May 11th, 2018 – Robert M. Bernstein MD, a pioneer in modern hair transplantation, led five robotic hair restoration physicians in an intensive master class focusing on ARTAS robotic techniques, surgical planning and aesthetics. The day included a live ARTAS Robotic FUE procedure, a series of twelve presentations and a Q & A period. The ARTAS Hair Transplant System, developed by Restoration Robotics, is the only robotic system in the world designed to aid surgeons in hair restoration procedures.
Dr. Bernstein was chosen to teach the first ever Master Class on Robotic Hair Transplantation because of his innovative work in the field of hair restoration and his contributions in the development of the ARTAS Robotic System. Dr. Bernstein is a Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University and founder of Bernstein Medical – Center for Hair Restoration, a state-of-the-art hair transplant facility in NYC and a beta-test center for Restoration Robotics.
Topics covered by Dr. Bernstein in the Master Class included technical aspects of robotic surgery, challenges of donor and recipient planning, hairline design, and when best to use Follicular Unit Excision (FUE). In his live demonstration and hands-on training, Dr. Bernstein also covered the techniques of Follicular Unit Graft selection and Long Hair R-FUE.
Dr. Bernstein presenting at the ARTAS Master Class.
Dr. Bernstein published “Follicular Unit Transplantation” in 1995 which now serves as the groundwork for modern hair restoration. Follicular Unit Transplantation (FUT) is the technique where the donor hair is removed from the scalp in one long thin strip and dissected into individual follicular units. Dr. Bernstein pioneered Follicular Unit Excision (FUE) in 2002, with his colleague Dr. William Rassman. Follicular Unit Excision (FUE) is the process of using an instrument to make a small incision around the skin of a follicular unit to separate it from the existing tissue. In 2011, Dr. Bernstein worked with researchers from Restoration Robotics to improve the newly released ARTAS Robotic System. Bernstein Medical was one of the first facilities in the world to use the ARTAS Robot to perform FUE hair transplantation.
In the first-ever master class, Dr. Bernstein shared his deep knowledge of hair transplantation and his experience using the ARTAS Robot with fellow hair transplant surgeons who traveled across the country for this opportunity.
Dr. Bernstein closed the 2017 ARTAS Users Meeting with a discussion of five advanced techniques in robotic hair transplant procedures that he developed at Bernstein Medical. His presentation covered the benefits of pre-making recipient sites, long-hair FUE, tensioner placement, feathering edges in harvesting, and robotic graft selection. The “Hair Restoration Pearls” presentation included case studies, photographs, and videos demonstrating the techniques to the audience of hair restoration physicians. The two-day affair; which was held in Coronado, California; was a huge success, with over 260 attendees from around the world representing 204 robotic hair restoration practices.
Pre-Making Recipient Sites
There are several advantages of pre-making recipient sites in Robotic FUE procedures. One of the most important is that grafts are out of the body for a shorter period, which increases graft survival. During placement, there is less bleeding and greater graft stickiness, which result in increased visibility for the physician, less graft popping, and up to a 30% decrease in placing time. By pre-making sites, the physician can determine the exact number of grafts needed in the hair transplant. Also, the healing process can begin in the recipient area in advance of placing. This creates a fertile bed of oxygenated tissue with factors that promote healing and the subsequent growth of the follicular unit grafts.
Long-Hair Robotic FUE
In Long-Hair Robotic FUE, the patient has their hair temporarily lifted with tape during the hair transplant surgery. The physician then harvests from the donor area in a linear configuration so that, after the procedure, the long hair is let down covering the harvested area. The long-hair technique can be applied using one harvesting row (which yields up to 1,600 grafts), a double-row (2,000 grafts), or two separate rows (2,400). Long-Hair Robotic FUE, using the ARTAS Robotic Hair Transplant System, allows the donor area to be camouflaged immediately after surgery and does not limit a patient’s ability return to work. It also makes robotic hair transplants more practical for women, who usually prefer not to shave their donor area.
