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ARTAS Robot for FUE

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Q: Does transplanted hair grow faster after 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, i.e., less 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.

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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.

Read more about Robotic Hair Transplant

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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.

Read more about Recipient Site Creation in a Robotic Hair Transplant

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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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ARTAS Robotic System display monitor showing parameters for the creation of recipient sitesARTAS Robotic System display monitor showing parameters for the creation of recipient sites

New York, NY (PRWEB) — Robert M. Bernstein, M.D., F.A.A.D., A.B.H.R.S., founder of Bernstein Medical – Center for Hair Restoration, 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, 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.

The ARTAS System is currently able to harvest intact follicular unit grafts from the permanent area in back of one’s scalp using precise robotic technology. This is the most difficult aspect of a follicular unit extraction hair transplant – the newer type of hair restoration procedure that avoids a linear scar in the back of the scalp. Now that site creation can also be done robotically, only one step remains – graft placement.

The ARTAS Robotic System maps the surgeon's hairline design onto a 3-D model of the patient's headThe ARTAS Robotic System maps the surgeon’s hairline design onto a 3-D model of the patient’s head

For the recipient site creation, the doctor first draws a hairline and other markings directly onto the patient’s scalp to delineate the surgical plan. Next, multiple photographs are taken and fed into software, called the ARTAS™ Hair Studio, which converts the images into a 3-D model of the actual patient. This computer model can be manipulated and saved for the patient’s procedure. Using the ARTAS™ Hair Studio software, the physician then specifies the angle, direction, density, and randomness of the recipient site incisions to create the most natural look. During the procedure, the robot uses image-guided technology to avoid existing hairs while it creates up to 1,500 recipient sites per hour. In performing recipient site creation, the robot automates a process that can be physically demanding and prone to human error.

On the advancement, Dr. Bernstein said:

“This development is a crucial step towards a robotic system that can perform every aspect of a hair transplant. A great deal of credit goes to the engineers of Restoration Robotics who have worked to make automated recipient site creation a reality. I am proud that this work not only improves hair transplants for patients, but adds to the increasingly important trend of using robotic technology in medicine.”

The site creation technology that Dr. Bernstein debuted at the ARTAS User Group Meeting; which was held in California (Laguna Niguel, CA) on February 7th and 8th, 2014; will be available to hair restoration physicians in the fall of 2014. Gabe Zingeratti Ph.D, head of R&D at Restoration Robotics, Inc., presented details of the technology, which was beta-tested at Bernstein Medical – Center for Hair Restoration. With the next generation ARTAS® Robotic System rolling out in the coming months, the focus of research will then be on the final phase of robotic hair transplantation, the robotic insertion of follicular unit grafts into recipient sites. This last step will take several more years to develop.

The ARTAS Robotic System, developed by Restoration Robotics, is currently in use by hair restoration physicians around the world to automate the extraction of grafts of skin and hair called follicular units.. Follicular units, which are natural groupings of one to four hair follicles, form the biological basis of the modern hair transplant procedure. Once extracted from the back of the patient’s scalp, the follicular unit grafts are then inserted into recipient sites in the balding area of the scalp where they grow hairs that are immune to the effects of common hair loss.

No stranger to innovative advances in hair transplant surgery, Dr. Bernstein introduced Follicular Unit Transplantation (FUT) to medical literature in a 1995 publication. FUT transformed hair transplants from the use of large grafts of skin and hair, known colloquially as “hair plugs,” to a more medically-oriented procedure that produces completely natural-appearing results. Dr. Bernstein with his colleague Dr. Bill Rassman again broke new ground with his 2002 publication that introduced the concept of Follicular Unit Extraction (FUE) to scientific literature. Dr. Bernstein was the first physician on the East Coast of the United Sates, and one of the first in the world, to use the ARTAS System to perform FUE using the new robotic technology.

About Robert M. Bernstein, M.D., F.A.A.D.

