*VIDEO* FUE Clinics To Avoid- Dr. Feller and Dr. Bloxham-Great Neck, NY

[ArochaHair]

Dr. Arocha has been performing manual FUE for a number of years now and with great success however he purchased the ARTAS as it was seen as an opportunity to participate in what he felt was the progression of the field. However, it was not long afterward that he felt it did not match the results he was getting from his manual FUE.

 

This is changing. The latest software update to the robot has allowed for smaller punches to be used and the results are vastly improved overall. Here is one recent case that we posted the other day.

 

 

The improvements to the robot are continuing. It is our opinion that FUE can be successfully performed if the practitioner understands how best to use the tools at their disposal. There are many tools available on the market and all of the top clinics use a mix of them to achieve their respective results. We believe that a clinic should be judged on their results, not on the tools they use to achieve them. If the tools were so important to warrant being on center stage we'd be arguing about the football instead of enjoying the fact that the Broncos won the Super Bowl:)

[Dr Blake Bloxham]

Sean,

 

That's precisely how I view it as well.

[Dr Blake Bloxham]

ArochaHair,

 

Thank you for sharing your input. It's great to have another clinic discussing these important topics.

 

I've heard a lot about the upgrades with the recent iteration of the ARTAS software, but I haven't had anyone describe what changes/improvements were made (aside from smaller diameter punches).

 

Would you be able to share some details about what else was changed?

[newbie33]

Sean, I agree with what you're getting at. Trouble is, manual - by the dictionary definition - just means by hand. So it's a bit ambiguous and leads some doctors to say any handheld device is a manual procedure. (Manus is hand in Latin... And learning is fun, kids!).

 

I agree with the sentiment of the video and many of comments so far. Thanks for doing it, chaps. Would be interested in you thoughts on European doctors who to varying degrees do not themselves score and/or extract the grafts, though it is done without mechanical devices. This goes for some I'd consider the best, such as Lorenzo and Feriduni.

 

We can probably all agree the most risky are those technician-led clinics where pretty much the entire procedure is done by non-doctors. But can a well-trained tech get the grafts out as good as the doctor whose name is above the door (with the doctor making the recipient incisions himself)?

 

And a thought occurs to me as I write 'himself'. It nearly always is a male surgeon. Why is that? Answers on a postcard, please, to...

[ArochaHair]

ArochaHair,

 

Thank you for sharing your input. It's great to have another clinic discussing these important topics.

 

I've heard a lot about the upgrades with the recent iteration of the ARTAS software, but I haven't had anyone describe what changes/improvements were made (aside from smaller diameter punches).

 

Would you be able to share some details about what else was changed?

 

Hi Dr. Bloxham,

 

The upgrades include a punch that is not only smaller but is also completely unique in the field of FUE. The design is such that allows for scoring, like every other punch on the market, but also complete detachment of the follicle. The punch literally separates the follicle from the scalp, 100%, as opposed to simply leaving it attached at the bottom to later be extracted with forceps. Imagine if you will a tree spade and how they can transplant a fully grown tree, roots and all. It is a similar concept and one that cannot be accomplished by hand with an expectation of getting enough grafts for a proper transplant. Once the graft is scored it is extracted without tension which cannot be said about any other method in the industry.

 

There is also true data logging for each procedure. For years there have been transection rates spoken about by various FUE practitioners with data that is compiled without third party oversight. Restoration Robotics has included data logging for not only each attempt made but also the true transection rates so it is a piece of information that cannot be manipulated.

 

They have also taken measures to prevent procedures from being prepared by non-medical professionals. This is to help ensure that the doctor is actually involved and prevents technician only oversight. The software also allows the robot to have more dexterity for reaching previously difficult areas such as the area just below the occipital protrusion.

 

Of course, the robot is not the only tool for all patients but it is a tool that is getting noticeably better with each update. Dr. Arocha is very good with his manual FUE extraction as evidenced by his results but he believes that there is a place for technology in our chosen field.

 

Remember, each update is the culmination of hundreds of thousands of attempts that are recorded and transmitted back to company, which they then use to make improvements for the next update. It is very impressive technology. It's not a perfect technology and there is still a need for very high quality manual FUE but we're already seeing the great improvements to the donor zone after the last update and the new update should see another big improvement as well.

