Dr. Bernstein was featured as the cover story of the April 27th edition of NY Japion, a weekly newspaper in the Japanese language, published in the New York tri-state area and distributed for free in the Japanese community.
Q: Can the ARTAS Robot FUE hair transplant be performed on blonds? I heard it only works on dark-haired individuals? — T.W., Jersey City, NJ
A: Correct, robotic FUE doesn’t work well on light-blond or white hair -– but it is easy to dye the hair prior to surgery, and this will solve the problem. We generally advise patients to dye their hair two to three days prior to the procedure so that any residue of the dying still on the scalp can be washed off.
Dr. Bernstein spoke with Bloomberg’s Matt Miller about the future of hair transplantation in a segment called, “The Bald Economy: Surgical Solutions to Hair Loss.”
Here is an excerpt from the segment:
Bloomberg’s Matt Miller: Riding the wave into the future happens to be one of the pioneers of FUE, Dr. Robert Bernstein.
Dr. Bernstein: “The robot now allows a mechanized system to do [follicular unit extraction] very, very quickly and very consistently, so that the human error in this part of the procedure is now gone.”
NY1, a New York City television channel, has featured Dr. Bernstein in a segment on robotic hair transplantation.
Here is a transcript of the video:
A new robot could help return hair to those of us who, as we get older, find ourselves a bit follically challenged. Called the ARTAS System from Restoration Robotics, it was recently approved by the FDA to help with a type of hair transplantation technique called follicular unit transplantation where follicular units, groups of one to four hairs, are removed directly from the back of the head and transplanted on the top and front. Removing those units has always proved to be the toughest part of this method, but the robot changes that, which is why even Dr. Robert Bernstein – the man who’s widely credited with developing follicular unit transplantation and [follicular unit extraction] – jumped to be among the first in the U.S. to use the device.
“A follicular unit is about a half a millimeter and you have a one-millimeter circle that has to go dead center over it to punch this out. So when you’re doing it by eye and you’re doing thousands of them over time you’re missing them over time it’s not exactly precise. The robot is dead center each time and follows the angle of the hair,” explains Bernstein.
While the robot doesn’t really have any direct impact on how the transplant will ultimately look – that’s still up to the doctor’s expertise and artistic skill. What it does do is give the doctor a better quality sample of hair with which to work.
“There’s always damage to the follicles when you’re doing it because you’re doing it by hand through these very tiny incisions and so the yield is going to be less and so with a robot if you try to get out 100 follicles you’ll get very close to 100 follicles,” says Bernstein.
Again, the robot just makes the incision, the doctor still has to pull the hair, make sites on the front where the transplants will go and then actually make the transplants. However, developers say they are working on having future versions of the ARTAS System help with the entire process.
Q: I wanted to find out about the difference between what Dr. Bernstein does with his robotic system versus NeoGraft. — G.M., Newark, NJ
A: The ARTAS robotic system, used at Bernstein Medical, has robotic control, video imaging and uses a blunt dissection technique. This allows for very precise extraction of follicular units from the donor area with minimal transection. The Neograft machine for FUE is a manually operated machine which uses sharp edge dissection. Because it relies on manual controls rather than robotics, it is less accurate and the cutting tip causes more graft injury. The precision of the robot allows the grafts to be harvested with less trauma and will thus result in better growth. In my opinion, these differences are very significant.
Dr. Bernstein with ARTAS Robot in New York City Facility
Interview Magazine is known for its glamorous and often edgy depictions of, and insights into, the lives of fashion and movie celebrities, musicians, and other artists. The February 2012 issue features a section on the “elite league of experts” who celebs are increasingly turning to in order to maintain their high profile image. The article describes Dr. Bernstein as a “pioneer in the world of hair replacement surgery,” and as the hair transplant surgeon of choice for “VIP clients from the world of fashion and entertainment.”
Dr. Bernstein’s publication “Follicular Transplantation” is referred to as a game-changing paper that has directly led to modern techniques, including the robotic hair transplant procedures currently being performed at Bernstein Medical – Center for Hair Restoration in New York City.
The article touches on one aspect of hair transplantation that Dr. Bernstein makes clear to all hair restoration patients in their initial consultation, and that is the fact that surgical procedures are not always recommended or indicated for a patient. As he says in the article, “Surgery is a personal option and a serious business, so I don’t oversell it.”
The photograph of Dr. Bernstein that accompanies the article — a small version of which is above — is an artist’s view of Dr. Bernstein using the ARTAS Robot for FUE. The emotion of the image is heightened by the subtle connection he makes with the patient with his outstretched arm, exhibiting the care and consideration for his patients’ condition that is the hallmark of Dr. Bernstein’s practice.
