Are some people choosing FUT for lack of intelligence?

[KO]

Not to derail this debate, but what is considered acceptable hair length with FUT? Is buzzing the sides to a no. 3 guard without a visible scar considered a "typical" scar or an "above average" scar? I'm curious as that's how short I usually go...and might go shorter in future.

[olmert]

Joe,

 

I definitely see your point. However, I still think the results are lacking and usually the "tides turn" on these types of devices. In the end, it seems like clinics buy these "latest and greatest" in cosmetic surgery/medicine, make some money from its novelty for a few years, and essentially stop once it becomes widespread and the hype dies down. We've seen it in the hair restoration field with devices like the NeoGraft, implanter wheels, "laser assisted site creation" and in other cosmetic fields with things like "cool lipo," laser hair removal, "vampire facelifts," etc. I suppose I simply don't see the ARTAS as revolutionary enough to follow a different destiny. I think people may "catch on" a bit, and it's popularity will peak and eventually decline (like the devices and methods described above). Do you really see it as revolutionary enough to differ from these trajectory?

 

 

Future Hair Doc is forgetting the maxim that it is very hard to convince someone he is wrong when his livelihood depends upon him being right. There is an inherent bias.

 

To make money in a field, it helps that the field not be a commodity. The more hair transplantation is commoditized, the more tools like ARTAS make the difference between doctors less, the less doctors will make.

 

There are doctors that laser the top layer off your facial skin off, which makes you look a couple years younger. And you don't get much different a result depending on the doctor. So doctors cannot distinguish themselves or charge more than the average doctor.

 

If ARTAS becomes the new gold standard, the top HT docs will be offering a product less distinguished form the worst HT docs. The premium they charge will go down.

 

So while Joe Tillman laments the day of commoditization, when you will find a HT doc on yelp, such a day will bring prices down for the patient, to the detriment of the top docs.

[scar5]

 

If ARTAS becomes the new gold standard, the top HT docs will be offering a product less distinguished form the worst HT docs. The premium they charge will go down.

 

 

 

We'll see if the price drops.

 

I am yet to see devices reduce prices like they are supposed to ( I believe Armanis prices dropped drastically about 8 years ago and that it coincided with a switch from him doing personal manual extraction to his docs (techs??) doing mechanized extraction)

 

Otherwise, stories like 'The Feller Punch' are the norm. Here a device is promoted on the basis that it reduces costs, and it doesn't reduce costs. I don't even think Feller himself dropped the price.

 

Clinics/Reps and Moderators always flog the same line;

 

"It doesn't matter about the device, all that matters is what the doctor is familiar with using"

 

This keeps the whole cartel pretty happy.

[Number47]

Well, I came to believe that 95 out of 100 patients going to top docs will be satisfied or better in the first go-round, and those 5 out of 100 who are unsatisfied will keep working at it with their doc until they get what they want. As for those who may think that top docs only show their best results, I think quite the opposite. Most who go to top docs are professionals who can afford to pay the top dollar for top results and the right to remain private...the type of people who generally will not approve use of their photos for public viewing. Many actors and other top professionals fall into this category. I sure wish I could see all of those results not shown by top docs, because I bet there are some grand slams.

 

I think you are presenting a somewhat cynical view of HT as an option for people, whether FUT or FUE. A Norwood 5 like myself does not worry too much about further native hair loss. I was almost maxed-out on loss before my procedure and I would not expect I would lose my new 4000 grafts that are DHT resistant, so I should be pretty stable, even without meds. For many, trying something is better than trying nothing. Shaving one's head as a last resort is not a confidence booster either.

 

That my friend is wishful thinking and statistics out of our a.... ! Usually a bad outcome is dealt with privately between a doctor and his patient, a free surgery, a refund so most of them we don't even hear about.I am not saying thats bad, top doctors have to do it due to the misconceptions like yours that a top doctor is a god and you have nothing to be afraid of. But when the bad cases come out u cross him of your list! People tend to do that thinking they will be safer with someone else, but the truth is it can happen to any top doc, its the nature of the procedure. And it happens more often than you think, i am not trying to rain on anyones parade here but its really unfair for prospective patients to think the risks are simply not there even with top docs!