Dr. Bernstein discussed a new two-handed technique for applying the robotic tensioner to the patient’s scalp. The tensioner applies traction to the scalp, stabilizes the skin, limits bleeding, and provides a system of fiducials that the ARTAS robot “reads” for proper orientation. Dr. Bernstein showed a video in which he demonstrates the technique and discusses the importance of applying the silicon straps as vertically as possible to ensure the greatest tension and stability. The two-hand technique allows for reduced stress on the physician’s hands, better control, and more accurate placement of the tensioner. It also facilitates easier edge engagement to create tension on the skin in preparation for harvesting.
Feathering Edges
Feathering is a common technique to avoiding a squared-off, geometric look after the FUE procedure. It allows the patient to maintain a natural look while wearing their hair short after the procedure. Dr. Bernstein presented two different ways to feather using existing capabilities of the ARTAS system. Dr. Bernstein showed how the physician can both round the edges of the harvest area and decrease the density on the outer edges, with simple, reproducible techniques. Most importantly, he discussed the situations in which feathering is important and the ones in which it should not be used.
Robotic Follicular Unit Graft Selection
Robotic graft selection is an advance over the harvesting technique used in earlier iterations of the ARTAS robot. The robot previously harvested grafts at random. By creating a software algorithm designed to skip over one-hair units and select only the larger follicular units, the harvesting process improved in efficiency. According to Dr. Bernstein’s study, the clinical benefit is 11.4% more hairs per graft and 17% more hairs per harvest attempt using this technique. Larger follicular unit grafts can be dissected into one-hair units for use in the frontal hairline and other cosmetically important areas in order to create the most natural aesthetic outcome in the hair transplant while minimizing the number of recipient wounds.
Q: How are specifications for making recipient sites inputted into the ARTAS® robot? — A.F., Queens, NY
A: At the outset of the procedure, the physician sits at a computer terminal that is connected to the ARTAS Robot and enters the specifications directly into the robot’s software. Variables programmed in this manner include the number of recipient sites, density of sites, angle that the hair will extrude from the skin, depth of recipient sites, and the minimum distance away from existing hair follicles that a site can be created.
Q: How does the ARTAS System avoid damaging hair follicles in the balding area during recipient site creation? — R.K., Brooklyn, NY
A: The ARTAS robot‘s optical guidance system enables it to accurately create recipient sites in areas of thinning hair without damaging existing hair follicles. During the recipient site creation process, the robot uses its advanced image-guided optical system to scan the surface of the skin, locate existing hair follicles in the recipient area, and then create recipient sites at a specified distance from these existing hairs.
The ARTAS robot carries out this process rapidly, accurately, and consistently according to the physician’s programmed specifications. Thanks to the microscopic precision of the image-guided technology, the robotic hair transplant system can avoid injury to follicles that can result when Follicular Unit Extraction (FUE) is performed using manual techniques.
Dr. Bernstein appeared on The Bald Truth, where he was interviewed by the show’s host, Spencer Kobren, about the ARTAS® Robotic Hair Transplant system for FUE and the latest updates to the robot. He also discussed increased demand for FUE procedures, and hair transplants in general, around the world.
Bernstein Medical was among the first facilities in the world to use the ARTAS Robotic System to perform Follicular Unit Extraction (FUE) hair transplants, a procedure pioneered by Dr. Bernstein. Bernstein Medical is a beta-test site for this innovative technology. Physicians at Bernstein Medical have introduced new applications for the robot, including: custom punch sizes, robotic recipient site creation, automated follicular unit graft selection, and a “long-hair Robotic FUE” technique that allows the patient to keep their hair longer in the donor area. Every FUE hair transplant at Bernstein Medical uses the ARTAS Robotic System. Dr. Bernstein is a medical advisor to Restoration Robotics, the company that manufactures the ARTAS hair transplant system.
Q: Why is using the robot to create recipient sites useful in a hair transplant? — S.K., Jersey City, NJ
A: The ARTAS® Robotic Hair Transplant system eliminates the inconsistencies inherent in creating large numbers of recipient sites by hand. The robot can create sites at a rate of up to 2,000 per hour. Although there is more set-up time compared to sites made manually, once the physician specifies the parameters such as punch depth, punch angle, and site direction, recipient site creation is precise and rapid.
One of the benefits of robotic site creation is that the distribution of grafts over a fixed area of the scalp can be exact. For example, if one wants to transplant 1,000 grafts evenly over 50cm2 of area, this can be done with great precision and with uniform site spacing. In addition, the physician can vary the densities in select regions of the scalp and the robot will adjust the densities in other areas so that the total number of sites remains the same.