[Sean]

Dr Bloxham, is there a good way to guage available donor capacity. Example: Patient A is told he has over 9000 grafts as donor hair for FUE based off eye fukment, then he has fue procedures totalling around 4500 grafts, then asks same doc how much is remaining then doc flat out says he doesnt really know after few followups. Also, is there a way for that Patient B to guage how many extractions were made in donor area overall from FUE. For example, if patient was told 800 extractions were done but then another doc says more like 1200 grfts and so forth. Are there machines that can help count extraction scars and points a year or two down the road?

 

Thanks for your inputs on forums, it helps a lot of folks.

[ClemensWeber]

Clemens,

 

Which statements are you referring to specifically?

 

Hi,

 

I am referring to the categorisation of the FUE clinics in your video.

 

1. manual

2. motorized

3. robot

4. technician

 

You say that manual working FUE clinics are the best, 2nd motorized, 3rd, robot, 4th technician clinics. I was just curious on what proof/study/... these assumptions are based? or are these just your (or Dr. Feller?s) personal observations and opinions?

 

e.g. did you compare the quality of grafts taken with a manual punch and taken with a motorized punch? is there a representative study reg. this matter?

have you done the same thing with grafts taken by a robot and taken by technician?

 

Thanks

[newbie33]

Patient A is told he has over 9000 grafts as donor hair for FUE based off eye fukment...

 

That's a novel way of doing it. ;-)

[Dr Blake Bloxham]

ArochaHair,

 

Again, thank you for engaging in the discussion. It's great to have another clinic participate.

 

And thank you for describing some of the updates to the ARTAS software. However, I'm not sure I fully agree with the idea that a tool aimed at freeing the tethered follicle from the dermis/subcutaneous attachment has never been used before or is completely unique. In fact, Dr Feller patented a device that did just this a long time ago. What's more, the patents and the description of the design was included in the Unger textbook (I believe in the 4th edition).

 

His tool was comprised of a standard motorized punch with a sharp, perforating apparatus around the punch. The punch would be used to score down to a certain depth, and then the perforating apparatus surrounding the punch would be engaged; this involved plunging the apparatus further down into the extraction site to the depth of subcutaneous/dermal border, cutting and breaking up the tissue attached to the follicle, freeing it from its attachments, and allowing it do be delivered with less traction.

 

In fact, we still do something similar with a handheld needle during manual FUE today (when indicated). It's called the "perforation method."

 

I'll try to scan the patents and put them in the thread later this week.

 

Altogether, however, I do agree with your final assessment of manual FUE.

 

Again, thanks for sharing!

[Dr Blake Bloxham]

Sean,

 

General consensus is that donor thinning -- with FUE -- occurs after 50% of the native density has been extracted. If you were told you had a capacity of 9,000 grafts, I would assume around 4,500 of them could be removed before donor thinning occurred. Though others may feel differently about how many could be removed from your donor specifically before thinning from overharvesting occurs.

 

I think it would be very hard for patient B to determine how many grafts were removed from the donor. This is because there are usually more attempts made compared to grafts successfully extracted in FUE. This means you may have had 1,000 grafts successfully extracted, but it could have taken 1,200 attempts to get 1,000 successfully delivered and implanted. There is software that can be used to count the scars, but it could be inaccurate because of the attempts made to grafts successfully delivered dilemma described above.

[Dr Blake Bloxham]

Clemens,

 

Aside from the general consensus of the field based upon years of results from different methods, there is objective evidence backing these claims:

 

Both Beehner and Wesley have shown that FUE grafts not only grow less when compared to grafts extracted via a non-FUE technique, but they have also demonstrated that this lower growth is directly correlated to both the trauma inflicted on the grafts and lack of supportive tissue surrounding the grafts (which is lost because of excessive tearing, shearing, inability to adjust when the angle of the follicle changes under the skin, et cetera).

 

Here is the data:

 

 

 

This data further indicates that the less traumatic the extraction, the better the grafts will grow (IE a more meticulous, less traumatic, more controlled approach).

 

So let's look at whether or not motorized/rotary and automated/robotic devices inflict further damage compared to careful manual extraction and produce a lower quality graft:

 

According to Dua – in an article published in the Journal of Cutaneous and Aesthetic Surgery -- A back-and-forth motion causes unnecessary transection and is incompatible with successful FUE, as is a 360 degrees rotation of the punch(2). This demonstrates that rotary methods – used in both rotary suction and the robotic device -- cause more trauma on the grafts (therefore producing a lesser quality graft). If anyone is interested in learning more about the spinning force and negative forces it creates, there are a variety of articles explaining the extremes that can be created by these rotary motor devices(26).

