Are some people choosing FUT for lack of intelligence?

[scar5]

An interesting battle is now playing out in winemaking. Hand harvesting of the grapes vs machine harvesting. It has parallels to the ht industry except u if a certain kind of grape gets damaged n machine harvesting, that causes oxidation (bad) it is feasable to plant a different grape next season. Still, it is often said that hand harvesting producs finer wine, especially where subtlety is a factor. Yet the argument goes back and forth, with many variables and as economics of scale keeps encroaching, both sides find a way to push their case in new ways.

[hairweare]

Olmert, I perform invasive cardiac procedures and your statement about robotic surgery or new devices is flat out incorrect. Again, one must wonder why so many ophthalmologists do the procedure but don't undergo it themselves. I have been a contact lens wearer for over 30 years and every doc I consulted with told me to stay the course since I have had no problems. It is the same in all surgery, once you are cut, you have irrevocably lost your virginity so to speak.

Edited November 19, 2014 by hairweare

[KO]

Seems like olmert is wishing and wanting rather than giving good explanations why ARTAS should be giving better results for lower costs.

[JoeTillman]

It is the same in all surgery, once you are cut, you have irrevocably lost your virginity so to speak.

 

Which is exactly why I went with PRK instead of LASIK:)

[olmert]

Olmert, I perform invasive cardiac procedures and your statement about robotic surgery or new devices is flat out incorrect. Again, one must wonder why so many ophthalmologists do the procedure but don't undergo it themselves. I have been a contact lens wearer for over 30 years and every doc I consulted with told me to stay the course since I have had no problems. It is the same in all surgery, once you are cut, you have irrevocably lost your virginity so to speak.

 

Does Hairweave have any citation for his belief that what I say about robotic surgery or new devices is incorrect? Or for that matter does he have any citation for his belief that opthamologists get lasik less often than non-opthamologists?

 

KO, what I say is not based upon belief. It is like when economists were arguing with geologists a couple years ago. The geologists vouched that they know the science and we are about to run out of oil. The economists said every time someone claims scarcity, the price goes up and the scarcity stops. And lo and behold the economists turned out right. Fracking got better and doubled oil reserves.

[hairweare]

Sorry, I am only a formerly university based triple board certified physician so I will defer to your vast experience and greater expertise on these matters.

[olmert]

Well, that explains it. Perhaps a currently university based physician would point out when he is relying upon mere anecdotal evidence, and further that the medical community regards relying upon anecdotal evidence as substantially less reliable than relying upon a study.

[JoeTillman]

Sorry, I am only a formerly university based triple board certified physician so I will defer to your vast experience and greater expertise on these matters.

 

If ever there was a need for a "like" button, this justifies it. The microphone has just been dropped.

[Spanker]

Does Hairweave have any citation for his belief that what I say about robotic surgery or new devices is incorrect? Or for that matter does he have any citation for his belief that opthamologists get lasik less often than non-opthamologists?

 

KO, what I say is not based upon belief. It is like when economists were arguing with geologists a couple years ago. The geologists vouched that they know the science and we are about to run out of oil. The economists said every time someone claims scarcity, the price goes up and the scarcity stops. And lo and behold the economists turned out right. Fracking got better and doubled oil reserves.

 

You may be so intelligent that it's difficult for us to communicate because of the large gap in our I.Q., so this could be completely my fault, but I'm reminded of this commercial when I read these posts. I'm just unable to follow you on some of the stuff you say.

 

http://m.youtube.com/watch?v=n8BMkR-pVW0

[Shampoo]

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.

 

So a "disaster" is less likely with an inexperienced clinic using an ARTAS machine,

vs. Hasson & Wong?

[olmert]

So a "disaster" is less likely with an inexperienced clinic using an ARTAS machine, vs. Hasson & Wong?

 

Yes, at least in the part of the surgery that ARTAS does. This has nothing to do with whether the average result is better, but speaks to the disaster rate.

 

If LASIK's disaster rate is 1 in 10,000, then Hasson's is probably higher. I don't know if he has done 10,000 transplants yet.

