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Bernstein Medical - Center for Hair Restoration
Bernstein Medical In The News

Dr. Bernstein Gives First Master Class in Robotic Hair Transplantation

First Master Class in Robotic Hair RestorationFirst Master Class in Robotic Hair Restoration

May 11th, 2018 – Robert M. Bernstein MD, a pioneer in modern hair transplantation, led five robotic hair restoration physicians in an intensive master class focusing on ARTAS robotic techniques, surgical planning and aesthetics. The day included a live ARTAS Robotic FUE procedure, a series of twelve presentations and a Q & A period. The ARTAS Hair Transplant System, developed by Restoration Robotics, is the only robotic system in the world designed to aid surgeons in hair restoration procedures.

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Bernstein Medical In The News

ARTAS Users Meeting 2018: Dr Bernstein Discusses Robotic Hair Transplant Techniques

Dr. Bernstein presenting at the ARTAS User Meeting 2018 On March 9th, 2018 at the 2018 ARTAS Users Meeting in Las Vegas, Nevada Dr. Robert M. Bernstein, a Clinical Professor of Dermatology at Columbia University and founder of Bernstein Medical – Center for Hair Restoration, presented the latest in Robotic Hair Transplantation using the ARTAS® Robot. Dr. Bernstein described the benefits of the new technology, such as decreased time and increased accuracy of the robotic procedure. Dr. Bernstein Presenting Long-Hair Robotic FUE and software and hardware updates of that ARTAS 9x; such as white LED lights that are easier on the users’ eyes, a base extender, smaller size needle options, a more ergonomic headrest, automated scar detection, faster harvesting, and streamlined ARTAS Hair Studio software.

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Hair Restoration Research

Innovations In Robotic Hair Restoration

Synopsis: With the latest version of the ARTAS platform, 9x, Restoration Robotics has designed a faster and more accurate system for hair transplantation. The improved accuracy of harvesting and shortened procedure time increases graft viability, while smaller needles reduce scarring and allow patients to wear shorter hairstyles. Many of the changes in this upgrade have been made as a response to specific physician feedback.

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Hair Restoration Research

Advances in Robotic FUE

Synopsis: Since the publication of “What’s New in Robotic Hair Transplantation” (Hair Transplant Forum Int’l. 2017; 27(3):100-101), there have been important improvements to the robotic system in both its incision and recipient site creation capabilities. These advances fall into four overlapping categories:increased speed, increased accuracy, increased functionality, and improved artificial intelligence (AI). The overlap occurs since improvements in functionality, accuracy, and AI can also increase the overall speed of the procedure. A faster procedure decreases the time grafts are outside the body and allows the physician to perform larger cases without placing additional oxidative stress on the follicles.

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Bernstein Medical In The News

Dr. Bernstein Featured in ARTAS Live Webinar

Dr. Bernstein's slide on Dr. Robert M. Bernstein were guest speakers in the ARTAS live webcast series where they discussed “What’s New in Robotic FUE.” They spoke to over 100 fellow surgeons and their staff on advances in robotic hair transplantation and led a Q and A session about the ARTAS Robotic System.

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Hair Restoration Answers

When is it Best to Feather in Robotic FUE?

Q: I thought that FUE extraction is performed in a way that it cannot be detected. Therefore, it is best to distribute the pattern evenly starting from the safe zone and fading out on the sides. The ARTAS results often show a smaller extraction area and harder edges (no transition from extraction to non-extraction area). Does this lead to a higher risk to detect the surgery? — H.K. ~ Chicago, I.L.

A: Feathering of the extraction zone in FUE is a technique where the distance between the extractions gradually increases as one reaches the border of the extracted zone. When this technique should be used depends upon the short- and long-term goals of the patient. If the patient’s main goal of the FUE procedure is to wear their hair very short, then the technique of feathering and rounding the edges to have a less distinct border is appropriate, as this will decrease the visibility of the harvested area.

However, if a person does not wear his hair very short (nor plans to) and maximizing the donor supply is paramount, then a more organized pattern, with less feathering, will give a greater long-term yield and a more even distribution. The reason is that the healing of FUE wounds distorts adjacent follicular units making subsequent extraction in the same regions more difficult and increases the risk of transection. For this reason, in subsequent procedures we generally prefer to harvest in new areas. If we need to harvest more hair from the same area, we rarely go back more than once.

When one feathers extensively in the donor area, this utilizes a larger surface area of the scalp with less graft yield, so it may become necessary to go back over the same area to obtain additional grafts, often multiple times. This risks increased transection and an uneven, mottled appearance to the donor area.