 

He goes on to say the following about motorized and automated devices: The FUE machine(s) are automated hair transplant machines that seek to assist the doctor in performing a hair transplant using the FUE technique.[20,21] [They are] claimed to give a faster extraction rate of grafts in a limited time. However, there is greater pulling and twisting of grafts which puts the graft at risk of damage, resulting in greater transection(2).

 

He goes on to make some assessments about robotic/automated devices specifically: Some of the drawbacks to robots include cost, non-versatility, inability to process qualitative information and lack of judgement(2).

 

He further describes the problems with the lack of dynamic feedback from robotic FUE here: The frequent lack of association between the exit angle of the hair and the subcutaneous course of the follicle is particularly problematic. When this is coupled with frequent changes in follicle direction, the follicular transection rate (FTR) is more[17](2).

 

As far as the technician model and why it produces inferior results is concerned, Avram noted the following:

 

No matter how sophisticated the instruments, the outcome of a surgical procedure is likely to be better for physicians who are skilled and experienced in performing the procedure(1). Dua noted that the following are pre-requisites for successful FUE: Adequate experience and training of the surgeon and proper understanding of hair physiology and anatomy (meaning a thorough understanding of the medical/surgical aspects of the follicle).

 

What's more, the International Society of Hair Restoration Surgery (ISHRS) has found the technician model to be such an issue, that they released the following statement/patient safety alert about this model:

 

The International Society of Hair Restoration Surgery (ISHRS) is concerned about the growing risk to patients of unlicensed technicians performing substantial aspects of hair restoration surgery.

 

The use of unlicensed technicians to perform aspects of hair restoration surgery, which should only be performed by a properly trained and licensed physician, places patients at risk of:

 

(i) misdiagnosis; (ii) failure to diagnose hair disorders and related systemic diseases; and (iii) performance of unnecessary or ill advised surgery all of which jeopardizes patient safety and outcomes.

 

The ISHRS believes the following aspects of hair restoration surgery should only be performed by a licensed physician:

 

• Preoperative diagnostic evaluation and consultation

• Surgery planning

• Surgery execution including:

o Donor hair harvesting

o Hairline design

o Recipient site creation

• Management of other patient medical issues and possible adverse reactions

• Post-operative care

 

To help insure patients have information needed to make informed decisions about who performs their hair restoration surgery, the ISHRS urges potential patients to ask the following questions as well as questions regarding costs, risks, and short and long-term benefits and planning:

 

Patients Should Ask These Questions:

 

1.Who will evaluate my hair loss and recommend a course of treatment? What is their education, training, licensure, and experience in treating hair loss?

 

2.Who will be involved in performing my surgery, what role will they play, and what is their education, training, licensure, and experience performing hair restoration surgery?

 

3.Will anyone not licensed be making incisions or harvesting grafts during my surgery? If so, please identify this person, explain their specific role and why they are legally permitted to perform it (http://www.ishrs.org/article/consumer-alert).

 

Hopefully this is helpful!

 

References:

 

1. Avram M, Rogers N. Contemporary hair transplantation. Derm Surg 2009; 35:1705-1719

2. J Cutan Aesthet Surg. 2010 May-Aug; 3(2): 76–81.

3a. Rassman WR, Carson S. Micrografting in extensive quantities: The ideal hair restoration procedure.Dermatol Surg. 1995;21:306–11. [PubMed]

3. Limmer BL. Elliptical donor stereoscopically assisted micrografting as an approach to further refinement in hair transplantation. Dermatol Surg. 1994;20:789–93. [PubMed]

4. Bernstein RM, Rassman WR, Szaniawski W, Halperin A. Follicular transplantation. Int J Aesthetic Restorative Surg. 1995;3:119–32.