 

Nobody said that hair transplants don't work or you will need an exit strategy. I am saying that having an exit strategy is the wisest thing to do!

 

Not all patients are willing to go to the same length for their hair back, some might even want to give up in the process if they see its not for them.

[KO]

ARTAS probably will not reduce costs dramatically. First of all the machine costs 100k apiece, and if I"m not mistaken, you have to pay Restoration Robotics a royalty on every graft. Feel free to correct me if I'm wrong on these points. I guess the main virtue of ARTAS is to allow FUT surgeons to switch over or offer this procedure, as they only need to change the extraction/implanter loading part.

 

FUE prices coming down will be likely driven by motorized FUE.

[Number47]

ARTAS probably will not reduce costs dramatically. First of all the machine costs 100k apiece, and if I"m not mistaken, you have to pay Restoration Robotics a royalty on every graft. Feel free to correct me if I'm wrong on these points. I guess the main virtue of ARTAS is to allow FUT surgeons to switch over or offer this procedure, as they only need to change the extraction/implanter loading part.

 

FUE prices coming down will be likely driven by motorized FUE.

 

i think its about 250K

[Blake Bloxham]

KO,

 

You are correct. The device costs somewhere between $80,000 to $100,000 and there is a royalty paid per graft. When something like this remains standard - and will likely even increase if the machine improves and costs more, it is difficult to see how it will drive costs down across the board and become the standard. What's more, this is assuming that it will eventually produce results on par with top FUE docs performing procedures by hand. I think I'll be more swayed by this idea when I see guys like Lorenzo purchasing an ARTAS.

 

I think there is validity in what Joe said. However, I think we've all seen the trajectory of devices like this before.

 

But maybe Olmert is right and I'm in a position where I'm inherently biased and can't be objective. However, I still just don't see a scenario where a delicate, cash-based, variable, cosmetic procedure is automated to the level of something like dentistry where you call 1-800-dentist or google the closest doctor to get your cavity fixed in the standard manner. 1-800- hair-now ?!!

 

Also, I think any "bias" I may have comes from years of studying FUE and coming to the conclusion that minimial depth, manual FUE with sharp hand-held punches is simply the most ethical, pratical way to perform the procedure. It's definitely far more operator dependent and takes a lot of time to learn and perfect - meaning you can't go from a predominantly strip practice to manual FUE overnight in the same way you could with an automated machine, but it's best for the patient.

[Spanker]

KO,

 

You are correct. The device costs somewhere between $80,000 to $100,000 and there is a royalty paid per graft. When something like this remains standard - and will likely even increase if the machine improves and costs more, it is difficult to see how it will drive costs down across the board and become the standard. What's more, this is assuming that it will eventually produce results on par with top FUE docs performing procedures by hand. I think I'll be more swayed by this idea when I see guys like Lorenzo purchasing an ARTAS.

 

I think there is validity in what Joe said. However, I think we've all seen the trajectory of devices like this before.

 

But maybe Olmert is right and I'm in a position where I'm inherently biased and can't be objective. However, I still just don't see a scenario where a delicate, cash-based, variable, cosmetic procedure is automated to the level of something like dentistry where you call 1-800-dentist or google the closest doctor to get your cavity fixed in the standard manner. 1-800- hair-now ?!!

 

Also, I think any "bias" I may have comes from years of studying FUE and coming to the conclusion that minimial depth, manual FUE with sharp hand-held punches is simply the most ethical, pratical way to perform the procedure. It's definitely far more operator dependent and takes a lot of time to learn and perfect - meaning you can't go from a predominantly strip practice to manual FUE overnight in the same way you could with an automated machine, but it's best for the patient.

 

I'll just be more swayed when I start seeing a decent number of impressive results, which has yet to happen. I feel like FUE is far too intricate for a machine to do well. Patients are very different. Some have splayed fu's, some cap, done come out easy, done don't.

 

I could be surprised but I'm waiting on a total robotic experience with the same enthusiasm that I'm waiting on a cute to MBP, without holding my breath.

