New Hair Transplantation Technology Opens Path to the Future
In recent years, surgical hair transplantation has been going through a significant but quiet revolution. Follicular Unit Hair Transplantation, the standard strip excision method that is still widely used, and the more minimally invasive Follicular Unit Extraction (FUE) approaches are being challenged by a technology from Restoration Robotics, Inc. (San Jose, Calif.), that automates the grafting process with more precision than is possible using manual FUE techniques. Lately, this company has signaled that this new approach to hair restoration is catching on by announcing new features for its ARTAS Robotic system as well as a new marketing / outreach program to help physicians attract and retain new patients.
The ARTAS Robotic System Heralds a Paradigm Shift in Hair Restoration Procedures
By Jeffrey Frentzen, Executive Editor
The ARTAS Robotic System employs a minimally invasive dissection punch process using an image- guided robotic arm. The system harvests follicular units from the patient’s donor area, exceeding manual FUE in terms of precision, control, reproducibility and efficiency, as well as eradicates the problem of physician fatigue.
The ARTAS easy-to-learn, programmable and automated robotics-based approach frees the practitioner to focus on the artistry of the procedure, as well as leave patients with virtually no scarring and minimal downtime after the work is done.
“There is no doubt that the ARTAS system is precipitating a paradigm shift,” expressed Mark A. Bishara, M.D., a cosmetic surgeon based in Mansfield, Tex. “For physicians and in particularly hair transplant surgeons who are only doing the strip based procedure and do not really do FUE, from hitting the ground they will be much more efficient at using a robot than if they would try to go back and learn to fine tune the eye-to-hand coordination type of skill necessary for doing manual procedures. The ARTAS system is definitely going to fulfill different voids in various practices.”
Increasingly, cosmetic surgeons and dermatologists are investigating the ARTAS Robotic System, noted Tim Parkyn, Senior Marketing Manager at Restoration Robotics. “They see the technology not only from the aspect of what they can do for the patient but also how they can adopt this into their practice. It is something they can learn and master in a decent amount of time, whereas the older techniques of hair transplantation are much more difficult to master.”
As with the introduction of any transformative technology the physician community takes its time to assess its value and potential for bringing in new patients. In the case of the ARTAS Robotic System, however, that time has come, according to Dr. Bishara. “I had a mixed practice of both cosmetic surgery and reconstructive surgery, along with hair restoration where we did around 50% strip procedures and 50% of FUE,” he said. “There is no doubt that with the results we’re achieving now with the robot, with the density and the overall hair maps, it is certainly acceptable to forego having a strip taken out of the back of your head. And that’s coming from somebody who did the manual transplantation procedure for several years before purchasing the robot.”
According to Gregory A. Turowski, M.D., Ph.D., F.A.C.S., a plastic surgeon in Skokie, Ill., the ARTAS system eases the tediousness of manual approaches and also dramatically speeds up the overall procedure. “I had used some FUE systems before, but they were manual systems and they require a lot of experience and concentration for long periods of time, and they were relatively slow,” he expressed. “The main advantages of using the ARTAS system is that it’s faster than doing transplantation manually, even for an experienced person. It doesn’t require a steep learning curve. One can become quite proficient compared with other approaches to FUE. More than that, I think it improves the quality of the grafts. The grafts are more consistently not denuded and not stripped from the surrounding tissue. This combination of features has us using the robotic system more than the manual technologies.”
Herbert S. Feinberg, M.D., a dermatologist in Englewood, N.J., said he implemented the ARTAS Robotic System in his practice in order to speed up the FUE process. “I found manual FUE too tedious. The ARTAS robot allowed me to perform FUE with more competencies that I could ever achieve manually. Certainly, it’s less physically demanding. I have now transplanted a number of patients who had traditional FUT or strip procedures in the past. All of them said they preferred the robotic transplant and they would never go back to a strip procedure if they needed more work in the future.”
