ARTAS grafts freshly harvested vs. trimmed and prepared by surgical technicians

[Ken Anderson, MD, FISHRS, ABHRS]

I wanted to share with readers what grafts look like straight from the ARTAS system, and what they look like after proper trimming. The ARTAS robot is not like a car wash where you just stick a patient in and *presto* out come the grafts and there you go. It's simply a tool. Like a paintbrush. No tool can guarantee good or even acceptable results, no more than any given paintbrush is going to result in the most beautiful paintings. It's the skill, talent, dedication and experience of the person using the tool. In this case it's an entire surgical team working in concert to provide the most optimal results for every single patient.

Pictured here are follicles freshly harvested using the ARTAS robot which are not suitable for transplantation, and below that follicles after proper trimming which are ready for transplantation. Quite a difference when you look really closely, for sure. For those not familiar with up-close views of untrimmed vs. trimmed follicles, one of the main differences is in the amount of dermal tissue (e.g.: skin) that is around the top of each follicle. Skin grafting works in the field of plastic surgery because skin wants to heal to other skin by nature. If this skin is left on the grafts it will heal into it's new location. The problem with transplanting skin along with follicles is that, just like in skin grafts, the tiny cuff of skin seen on the untrimmed grafts will heal into the recipient bed. This is a problem because if each hair brings a tiny bit of skin, and the skin doesn't happen to heal **perfectly** flush with the surrounding skin, the risk of 'cobblestoning' goes up significantly. Cobblestoning is the phenomenon where the surface of the skin that has received transplanted grafts no longer looks smooth but has bumps all over it, like an orange peel but much worse. It is something to avoid in a hair restoration procedure. So it's critical to have top-notch surgical staff with significant experience as their work under the microscope trimming these grafts is absolutely critical to an outstanding result.