[JoeTillman]

I also heard from many doctors that each patient is different. When they do FUE on you they somehow understand after the first removals how your hair responds and they adjust accordingly. The strength they use, the prefect direction that they must take to extract the graft etc.

 

They learn your head as they work on it. I am not sure a robot can have the instinct and the intelligence to understand your physiology and work accordingly.

 

That is where the doctor or operator input comes into play as adjustments are made as needed. I know that they don't just hit a few buttons and walk away to let the robot do it's thing. I'm not the biggest ARTAS expert but I intend to learn more about the details as my gut tells me it is here to stay.

 

Scar5,

 

Your comments about FUE holes is completely irrelevant. I hope your (our lol) fans know that by now.

 

If you believe this then there is no point in discussing this further. Fans? If you say so.

 

So yers, apart form buckling and misdirected planes of hair, strip donor scalp looks nicer and more natural. Further more, the FUE boundaries are blunt which forms a contrast. Also can look nasty. The tone of a buzzed strip donor area looks nicer than a FUE one, apart from the zone of incision and the buckling around it. (there are no guarantees)

 

And there we have it. Yes, it looks nicer, but how do you explain the "economics" behind my own donor zone? I've had early 10,000 grafts taken out NOT COUNTING my previous two mini-micro sessions and my donor does not look "motheaten" as it should since you say that there is no difference between the two end results. I did not have more hair in my donor zone as the density was no better than average, at best.

 

Of course you can see the hair if is still sitting in the bundle. No one ever said you couldn't. My speculation (and it is just speculation) Is that stretching exercises are bad in the sense that they might ease out these telegon hairs.

And in FUE transection is always a possibility, with or without telegon. But the telegon story works out in favour of FUE.

 

And if your speculation is correct it makes no difference since no more than an average of 3.5% of singles are in telogen to begin with and since your speculation assumes that these telogen hairs are not shed but will be with scalp laxity exercises then it does not change the final numbers I was speaking about with Mickey with regards to what may or may not be lost due to transection.

 

Joe,

Re; the ARTAS (and I know this is a billion dollar question, seriously) how adept is it at knowing and adjusting the diameter of extraction tools? Does it do it at all?

 

This goes back to the interaction with the operator. The system will choose which grafts to score based on the size punch it has been fitted with and according to the parameters set by the operator. In other words, it chooses the graft based on the size punch it is fitted with. It does not choose the punch for the graft. This is changed out manually if the operator wants to switch to smaller or larger grafts. What you said about the abrupt or blunt boundaries of FUE extraction are addressed by the robot in that it is programmed to make the extraction as random as possible to avoid that exact scenario. I see this myself in results and I wish doctors, or technicians, would use better judgement with their extraction patterns.

 

KO,

 

Not to derail this debate, but what is considered acceptable hair length with FUT? Is buzzing the sides to a no. 3 guard without a visible scar considered a "typical" scar or an "above average" scar? I'm curious as that's how short I usually go...and might go shorter in future.

 

If you can get away with a 3 guard, you're lucky. A 4 guard is probably average from the better clinics and while a 3 guard is common I think it is in the minority. Any shorter than that and you're gambling with bad odds. This also depends on your donor density, assuming the best scar outcome possible, as the higher the density of the hair above and below the scar line the easier it is to hide the scar at shorter and shorter lengths. This is also assuming there was no peripheral permanent shock due to transection.

[Number47]

That is where the doctor or operator input comes into play as adjustments are made as needed. I know that they don't just hit a few buttons and walk away to let the robot do it's thing. I'm not the biggest ARTAS expert but I intend to learn more about the details as my gut tells me it is here to stay.

 

.

 

The day that a software glitch will be responsible for a failed hair transplant is near :D.

[JoeTillman]

The ARTAS costs 200K, potentially more in different countries due to import/export fees and there is a fee for each graft extraction "attempt" so if the graft is unworthy of placement the clinic is still charged for the attempt, successful or not. This is similar to the pricing structure of large business copier/printer leases as well as many other medical devices found in hospitals. The fear of some clinics is that as more and more clinics step on board with ARTAS and the quality improves the clinics will effectively be locked in to the product and short of dumping the system all together they will be stuck with any price increases that are charged by Restoration Robotics. The software updates to the system are not free either so the clinics have to pay through the nose to have the latest and greatest firmware. RR wants to make money, that is their job and their responsibility to their shareholders, but they want to do it by delivering the best results possible not to mention constant improvement is the only way to survive.

