Robot-assisted hair restoration LA Times Article

[topcat]

I’m all for technology and advancements but I’m also for providing the patient with as much information as possible and letting them make an educated decision. I hope everyone associated with this business regardless of their capacity becomes a billionaire but that do it honestly.

Let the patients that sign up for this robot know that the punch is bigger than what most highly skilled doctors are using and are getting a comparable or lower transaction rate. The result of using a bigger punch obviously is a greater chance for white dot scarring. Some of the pictures I have seen of clinics using a 1mm punch can only be described as shot gun blast to the back of the head.

This machine in its current state also limits the harvesting area so what exactly is the limit on how many fue’s can be extracted over time. My guess is that it would be a fairly low number so what is the point? As I stated in my previous post the odds of over harvesting is going to be very high.

I would like to know the thoughts of all the consumer advocates out there. Why is important information always conveniently left out by many clinics and people in this industry?

I understand that we don't want to step on anyone's toes but you are either a consumer advocate or you're not. There is no in between.

[Winston]

Topcat, you have always offered a lot to this forum, but I think your reasoning might be a bit skewed on this subject. From everything that I have read and from what Spencer Kobren explained on his radio show, the ARTAS actually has a two punch mechanism that can in fact be customized to fit a smaller punch. A sharp punch is used to cut through the surface of the skin that measures 1mm, which is then followed by a 1.3mm dull punch to separate and then remove the lower part of the graft.
If I understand how he explained it, even if they choose to make the initial cut with a slightly lager punch then a .8mm, for example, since it is not completely cutting the graft out, the surface has much less sharp trauma and will contract and heal as well as using a smaller punch. So in the end the result should be the same or better and more consistent. Like he says, only time will tell, but I personally think it’s a wonderful step forward to getting good FUE to those who want it.

[topcat]

I’m not sure if I would agree with you view on my reasoning being skewed. I have seen plenty of white dot scarring from FUE and I have spoken to numerous patients that never expected nor were they told about it before having surgery. I knew at least 5 years ago that I would only accept a punch that was .75 or something very close to it. This is why I was able to have 500 fue’s extracted from my face within a very small area.

I would also disagree with what you wrote about the 1mm punch that is only scoring the area not being a problem. It is drastically larger than a .75mm punch when the surface area is calculated. But that is the whole idea of the posting. Ask the right questions before having any procedure. Ask to see the donor area shaved after it has completely healed and evaluate the result for yourself.

I have had my share of scarring over the last 25 years no need for others to have to have the same experience. You will not see any ethical clinics using a 1mm punch on someone’s face for obvious reasons. The scalp is no different. Is that smaller punch slow, tedious and not as profitable, absolutely. But some things are more important like what is best for the patient. I know for many this will not be a popular opinion but I’m not trying to be popular. These same issues were being discussed back in 2004 yet too many patients were still in the dark and have paid the price. Anyway I like a healthy civil debate and anyone that thinks because a person is a doctor that they have all the answers they would be wrong. They are here to make money and there is nothing wrong with that just do it ethically.

[Follicle Death Row]

Hmmm. Watch this space. I'll thorw out a wild optimistic guess but I think in 3 years this system will be using multiple size extraction punches, 0.75mm, 0.85mm, 0.95mm, will be perfectly identifying the number of hairs per FU and will be operating at 1500FU/hour.

It could create extraction maps so that after extracting say 3000 FU it knows how to best extract extract another 2000 on a second pass years down the line.

Perhaps scanning and mapping the recipient could be used in conjunction with ARTAS and some software to layout a plan to optimise the use of extracted hair in the recipient. I'd love to see such software. A laser overlay that tracks even minute movements of the patient's recipient could show where to make incisions for certain densities etc. That would be pretty cool. Maybe wishful thinking on my part but that would be my vision for FUE.

[gillenator]

Hmmm. Watch this space. I'll thorw out a wild optimistic guess but I think in 3 years this system will be using multiple size extraction punches, 0.75mm, 0.85mm, 0.95mm, will be perfectly identifying the number of hairs per FU and will be operating at 1500FU/hour.

It could create extraction maps so that after extracting say 3000 FU it knows how to best extract extract another 2000 on a second pass years down the line.

Perhaps scanning and mapping the recipient could be used in conjunction with ARTAS and some software to layout a plan to optimise the use of extracted hair in the recipient. I'd love to see such software. A laser overlay that tracks even minute movements of the patient's recipient could show where to make incisions for certain densities etc. That would be pretty cool. Maybe wishful thinking on my part but that would be my vision for FUE.

Actually FDR, I don't think your optimism is wild nor a guess but rather educated observations and conclusions to date. I think vascular surgeons are working on similiar software. Watch this technology really take off in the next several years just as you stated.

[topcat]

I’m all for advancements but I’m more for absolute complete honesty for the patient’s benefit. In its present form the punches on this robot are too large. Patients need to be advised that there are smaller punches being used which will be less apt to cause visible scarring. Because that is informing the patient and it’s only with information that a patient can make an intelligent and responsible decision.

The reality of this industry is that too many clinics like to tell prospective patients only what they want them to know. So yes I agree let the patients know that one day this robot will be using an assortment of extremely small punches and software will be loaded that will optimize the extraction pattern but it’s just not there yet, would you still like to get into the chair.

[Follicle Death Row]

I’m all for advancements but I’m more for absolute complete honesty for the patient’s benefit. In its present form the punches on this robot are too large. Patients need to be advised that there are smaller punches being used which will be less apt to cause visible scarring. Because that is informing the patient and it’s only with information that a patient can make an intelligent and responsible decision.