5. Bernstein RM. A neighbor’s view of the “follicular family unit.” Hair Transplant Forum Int. 1998;8:23–

6. Shiell RC. A review of modern surgical hair restoration techniques. J Cutan Aesthet Surg. 2008;1:12–6.[PMC free article] [PubMed]

7. Marzola M. Trichophytic closure of the donor area. Hair Transplant Forum Int. 2005;15:113–6.

8. Bernstein RM, Rassman WR. Follicular transplantation: Patient evaluation and surgical planning.Dermatol Surg. 1997;23:771–84. [PubMed]

9. Bernstein RM, Rassman WR. The aesthetic of follicular transplantation. Dermatol Surg. 1997;23:785–99.[PubMed]

10. Rassman WR, Bernstein RM, McClellan R, Jones R, Worton E, Uyttendaele H. Follicular Unit Extraction: Minimally invasive surgery for hair transplantation. Dermatol Surg. 2002;28:720–7. [PubMed]

11.Donor sealing: A novel method in hair transplant surgery. Indian J Dermatol. 2006;51:55.

12. Chest hair micrografts display extended growth in scalp tissue: A case report. Br J Plast Surg.2004;57:789–91. [PubMed]

13. Kingsley S. Sharing experiences of follicular isolation technique? Follicular Unit Extraction. Hair Transplant Forum Int. 2004;14:15–6.

14. Bernstein RM, Rassman WR, Anderson KW. Follicular unit extraction mega sessions: Evolution of a technique. Hair Transplant Forum Int. 2004;14:97–9.

15. Body hair transplant: An additional source of donor hair in hair restoration surgery. Indian J Dermatol. 2007;52:104–5.

16. Serdar G, Nessin B, Gurcan A. Follicular Unit Extraction in hair transplantation: Personal experience.Ann Plast Surg. 2008;60:127–33. [PubMed]

17. Harris JA. The SAFE System: New instrumentation and methodology to improve follicular unit extraction (FUE) Hair Transplant Forum Int. 2004;14:163–4.

18. Bernstein RM, Rassman WR. New instrumentation for three step Follicular Unit Extraction. Hair Transplant Forum Int. 2006;16:229–37.

19. Ekrem C, Aksoy M, Koc E, Aksoy B. Evaluation of three instruments used in FUE. Hair Transplant Forum Intl. 2009:14–5.

20. Rassman WR. New instruments for automation. Hair Transplant Forum Intl. 2004;14:131.

21. Rassman WR, Bernstein RM. Automation of hair transplantation past, present and future. In: Harahap M, editor. Innovative techniques in skin surgeon. New York: Marcel Dekker, Inc; 2002. pp. 489–502.

22. Avram MR, Rogers NE. Hair transplantation for men. J Cosmet Laser Ther. 2008;10:154–60. [PubMed]

23. Bertram NG, Damkemg P. Follicular Unit Extraction; experience in Chinese population. Hair Transplant Forum Intl. 2009;19:14.

24. Yamamoto K. Intra-operative monitoring of the follicular transection rate in follicular unit extraction. Hair Transplant Forum Intl. 2008;18:175.

25. Beehner M. Roundtable discussion – donor closure. Hair Transplant Forum Int. 2005;15:124–7. 152005.

26.Int J Prosthodont. Effects on Drill Speed and Heat Production. 1997 Sep-Oct;10(5):411-4.

[Stig]

Sean, I agree with what you're getting at. Trouble is, manual - by the dictionary definition - just means by hand. So it's a bit ambiguous and leads some doctors to say any handheld device is a manual procedure. (Manus is hand in Latin... And learning is fun, kids!).

 

I agree with the sentiment of the video and many of comments so far. Thanks for doing it, chaps. Would be interested in you thoughts on European doctors who to varying degrees do not themselves score and/or extract the grafts, though it is done without mechanical devices. This goes for some I'd consider the best, such as Lorenzo and Feriduni.

 

We can probably all agree the most risky are those technician-led clinics where pretty much the entire procedure is done by non-doctors. But can a well-trained tech get the grafts out as good as the doctor whose name is above the door (with the doctor making the recipient incisions himself)?

 

And a thought occurs to me as I write 'himself'. It nearly always is a male surgeon. Why is that? Answers on a postcard, please, to...

 

Disagree Newbie, under your interpretation then any task or procedure that it is initiated by the hand can be considered manual, where does that line start, I.e when the button is pressed by a hand to start an automated process? If there is an automated tool involved then at a minimum it should be called semi-automated or semi-manual, but saying that using an automated tool is manual is deceiving, and everyone knows this.