The New York Times, once again, has recognized Dr. Bernstein’s pioneering hair restoration techniques. The NYT Fashion and Style section noted that he is, “the first hair transplant surgeon on the east coast,” to use the ARTAS robotic system for Follicular Unit Extraction.
This precision, image-guided robot is unique in its, “use of digital mapping and tracking to extract and harvest ‘follicular units.'”
Dr. Bernstein’s pioneering work in developing FUT and FUE hair transplant procedures has influenced hair restoration physicians across the globe. Recently, his use of the ARTAS System for robotic FUE has grabbed international attention.
Yomitime, a Japanese web-zine, recently featured Dr. Bernstein and his foray into robotic hair restoration. The article describes the “cutting-edge” ARTAS robot, while also covering the basics of Dr. Bernstein’s FUT and FUE procedures.
Patients of Bernstein Medical fly in from around the globe to receive world-class treatment for their hair loss. This past year alone he has treated patients from India, Japan, South Korea, Saudi Arabia, Mexico, France, Germany, United Arab Emirates, Brazil, Israel, the UK and Russia.
For more about visiting our office from abroad, visit Our Patients in the New Patient Information section. Or, to have a consultation with Dr. Bernstein via the internet, visit our Photo Consult page and submit the form.
You don’t have to be interested in a hair transplant to appreciate the advanced technology in the ARTAS system for robotic FUE. That is why the technology and media website “All Things D” has featured the image-guided hair restoration robot in an article titled, “All I Want for Christmas is a Robot Hair Transplant.”
The article gives the reader an overview of the system and why it is beneficial. Dr. Bernstein provided some insight for the piece, particularly regarding the reduction of human error that can occur in long procedures. The article also notes that, as of the date of publication, there are only four ARTAS robotic systems in use in the United States. The system in use at Bernstein Medical is the only one on the East Coast.
For a more detailed description of the system, how it works, and its benefits please visit our section on Robotic Hair Transplantation.
We are pleased to announce that robotic FUE is now available at Bernstein Medical – Center for Hair Restoration. This is a major advance in FUE technology.
The ARTAS system for hair restoration allows us to more effectively isolate follicular unit grafts from the donor area of the scalp without causing damage to individual follicles, a problem that has been a limitation of manual FUE techniques. Many other important parts of the FUE procedure will still be performed by the physician and team, including actual removal of the follicular units from the scalp, recipient site creation, and graft placement. The aesthetic elements that give a hair transplant a natural-looking result will still be in the hands of the physician. Read more about the benefits of robotic hair transplantation.
We are proud of the cutting-edge work we do in our state-of-the-art medical facility and are excited as we take FUE hair transplantation to the next level.
A: In our practice, we charge the same per graft for both procedures. However, there is a slightly higher minimum fee for robotic FUE procedures. See our Hair Transplant Costs & Consultation Fees page.
Q: Does the robotic hair transplant system do the whole operation or does the doctor do any of it? — B.W., Brooklyn, NY
A: The ARTAS robot only performs a small part of the FUE procedure, although it is an important one. FUE comprises four basic steps:
Isolation of follicular units from the surrounding skin
Removal of follicular units from the scalp
Making recipient sites
Placing grafts into these sites
The robot only performs the first step, follicular unit isolation.
Even in this first step, however, physician control is extremely important, as the doctor must determine the precise depth to which both the sharp and blunt dissection are set. They must also make constant adjustments to the angle that aligns the instrument with the graft.
The ARTAS robotic system gets all of its cues from the surface of the skin, so that it can place the target follicular unit in the exact center of the cutting field of the robotic tip. It can also align the tip parallel with the emergent hairs. However, the angle of the hair as it emerges from the scalp is slightly different than the angle below the skin and the doctor needs to tell the robot what this angle is. Fortunately, the robotic imaging system provides the doctor with the information he needs to make this determination.
Q: Is Robotic FUE faster than traditional FUE hair transplants? — F.W., Hoboken, NJ
A: Yes. Although, the speed of removal per graft is about the same, the actual procedure time is shortened when using the robotic device. The ARTAS robotic FUE system has a longer set-up time, but this is more than offset by the fact that the robot doesn’t “tire” during longer procedures.
Q: How many different kinds of robotic devices are there? — T.R., Boca Raton, FL
A: There is only one, the robot called the ARTAS System for FUE, made by Restoration Robotics. The Neograft machine, occasionally confused with a robotic device, is actually a hand-held instrument that is not robotically controlled and lacks image-based tracking. It is, therefore, not capable of eliminating the operator error and variability of hand operated devices and does not decrease the damage to follicles, called transection, inherent in manual techniques.