Dr. Robert M. Bernstein is a Clinical Professor of Dermatology at Columbia University and founder of Bernstein Medical – Center for Hair Restoration. His landmark scientific papers are considered seminal works in the field of hair transplant surgery. Other publications include textbook chapters on dermatologic surgery and books, like Hair Loss and Replacement for Dummies, aimed at the consumer audience. He has been selected as one of New York Magazine’s “Best Doctors” for fourteen consecutive years and has appeared as a hair loss and hair transplantation expert on The Oprah Winfrey Show, The Dr. Oz Show, Good Morning America, The Today Show, CBS News, Fox News, and The Discovery Channel. Dr. Bernstein has been interviewed or featured in articles in the New York Times, GQ Magazine, Men’s Health, Interview Magazine, Vogue, and others.

About Bernstein Medical – Center for Hair Restoration

Bernstein Medical – Center for Hair Restoration, founded in 2005, is a state-of-the-art facility and international referral center for the treatment of hair loss that is located in midtown Manhattan, New York City. Hair transplant surgery, hair repair surgery, and eyebrow restoration are performed using Dr. Bernstein’s pioneering techniques of Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE).

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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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Dr. Bernstein Presenting ‘Follicular Unit Extraction: Then and Now’

Dr. Bernstein was honored to deliver the keynote address at the ARTAS International Users Forum in San Francisco, California. Dr. Bernstein’s presentation, “Follicular Unit Extraction: Then and Now,” was a review of the evolution of surgical hair restoration from Follicular Unit Transplantation (FUT) through Follicular Unit Extraction (FUE) to the cutting edge technique of Robotic-FUE.

The presentation described the steps that resulted in the use, and growth in popularity, of the state-of-the-art ARTAS Robotic System for FUE. Dr. Bernstein pointed out that with the introduction of each procedure — FUT, FUE, and Robotic-FUE — there was initially a rocky reception with physicians. In each instance, however, the surgeons’ concerns were overcome first by strong, patient interest and then by clinical studies that confirmed the procedures’ usefulness.

Dr. Bernstein discussed how FUE procedures progressed from the use of hand-held instruments to the computer-assisted, image-guided ARTAS Robot. One of the initial hurdles of FUE procedures using hand-held devices was a high rate of follicular unit transection (cutting of the follicles). Restoration Robotics, Inc., the company that developed the ARTAS system, used a “sharp/blunt” punch technique that was introduced by Jim Harris in his 2004 publication on the SAFE System for FUE. The sharp/blunt technique, that was validated in 2006 by Dr. Bernstein’s research publication, “New Instrumentation for Three-Step Follicular Unit Extraction,” reduced transection of follicles when compared to older instrumentation. Dr. Bernstein then detailed modifications to the system that he proposed in order to improve the ARTAS robot. These improvements include: a smaller tip for the sharp/blunt punch, selection of larger over smaller follicular units, tensioner placement, ‘feathering’ the ends of the tensioner, and pre-making recipient sites before extracting the follicular unit grafts.

Looking to the future, Dr. Bernstein mapped out the further evolution of the Robotic FUE procedure and the tasks it will be required to perform. In future procedures, the physician will not only guide the robot on extracting follicular units, but also in creating recipient sites and, further down the road, placing grafts into the recipient sites. Graft placement will represent the most significant challenge to the robotic system as this step is the most sensitive to patient to patient variability. Once this last step is accomplished, a fully automated hair transplant should be possible, eliminating much of the human error in the mechanical aspects of the hair restoration process.

More photos from the event:

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Innovative Bernstein Medical Awarded As Best New York Small Business To Work ForBernstein Medical Wins 2013 ‘Best Companies to Work For in New York’ Award. Sandra Medina (2nd from left) an Employee for 18 years, accepts award.

Dr. Bernstein has received plaudits for his innovation and leadership in hair transplantation and medical hair restoration. However, what is less frequently noted is that he holds an MBA from Columbia University and has applied some of this knowledge toward making his company a leader in the business community as well.