In order to help physicians retain those patients and attracting new ones, Restoration Robotics has recently started to roll out a new Internet-based advertising and social media-based marketing and patient outreach program. “Hair transplantation is a unique market space,” said Mr. Parkyn. “Unlike the behavior of female patients that regularly return to their aesthetic physician, the typical male is not going to ask friends about where they go for hair transplantation. Identifying and marketing to these men, and getting our message in front of them can be a challenging task. A lot of men have certainly heard about hair transplantation, but they might not believe that it works.”
When people start noticing their hair loss, one of the key places they go for information are the online search engines, added Mr. Parkyn. “With this program, anyone searching online for any information in this category will find our information at the top of the search results page, encouraging them to response or look up a doctor to see. We can see expanding into other media as we go forward including banner ads and inbound marketing, as well as informational videos and infographics and trying to take a lot of the mystery out of hair transplantation. This kind of education will hopefully convince both men and women to seek out hair transplantation with one of the physicians that use the ARTAS system. We look to empower our physicians with this kind of information so that they can then take it out to the market.”
Any time industry comes out with a new technology that is relatively new to the consumer, the manufacturer bares a large majority of the burden to educate via public awareness and other campaigns. “Restoration Robotics has done exactly that,” noted Dr. Bishara. “The company has been getting the word out about the robotic technology. They’ve used cooperative advertisement agreements for more of the grassroots efforts, and also have taken on a large scale Google AdWords campaign for advertising the system and the procedure. So many times, industry will focus just on the providers and leave it up to them to educate patients and the public on new techniques and technologies. However, Restoration Robotics is taking the lead in this case, picking up the flag for practices that need marketing help in order to accomplish the goals of public outreach and letting them keep my marketing dollars.”
The company’s patient marketing program is a necessary component for practice success, noted Dr. Feinberg. “The materials provided by Restoration Robotics were well thought out and professionally presented. Most important to me was their focus on Internet presence. While most of my patients were referred from traditional sources, such as patient, doctor and barber referrals, the Internet has been the go to medium for most people seeking information about robotic transplants. For example, most of my consults have come to me via the Internet, such as the ARTAS website.”
Unless a physician already has the kind of extensive funds and access to an existing public relations firm or marketer, “You will need all the help you can get when you’re starting up something that’s so new, unique and somewhat mysterious to most people,” added Dr. Feinberg. “Today, to make yourself visible in what’s become a quite competitive environment you need professional assistance.”
One result of the company’s outreach would be to reel in physician naysayers, as more consumers learn about the ARTAS Robotic System and approach those physicians with questions about it. “These physicians will be compelled to start buying into the concept of non-manual grafting,” noted Dr. Bishara. “When you look at the naysayers you can scratch the surface and find out that there is usually some other type of fear motivating them to behave like that. This new technology needs to be truly embraced. Whenever you see such see such drastic game changing take place in medicine and other fields, as well, it induces a lot of fear. For instance, surgeons that are in different parts of their career and are not willing to switch over, and they feel that their craft is being lost or that all of their life’s efforts have gone by the wayside. They feel like they’re being replaced by something newer and better. But history has taught us that those that have been courageous enough to be early adopters, and embrace new things and new technology, and opening want to be at the forefront of change and participate in that change, are those that usually end up being laureates in the field.”
Dr. Turowski agreed that the ARTAS Robotic System confronts the hair restoration surgeon with a radically new procedure and technology, “It makes sense that at first people would be somewhat skeptical. And though public awareness is a key to the success of this system, public perception and physician acceptance has also changed during the past several months for one other important reason,” he said. “After two and a half years of doing the procedure, I and I’m sure others have demonstrated excellent results. We have the data and the before and afters to show to prospective patients to show that the procedure not only works but works well.”
In addition to offering global marketing support for practices, Restoration Robotics has also announced the ARTAS Hair Studio (AHS), which will improve the functionality of the robotic system by incorporating a new tablet-based interface that physicians can use in both patient consultations and in programming aspects of the hair restoration procedure.