[JoeTillman]

The day that a software glitch will be responsible for a failed hair transplant is near :D.

 

Follicular BSOD.

[Spanker]

I've worked in biomedical engineering for almost 2 decades, since the mid nineties

. I'm not trusting my follicles to a machine. It's kind of like a politician not trusting the government, so you can take it for what it's worth. Science and engineering are amazing but I'd have to know a lot more before I could be on board. I'm sure the clinic would catch it before it damaged too much if something was out of calibration but I think I would just not be at ease, plus, my lumpy head would possibly make the thing explode. Plus I would guess that 20 percent of maintenance calls are due to user error. It blows my mind how dependent the medical field has become reliant on technology and it could be argued that in many cases it's not for the better.

[Blake Bloxham]

Spanker,

 

Nicely stated. Taking the human element out of the equation and replacing it solely with a machine seems strange to me as well. Grafts are finite. Patients don't get another go-around if a machine extracts 2,000 of them before someone checks and realizes something isn't correct or transection rate is high.

 

If I underwent FUE today, it would be with a physician meticulously extracting the grafts by hand. I've probably spent 5 years officially working in this field - nothing compared to Joe! - so take that for what it's worth.

 

Joe, I didn't realize it cost $200,000 and required so much additional input. I think restoration robotics will see a nice ROI regardless; especially with the payment per graft scenario.

[Spanker]

Spanker,

 

Nicely stated. Taking the human element out of the equation and replacing it solely with a machine seems strange to me as well. Grafts are finite. Patients don't get another go-around if a machine extracts 2,000 of them before someone checks and realizes something isn't correct or transection rate is high.

 

If I underwent FUE today, it would be with a physician meticulously extracting the grafts by hand. I've probably spent 5 years officially working in this field - nothing compared to Joe! - so take that for what it's worth.

 

Joe, I didn't realize it cost $200,000 and required so much additional input. I think restoration robotics will see a nice ROI regardless; especially with the payment per graft scenario.

 

Joe also didn't mention the maintenance contract that I do not believe is included in the price per graft cost. Maybe he can elaborate on it. I'd have to get someone to confirm that but in addition to the price per grafts, $200k plus for the machine, and the software updates, I do think that the annual maintenance agreement is additional.

 

Bottom line, if the price doesn't drop I wouldn't expect one to pop up on every corner.

[olmert]

Fear of computer failure is irrational. When was the last time you swiped your credit card and was charged the wrong amount? If that happens, it was because of the human that inputed the number. In short, you are safer with the computer than you are with the chance of human error. These computers have so many check sums, which in short are mathematical verifications of a million things, and if everything is not perfect, will not continue. You would need the perfect storm, one chance in a billion, to screw up. So plenty of times the credit card does not work. This happens when the check sums fail. But ARTAS will know to shut itself off when this happens, not to keep transecting.

 

Computers also do most of the work for LASIK surgery, and I don't think the computers have ever botched that, not even once. There haven't yet been a billion LASIK surgeries.

Edited November 19, 2014 by olmert

[Number47]

Yeah lets see how it works and then we can judge it. I keep an open mind for now cause i am curious.

[Spanker]

Fear of computer failure is irrational. When was the last time you swiped your credit card and was charged the wrong amount? If that happens, it was because of the human that inputed the number. In short, you are safer with the computer than you are with the chance of human error. These computers have so many check sums, which in short are mathematical verifications of a million things, and if everything is not perfect, will not continue. You would need the perfect storm, one chance in a billion, to screw up. So plenty of times the credit card does not work. This happens when the check sums fail. But ARTAS will know to shut itself off when this happens, not to keep transecting.

