Both methods have benefits and drawbacks. FUE generally has a shorter recovery time than strip harvesting and does not leave a linear scar; it also allows for finer hair to be harvested and is a beneficial choice in situations when the scalp is too tight for a strip incision to be feasible; however, FUE is done over a much larger area than strip harvesting, so hair thinning in harvested areas is a possible aftereffect.
Explore This IssueOctober 2014
Robotic devices for hair restoration were initially discussed as far back as 2007. In 2011, the ARTAS Robotic System received FDA clearance for performing FUE to harvest hair follicles from the scalps of men diagnosed with androgenic alopecia. The unit uses an image-guided robotic arm, special imaging technologies, small dermal punches, and a computer interface to harvest individual follicle units for transplantation.
Benefits to using a robotic surgical unit include increased speed and precision, the ability to set key parameters such as depth, and a lower possible error rate due to physician fatigue.
Dr. Ishii isn’t convinced that the use of robotics to achieve FUE is necessarily more beneficial, however. “The real disadvantage to strip harvesting is that it leaves a scar on the back of the scalp,” she said, “but it’s a very low-morbidity procedure, and any scar is concealed by remaining hair. A scar would be a concern to a patient who wears his hair very short to the scalp or who decides to throw in the towel and shave his scalp completely bald. When placing the roots in the recipient area, there is no reason for me to think that a robot will be able to do it with higher precision than humans who are expert at performing the surgery.
Dr. Kuka agreed, although she does see some benefit to using robotics. “I support the idea of having a robot doing a surgical procedure, but I don’t believe the time for it has come yet,” she said. “I believe the device itself has some deficiencies that need to be resolved before we can say that what it is doing is equal to or better than what can be done by an experienced doctor.”
Although there are no other new procedures in clinical use at this time, Dr. Ishii and Dr. Kuka do see some interesting technology for hair transplantation in development.
Hair root culturing. Dr. Ishii believes that there are studies currently underway with developing hair roots in culture. “Let’s say that a patient wants a hair transplant but doesn’t have a lot of hair left anywhere,” she said. “With this technology, we could take out five of that patient’s hair roots, and in culture, turn them into 5,000 hair roots. I believe this is definitely on the horizon, but I don’t know how far off on the horizon.”