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Imagine meticulously counting the hairs on a portion of your head. Now imagine identifying and manually extracting tiny, randomly-spaced units of hair follicles, moving them to another location, and re-implanting them. If that sounds labor- and time-intensive, you’re right. For patients desiring quality FUE hair transplants (follicular unit extraction) with a natural hairline and acceptable density, however, it was the state of the art for many years. Fortunately, technology wasn’t standing still. Today, the ARTAS robotic hair transplant system—now offered exclusively in Texas by Dr. Mark Bishara—has brought digital optics and cutting-edge computer-aided robotics together to substantially automate what was once a tedious, prolonged procedure.
FUE hair transplants are the gold standard in hair replacement—minimally invasive, no staples or sutures, and offering quick recovery plus a high success rate of transplanted hairs. Typically, the surgeon employs a 1 mm dermal punch to manually extract follicular units containing from one to four hairs from donor areas of at the back and sides of the scalp. These follicles are genetically immune to  male pattern balding and remain viable for life. After the follicular units are removed, the surgeon transplants them to balding areas to restore a natural hairline and scalp coverage.
While the results are highly aesthetic, there are downsides to conventional FUE hair transplants. Sessions are extremely lengthy and costly, as well as fatiguing to both surgeon and patient. Most of this results from the time-intensive process of identifying, isolating and extracting FUEs from the donor area. Accuracy in the extraction process—an important factor in the survival of follicle units in FUE hair transplants—is also dependent upon human factors which may be inconsistent, particularly in long, tiring sessions. This is one reason why only ten percent of hair restoration surgeons perform challenging FUE hair transplants, despite their incontestably superior results.
The ARTAS system utilizes digital imagery to magnify and track follicular units in the donor area, then precisely isolates and extracts them with a dissecting needle punch on a robotic arm, monitored by the surgeon. The time required for the extraction process is effectively cut in half. ARTAS can extract up to 1,000 follicular units per hour for FUE hair transplants which are then manually implanted by the surgeon in the balding area. Follicular units extracted by ARTAS are removed intact and with a reduced rate of “transection” (damage to the follicle caused by extraction). ARTAS boasts a transection rate of just 8 percent compared to up to 30 percent for manually-extracted FUE hair transplants.
ARTAS software identifies and isolates follicular units for extraction in a random pattern, preserving a  natural appearance in the donor area. To prepare for FUE hair transplants, patient’s donor area is shaved down to a 1 mm length and numbed with a local anesthetic. The patient sits in an ergonomically-designed chair with the robotic arm positioned over him. A skin tensioner placed on the scalp has markings which serve as optical reference points, enabling the computer to track and compensate for movements of the patient’s head. ARTAS identifies the location and angle of each follicle within the donor area and utilizes complex algorithms and programming to determine the proper approach for extraction. Each extraction is previewed by the surgeon on a monitor, who inputs additional instruction to the computer. The robotic arm uses a sharp needle to score the skin, then a punch to dissect the follicular unit from the skin.
Follicular units extracted by ARTAS generally require no trimming or processing and are available for implantation immediately after extraction, enhancing the success rate of the grafts and the ultimate cosmetic appeal of FUE hair transplants.
Mark A Bishara, M.D., P.A. Medical Director
Bishara Cosmetic Surgery and Hair Restoration
Bishara Cosmetic Surgery and The Paragon Med Spa 76063 serves clients from the Dallas Fort Worth Metroplex:
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