Dr. Bernstein is quoted extensively in an article on robotic hair transplantation in the online magazine American Health & Beauty.
ARTAS Robotic FUE Imaging System Click for larger version
In “ARTAS: A Faster and More Accurate Hair Transplant Using Robotics?” Dr. Bernstein explains the benefits of robotic FUE over traditional FUE hair transplant procedures. He describes how the new robotic device overcomes some important limitations of FUE when performed manually. To better understand the role of the new instrument, Dr. Bernstein simplifies the FUE procedure into four basic steps and discusses where the image-guided robotic system fits into this process.
Dr. Bernstein explains how the new technology enables the robotic device to preserve follicular units and minimize damage to grafts though its image-guided system.
“ARTAS allows us to do the FUE procedure with much less damage to the graft which means much healthier grafts. Grafted follicles extracted by ARTAS are not cut, which has been a problem with FUE, but the grafted follicular units are actually chunkier with more protective tissue around them, resulting in a better graft survival with the robotic FUE vs. doing FUE manually,” says Dr. Bernstein.
Follicular Unit Grafts Removed by ARTAS Robotic System Click for larger version
In addition to extracting grafts that have a higher chance of surviving the extraction and transplantation process, the article discusses the increased speed and accuracy of the automated procedure, as well as the safety mechanisms built into the robotic unit.
Always with an eye towards the future of hair transplantation, Dr. Bernstein predicts what he sees as an inevitable rise in the use of robotics in the field:
“I imagine that within a relatively short time, everybody will be offering the robot-assisted device when considering FUE procedures, because it’s just a better way of doing it: more accurate, quicker extraction and healthier grafts.”
The ARTAS System, developed by the California-based Restoration Robotics, Inc., will be available for FUE hair transplant procedures at Bernstein Medical – Center for Hair Restoration in November 2011.
Dr. Robert M. Bernstein – pioneer of the follicular unit transplantation (FUT) and follicular unit extraction (FUE) hair transplant procedures – will become the first hair restoration physician on the East Coast to employ the robotic ARTAS™ System for FUE hair transplantation.
New York, NY — Robert M. Bernstein, M.D., F.A.A.D., world-renowned pioneer of the Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) hair transplant techniques and founder of Bernstein Medical – Center for Hair Restoration, will become the first hair transplant surgeon on the East Coast to use the robotic ARTAS System for Hair Restoration. Procedures using the computer-driven, automated system will begin in November 2011 in his state-of-the-art New York City facility.
ARTAS Robotic System for FUE at Bernstein Medical
Dr. Bernstein, a Clinical Professor of Dermatology at Columbia University in New York, said that he is excited to incorporate the image-guided robotic system into his FUE procedures. “The ARTAS System is a ground-breaking technology for hair transplantation that will provide significant benefits to our patients,” said Dr. Bernstein. “From the accuracy of follicular unit graft extraction to the automation of what is normally a labor and skill intensive procedure, the outcome is better hair restoration results and faster, more comfortable procedures.”
The ARTAS System for Hair Restoration, developed by Restoration Robotics, Inc., overcomes some of the human limitations in performing FUE hair transplant procedures. Greater accuracy in extracting follicular unit grafts, combined with the sharp/blunt extraction technique, allows for graft removal with less damage to the graft and greater preservation of its protective tissues. A lower rate of damage increases the probability that the grafts will survive the transplant process, leading to better hair restoration results. The automation of what is a technically challenging and physically demanding process for the physician when performed manually, contributes to a shorter procedure and a decreased need for local anesthetic.
By utilizing the latest and most effective advancements in hair transplantation technology, Dr. Bernstein, a New York native, is extending his record as a true pioneer in the field of hair restoration. His landmark medical publications on follicular unit transplantation and follicular unit extraction revolutionized the field and provide the foundation for techniques in use by hair transplant surgeons across five continents. His medical practice has been devoted exclusively to the treatment of hair loss since 1995 and he now performs both restorative and corrective hair transplant procedures at his state-of-the-art hair restoration facility in mid-town Manhattan.
Dr. Bernstein has appeared on a wide variety of notable media programs and publications. Some of these include: The Oprah Winfrey Show, The Dr. Oz Show, The Today Show, Good Morning America, ABC News, CBS News, Fox News, National Public Radio, New York Times, Men’s Health Magazine, GQ Magazine, Univision, Telemundo, “O” the Oprah Magazine, and more. He is co-author of Hair Loss & Replacement for Dummies and The Patient’s Guide to Hair Restoration. He has been selected as one of NY Magazine’s “Best Doctors in New York” for 12 consecutive years.