Another benefit of the new technology is that the robot can be programmed to avoid existing hair and select which specific hair diameters to avoid. The robot is programmed to keep a specified distance from the existing hair to ensure that the resident follicles will not be damaged and that the distribution of new hair is even and natural. This computerized mechanism appears to be more accurate than what can be done by hand and, importantly, does not sacrifice speed in the process.
Q: How do recipient sites get made in Robotic FUE? And how does the robot know where to create the sites? — K.K., Bergen County, NJ
A: In performing recipient site creation, the ARTAS Robotic Hair Transplant system automates another part of the hair transplant process that is repetitive and prone to human error. In robotic site creation, the physician first designs the hair restoration and then specifies the angle of hair elevation, hair direction, site depth, average density, and total number of the recipient site incisions. The robot then creates the sites according to these specifications.
During site creation, the robot automatically uses its image-guided technology to avoid hairs of a certain diameter (specified by the doctor). The robot creates sites at a minimum distance from hairs of the specified diameter (the distance is also specified by the physician) and will do so randomly throughout the areas where the hair is finer or the scalp is bald. With this important feature, the new distribution of sites can be made to complement the distribution of existing hair. Observation of the ARTAS System suggests that it performs recipient site creation with greater precision and consistency than can be accomplished manually.
Dr. Bernstein Presenting at ARTAS User Group Meeting 2015
Dr. Robert M. Bernstein introduced a new capability of the ARTAS® robotic system, “Follicular Unit Graft Selection,” at the ARTAS User Group Meeting on February 7th, 2015 in Newport Coast, CA. He presented the new technology and the preliminary results of a bilateral pilot study of the technique conducted at Bernstein Medical.
In robotic graft selection, the hair restoration surgeon programs the ARTAS robot to harvest follicular units based on the number of hairs in each unit. The robot first selects and then isolates larger follicular units of 2-hairs or more. If too few 1-hair units are extracted, the surgeon can program a second pass at extracting only the smallest grafts. As an alternative, the larger units can be divided into smaller ones using stereo-microscopic dissection. The goal is to both minimize wounding and harvest an adequate distribution of varying size follicular units to satisfy the surgeon’s, and ultimately the patient’s, aesthetic hair restoration needs. The new robotic graft selection system enables the robot to intelligently and efficiently harvest follicular units.
Results of the bilateral pilot study showed that the robot’s new graft selection capability was superior to random graft selection, the robot’s default setting, in the amount of hairs extracted per harvest attempt. Dr. Bernstein described how he was able to generate more transplantable grafts with fewer attempts at harvesting. By splitting larger follicular units into smaller grafts under stereo-microscopic dissection, he was able to produce additional grafts for use in the transplant without causing further wounding.
When the new computerized graft selection capability is coupled with dissection of larger units, the result is a substantial improvement over randomized graft selection. Read more about Robotic Graft Selection and the pilot study.
Dr. Bernstein also updated the meeting attendees on the robot’s recipient site creation technique that he introduced the prior year and some best practices in incorporating the ARTAS Hair Studio software into clinical practice.
Q: How does the ARTAS robot control the depth of the incision in Robotic FUE? — B.V., Old Greenwich, CT
A: The ARTAS robotic system is equipped with advanced sensors that determine the precise depth of the sharp and blunt needles used both in the graft harvesting step and for recipient site creation. The robot automatically adjusts to the precise depth needed for the non-traumatic extraction of the grafts. The tip of the punching mechanism contains depth markings so that the physician can visually override the punch when he wants to fine-tune its action. While monitoring the procedure in real time, if it is observed that the punches are too superficial or too deep, punch depth can be modified using the robot’s computer system.
The physician can also use the ARTAS system to precisely control the depth of recipient sites. As with harvesting, the robot automatically adjusts the depth based on parameters set by the physician and the doctor can then make further adjustments, in real-time, during the procedure.
Dr. Robert M. Bernstein presented the ARTAS Hair Studio™ digital hair transplant design software and robotic recipient site creation using the ARTAS® Robotic Hair Transplant system, each advances in key aspects of hair transplantation, at the International Society of Hair Restoration Surgeons (ISHRS) annual meeting in Kuala Lumpur, Malaysia on Saturday, October 11th, 2014.