 

LOL. That's actually funny. I'm glad it's not true or I wouldn't have a job, or at least it would be a different job. I dealt with 4 x-ray/cath lab machines that were broken in one hospital, TODAY. You see things from a consumer standpoint and are using an internet based program as an example (that's like saying that Google never breaks, as long as your computer is working, I agree that it is rare). However, I have been to a lot of gas stations that say,"our credit card machine is down, cash only." Buttons stop working, it won't read a card, etc. Also, don't confuse something breaks less often that is solid state electronics with something is electromechanical, which has electronic components and moving parts. These units often require more maintenance. I'm not saying this happens with the ARTAS, I don't know, but I know enough that I'm not trusting it with my grafts and not only because it's a machine but mostly because I just haven't seen a lot of impressive results. Maybe something will change my mind.

[Blake Bloxham]

Computers and machines break all the time. The last time I had an issue with my credit card? Well, the number was stolen twice in the past year because of a problem with the security software; it was also shut down after I used it at a gas station out of state because a different security program thought it was stolen. I then called the bank and the lady sitting in front of a computer on the other end of the line told me there was nothing she could do to help because it was locked in the computer and couldn't be reset without doing a bunch of other stuff. This happened within 12 months with one of the biggest credit card companies in the world.

 

Also, like Spanker said, medical equipment is different. I work around it every day as well, and it's far, far from foolproof.

 

ALSO, it depends on what iteration of LASIK you're referring to; however, an ophthalmologist is always right there doing the work. Saying there has never been a "botched" LASIK procedure is also very, very inaccurate. WebMD quotes the rates of visual loss from LASIK as 1 in 10,000. Wiki also has a convenient list of complications; these range from things as serious as issues with the initial corneal flap to permanent visual halos to corneal scarring to retinal detachment to glaucoma.

 

Trust me, I'm far from the "don't trust the computers, man" type of guy. However, unbridled faith in these types of devices or thinking that complications and breakdowns don't occur is just as misguided. At the end of the day, I just don't see the advantage of it. Even if results were, in some sense, on par, I would still wouldn't want to use finite grafts and significant amounts of time and money for something that standardized and automated.

 

Again, maybe that's just me.

[olmert]

Spanker and Future HT Doc don’t understand the difference between computer failure and computer check sum failure.

 

Computer failure is common. A credit card does not get accepted. A red light is broke and turns dark.

 

Computer check sum failure is when person A swipes a credit card and person B gets charged. Or when the traffic light gives a green light to the cars in all directions. This is a one in a billion chance because the computer knows when the check sum fails, and turns off. A million things have to go wrong in sync for a check sum failure. Perfect storms are rare.

 

A human stealing your credit card even because of bad computer security is not a computer check sum failure. No one, by the way, is going to hack ARTAS to screw up transplants. Terrorists have other targets.

 

The LASIK comparison is equally flawed. No one has ever gone blind from LASIK. There may be a 1 in 10,000 incidence of some visual loss. There are also known risks such as the halo effect. This has nothing to do with introducing the computer element, as done with LASIK. You need to compare the LASIK side effect rate to the rate at which these bad results occur in comparable surgeries that are not computer assisted, perhaps PRK. Google “PRK.” When I got PRK in one eye and LASIK in the other eye, Dr. Manche at Stanford told me the incidence of bad results is equal for both tactics.

 

Even assuming that computers will never improve upon the results of the best doctors (which is extremely unlikely in the long term), computers will bring the patient cost down and top doctor salary down.

 

There are two components to what the top doctors charge. 1) Average doctor charge, and 2) Fancy doc premium.

 

The fancy docs don’t pick their prices randomly and certainly not exclusively based upon their own expenses. They look at the market and charge the most they can. At the end of the day, they are economic entities in a free market and not working for a dime less than they can get away with.

 

I will pick simplified numbers. Say the average doc charges $9K for a HT, and the average fancy doc charges $20K. $11K is the fancy doc premium. $9K reflects actual expenses plus the average doc wage. Future HT Doc says "it is difficult to see how [ARTAS] will drive costs down.” He cites the cost of ARTAS. But $300K is pennies when spread over thousands of surgeries (or actually $100 per surgery). ARTAS could get competitors, which will limit how much they can charge.