 

It is because disasters caused by human error is more common than disasters caused by computer error, which mostly derives from checksums. This rule even applies to work by formerly university affiliated physicians, including those who exaggerate their predictive powers in ways the medical community call inconsistent with their teachings.

 

And while Spanker is reminded of that commercial, I am reminded of when Bill refused to add Dr. Bhatti to the recommended list of doctors here, and suggested the reason was other doctors said Dr. Bhatti is irresponsibly making wrongful and exaggerated claims about FUE that is inconsistent with the medical evidence. (Bhatti only does FUE.) I don't know whether Dr. Bhatti is formerly university affiliated, but it appears Dr. Bhatti recently stopped exaggerating and thus was added to the recommended list.

[Sean]

Artas certainly needs to be watched more closely. FDA filings state intended use is for only brown or black 'straight' hair, but yet some docs with the machine are operating on other hair colors (maybe even textures). FDA filings state it's efficacy is like the automated manual fue process, but I have yet to see a similiar yielding result, especially on hairline areas. FDA filings talk about a clinic study with patients, but I have yet to see any of those patients post on forums, considering this technology would have been well known to forums during trials. I am very cautious of Artas. There are intended uses some docs are not adhering to, according to it's own FDA filings/paperwork. There hasn't been evidence of Artas hairlines, yield rates effectively to determine its efficacy to the automated manual fue process and other machines.

 

In my opinion, These robotic tools need more FDA review and monitoring before such organizations approve the use of such tools. They are used for surgery that is cosmetic in nature and any issue could have disastrous psychological/physical effects.

 

There are some docs that may have their techs extract through Artas, but again some docs have their technicians extract FUE through motorized fue as well. Machine or not, computer or not, expert manual surgical skill by a doctor should not be replaced with machīnes nor inexperienced employees. Machines can break down or malfunction. how do we know it s extracting each and every follicle with 100% accuracy? any results to prove yield? what about hairlines to prove artistic placement ?

[scar5]

I know this has gone ARTAS, etc, and let it go on, but I'll squeeze this in.

 

 

 

 

Scar5,

 

....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"

 

And if your speculation is correct it makes no difference since no more than an average of 3.5% of singles are in telogen

 

Because;

 

1) the strip stretch is a linear one. And the gaps are evened out. The FUE tries to strategically take pot shots here and there, bit the gaps will be uneven.

 

2) your neck line was stretched up, your crown stretched down.

 

But you still have the identical number of less hairs either FUE or strip. Strip actually takes out more skin but your skull being the same size and having less grafts to cover it is what determines the thinning.

 

PS> Thanks for explanation about ARTAS chuck. I think that is great info.

[Blake Bloxham]

Sean,

 

Nicely stated. It's also not FDA approved for females either.

 

I'm curious as to what the FDA approval said regarding site creation as well.

[olmert]

Sean, after the fda approves something for one use, docs are allowed to use it for anything. It is called off label and happens with just about everything fda approved. It costs too much to get fda approval for everything.

 

Scar5, if fut stretches up the neck and this leaves the donor region more dense looking, then this is a good reason to get fut instead of fue. Who needs neck hair? I don't believe fut raises the neck much. I have heard 90% of the stretching is within 1 inch of the scar.

[Spanker]

Artas certainly needs to be watched more closely. FDA filings state intended use is for only brown or black 'straight' hair, but yet some docs with the machine are operating on other hair colors (maybe even textures). FDA filings state it's efficacy is like the automated manual fue process, but I have yet to see a similiar yielding result, especially on hairline areas. FDA filings talk about a clinic study with patients, but I have yet to see any of those patients post on forums, considering this technology would have been well known to forums during trials. I am very cautious of Artas. There are intended uses some docs are not adhering to, according to it's own FDA filings/paperwork. There hasn't been evidence of Artas hairlines, yield rates effectively to determine its efficacy to the automated manual fue process and other machines.

 

In my opinion, These robotic tools need more FDA review and monitoring before such organizations approve the use of such tools. They are used for surgery that is cosmetic in nature and any issue could have disastrous psychological/physical effects.