Kuala Lumpur, Malaysia (PRWEB) October 31, 2014 — Robert M. Bernstein, M.D., F.A.A.D., a world-renowned hair transplant pioneer, has presented two advances in robotic hair transplant surgery to the hair restoration industry’s largest conference; an interactive hair restoration design software suite called ARTAS Hair Studio™ and recipient site creation capability in the ground-breaking ARTAS® Robotic Hair Transplant system. Dr. Bernstein’s presentation highlights the fact that the ARTAS System is the first system to integrate the planning and performance of a hair transplant procedure. Dr. Bernstein presented these new technologies at the 22nd Annual Science Meeting of the International Society of Hair Restoration Surgeons (ISHRS) in Kuala Lumpur, Malaysia, on October 11th, 2014.
ISHRS 2014 – 22nd Annual Scientific Meeting in Kuala Lumpur, Malaysia
ARTAS Hair Studio is a planning tool that assists the physician in the design phase of the hair restoration procedure. Dr. Bernstein’s presentation described how this software enables the physician to generate a three-dimensional model of the patient’s head and then create a treatment plan based on parameters such as the number of recipient sites, the angle of elevation of the hairs, and the direction of the hairs. With small modifications of the software, the technology can add “virtual” hair to the 3-D model and allow patients to see how the results will actually look. This will create a more interactive, educational experience for the patient and one that helps align the patient’s expectations with what is possible given their specific hair loss characteristics.
Dr. Bernstein showed how, using the new software, the surgeon can divide the treatment area into two or more sections and then program different recipient site densities for the different areas to closely mimic how hair grows in nature. The treatment plan created using ARTAS Hair Studio can be saved and then imported into the ARTAS hair transplant robot.
Once the design specifications have been imported, the ARTAS Robot can then create the recipient sites, the tiny incisions made in a patient’s scalp, into which transplanted grafts of naturally-occurring groups of 1-4 hairs, called follicular units, are placed.
Recipient Site Creation at Bernstein Medical Using ARTAS Robotic System
In his presentation to the ISHRS, Dr. Bernstein described several advantages of robotic site creation over manual site creation, including: the elimination of inconsistencies in creating large numbers of recipient sites by hand, precise distribution of follicular unit grafts, automatic adjustment to site densities, and automatic avoidance of existing hairs without sacrificing speed. The robot uses advanced sensory equipment and optical cues to locate potential recipient sites on the scalp and then quickly and accurately make the incisions based on the pre-programmed parameters. The robot can create up to 2,000 recipient sites in approximately one hour.
Dr. Bernstein noted that these advances represent an integration of the design and planning processes with the actual performance of the procedure. Whereas in the past, the doctor would describe the treatment plan to the patient and then manually implement the prescribed plan, today’s computerized robotic system allows the physician to digitally design the hair transplant treatment plan, and then that plan directs the robot in the operating room.
Restoration Robotics Inc., the company that developed the robot, collaborated with Dr. Bernstein, using the Bernstein Medical – Center for Hair Restoration facility as a beta-testing site, to upgrade the ARTAS robot and test these and other advances. The ultimate goal is to deliver a robot that will mechanize every surgical aspect of an FUE hair transplant procedure.
About Robert M. Bernstein, MD, MBA, FAAD
Dr. Bernstein’s published articles on follicular unit hair transplant procedures have been called “Bibles” for the industry. He has received the Platinum Follicle Award, the highest honor in the field. He is a fellow of the International Society of Hair Restoration Surgery (ISHRS). Dr. Bernstein has appeared as a hair restoration expert on many notable television programs and in many news and lifestyle publications over the years. Examples include: The Oprah Winfrey Show, The Dr. Oz Show, The Today Show, Good Morning America, ABC News, CBS News, New York Times, Wall Street Journal, Men’s Health Magazine, and more. He is co-author of Hair Loss & Replacement for Dummies. Dr. Bernstein graduated with honors from Tulane University, received the degree of Doctor of Medicine at the University of Medicine and Dentistry of NJ, and completed his training in Dermatology at the Albert Einstein College of Medicine. Dr. Bernstein is a Clinical Professor of Dermatology at Columbia University.