Now, Bernstein Medical – Center for Hair Restoration is receiving its own recognition for leadership in appreciating the value of its workers. The Society for Human Resource Management (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.

Bernstein Medical was also featured in the 2013 awards program:

“A recognized leader in the development of hair transplantation techniques and clinical research, the center was the third in the world and one of 12 current hair restoration practices to utilize and control the ARTAS Robot in follicular unit extraction procedures. Seminars, meetings and continuing education classes help the physicians, surgical team and front-office staff to maintain a high degree of ethics, innovation and the latest skills.

The long-term, family-forward attitude of the workplace is supported by a retirement plan and package that couples a 401(k) with both safe harbor and profit-sharing benefits. […] A team culture allows those who work there to voice their ideas and opinions with confidence.”

Created in 2007, these celebrated annual awards are a distinctive program that evaluates and ranks the best places of employment based on employee satisfaction and engagement, as well as workplace practices and policies. The assessment is made using a two-part survey process. In the first part, the employer provides details about company benefits, policies, and practices. The second, and most important, part is a confidential employee survey in which employees evaluate their workplace experience.

The program is a partnership of New York State SHRM, Best Companies Group, Journal Multimedia Corporation and The Business Council of New York.

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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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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.

See before & after hair transplant photos of patients with curly hair

Read about Robotic Hair Transplantation

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Dr. Bernstein, ARTAS Robot for FUE in Brazil's Veja MagazineDr. Bernstein was quoted in an article on robotic follicular unit extraction (FUE) that appeared in Brazil’s Veja Magazine. It is titled, “Vai Ficar Mais Fácil Deixar de Ser Careca,” which translates to, “It Will Be Easier To Stop Being Bald.”

The article describes how the ARTAS System improves on traditional FUE procedures. It contains a diagram which shows that the hair transplant robot can extract almost twice as many follicular units as extraction techniques that use manual methods. Whereas manual procedures can yield about 400 follicular units in one hour, the robot for FUE can extract 750 units in an hour. The article indicates that the total duration of a hair transplant procedure can be significantly reduced using the new robotic system.

The magazine, which focuses on Brazilian business and culture, quotes Dr. Bernstein:

“É muito difícil retirar os folículos manualmente”, diz Robert Bernstein, um dos pioneiros a fazer o transplante capilar manual e a user o ARTAS.”

Translated, it reads:

“It is very difficult to manually remove the follicles,” says Dr. Robert Bernstein, one of the pioneers of manual hair transplants and of the ARTAS System.

The person pictured with the article is celebrity actor Bruce Willis. Under the photo is the caption “Duro de Crescer: Raros são os atores, como Bruce Willis, para quem a ausência de fios só faz aumentar o charme.” This translates to: “Hard to Grow: Rare are the actors like Bruce Willis, for whom the absence of hair increases the charm.”

Bernstein Medical – Center for Hair Restoration treats patients from all over the world, including Brazil and South America. Anyone who is unable to visit our center in New York City for a consultation may submit a photo consultation.

Read more about the benefits of Robotic FUE

Read about our hair restoration patients

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Q: I read your post 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 hair transplant 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.

See before & after hair transplant photos organized by hair character

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

Dr. 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.

Dr. Bernstein led a roundtable discussion in the ‘Coffee with the Experts’ session on robotic follicular unit extraction. See above photo of the session (click on it to view a larger version). Some of the topics he covered were; the proper indications for FUE, the advantages of Robotic FUE over other methods, how doctors can best implement robotic hair transplants in their practices and recent advances in robotic technology. He was also a panelist at the Finasteride Symposium and gave a presentation on protocol in prescribing Finasteride to hair restoration patients.