 

The bigger charge of the fancy docs is the fancy doc premium. This goes down the more a hair transplant is closer to a commodity, that is to say the less distinguished the fancy doc process is from the average doc, or the more all docs are using ARTAS.

 

The price of the fancy docs will depend much more on how much they can distinguish themselves than upon their actual expenses, including ARTAS. So if ARTAS becomes the gold standard, fancy docs will charge less. Patient wins a lot. Average doc wins a little. Fancy doc loses a lot. In my equation, the world as a whole becomes a better place, even if the fancy docs lose part of their premium.

[Loags79]

olmert: what is a fancy HT doc? Best not to be labelling and name calling when trying to state your argument and contention. Perhaps you might want to refer to these fancy doctors "established". They docs have been in the industry for a long time, worked hard for their credibility and deserve respect from colleagues and patients alike with their history of excellent consistent results. Also any surgeon has a right to charge whatever that want and think their skill is worth. The market will ultimately dictate if their fee are too high or not by how busy they are.

In HT (or any aspect of life) there is a price point that is suitable for everybody. Go with whom you're confident with and who's fee suit your financial situation.

[Spanker]

Spanker and Future HT Doc don’t understand the difference between computer failure and computer check sum failure.

 

Computer failure is common. A credit card does not get accepted. A red light is broke and turns dark.

 

Computer check sum failure is when person A swipes a credit card and person B gets charged. Or when the traffic light gives a green light to the cars in all directions. This is a one in a billion chance because the computer knows when the check sum fails, and turns off. A million things have to go wrong in sync for a check sum failure. Perfect storms are rare.

 

A human stealing your credit card even because of bad computer security is not a computer check sum failure. No one, by the way, is going to hack ARTAS to screw up transplants. Terrorists have other targets.

 

The LASIK comparison is equally flawed. No one has ever gone blind from LASIK. There may be a 1 in 10,000 incidence of some visual loss. There are also known risks such as the halo effect. This has nothing to do with introducing the computer element, as done with LASIK. You need to compare the LASIK side effect rate to the rate at which these bad results occur in comparable surgeries that are not computer assisted, perhaps PRK. Google “PRK.” When I got PRK in one eye and LASIK in the other eye, Dr. Manche at Stanford told me the incidence of bad results is equal for both tactics.

 

Even assuming that computers will never improve upon the results of the best doctors (which is extremely unlikely in the long term), computers will bring the patient cost down and top doctor salary down.

 

There are two components to what the top doctors charge. 1) Average doctor charge, and 2) Fancy doc premium.

 

The fancy docs don’t pick their prices randomly and certainly not exclusively based upon their own expenses. They look at the market and charge the most they can. At the end of the day, they are economic entities in a free market and not working for a dime less than they can get away with.

 

I will pick simplified numbers. Say the average doc charges $9K for a HT, and the average fancy doc charges $20K. $11K is the fancy doc premium. $9K reflects actual expenses plus the average doc wage. Future HT Doc says "it is difficult to see how [ARTAS] will drive costs down.” He cites the cost of ARTAS. But $300K is pennies when spread over thousands of surgeries (or actually $100 per surgery). ARTAS could get competitors, which will limit how much they can charge.

 

The bigger charge of the fancy docs is the fancy doc premium. This goes down the more a hair transplant is closer to a commodity, that is to say the less distinguished the fancy doc process is from the average doc, or the more all docs are using ARTAS.

 

The price of the fancy docs will depend much more on how much they can distinguish themselves than upon their actual expenses, including ARTAS. So if ARTAS becomes the gold standard, fancy docs will charge less. Patient wins a lot. Average doc wins a little. Fancy doc loses a lot. In my equation, the world as a whole becomes a better place, even if the fancy docs lose part of their premium.

 

Every time someone disagrees with you, you say that person "doesn't understand" or that you "don't understand" but what you mean is that you just disagree and it's really annoying and honestly pretty offensive.

 

How does the ARTAS know that it's transecting grafts? It doesn't pull the grafts, it just does the cuts. How does the software pick up that it is cutting decent grafts? Do you think there is a camera on the blade as it enters your body? Maybe you can explain this "computer check sum" failure(It's checksum btw.)