If a person wears his hair very short, then feathering is critical (even though it makes subsequent extraction more problematic). It is very easy to feather and round edges with the ARTAS robot, but we make the decision to do so based upon the specific needs and goals of the patient.

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Hair Restoration Answers

Is Manual FUE Better Than Robotic FUE Because The Physician Can “Feel” The Follicle During Extraction?

Q: Is it true that performing FUE hair transplant procedures by hand is better because the physician can better adjust and feel the follicle when extracting? — M.H. ~ Great Neck, N.Y.

A: The ARTAS robot is a physician controlled, computerized device that uses a three-dimensional optical system to isolate follicular units from the back of the scalp in a hair transplant. The robotic system assists the physician in the extraction of grafts with precision and speed. Although there is some advantage to having “human feel” for the tissue, this is far outweighed by the fact that repetitive procedures performed manually thousands of times lead to operator fatigue and result in increased transection and damage to grafts. With the ARTAS robotic system, the quality of the first and the last graft harvested will be the same.

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Hair Restoration Answers

What Is The Difference Between The ARTAS 9x And The Earlier Versions Of The Robot?

Q: What is the difference between the ARTAS 9x and the earlier versions of the robot? — T.J. ~ Washington, D.C.

A: The differences can be grouped into four broad categories:

1. Speed: The 9x is 20% faster than the 8x. This is achieved through the ARTAS robot’s ability to more quickly and accurately align with the follicles, faster movement from follicular unit to follicular unit while harvesting, and a shortened dissection cycle (less than 2 seconds). In addition, the 9x uses white LED lights instead of red, which permits an increased work flow from the ability to simultaneously incise and extractions grafts. The decreased strain on the eyes from the white lights (compared to red) makes this possible.

2. Accuracy: The 9x uses smaller needles that minimize wounding and donor scarring. It is especially useful for patients with fine hair or those who want to keep their hair short.

3. Functionality: The robotic arm on the 9x has a 1-inch base extender that gives the machine a longer reach and decreases the need for the patient to be repositioned. The ARTS 9x also has a smaller robotic head allowing the robot to harvest the grafts at a more acute angle. The ARTAS 9x also allows for more site making options due to the universal blade holder and the ability to program a change in the orientation of the incision in different regions of the scalp. The ARTAS 9x also uses a new harvesting halo to secure the tensioner (the grid-like device that indicates where the robot should harvest) which is faster to apply and more comfortable for the patient.

4. Use of Artificial Intelligence: The technology notifies the physician early-on if the harvesting is not precise, so that action can be taken to ensure most effective results. The ARTAS software can now detect areas with low (or no) hair density and prevent those areas from being over-harvested. This also decreases human error and saves time by automatically blocking these areas with low density. Finally, the ARTAS Hair Studio, can now create a 3-D image of the patient’s head with only one photo (as opposed to the prior requirement of 3 to 5).

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Hair Restoration Research

What’s New in Robotic Hair Transplantation

Synopsis: Since the introduction of robotic FUE technology over five years ago, there have been numerous upgrades to the system. The current paper describes the most recent advances. These include a more user-friendly interface, the ability to select for larger follicular units, greater range-of-motion of the robotic arm, improved methods for stabilizing the scalp and newly designed needles for more accurate harvesting.

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Bernstein Medical In The News

ARTAS 9x – Bernstein Medical Introduces Major Upgrade To ARTAS Robotic Hair Transplant System

First ever case with ARTAS 9x at Bernstein MedicalIn April 2017, Bernstein Medical became the first hair restoration practice to perform robotic hair transplant surgery using the new ARTAS Robotic System 9x. ARTAS 9x is a major upgrade of the hair transplant robot, enabling faster and more precise Robotic FUE procedures. Some of the hardware improvements to the system include a white light LED, color camera and tensioner, 20-gauge harvesting needle, robotic base extender, new needle mechanism cover, and more comfortable headrest and halo. Software upgrades include better scar detection, faster harvesting, ability to zoom in to the main viewing screen, and improved ARTAS Hair Studio software.