The AHS allows physicians to use the tablet to create an onscreen photorealistic model of the patient’s head, explained Mr. Parkyn. “You can spin that head around in any direction and see it from any angle. The physician would literally draw the transplant, adjusting for lines, different levels of density in different areas of the head, etc.,” he stated. “We see it as an interactive tool, with which a physician can sit down with a patient and try out different simulations of what the patient’s hair transplant will look like. It allows the patient and the physician to explore and experiment and look at which way they want or need to go. Eventually that information can be fed to the robot, which would then perform a lot of the procedure based on the design the physician and patient have agreed upon.”
The new product will provide the patient with insight into what a hair restoration procedure can offer, noted Dr. Bishara. “In addition, the AHS turns out to be a great pre-op planning device. Physicians will be able to easily predict the amount of grafts needed for a certain operation. It is a good integrated approach as well as a good sales tool during the consult. It should not extend the time of the consult, but rather it does provide good information that is accurate.
For Dr. Feinberg, “The new AHS impressed me enough to put in my order. Anything that can enhance a procedure that is working so well now can only have a positive effect,” he expressed. “The robotic system is very high-tech and that has been a strong selling point for many of my patients. Any improvement can only create more interest and acceptance from and by patients. Also, for the ‘techie’ doctor — and I speak as one of that species — these enhancements can be very stimulating and certainly a lot of fun.”
The result of the company’s effort, in part, will be that the public’s perception of hair transplantation will move from older approaches to the automated robotic FUE method. “There are some patients that definitely benefit from the strip procedures,” noted Dr. Turowski, “but in my opinion if you have a choice of leaving a large scar on a patient’s skull versus no scar — or a nearly invisible little scars — it is a pretty simple choice.”
Bringing along the skeptics in the medical community will happen, as well, because of good patient outcomes and the kind of next-generational improvements in the technology represented by the ARTAS system.
“Every surgeon who has one will tell you why they have it, and the people that don’t have one are going to tell you why they don’t have one,” said Dr. Bishara. “They’ll give you an excuse on why they haven’t purchased one. The fact remains is that it’s worth making the switch to next generation. I think technology that a few years ago may have sounded very futuristic and unreal will become the new standard. Then, we will wonder how we could have lived without it.”
The thought process of arriving at that point varies depending upon the physician’s orientation, Dr. Bishara added. “For surgeons that have been doing hair and only do hair, increasing productivity and clinical outcomes using this system can be beneficial and even allow them to expand their aesthetic offerings. Those who embrace the new and explore the ARTAS system may ultimately be free to offer a wider scope of cosmetic surgery and other procedures, which can expand their business.”
THIS INFORMATION IS BROUGHT TO YOU COURTESY OF DR. MARK BISHARA AND THE PARAGON PLASTIC SURGERY & MED SPA
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Beards, Eyebrow and Eyelash Transplants on the Rise
The elusive hipster population has not been without their fads — from skinny jeans to plaid — but none have rivaled the importance of facial hair.
With the increase in beard popularity, some men who feel they lack the right amount of stubble have started visiting their local plastic surgeon for help.
As first reported in DNA Info, some New York plastic surgeons say they have even seen a rise in demand for beard transplants in recent years.
The American Society of Plastic Surgeons reported there was a four percent increase in hair transplants overall in 2012.
Dr. Jeffrey Epstein, a plastic surgeon based in Miami and New York, said he is now doing three beard transplants a week, up from about one a week a few years ago.
“We’re seeing more and more hipsters,” said Epstein, who said most of his patients are in their 30s and 40s. “People work from home and have the ability to be themselves and let their beard grow out.”
Beard transplants are just one example of hair-loss treatments that are a far cry from the days of toupee, glue and hats.
Plastic surgeons have been helping the follicly challenged for decades by grafting hair from the back of the head to the top of the scalp.
New technologies from “tattooed hair” to delicate transplants, where hair follicles are implanted one by one, has allowed people who are unhappy with the amount of hair on their face, or even chest, an opportunity to get the look they want.
Courtesy Dr. Jeffrey Epstein
Men are requesting hair transplants to make their beards more robust, here a patient is pictured after a transplant.
