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Bernstein Medical - Center for Hair Restoration
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Hair Restoration Answers

What’s the Outlook on a Hair Transplant Robot Performing the Entire Procedure?

Q: I understand that in robotic hair transplant, a robot performs the extraction part of the FUE procedure. What’s the outlook on the robot doing more of the hair transplant procedure? — B.B., Greenwich, CT

A: Currently, the ARTAS® Robotic System is a technology for extracting grafts. This is the most difficult part of a follicular unit extraction procedure, but it is only one part.

There are two other major parts to the FUE procedure: one part is the creation of recipient sites (in our practice, we create the recipient sites first, so that once we harvest the grafts, we can immediately place them into the scalp), and the other part is graft placement.

Recipient site creation involves more than merely making holes in the recipient area.

It involves making decisions on hairline design, graft distribution, hair direction, recipient site size and depth. When done manually, the surgeon first designs the new hairline so that the hair transplant will look as natural as possible, particularly as the person ages. Next, the surgeon will demarcate the extent of the area to be transplanted and decide on the graft distribution (i.e., how much hair will be placed in each part of the scalp) and then prepare a “recipient site” on the part of the scalp that has lost hair. The surgeon will then manually create incisions in the recipient site into which the follicular units will be placed.

On February 8, 2014, Dr. Bernstein unveiled “recipient site” creation capabilities of the hair transplant robot. These new capabilities allow the doctor to import a hairline design and other markings that have been made on the patient’s scalp directly into the robot. The robot then maps the design onto a precise 3-D model of the patient’s head. The physician can then program the proper distribution, direction and depth of the future recipient sites and the robot then creates the sites according to the physician’s specifications.

Graft placement, the last step, is perhaps the most challenging to automate. Engineers are currently working to design and build the capacity to automate the placement of extracted follicular units into recipient site incisions. Done manually, it requires significant hand-eye coordination and a very slow learning curve. For the hair transplant robot, it will be a significant challenge with development taking several years or more.

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Hair Restoration Answers

Compared to Manual FUE, Does Robotic Transplanted Hair Grow Faster?

Q: Does transplanted hair grow faster after a robotic FUE? — P.P., Flatiron, NY

A: There is no difference in the rate of growth between manual FUE verses robotic FUE. However, with robotic FUE, the actual growth should be better due to less transection (damage to follicles during the harvest).

In general, one can expect transplanted hair to start to grow within two to five months with the transplanted hair taking on its final appearance after approximately one year.

Read more about Robotic Hair Transplant surgery.

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Hair Restoration Answers

What is the Main Advantage of Robotic FUE Over Manual FUE?

Q:  I’ve heard that robotic-assisted FUE is better than manual FUE, but what exactly is the main advantage of Robotic FUE? — N.K., Bergen County, NJ

A: Robotic FUE is a significant improvement over other FUE techniques for a number of reasons. The accuracy and ability of a robot to perform countless repetitive motions are key reasons why robotic techniques are an improvement over manual techniques.

In a manual procedure, the skill and speed of a physician are under constant stress, as he or she must follow the angle and depth of the hair precisely hundreds to thousands of times. This task is almost impossible for even the best surgeons to perform without risking harm to the integrity of the follicles. Entering the skin at the wrong angle risks transecting or cutting the follicles and may render them useless for transplantation. Making too shallow an incision can also damage follicles, as the important base of the follicle can become sheared off when it is subsequently extracted.

The robot is engineered to avoid these problems, and so the number of viable grafts that the robot extracts is increased. As a result, the likelihood of the success of the transplant is greater using the robotic system.

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Hair Restoration Answers

Can A Robotic Hair Transplant System Create a Natural Looking Transplant?

Q: I’ve heard it takes the artistry of the surgeon to create a natural looking hair transplant. How do you do this with a robot? — S.S., Shanghai, China

A: I currently create the recipient sites by hand using different size needles. They determine the angle, direction and distribution of the grafts, and these three variables determine the aesthetic aspects of the hair transplant.

However, I am working with Restoration Robotics to have the ARTAS System create recipient sites and we are currently beta-testing this technology. The robot can now make very precise recipient sites. The ability of the robot to mimic the art of the surgeon is in the works, and we expect it to be ready in the fall of 2014.