About Bernstein Medical – Center for Hair Restoration
Bernstein Medical – Center for Hair Restoration, the facility Dr. Bernstein founded in 2005, is dedicated to the diagnosis and treatment of hair loss in men and women using the most advanced technologies. The state-of-the-art facility is located in midtown Manhattan, New York City and treats patients from around the globe. In 2011, Bernstein Medical became one of the first practices in the world to offer Robotic FUE procedures using the image-guided, computer-driven technology of the ARTAS Robotic System. Bernstein Medical is a beta-testing site of the robot’s new capability including the creation of recipient sites and Dr. Bernstein is a medical advisor to the company that produces the robotic system, Restoration Robotics, Inc. The board-certified physicians and highly-trained clinical assistants at Bernstein Medical take pride in providing the highest level of treatment and care for all patients.
Q: I’ve heard that your ARTAS hair transplant robot can now create the recipient site in a hair transplant procedure. Has it been done on humans or is it still in an experimental phase, and if so can you tell if it looks as natural as when the surgeon does it? — P.S., Miami, Fl
Dr. Bernstein discusses the breakthrough technology of the ARTAS® Robotic Hair Transplant system — and how the robot has improved since its initial version — in an article in Health News Digest.
Not only is the mainstreaming of the hair transplant robot changing perceptions of surgical hair restoration in the public eye, says author of the article Wendy Lewis, but the robot is increasingly in demand at the leading hair restoration facilities across the country.
According to Robert M. Bernstein, MD, FAAD, founder of Bernstein Medical – Center for Hair Restoration in New York City, “Follicular unit extraction (FUE) procedures have progressed from using labor-intensive, hand-held instruments all the way to a computer-assisted, image-guided robot. It dissects follicular units accurately and consistently, thousands of times in a single session.”
ARTAS Robot In Use at Bernstein Medical
In a recent interview with Bald Truth’s Spencer Kobren, Dr. Bernstein noted that the impression many physicians have of the FUE robot is of the initial iteration that was launched more than three years ago. In the Health News Digest article, Dr. Bernstein again makes the point that the ARTAS robot of 2014 is better than version 1.0:
“Robotic extraction has been greatly improved since the first machines were introduced over three years ago and the ARTAS robot is now used by over 70 surgeons worldwide,” said Dr. Bernstein. “We are comfortable offering it to patients as the state of the art procedure for permanent hair restoration. […] According to Dr. Bernstein, “With the addition of recipient site creation to the ARTAS Robotic System, we are one step closer to fully-automated robotic hair transplantation.”
Another breakthrough advance of the ARTAS system is the interactive visualization software called ARTAS Hair Studio:
Using actual photos of the patients, the ARTAS Hair Studio software generates a three-dimensional model on a touchscreen tablet, which allows physicians to customize a recipient site pattern design – creating hairlines and specifying hair location, distribution densities and growth directions. It also permits patients to visualize how a simulated number of grafts will appear on the scalp, with the intention of increasing the predictability and confidence of the outcome.
Dr. Bernstein has used the robot for FUE procedures at the state-of-the-art Bernstein Medical – Center for Hair Restoration since the fall of 2011. All FUE procedures at Bernstein Medical are currently performed using the ARTAS system. Bernstein Medical is a beta-testing site for developments to the robot, including several improvements to the punch mechanism, as well as the development of robotic recipient site creation. Dr. Bernstein is an advisor to the company that developed the robot, Restoration Robotics, Inc., out of Mountain View, California.
HealthNewsDigest.com is an 11 year old online magazine that is considered the premier electronic health news network and #1 provider of health news content. It is syndicated to thousands of major health industry websites and journalists in 164 countries. The author of the article is President of Wendy Lewis & Co. Ltd. Global Aesthetics Consultancy, author of 11 books, and Founder/Editor-in-Chief of BeautyintheBag.com.
Q: I understand that in robotic hair transplantation, 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 will then prepare a “recipient site” in 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.
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.
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.
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.
ARTAS 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 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).
First Master Class in Robotic Hair Restoration
Dr. Bernstein discusses the breakthrough technology of the 
ARTAS Robotic System display monitor showing parameters for the creation of recipient sites
The ARTAS Robotic System maps the surgeon’s hairline design onto a 3-D model of the patient’s head