Program biography on Dr. Bernstein

Robert M. Bernstein, M.D., F.A.A.D., A.B.H.R.S., Clinical Professor of Dermatology, Columbia University, is an early adopter of the ARTAS System for Robotic-FUE. Bernstein Medical, PC, serves as a beta-site to study new product features and enhancements. Dr. Bernstein’s contributions and expertise have materialized in making the ARTAS System more user friendly, improving the harvesting technique and making the ARTAS procedure more compelling for patients at this early stage of commercialization of the product. Pre-Making Recipient Sites to Increase Graft Survival in Manual and Robotic FUE Procedures, has been submitted for publication.

Dr. Bernstein’s comments on roundtable discussion

One of the most important new advances in hair transplantation is Robotic Follicular Unit Extraction (R-FUE). I have been using the new ARTAS Robot, manufactured by Restoration Robotics, for almost a year now. It has made FUE a more exacting and reliable procedure. The “Coffee with the Experts” session that I gave on the topic of Robotic FUE at the ISHRS was standing room only, attesting to the great interest that members of our society have in this new technology.

The theoretical advantage of using a robot to minimize human error in a very repetitive procedure was acknowledged by most members of the discussion group. The ARTAS system has the advantage of using a combination of sharp punch and blunt dissection, a model that was based on Dr. Jim Harris’ SAFE System and one that we have found to work best with the hand-held devices. It also allows us to remove grafts with forceps, rather than by suction. This feature is important since strong suction used to remove the grafts can be more damaging than mechanical removal with forceps.

Its dissection technique uses two punches which are concentrically arranged – a small diameter, sharp bi-beveled punch is nested within an outer, dull punch. The inner punch has a cutting end to score the upper most part of the skin and the outer punch has a blunt edge that dissects the follicular units from the surrounding tissue. We have also found that grafts harvested with Robotic FUE showed less transection compared to other devices that we have used and contained more of the surrounding protective tissue, so it is assumed that this will lead to improved graft survival, but this has not yet been proven.

We find that the robot is more versatile in its ability to harvest grafts from patients with different hair characteristics and from different parts of the scalp. Although there is still variability in the ease of extraction among patients of different racial backgrounds, in our experience, the differences are less when compared to a hand-held system. Also, with the robotic system it seems easier to extract grafts from the sides of the scalp where the hair lies flatter on the skin.

In our practice, we are now able to comfortably extract 2,000 grafts in one day and over 2,500 grafts in two consecutive days. Some of the doctors at the discussion claimed to be able to consistently extract far greater numbers in a single session using manual methods, but it is hard to compare speed without comparing graft quality and transection rates.

One of the exciting things about the new device is that it is continuously evolving. As a beta-site studying new enhancements and features, we have seen all the nuanced changes that continually improve the technique. The initial version of the robot required many intra-operative adjustments to depth, angulation, and the speed of punch rotation, so there were a number of adjustments to monitor. The current system needs far less human intervention than with earlier versions and is simpler to operate, but significant experience is still needed to get the best results. Of course, all the other issues of a hair transplant including; planning, design, site creation, atraumatic graft insertion, etc. persist.

One of my special interests had been to offer patients Robotic FUE with a smaller punch size. We have been working with a 0.9mm punch (the standard is 1.0mm) and have found that this shortens healing time, decreases donor scarring and increases the number of follicular units that can safely be harvested in a specific area. It also creates grafts that require less trimming. On the other side of the coin, some patients, especially African-Americans have less transection with the larger punch, so it is important to be able to customize the technique to the particular person.

Another important modification of the technique that we have implemented since the introduction of the ARTAS system, but that is also applicable to FUE in general, is pre-making recipient sites. This is done either prior to extraction in a one-day procedure or at the beginning of the first day in a two-day procedure. With this change, as soon as the grafts are harvested, they can be placed immediately into the recipient scalp. Not only does this minimize the time that grafts are outside the body, but; by allowing the healing process to begin in the recipient area; it minimizes popping, increases visibility when placing (due to less bleeding), and may create a better environment in which the newly transplanted grafts can grow.