 

I went and searched for impressive ARTAS results and for the most part, they seem to be missing, and that's really the bottom line.

 

If I were as smart as you I would just make my own machine, or invent a cure for baldness so we can just shut this site down and all go on with out lives.

[Blake Bloxham]

Olmert,

 

We could argue semantics all day, but, like Spanker said, the core of our arguments simply disagree: you believe automated devices will evolve to the point where excellent hair transplantation is performed by a standardized machine; the division within the field of hair restoration narrows, many practices buy the standardized machine, this drives down costs, and hair transplantation becomes a much more affordable commodity. I simply disagree. I don't ever see an automated machine replacing the mind and touch of a trained physician. At the end of the day, it's really that simple. We could go back and forth for hours. It won't, however, change anything.

 

I find myself driving my opinion home, however, because of the following: I want to give members the best advice and allow them to use their limited time, money, and, most importantly, finite grafts wisely. I do not think this involves automated machines now or in the foreseeable future. This means I will continue advocating for other mechanisms of FUE.

[hairweare]

I always wondered why so many of my opthalmology colleagues wear glasses but could never get a straight answer. Below is a post from a medical forum that may partially explain why.

 

Posted by omar193 on November 18, 2014 - 11:35PM EST

Author Specialties: Ophthalmology

A 46 year old caucasian female presented to the Emergency Room complaining of a foreign body striking OS approximately 3 days prior while driving with her window open. Past Ophthalmic history is notable for myopia status post LASIK in 2002.

Visual acuity OS 20/200. Slit lamp exam reveals a a lasik flap with nasal hinge, vertical striae adjacent to the hinge, and a nasal 3 x 4 pericentral epithelial defect. CT orbits was negative for radiopaque foreign body. No foreign body is detected on comprehensive anterior and posterior segment ophthalmic exam. The remainder of the ophthalmic exam revealed no intraocular abnormality.

A bandage contact lens was placed and the patient was urgently scheduled for exploration and repair of the cornea. During the surgery the LASIK flap was easily lifted and a large sheet of epithelium was peeled from the stromal bed. The bed was cleaned with a corneal spatula and the flap was repositioned stretched and smoothed back into anatomic positon.

The patient's original record was requested and the patient had undergone LASIK OU for 4 diopters of myopia using a mechanical microkeratome in 2002. Estimated flap thickness OS was in the 90-100 micron range.

[olmert]

Hairweare, LASIK is not risk free. With millions of LASIK’s performed, you will find disasters, but you won’t find a higher incidence than with the equivalent procedure that is not computer assisted. They probably have computer assisted heart surgery that does not always work, but is still safer than the non-computer assisted version.

 

 

Future Hair doc, it is just a matter of time before technology commoditizes every field. Much of law work is now done by software, and the end result is you need fancy lawyers for less and less of your work. The question is not if, but when. (Even in the short term, you will see incremental commoditization, which is really all ARTAS is, since there is other work besides hair plucking.

 

 

Spanker asks the wrong questions. I don’t know the answers to them. I am not an ARTAS engineer.

 

But I do know something about regulation and lawsuits. I do know that traffic lights go dark all the time, yet no traffic light has ever flashed green for all traffic.The lawsuits and regulators do not allow technology that has a greater chance to go awry than the alternative without the new technology.

 

This does not mean that all new technology is better. The average result might be worse with the new technology. But the chances of disasters happening are always less with new technology. New technology abides the maxim first do no wrong.

 

There is a reason no one has ever gone blind from LASIK. Telling me you had a bad result is no evidence at all, unless you are comparing the rate of bad results between LASIK and the old technology.

 

The FDA has cleared a number of hair lasers, which is not from testing that they reduce hair loss, but from testing that they never cause disasters.

 

And I don’t mean to say ARTAS results are better, at least not yet. But you won’t get a disaster from it, and you are more likely to get a disaster from Hasson and Wong, or any other fancy or non-fancy doc slipping up. In other words, the disaster rate from the human hands will always be greater than any newly approved technology, or the new technology will not get approved. This is not blind faith. This is proven human history.