The reality of this industry is that too many clinics like to tell prospective patients only what they want them to know. So yes I agree let the patients know that one day this robot will be using an assortment of extremely small punches and software will be loaded that will optimize the extraction pattern but it’s just not there yet, would you still like to get into the chair.

I agree 1mm is too big. Dr. Feriduni thinks that the biggest punch that should be used is 0.95mm for multiple hair FUs but smaller punches such 0.85mm can be used for singles and doubles.

[topcat]

FDR I would agree .95 is a step in the right direction but there is no need to use a punch much larger than .85 even for multiple hair units. When you start doing the math and measuring the square surface area of the extraction site you realize that a 1mm punch starts to approach double the surface area of a .75mm punch. That does help one to realize why it matters.

[Follicle Death Row]

FDR I would agree .95 is a step in the right direction but there is no need to use a punch much larger than .85 even for multiple hair units. When you start doing the math and measuring the square surface area of the extraction site you realize that a 1mm punch starts to approach double the surface area of a .75mm punch. That does help one to realize why it matters.

Yeah I know. A slightly smaller diameter makes a big difference area wise. Whatever the case is with HST, it is unquestionable that the extraction sites are so clean and hardly noticeable. Punch size makes a big difference despite what so docs will say. If you want to be using FUE and in the IAHRS they should have to use at largest 0.9mm diameter I think. Completely agree with you mate.

[Follicle Death Row]

Just as an aside here's a FUE related tidbit to ponder. One thing that astounded me recently was the live HT that Dr. Bauman performed on Nalts. They asked how many FUE grafts in total did Nalts have available. Dr. Bauman estimated his total donor FUE reserves at 8000-10000! So after the 3500ish he's had already he may have 4500-6500 remaining! That seems a little crazy to me. It would be great if FUE reserves really did equal strip reserves but I'm still not completely convinced.

Those numbers sound incredible. If I thought I could get strip numbers by FUE I would pursue surgical hair restoration for sure.

[RichardDawkins]

If they would use smaller diameter needley and the correct storage solution they could copy HST, just a sidenote from me to maybe put things into perspective.

This would be the first automated hair multiplication device if done correctly

[Juldsc]

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[topcat]

Those numbers in my opinion are complete horseshit. An ethical clinic would advise you that it is best not to harvest more than 30% or so of the donor area by way of FUE 10,000 sounds insane to me. But I’m sure there are plenty of clinics that are willing to harvest that many grafts as long as you are paying them. They will just leave the part out about the see through donor area you are going to be left with in the end.

It’s amazing to listen to some of these doctors as for them anything seems to be possible. Anything new that comes out and they are like a kid with a new toy and they can’t wait to give it a whirl. Funny how you never hear these same doctors speaking about proceeding with caution, maybe because caution does not make them any money.

RD one of the reasons you were banned from the other forum I would guess would be that you feel it is okay to hijack every thread on the forums and talk about HM. I don’t see anyone trying to limit your speech. Just start a thread about HM and those that are interested in what you have to say will respond. In fact you can start that thread off with why you are such a strong supporter yet you yourself have not had a procedure performed. Now that would be interesting to read.

[Follicle Death Row]

Those numbers in my opinion are complete horseshit. An ethical clinic would advise you that it is best not to harvest more than 30% or so of the donor area by way of FUE 10,000 sounds insane to me. But I’m sure there are plenty of clinics that are willing to harvest that many grafts as long as you are paying them. They will just leave the part out about the see through donor area you are going to be left with in the end.

It’s amazing to listen to some of these doctors as for them anything seems to be possible. Anything new that comes out and they are like a kid with a new toy and they can’t wait to give it a whirl. Funny how you never hear these same doctors speaking about proceeding with caution, maybe because caution does not make them any money.

RD one of the reasons you were banned from the other forum I would guess would be that you feel it is okay to hijack every thread on the forums and talk about HM. I don’t see anyone trying to limit your speech. Just start a thread about HM and those that are interested in what you have to say will respond. In fact you can start that thread off with why you are such a strong supporter yet you yourself have not had a procedure performed. Now that would be interesting to read.

Yeah I don't think it's done in practice by most ethical docs. I should think 7000 tops by FUE before it looks patchy for nw 6 donor. That's around 35-40% donor thinning. If they could thin it uniformly they maybe could push the number a little bit but they don't thin it uniformly even though they try.

Dr. Rahal said around 8000 for a patient recently which seems the upper limit for a denser than normal donor. I've seen others say no more than 6500.

Dr. Bauman surprised me with that. He'll be getting into Dr. AA ravaged donor area territory if he goes that far with it.

[RichardDawkins]

I am serious topcat, i dont care what you hink or why you think i was banned. I was banned because i was stupid enough to get into fights with insane people because they provoked me and i made the mistake to get into this.

But i said this numerous times before. I was never banned because of "hijacking" which in the case of HM is simply untrue because to poiint out possibilities to people is not a crime nor is it highjacking, its only highjacking for people ho live in their dreamworld and dont wanna get woken up.

Why do you attack me when i clearly stand on toppic here by saying that if done correct automatic devices could be used as HST automatisms? This doesnt hurt anyone it keeps people on the run to look into options so that they ont fall for

"Robot FUE without donor regeneration"

Right now people have the choice to say "Hey clinics you could get a robot and we like it, but if you are only offering FUE without looking into donor regeneration, we say you can suck your robots wiener"

Do you undertand this topcat.

Why i havent had it done yet? I sid it numerous times that i wanna save up some money. With all seriousness you are starting to become another SpanishDude