For the beard, men can have either just sparse areas filled in or a full beard.
Dr. Yael Halaas, a facial plastic surgeon based in New York, said many of her clients come in with pictures and ask for a beard similar to a celebrity such as Ryan Gosling or Jake Gyllenhaal.
Even though the hair comes from the back of the head, Halaas said after it is implanted and starts to grow, it blends with the rest of the facial hair. If a person wants that ZZ top beard, Halaas said it’s possible to obtain that look — they just need to be sure to get the right plastic surgeon. A beard transplant gone wrong can mean scarring or having facial hair grow in opposite directions, she said.
“The basic technique is the same [but] it becomes more much important on the face,” said Halaas. “It has to have design and angle.”
For men who want to replace the hair they lost on their head, a surgical technique (or toupee) isn’t their only option.
Anyone with an aversion to the surgical procedure can turn to Good Look Ink, which has another option: pigmented hair. The “hair” is tattooed onto the scalp.
Wade Griffith/Getty Images
In this stock image, a tattoo artist’s machine and ink are pictured.
The procedure is done on people with shaved heads and gives the appearance that their hair is growing in.
Good Morning America consumer correspondent Elisabeth Leamy said there are a few factors to consider before getting inked hair. Leamy said potential clients should be sure that cosmetic needles rather than the larger tattoo needles should be used.
Additionally because ink can fade in the sun, Leamy said clients should be careful to wear a hat and put on plenty of sunscreen or risk losing their inked “hair.”
And ladies shouldn’t feel that there’s no hair transplant options for them. If you’re happy with the hair on your head (and chin) but still think your eyebrow or eyelashes are sparse, there is hope for you too.
Although cosmetics to enhance eyelashes and eyebrows have been around for centuries, now you can add transplants to the options available to you.
Maria Teijeiro/Getty Images
In this stock image, a closeup of a woman’s eyebrow is pictured.
Dr. Halaas said she has performed eyelash and eyebrow transplants on patients who have wanted a fuller look. Occasionally she’s even added just a tiny amount of hair to an eyebrow to change the shape.
However, Halaas warns that the procedure should not be taken lightly or done for reasons such as your favorite mascara being discontinued. Because the hair used in transplants is from the back of the scalp, it will grow and it has to be cut often or you risk having more hair curtains than long lashes.
“The hair on your head is not programmed to stop growing. It really requires a lot of maintenance,” said Halaas.
Halaas said there are numerous reasons for people wanting hair-transplants from never liking how their body looked to those who have suffered either a trauma or burn and want to replace hair that they’ve lost. For surgeons, Halaas said performing these unusual hair transplants take some artistic ability in addition to medical knowledge.
“It’s fun [to] design,” said Halaas. “There’s many surgeons doing hair transplant, there’s not that many doing hair transplants on the face.
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX
The ARTAS System is an interactive, computer assisted equipment employing image guidance to enhance the quality of hair follicle harvesting. ARTAS is the first hair transplant robot to improve the most challenging aspects of Follicular Unit Extraction (FUE).
There are two common ways to treat balding including strip harvesting and follicular unit extraction (FUE). Strip harvesting is the most commonly used technique right now, and it is an efficient means of harvesting large quantities of follicles.
FUE offers less discomfort and a faster return to normal daily activities than traditional, more invasive methods of hair restoration. Performed in Dr. Bishara’s office, FUE with ARTAS moves healthy, functioning follicles to the areas of the patient’s scalp most impacted by baldness for more dramatic results. The implanted hairs develop their own blood supply, begin to grow and new hairs are seen a few months after the procedure has taken place. New hair continues to grow over the course of a full year, making the change in the patient’s appearance gradually noticeable to others. Healing time is short, and there is no resultant linear scar as happens with other methods of hair restoration. The only evidence is tiny, white scars left in the donor area, which are the same as those produced by manual FUE.