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Bernstein Medical In The News

Dr. Bernstein Presents Advanced Robotic Hair Transplant Techniques at 2017 ARTAS Users Meeting

Dr. Bernstein Presenting at the 2017 ARTAS Users MeetingDr. Bernstein closed the 2017 ARTAS Users Meeting with a discussion of five advanced techniques in robotic hair transplant procedures that he developed at Bernstein Medical. His presentation covered the benefits of pre-making recipient sites, long-hair FUE, tensioner placement, feathering edges in harvesting, and robotic graft selection. The “Hair Restoration Pearls” presentation included case studies, photographs, and videos demonstrating the techniques to the audience of hair restoration physicians. The two-day affair; which was held in Coronado, California; was a huge success, with over 260 attendees from around the world representing 204 robotic hair restoration practices.

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Bernstein Medical In The News

Dr. Bernstein Named a Top 100 Influencer on Robotics

Onalytica - Robotics Top 100 InfluencersOnalytica, a company that provides Influencer Relationship Management software and services, has named Dr. Bernstein one of the top influencers (#39 out of 100) on the topic of robotics due to his pioneering work in robotic hair transplant surgery with the ARTAS Robotic System.

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Hair Restoration Answers

Can I Have Robotic FUE If I Have Gray Hair or Curly Hair?

Q: I have read that the ARTAS System works best on straight black hair. Is this an option for gray hair? How about wavy or curly hair? – P.W., Fort Lee, NJ

A: The ARTAS robotic system can be used in patients with any hair color although in order for the robot to visualize white hair (or very light blond hair) the hair must be dyed. Curly hair is also not a problem as the donor hair in a robotic procedure is shaved to approximately 1 mm in length so a wave or curl is eliminated. In patients of African descent, where the hair below the surface of the skin may be curved, a slightly larger punch can be used. we have patients dye their hair the evening before or the day of the procedure. For convenience, only the hair in the donor area (back and sides) where the robot will be doing the harvesting needs to be dyed.

In patients who prefer not to shave or dye the entire back and sides of the scalp, we can perform the ARTAS robotic FUE using the long-hair technique. With this technique, you will grow your hair on the back and sides of the scalp a bit longer so it can cover the harvested area. On the day of the procedure, we will lift up the hair, clip a long thin band of donor hair and then extract follicular units from this limited region of the scalp. After the procedure, you can simply comb down your hair to cover the donor zone. The area that has been harvested (and possibly dyed depending on your hair color) will not be visible.

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Bernstein Medical In The News

Key Advance in Robotic Hair Transplants Presented by Dr. Robert Bernstein at 2016 ARTAS Users Meeting

Dr. Bernstein Presenting at the 2016 ARTAS User Group MeetingDr. Robert M. Bernstein, a pioneer of robot-assisted hair transplantation, presented results of a study on a major new advance in robotic follicular unit harvesting, a key step in the surgical procedure, at the 2016 ARTAS User Group Meeting in Dana Point, CA. He reported that the new robotic technique resulted in a clinical benefit of up to 15% more hairs per harvest attempt and 11.4% more hairs per graft than with the current iteration of the ARTAS® Robotic Hair Transplant System. The improvement in graft harvesting should result in better aesthetic outcomes for patients, and this will have wide implications around the world as robotic hair transplant procedures are booming in popularity. Dr. Bernstein presented the findings to a “who’s who” group in the new field of robotic hair restoration surgery at their annual meeting held on February 20th, 2016.

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Hair Restoration Answers

How are Recipient Sites Programmed into the ARTAS Robot?

Q: How are specifications for recipient sites inputted into the ARTAS® robot? — A.F., Queens, NY

A: At the outset of the procedure, the physician sits at a computer terminal that is connected to the ARTAS Robot and enters the specifications directly into the robot’s software. Variables programmed in this manner include: the number of recipient sites, density of sites, angle that the hair will extrude from the skin, depth of recipient sites, and the minimum distance away from existing hair follicles that a site can be created.

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Hair Restoration Answers

How Does the ARTAS Robot Avoid Transection of Hair Follicles During Recipient Site Creation?

Q: How does the ARTAS System avoid damaging hair follicles in the balding area during recipient site creation? — R.K., Brooklyn, NY

A: The ARTAS robot’s optical guidance system enables it to accurately create recipient sites in areas of thinning hair without damaging existing hair follicles. During the recipient site creation process, the robot uses its advanced image-guided optical system to scan the surface of the skin, locate existing hair follicles in the recipient area, and then create recipient sites at a specified distance from these existing hairs.

The ARTAS robot carries out this process rapidly, accurately, and consistently according to the physician’s programmed specifications. Thanks to the microscopic precision of the image-guided technology, the robotic hair transplant system can avoid injury to follicles that can result when Follicular Unit Extraction (FUE) is performed using manual techniques.

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