In this new robotic-assisted process, the surgeon designs the hairline and delineates the area to be transplanted directly on the patient’s scalp. The surgeon then photographs the patient’s scalp and feeds the photograph into the robot’s computer to create a digital 3-D image. The doctor, in order to have the robot mimic what he would do by hand, can then manipulate various parameters, such as hair angle, direction and density.

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Hair Restoration Answers

Why does the ARTAS® Robotic System only do FUE, Not FUT?

Q: Why does the ARTAS® Robotic System only do FUE, not FUT? — V.Z., Chicago, Illinois

A: Currently the robot is only used for harvesting grafts from the donor area. In FUE, the doctor punches out hundreds to thousands of individual follicular units from the back and sides of the scalp by hand using a small round instrument called a punch.The punch has to be held at exactly the right angle, with just the right pressure applied, stopped at a precise depth and, during this time, rotated (or spun mechanically) without changing the alignment.

As one can imagine, this exhaustingly tedious process can best be done using the precision of a robotic device.

In FUT, the harvesting is done by a surgeon using a scalpel to make a long incision in the back of the scalp. It only takes a few minutes. The harvested strip is removed and then placed under dissecting microscopes where the individual follicular units are isolated. This dissection, thus far, can only be done by hand. There is no robotic technology available to do this.

Harvesting the donor hair, of course, is only one part of a hair transplant. The other steps, recipient site creation (making the holes that the grafts are placed into) and actually placing the grafts into those sites are similar in both FUE and FUT.

It is anticipated that robotic site creation will be available in the fall of 2014 and robotic graft placement, the third and final step, about two years after that. At that time, the robot will be able to perform the entire FUE procedure and the last two parts of the FUT procedure.

Of course, the robot doesn’t do the surgery alone. The physician must input all the information regarding the design and planning of the procedure and closely monitor each step of the robotic process. Unlike automating industrial production, the human scalp has great variability, so there is no one formula that will be appropriate for every patient. Physician skill and involvement is just as important in robotic hair transplantation as it is with every other type of surgical hair restoration procedure.

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Bernstein Medical In The News

Press Release: Hair Restoration Pioneer Introduces Next Step in Robotic Hair Transplants

ARTAS Robotic System display monitor showing parameters for the creation of recipient sitesDr. Bernstein introduced new technology that allows the ARTAS Robotic System to accomplish a critical step in hair transplant surgery, the creation of recipient sites. Presenting at the 2nd ARTAS User Group Meeting on February 7th and 8th, 2014, Dr. Bernstein previewed the recipient site creation technology that brings the robotic system one step closer to performing critical aspects of the labor-intensive, hair transplant procedure.

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Hair Restoration Answers

What Part Of a Hair Transplant Can Be Done By a Robot?

Q:  Is it true that hair transplants can now be done totally by a robot? — M.S., Los Angeles, California

A: The ARTAS Robotic System, developed by Restoration Robotics, is the most advanced technology for extracting grafts (the first and most difficult step in a Follicular Unit Extraction procedure), but it cannot yet do the entire hair transplant procedure, nor can it work without the supervision of the hair restoration surgeon.

Currently, the  ARTAS System assists the surgeon in performing the first part of an FUE hair transplant (i.e., the extraction phase) with greater precision and consistency than can be done by hand. Engineers and researchers are currently developing the ARTAS to do the remainder of the procedure as well, i.e., making recipient sites in parts of the scalp that have lost hair and then implanting the harvested grafts into these sites.

The next step, recipient site creation, will be available in the latter half of 2014. Dr. Bernstein is already testing a beta version of this new technology. We anticipate that within two years, under the supervision of the surgeon, the ARTAS robot will be performing most of the FUE hair transplant procedure.

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Bernstein Medical In The News

Bernstein Medical Named Best Small and Medium Sized Company to Work For in New York State

Innovative Bernstein Medical Awarded As Best New York Small Business To Work ForBernstein Medical – Center for Hair Restoration is receiving recognition for leadership in appreciating the value of its workers. The New York State Society for Human Resource Management (NYS-SHRM) has named Bernstein Medical the number one small or medium-sized business to work for in the state. The 2013 ‘Best Companies to Work For in New York’ list placed Bernstein Medical at the top slot, out-ranking companies from New York City as well as Rochester, Syracuse, and elsewhere in the state.