 

There are some docs that may have their techs extract through Artas, but again some docs have their technicians extract FUE through motorized fue as well. Machine or not, computer or not, expert manual surgical skill by a doctor should not be replaced with machīnes nor inexperienced employees. Machines can break down or malfunction. how do we know it s extracting each and every follicle with 100% accuracy? any results to prove yield? what about hairlines to prove artistic placement ?

 

I don't know the exact reason, and maybe they'll chime in, but I know SMG hit the ARTAS and now no longer uses it. That says something to me, it is either economically not a good option it they didn't like the grafts they were getting, etc. Either way, I feel like if it were that great they would still be using it.

[Blake Bloxham]

Spanker,

 

Did they officially stop using the ARTAS? I know they were using a hybrid of SAFE motorized and ARTAS for a while? Maybe Janna will chime in.

[Blake Bloxham]

Olmert,

 

You're point about off-label use is correct in theory. However, it's not as straightforward and simple in practice. There are a lot of medico-legal issues that make complete "cowboy" prescribing/utilization off-label a bit tricky.

[haircut]

I was at SMG in August and they were talking about getting rid of the ARTAS machine. Don't know if they did though.

[Blake Bloxham]

@haircut,

 

Interesting ...

[scar5]

Scar5, if fut stretches up the neck and this leaves the donor region more dense looking, then this is a good reason to get fut instead of fue....

... I have heard 90% of the stretching is within 1 inch of the scar.

 

It doesn't leave the donor more dense looking. It is still thinner then before.

Moreover, the closure also draws the skin down from the crown, so you are making your balding crown look even more open.

 

re. the 90% . Yes, it depends who you ask in my experience. if you are worried about thinning they tell you it is around the scar. If you are worried about the crown getting stretched, or thinness around the scar, they tell you it is global stretching. I guess the truth lies somewhere in between.

[Spanker]

Spanker,

 

Did they officially stop using the ARTAS? I know they were using a hybrid of SAFE motorized and ARTAS for a while? Maybe Janna will chime in.

 

Blake,

On 10/25 Janna wrote I'm another thread, "Artas*will score each graft and then the grafts are pulled out manually by hand. Shapiro Medical no longer has the*Artas."

[Number47]

Maybe Janna can tell us why they stopped using it. Was it because it was not performing as expected? Was it a business decision?

[Sean]

Sean, after the fda approves something for one use, docs are allowed to use it for anything. It is called off label and happens with just about everything fda approved. It costs too much to get fda approval for everything.

 

Scar5, if fut stretches up the neck and this leaves the donor region more dense looking, then this is a good reason to get fut instead of fue. Who needs neck hair? I don't believe fut raises the neck much. I have heard 90% of the stretching is within 1 inch of the scar.

 

 

Olmert, I just got some clarifications from a team of government/federal lawyers that i have meetings with from time to time. Some of these guys are part of firms that have dealt with class action lawsuits. They deal with federal and government lawsuits. So, I asked them about Artas and etc, raised it to their attention. There are a lot of medical stipulations that may be broken by the use of this machine as not intended. There may also be legal issues with Artas fda claims, that it as working like other methods but no public data proves it as such and in very few cases available online, may go against efficacy claims (Manual fue process, Calvatron, etc) and many other things. In fact, it turns out if a physician is using it as not intended, they can be held for damages. It can equate the use to medical malpractice, misinformation, disinformation, even others depending on various factors. Restoration Robotics can also be held liable in a couple of scenarios they spoke of. The discussion certainly raised their interest about Artas, the transplant industry, and machines being used with or without physician use, doctors using it and on what kind of patients, etc. It's possible FDA can get queried for an explanation.

 

Some FDA reference documents: http://www.accessdata.fda.gov/cdrh_docs/pdf10/K103428.pdf

 

http://www.accessdata.fda.gov/cdrh_docs/pdf12/k123548.pdf

[Nowsthetime9]

I have spoken recently with both Janna and Dr Paul Shapiro and can confirm they no longer use the ARTAS.

 

1550 FUE w/ the ARTAS at SMG

June 2013