Robotics in FUE hair transplant surgery is a topic that is attracting increasing attention in the world of hair restoration. As we have discussed, the ARTAS robotic system for hair restoration is the newest technology in this ever-evolving field.
Before & 9 Months After FUE with ARTAS Robotic System Click image for larger version
This new system, developed by Restoration Robotics, Inc., is more than just a new tool for performing Follicular Unit Extraction. Rather, it is a complex system that uses the latest in mechanical and software technology to automate FUE surgery. The robot not only allows doctors to perform this typically labor and skill intensive procedure, but it provides a variety of benefits to their patients. Among these benefits are increased accuracy in follicular unit graft harvesting, reduced harvesting time, and increased graft survival.
An article in the September/October 2011 issue of the journal Aesthetic Trends & Technologies adds detail to our knowledge of the benefits of the ARTAS System. The article, titled, “How Technology is Changing the Hair Restoration Industry,” first gives a basic overview of the system and why it was developed. It then goes on to describe how a specially-designed device, called a skin tensioner, along with an image-guided system, tracks each follicular unit on the patient’s scalp and allows for the precise control of graft extraction.
From the article:
The technology determines the location, angle, and direction of each individual hair follicle; and via complex algorithms and computer programming, it is able to determine almost instantaneously the proper approach to harvest each follicular unit. The image-guided robotic arm begins harvesting the hair follicles in random patterns, according to the harvest spacing set by the physician. These random patterns make the procedure virtually undetectable after the wounds have healed.
The accuracy and performance of the image-guided robotic system is notable and contributes significantly to the improved outcome of the FUE procedure. As Miguel Canales, M.D., Medical Director for Restoration Robotics, says in the article, the transection rate, or rate at which follicular units are damaged in the extraction process, is consistently less with robotic controlled FUE compared to that performed manually.
This kind of consistency yields a benefit not only to seasoned hair restoration surgeons, but to physicians of all skill levels. James Harris, M.D., a hair restoration physician based in Colorado, says that a novice physician, who might only be able extract 50-70 grafts in one hour using the traditional manual technique, extract 600-700 an hour. For a procedure of 1,500 grafts, the physical demand on both the physician and the patient is substantially reduced with the ARTAS System versus the standard manual graft excision techniques in FUE surgery.
Before & 7 Days After FUE with ARTAS Robotic System Click image for larger version
The developers of the ARTAS System were also conscientious of the safety of the FUE patient. An array of sensors monitors patient movement and causes the system to respond to the force of the punch used in graft excision or to any instances where the system’s casing touches the patient. If the force exerted is too strong, or if the casing touches the patient, the system automatically backs away from the patient, allowing the physician to make sure that all is well before the surgery proceeds. According to the article, there were no safety-related “adverse events” in trials with over 350 patients.
From the efficiency of the ARTAS System in extracting follicular unit grafts, to the quality of the grafts, to patient safety, the benefits are many for the physician. The patient will receive a high quality hair transplant with a less intensive time commitment, less local anesthesia needed to numb the area, improved hair growth rates, and a better overall FUE hair transplant experience.
Q: What is the main difference between NeoGraft and the ARTAS™ robotic system? — H.T., Staten Island, NY
A: The Neograft device is basically a powered FUE tool. It is still done by hand and therefore risks operator induced errors and damage to hair follicles. The ARTAS System, made by Restoration Robotics, uses electronic image-based tracking capabilities to map the individual follicular units. It does so to determine the optimal approach for automated graft harvesting. The robotic harvesting device produces consistently high quality grafts and low dissection rates.
Restoration Robotics, Inc. — based in Mountain View, CA — has developed a robotic system for follicular unit extraction (FUE), called the ARTAS™ robotic system for hair restoration. The computerized device has received 510(k) approval from the Food and Drug Administration. Restoration Robotics is due to begin marketing the system for use in hair restoration clinics in the United States.
The FDA classifies the ARTAS robotic system for hair restoration as a “computer assisted hair harvesting system” and describes it as being used to identify and extract follicular units to aid the surgeon during hair transplant procedures.
The robot consists of a computer assisted station with needle mechanism, force sensor, robotic arm, and video imaging system. The software that runs the instrument helps the surgeon target follicular units for extraction and also uses stereoscopic video images to guide the needle mechanism and robotic arm.
At present, the device is used only for the graft harvesting aspect of the follicular unit transplant procedure.
Bernstein Medical – Center for Hair Restoration has been using the ARTAS robot for FUE since December 2011.
The following is an excerpt of a press release about the ARTAS™ System by the developer of the device, Restoration Robotics, Inc.