Some of the concerns that doctors had were the relatively high start-up cost in purchasing the robot, the amount of set-up time at the beginning of each procedure and the need, at present, to use two ORs – one for robotic harvesting and one for placing. At present, the patient can only lie on the robotic device face-down. While this position is necessary for the robotic arm to have full access to the donor area, it does not allow easy access to the front or top of the scalp. As a result, graft placement must be performed using a separate operating chair, necessitating the use of two operating rooms for one patient. It is anticipated that within a year, the robotic operating table will be re-designed so that harvesting and placing can be performed in the same room.

Besides some set-up time, one of the things that slows down the robotic process is the tensioner mechanism used to stretch the scalp. Although this feature has the advantage of decreasing damage to follicles, it must be moved every 100 to 150 grafts. With a larger and easier to use tensioner already designed, the delay from its re-positioning should be significantly decreased.

Another concern expressed was that the robot harvests grafts in a somewhat geometric pattern. With experience, one is able to overlap grids and feather the edges so that this appearance, even if temporary, is minimized. New software is planned which can do this automatically.

At the time of the meeting, there were twelve centers in the United States offering Robotic FUE with additional practices in the queue. There was also a strong interest in Robotic FUE among physicians outside the US, particularly in South Korea, Taiwan and Japan.

Read about the latest in Robotic FUE

Read about how Dr. Bernstein has improved Robotic FUE procedures

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New 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.

Dr. Bernstein receives recognition from Restoration RoboticsDr. Bernstein receives recognition from Restoration Robotics

Dr. Bernstein described his series of improvements in a lecture to an elite group of physicians who are among the first adopters in the industry of the image-guided, robotic-assisted system. The updates are designed to improve the results of FUE hair transplantation by enhancing both the surgical protocols of the procedure as well as the functionality of the robotic system. In FUE, small groups of one to four hairs, called follicular units, are extracted individually from the back and sides of the scalp and are then implanted into recipient sites, which are tiny holes that the surgeon creates in a balding area of the scalp.

Dr. Bernstein discussing robotic-assisted FUE at Restoration Robotics' first user meetingDr. Bernstein discussing robotic-assisted FUE at Restoration Robotics’ first user meeting

The most important update to the FUE procedure that Dr. Bernstein proposed is for surgeons to create recipient sites before they extract the grafts, rather than create the sites after grafts are extracted. Drawing on his decades of experience in hair transplantation, Dr. Bernstein developed this technique of “pre-making” recipient sites in order to maximize survival of the grafts during the hair transplant. Using this technique, extracted grafts are outside the body for a shorter duration of time. It also minimizes instances of “popping,” in which grafts are exposed to desiccation (drying) and hypoxia (low oxygen) before they are inserted back into the scalp. By “pre-making” the recipient sites, these harmful factors are mitigated and a greater number of the grafts grow into viable, hair-producing follicular units. Dr. Bernstein encourages surgeons to use this technique on all FUE procedures, whether using manual methods or robotic instrumentation.

When asked to comment on his improvements to the robotic FUE procedure, Dr. Bernstein said:

“It was fortuitous timing that the ARTAS Robot became available just as I was developing my refinements to the FUE procedure. The combination of the automated robot for graft extraction with the technique of pre-making recipient sites has led to a significant improvement in hair transplant surgery.”

Dr. Bernstein is the founder of Bernstein Medical – Center for Hair Restoration, and he is recognized world-wide for his innovative work in the treatment of hair loss. He is among the first hair transplant surgeons in North America to utilize the ARTAS Robot for FUE in his practice.

Being an early adopter of the advanced follicular unit extraction system has enabled him to work with Restoration Robotics to refine it to his exacting standards. Dr. Bernstein has, again, put his fingerprints on a revolutionary upgrade to the hair transplantation industry. He was the first to describe FUT and FUE procedures in the medical literature, in 1995 and 2002 respectively. In contrast to FUE, where follicular units are extracted individually, in FUT procedures a strip of skin is removed from the back of the scalp, it is then dissected into follicular units, and those follicular unit grafts are then implanted into recipient sites in the patient’s scalp.