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Hair Restoration Answers

Can You Program the FUE Robot To Avoid Scars?

Q: I heard that for someone who has had several strip procedures, the ARTAS robot for FUE does not work because it is programmed to work with “textbook male pattern baldness”, which I no longer have. I thought the scars from previous procedures, as well as the large amount of already transplanted hair, might throw off the robot’s programming (it wouldn’t quite know what to do). But if I am wrong about this then the robot may in fact be the best approach for me. Please advise. — N.C., Paris, France

A: When performing robotic hair transplants on patients with prior surgery, I program the robot to avoid scarred areas – just as we would do visually when performing manual FUE.

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Hair Restoration Answers

Does ARTAS FUE Robot Work with African-American (Very Curly) Hair?

Q: I am an African-American man with tight curly hair. Will the FUE robot be able to work on curly hair? — E.O., Manhattan, N.Y.

A: Yes, the ARTAS robot for FUE can be adapted for African-American hair when performing follicular unit extraction. We use a punch that is 0.1mm wider in diameter than the instrument used for Caucasians. It allows us to incorporate the slightly larger volume of tissue that results from the curved hair and enables us to accomplish the hair transplant with less in jury to follicles than if a smaller instrument were used.

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Hair Restoration Answers

Does the ARTAS FUE Robot Work with Dark Hair?

Q: I read on your blog that the ARTAS robot doesn’t work well in patients who want FUE but have blond hair. I have dark skin and hair, does that present a problem for the machine? — J.S., London, England, U.K.

A: The ARTAS Robot performs follicular unit extraction just as well with blond hair as dark hair, but not white hair. It is simple to just to dye the white donor hair prior to the procedure. This donor hair will be clipped very short the morning of surgery removed anyway, so it will not present too much of a cosmetic issue.

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Bernstein Medical In The News

Dr. Bernstein Leads Robotic FUE ‘Coffee With Experts’ At ISHRS 20th Annual Meeting

Dr. Bernstein Leads Robotic FUE 'Coffee With Experts' At ISHRS 20th Annual MeetingDr. Bernstein heads discussion on Robotic FUE at the 20th annual meeting of the International Society of Hair Restoration Surgery (ISHRS) which took place October 17-20, 2012. He led a roundtable discussion in the ‘Coffee with the Experts’ session on robotic follicular unit extraction. He was also a panelist at the Finasteride Symposium and gave a presentation on protocol in prescribing Finasteride to hair restoration patients.

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Bernstein Medical In The News

Press Release: Hair Restoration Pioneer Improves Robotic FUE Hair Transplant Procedures

Dr. Bernstein receives recognition from Restoration RoboticsNew York, NY (PRWEB) — Robert M. Bernstein, M.D., F.A.A.D., A.B.H.R.S., a world-renowned hair transplant surgeon, presented a series of improvements to hair transplant procedures which use the ARTAS Robotic System for Follicular Unit Extraction (FUE). These updates include revisions to the FUE surgical protocol and technical adjustments to the robotic extraction system. He presented his refinements at the first user meeting held by the developers of the system; Restoration Robotics, Inc.; on September 14 – 16 in Denver, Colorado.

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Bernstein Medical In The News

CBS News Report On Robotic FUE Features Dr. Bernstein

CBS News Report On Robotic FUE Features Dr. BernsteinDr. Bernstein was featured in a CBS News report on robotic hair transplantation. During Dr. Max Gomez’s visit to the Bernstein Medical – Center for Hair Restoration, Dr. Bernstein discusses with Dr. Gomez the difference between FUT and FUE hair transplants, how the robotic system works, and the benefits of extracting hair follicles using robotic FUE rather than by traditional hand-held methods.

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Bernstein Medical In The News

Dr. Bernstein Featured With “First Of Its Kind” Robotic Hair Transplant System On NY1

Dr. Bernstein Featured With "First Of Its Kind" Robotic Hair Transplant System On NY1Dr. Bernstein not only pioneers hair transplant procedures, but hair restoration technology as well. The NY1 television station, based in New York City, visited Bernstein Medical to see a demonstration and talk about the newest tool in the hair restoration toolkit, the ARTAS Robot for Hair Restoration.

The NY1 piece shows the robotic FUE system in action at Bernstein Medical, with views of the robotic arm, the image-guided system, the punch tool, and the user interface.