ARTAS System Receives FDA Clearance for Ground-Breaking Technology Treating Hair Loss
Restoration Robotics, Inc., a medical device company that pioneered the first robotic follicular unit harvesting system, today announced that it has received FDA 510K clearance for its revolutionary ARTAS System
ARTAS System for FUE Hair Transplantation
Mountain View, CA – April 14, 2011 – Restoration Robotics, Inc. a privately-held medical device company, today announced that its revolutionary technology, the ARTAS™ System, has received 510K clearance from the Food & Drug Administration (FDA) for harvesting hair follicles from the scalp in men diagnosed with androgenetic alopecia (male pattern hair loss) with black or brown straight hair. The ARTAS™ System was developed in close collaboration with several leading hair restoration physicians to enhance the quality of follicular unit harvesting for the benefit of physicians and their patients.
“We are thrilled to receive FDA clearance, and look forward to rolling out the ARTAS™ System to leading hair restoration physicians,” said Jim McCollum, Chief Executive Officer, Restoration Robotics. “Hair loss is a very real issue for millions of men in the United States. We’re pleased to offer a powerful new technology for patients who are interested in a safe new way to enhance their quality of life.”
ARTAS™ is a physician-controlled, state-of-the-art, interactive, computer-assisted system that enables harvesting of hair follicles during hair restoration procedures. It combines several features including an image-guided robotic arm, special imaging technologies, small dermal punches, and a computer interface. The ARTAS™ System is capable of identifying and harvesting individual follicular units to implement the follicular unit extraction (FUE) technique.
A: The ARTAS System for Follicular Unit Extraction (FUE) combines several features including an interactive, image-guided robotic arm, special imaging technologies, small skin punches of two different sizes, and a computer monitor. After the system is positioned over the patient’s donor area of the scalp, ARTAS is capable of identifying and isolating follicular units from the surrounding scalp.
After the robotic arm is aligned with the follicular unit, a sharp 1-mm punch is used to cut through the upper part of the skin (the epidermis and upper dermis).
Immediately following this, a duller, 1.3mm punch is used to separate the deeper part of the follicular unit from the remainder of the dermis and subcutaneous fat. Once separated by the robot, the follicular units are manually removed from the scalp and stored until they are implanted into the patient’s recipient area.
A: The ARTAS robotic system for hair restoration is a computer assisted system, made by a company called Restoration Robotics, that utilizes image-guided robotics to increase the quality of the hair follicles harvested during FUE. It aids in the initial part of the FUE hair transplant procedure where follicular units are separated from the surrounding tissue. The system is operated under direct physician supervision.
Q: When was the ARTAS robot for FUE approved for use in hair transplantation? — J.B., Jersey City, NJ
A: Restoration Robotics’ ARTAS System for robotic follicular unit harvesting, received 510K clearance by the Food and Drug Administration (FDA) on April 14, 2011. The indication is for “harvesting hair follicles from the scalp in men diagnosed with androgenetic alopecia (male pattern hair loss) with black or brown straight hair.”
Q: What is Restoration Robotics? — L.N., East Brunswick, NJ
A: Restoration Robotics is a medical device company, based in Mountain View, California, that has developed a computerized instrument to assist in the graft extraction phase of follicular unit extraction (FUE) hair transplant procedures. Their patented device, called “ARTAS,” is an image-guided system for FUE. Their website is: www.restorationrobotics.com.
Q: I have read your page on robotics in hair restoration and am interested in learning more. Are there any updates in the development of the system you mentioned? — W.T., London, UK
A: Restoration Robotics, Inc. — based in Mountain View, CA — has spent the last few years developing and testing a robotic hair transplant device for follicular unit extraction (FUE). The ARTAS™ robot system has recently received 510(k) approval from the Food and Drug Administration, meaning that the company may now begin marketing the system for use in hair restoration clinics.
The FDA classifies the device as a “computer assisted hair harvesting system” and describes it as being used to identify and extract follicular units and to help the surgeon do the same during hair transplantation.
The ARTAS™ robot consists of a computer assisted station with needle mechanism, force sensor, robotic arm, and video imaging system. The software that runs the instrument helps the surgeon target follicular units for extraction and also uses stereoscopic video images to guide the needle mechanism and robotic arm.
We will update you as more information becomes available about the ARTAS™ system and Restoration Robotics.
See a photo of the ARTAS robot and stay on top of developments by visiting our Robotic Hair Transplantation page
The New York Times, once again, has recognized Dr. Bernstein’s pioneering hair restoration techniques. The NYT Fashion and Style section noted that he is, “the first hair transplant surgeon on the east coast,” to use the ARTAS robotic system for Follicular Unit Extraction. 