Benefits of ARTAS System
Robotic technology is used in numerous surgical and diagnostic procedures to improve the efficacy of treatments. Restoration Robotics has incorporated robotic technology into FUE resulting in the ARTAS system which is the first and only FDA-cleared technology that allows the physician to control the image-guided robot. I am able to make minor adjustments to dissection depths and angles during the extraction process ensuring my patients receive optimal results.
Before and After Pictures:
Please view more before and after pictures on our website at markbisharamd.com/robotic-hair-transplants.php#artas
The ARTAS Robotic Hair Transplantation procedure is preferred because of its minimally invasive nature and no need for anesthesia or downtime. This procedure is designed to produce effective results with minimal downtime and no damage to surrounding hair follicles. I will help you determine how to achieve the best possible results. Please contact our office for more information at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.
Would you consider traveling to Mexico or India for a less-expensive rhinoplasty or breast augmentation procedure? Would you consider traveling to Texas for a Robotic Hair Transplant procedure? Many Americans are doing just that-and the trend is having an impact on the market for cosmetic plastic surgery.
The paper, by ASPS Member Surgeon Dr. Kevin C. Chung and Lauren E. Franzblau of the University of Michigan, discusses “the rise and transformation of the medical tourism industry, foreign and domestic forces that influence cosmetic surgical tourism, and the pros and cons for all involved parties.” Chung and Franzblau write, “The rapid globalization of the industry also marks a fundamental shift in the world’s perception of elective procedures: patients are becoming consumers and these medical services are being viewed as commodities.”
At the office of Dr. Mark Bishara, with offices in Mansfield and Southlake, TX- we have patients traveling from all over the world for Robotic Hair Transplants. We perform the surgery in both of our locations, making it even easier for patients to access the closest office for them.
More ‘Medical Tourists’ Are Traveling for Cosmetic Surgery
Traveling for medical care is nothing new-but in the past, people were more likely to travel from poor countries to obtain higher-quality care in wealthier countries. Today, prompted by the ease and relatively low costs of travel, more patients from the United States and other western countries are traveling to the developing world to access less-costly medical and surgical procedures. Because cosmetic plastic surgery procedures aren’t covered by insurance, they make up a major part of the burgeoning medical tourism market.
Figures vary, but there’s a consensus that medical tourism is growing rapidly: India alone may have more than one million medical tourists per year. Other countries with growing medical tourism industries include Mexico, Dubai, South Africa, Thailand and Singapore.
In many countries, governments are working actively to foster their medical tourism industry. Some destinations even market procedures performed in resort-like settings, encouraging patients to combine a vacation with cosmetic surgery. Traveling abroad also lets patients recuperate privately, without anyone at home knowing that they’ve had plastic surgery.
Raising Potential Concerns Over Safety and Quality
The growth of medical tourism may have a significant impact on the cosmetic surgery market in the U.S., but also raises concerns over physical safety and legal protection. Although destination countries promote the quality and safety of their procedures and facilities, there is often little evidence to support these claims.
“Because the practice of medical travel does not appear to be going away in the foreseeable future, plastic surgeons must understand the international market and learn to compete in it,” Chung and Franzblau write. Since U.S. surgeons may find it hard to compete on price, effective strategies may include emphasizing superior quality and safety of care, or developing “niche markets” of procedures that can be profitably performed at home.
The authors emphasize that medical tourism “is not purely good or bad”-neither for patients nor the countries involved. Patients may be drawn by lower costs, but must consider the potential risks of undergoing surgery in a foreign country, as well as traveling after surgery. ASPS provides information for patients considering travel abroad for cosmetic surgery, including risks and follow-up care.
For the U.S. and other developed countries, medical tourism means fewer patients and less revenue-but may also bring increased opportunities for collaboration with rapidly modernizing countries in other parts of the world. Chung and Franzblau conclude, “To retain patients and be competitive in a global market, U.S. plastic surgery must be vigilant of the changes in medical tourism and must adapt accordingly.”
This news is brought to you courtesy of Dr. Mark Bishara and
The Paragon Surgery & Med Spa
Cosmetic Surgeon Dr. Mark A. Bishara, M.D., serving Fort Worth, Arlington, and the surrounding area.
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