About Dr. Bernstein

Robert M. Bernstein, M.D., F.A.A.D., A.B.H.R.S. is a Clinical Professor of Dermatology at Columbia University and a pioneer in the field of hair restoration. His landmark scientific papers are considered seminal works in the field of hair transplant surgery, and he is the most widely published author on the topic having published more than sixty articles, editorial reviews, books, and textbook chapters.

Dr. Bernstein has been selected as one of New York Magazine’s “Best Doctor’s” for thirteen consecutive years and he has appeared as a hair loss and hair transplantation expert on The Oprah Winfrey Show, The Dr. Oz Show, Good Morning America, The Today Show, The Discovery Channel, CBS News, Fox News, and National Public Radio. Dr. Bernstein has been interviewed or featured in articles in GQ Magazine, Men’s Health, Interview Magazine, Vogue, the New York Times, and others.

About Bernstein Medical – Center for Hair Restoration

Bernstein Medical – Center for Hair Restoration is a state-of-the-art hair restoration facility and international referral center, located in midtown Manhattan, New York City. The center is dedicated to the diagnosis and treatment of hair loss in men and women. Hair transplant surgery, hair repair surgery, and eyebrow restoration are performed using Dr. Bernstein’s pioneering techniques of Follicular Unit Transplantation (FUT) and robotic Follicular Unit Extraction (R-FUE).

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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.

Read a transcript of the piece:

CBS 2 News Anchor Chris Wragge: These days we’ve seen robots doing everything from vacuuming our floors to building cars. You may have even had surgery done with the help of a robot. But what about something personal and cosmetic like a hair transplant? Our Dr. Max Gomez tells us about a robot doing just that.

Dr. Max Gomez: Well that’s right Chris. Now first we should make clear that robots in medicine don’t act alone, at least not yet. They’re always under the direction of a doctor. Now, that said, what robots are really good at are tedious, repetitive tasks that need to be done quickly and accurately. Something like a hair transplant.

Dr. Gomez: A full head of hair is called a person’s “crowning glory”. Sure, going bald is a common fashion statement, but most people are like Sam.

Sam, Hair Transplant Patient: I wanted more hair on my head, obviously, and I didn’t want to be bothered with any of the other treatments that are available.

Dr. Gomez: For Sam that meant a hair transplant, where donor hair follicles are taken from the back of the head and transplanted to the thinning areas, usually on top or the former hairline.

Dr. Robert M. Bernstein: The hair on the back and sides of the scalp are not effected by the same genetic process that the hair on the top of the scalp is.

Dr. Gomez: That donor hair is typically taken from a strip of scalp that is cut out and then sutured closed, but that’s not the best choice for everyone.

Dr. Bernstein: Some patients, who want to wear their hair very short, that line can be a problem. Also, there are some people who are at risk of having a wider scar.

Dr. Gomez: The solution is to randomly extract individual follicular units, small groups of one to four hairs.

Dr. Bernstein: The procedure is very labor intensive and you have to do thousands of these in a single session.

Dr. Gomez: Enter the ARTAS robot. It’s a sophisticated hair mapping and extraction system. Once the donor area is identified, the robot maps all of the follicles, and then randomly extracts them with a series of punches. It can even tell the angle the hair is growing at to avoid damaging it.

Dr. Bernstein: It is much more precise than the human hand. It doesn’t tire if you’re doing thousands of grafts. It’s the same every single time.

Dr. Gomez: And here’s the result a few weeks later. Even with short hair, the random extraction means it’s virtually impossible to tell where the donor hairs came from.

Now, the rest of the transplant procedure is pretty much the same as without the robot. That’s where the art comes in. Deciding where, how many, how dense, and at what angle the donor hairs are inserted, that’s what makes a hair transplant look natural. And a well-done transplant is amazingly natural.