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Bernstein Medical In The News

Dr. Bernstein, ARTAS Robot for FUE Featured in Japanese Language Magazine ‘NY Japion’

NY Japion Features Dr. Bernstein, ARTAS Robot For FUEDr. 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.

The article includes an interview with Dr. Bernstein about the latest in hair transplant surgery, including his pioneering use of the ARTAS robot for FUE hair transplantation.

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Hair Restoration Answers

Does ARTAS Robot For FUE Work With Blond Hair?

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.

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Bernstein Medical In The News

Dr. Bernstein Discusses Benefits Of Robotic FUE On Bloomberg TV

Dr. Bernstein Touts Benefits Of Robotic FUE On Bloomberg TVDr. 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.”

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Hair Restoration Answers

ARTAS Robot vs. Neograft Machine in Follicular Unit Extraction

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.

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Bernstein Medical In The News

Interview Magazine: Dr. Bernstein a “Game-Changing” Hair Transplant Pioneer

Interview Magazine: Dr. Bernstein a Game-Changing Hair Transplant Pioneer
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.”

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Bernstein Medical In The News

Robotic FUE Comes To Town

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 robot in an article titled, “All I Want for Christmas is a Robot Hair Transplant.”

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Bernstein Medical In The News

ARTAS System For Robotic FUE Arrives At Bernstein Medical

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.

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Hair Restoration Answers

Is Robotic FUE Faster Than Traditional FUE Hair Transplantation

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.

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Hair Restoration Answers

How Many Devices Exist for Robotic FUE Hair Transplantation?

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 inherent in manual techniques.

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Bernstein Medical In The News

Dr. Bernstein Discusses Robotic FUE In American Health & Beauty Article

ARTAS Robotic FUE Imaging SystemDr. Bernstein is quoted extensively in an article on robotic hair transplantation in the online magazine American Health & Beauty.

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.

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Bernstein Medical In The News

Hair Transplant Pioneer To Use Robotic ARTAS System For FUE Hair Transplantation

ARTAS Robotic System for FUE at Bernstein MedicalRobert 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.

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Bernstein Medical In The News

Article Details Benefits of ARTAS Robotic System for FUE Hair Transplant Surgery

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 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.

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 anesthesia needed to numb the area, improved hair growth rates, and a better overall FUE hair transplant experience.

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Hair Restoration Answers

What is the Difference Between NeoGraft and ARTAS Robotic System for FUE Hair Transplant Surgery?

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.

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Bernstein Medical In The News

Restoration Robotics Receives FDA Approval for FUE Hair Transplantation

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.

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Hair Restoration Answers

What Part of FUE Hair Transplant is Performed by ARTAS Robotic System?

Q: With the ARTAS robotic system, by Restoration Robotics, what part of the FUE hair transplant procedure can actually be done by the robot? — A.M., Los Angeles, CA

A: The ARTAS System is a computer guided method of harvesting follicular units in the donor area during FUE. The initial phase of FUE, where the follicles are selected, scored and separated from the surrounding scalp is done by the ARTAS System. All other phases of the procedure including; actual follicular unit graft removal from the scalp, hairline design, recipient site creation and placement of the grafts into the balding scalp are done by the surgical team.

In the near future, improvements in the ARTAS System should allow it to be able to actually extract the separated grafts from the scalp. Eventually, the engineers hope to be able to increase the capability of the system so that it can create recipient sites and implant the extracted grafts into them.

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Hair Restoration Answers

How Does the ARTAS Robot Work?

Q: How does the ARTAS robotic hair transplant system actually work? — J.N., Fort Lee, NJ

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.

Read about robotic FUE hair transplantation

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Hair Restoration Answers

What Does the ARTAS Robotic System for Follicular Unit Extraction (FUE) Actually Do?

Q: What does the ARTAS robotic system for Follicular Unit Extraction (FUE) actually do? — E.J., Plainsboro, NJ

A: ARTAS 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 procedure where follicular units are separated from the surrounding tissue. The system is operated under direct physician supervision.

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Hair Restoration Answers

When Was the ARTAS Robotic System Approved For FUE Hair Transplants?

Q: When was 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.”

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Hair Restoration Answers

What is Restoration Robotics?

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.

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Hair Restoration Answers

What is the Latest in Hair Transplant Robotics?

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.

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