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Dr. Bernstein Featured With "First Of Its Kind" Robotic Hair Transplant System On NY1
Dr. Bernstein with ARTAS System for Robotic FUE

Dr. 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.

The segment also reports that Dr. Bernstein is among the first hair transplant physicians to use the technology:

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.

Dr. Bernstein speaks to one of the main benefits of the robot, the increased efficiency in extracting follicular unit grafts.

NY1 serves 2.1 million people in the tri-state area, including all five boroughs — Manhattan, Brooklyn, Queens, Staten Island, and The Bronx –– parts of Westchester and Hudson Valley, as well as cities and towns in Bergen County and Hudson County in New Jersey.

Read more about Robotic Hair Transplantation

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NY Japion Features Dr. Bernstein, ARTAS Robot For FUE
Dr. Bernstein with ARTAS Robot for FUE

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.

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.

NY Japion featured Dr. Bernstein in a 2006 series on hair restoration in which Dr. Bernstein discussed hair loss and its implications.

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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.

Read more about Robotic FUE Hair Transplantation

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Dr. Bernstein Touts Benefits Of Robotic FUE On Bloomberg TV
Dr. Bernstein discusses the ARTAS Robot for FUE

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.”

Matt Miller: That’s right, a robot. Dr. Bernstein is piloting a high-tech solution called ARTAS.

Dr. Bernstein: “What it is very precise at doing is getting around the follicular unit to separate it from the tissue.”

Matt Miller: The procedure, which costs twice as much as the standard surgery, has one clear advantage.

Dr. Bernstein: “The difference is, in the back, in the area where we take the hair, there will be little tiny dots that just fade into the scalp.”

Read more about the ARTAS Robot for FUE and Robotic Hair Transplantation

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Dr. Bernstein discusses ARTAS Robotic FUE system on NY1

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.

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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.

Read more about the differences between the ARTAS Robot and Neograft

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

Watch a video clip of Dr. Bernstein describing his approach to addressing patients’ hair loss.

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.

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Eyebrow transplant and restoration article - New York TimesThe 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.'”

For more information about the ARTAS System see our Robotic Hair Transplantation section of our website.

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Dr. Bernstein in Japanese Magazine
Dr. Bernstein and ARTAS Robot

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.

If you can read Japanese, download the article here.

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ARTAS at Bernstein Medical

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.

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ARTAS at Bernstein Medical - Center for Hair Restoration
Dr. Bernstein and Staff with ARTAS System

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.

View our press release about the ARTAS system at Bernstein Medical.

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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:

  1. Isolation of follicular units from the surrounding skin
  2. Removal of follicular units from the scalp
  3. Making recipient sites
  4. 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.

Read about Robotic Hair Transplantation.

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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.

For more information, visit the page on Robotic FUE Hair Transplantation or read answers to questions on Robotic FUE.

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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.

Read more about Robotic FUE hair transplantation.

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Dr. Bernstein is quoted extensively in an article on robotic hair transplantation in the online magazine American Health & Beauty.

ARTAS Robotic FUE Imaging System
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

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.

Read the full version of the article.

You can read much more about the ARTAS System for FUE or Robotic FUE hair transplantation.

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Press Release

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
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.

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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
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
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.

Download and read the article here (pdf).

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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.

For more information on these systems, visit the Follicular Unit Extraction (FUE) section or read Dr. Bernstein’s answers to questions on Robotics.

Read about Robotic FUE Hair Transplantation

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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.

Read more about developments in Robotic FUE

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Q: With the ARTAS robotic system for FUE hair transplantation, 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 Follicular Unit Extraction (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.

Read about Robotic FUE Hair Transplantation

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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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Robert M. Bernstein M.D.

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

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.

Read about robotic FUE hair transplantation

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Robert M. Bernstein M.D.

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.”

Read about robotic FUE hair transplantation

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Robert M. Bernstein M.D.

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.

Read about robotic FUE hair transplantation

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Robert M. Bernstein M.D.

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

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