[newbie33]

Stig, we're not disagreeing. And save going into an argument over semantics of what is manual, mechanical, or automated, I'll just say that I wouldn't ascribe dark motives for people saying they manually extract grafts when they use a handheld mechanical device. What constitutes manual is ambiguous (I drive a manual transmission car, but I clearly don't lift and mesh the gear cogs by hand) until we/the doctors/whoever agree a common definition. So the obvious solution is to define those terms.

[Sean]

That's a novel way of doing it. ;-)

 

Frustration...but i guess it happens quite often. It means patients are uninformed and it goes against the consents.

 

Sean,

 

General consensus is that donor thinning -- with FUE -- occurs after 50% of the native density has been extracted. If you were told you had a capacity of 9,000 grafts, I would assume around 4,500 of them could be removed before donor thinning occurred. Though others may feel differently about how many could be removed from your donor specifically before thinning from overharvesting occurs.

 

I think it would be very hard for patient B to determine how many grafts were removed from the donor. This is because there are usually more attempts made compared to grafts successfully extracted in FUE. This means you may have had 1,000 grafts successfully extracted, but it could have taken 1,200 attempts to get 1,000 successfully delivered and implanted. There is software that can be used to count the scars, but it could be inaccurate because of the attempts made to grafts successfully delivered dilemma described above.

 

Dr Bloxham, that is quite alarming. Gaurantees should not be given to patients and things like this constitute as uninformed consent. Thank you for your input though.

 

What is also sad is a surgeon may say 1000 grafts were extracted but wont tell you 1500 extraction attempts were made doing it harming donor areas further. That shows that some clinics may have extraction and transection issues and not up to par with exteacting certain hair types. That is also uninformed consent where patients are not fully informed. Maybe thats why some patients end up with donor extraction halos when they are told you had x number of grafts extracted but in actuality you may have had anotger couple hit and miss extractions.

 

Are you able to repair fue donor that has varying degrees of halos? Have you worked on such repair patients yet? Can you fix hairlines and temporal areas through pure manual fue extraction and maybe in safe multiple sessions to maximize graft yield? I think it is not right to implant in existing heavily impacted recipient areas but in front of them to blend it in. Both for hairline and temporal areas. With manual FUE, how effective can you rate your yield and growth? Dr Bloxham, are you in the upstate NY area or ever around this area (Saratoga or Albany areas)? Have you ever also done any extractions with other donor sources (beard, body, or leg hairs)?

[Sean]

Also. Is there a way to reduce the bumpy recipient site. It is kind of raised because i had 65cm2 density in it first time around, then the doc went back in and attempted to add more recipient cm2 to that original area. The recipient area is raised and feels awkward. Is that called pitting? Ive got a lot of folks concerned about my overall situation and I am trying to find a way to move forward to get things addressed soon. Thanks.

[Bald36]

This is a fascinating thread. I have some questions. Dr. Feller talked about tactile feel and Dr. Bloxham said they can feel when "something is in the way" and they can make adjustments. What can get in the way? The hair? If you are using a punch and you feel the hair does this mean that by "feeling" the hair with the punch you just cut it? Is this called transection? One of the bullet points about the robot says that it is designed just for beginners but Dr. Bernstein uses it and he was one of the pioneers. The confusing part is that I haven't seen bad results with the robot.

[Sean]

This is a fascinating thread. I have some questions. Dr. Feller talked about tactile feel and Dr. Bloxham said they can feel when "something is in the way" and they can make adjustments. What can get in the way? The hair? If you are using a punch and you feel the hair does this mean that by "feeling" the hair with the punch you just cut it? Is this called transection? One of the bullet points about the robot says that it is designed just for beginners but Dr. Bernstein uses it and he was one of the pioneers. The confusing part is that I haven't seen bad results with the robot.

 

You haven't seen any bad results or lower yielding results with the ARTAS robot? What particular Artas results have you looked at and where? Can you Direct me to results where grafts extracted solely by Artas were for major hairline work? The way its being pushed across some forums is that it is very improved and basically flawless due to the algorythms and learning patterns and its ever so many improvements time to time. There is some other forums where some member docs have sections related to ARTAS, but other forum members and persons can not comment or give opinions in such threads as the moderator may edit or deletes the posts. Maybe on such forums you havent found negative feedback on it, which may make sense?

 

Tons of forum members and other parties have spoken tons offline and privately, and most opinion believes a robotic tool can't supersede human skill and art and that is why 'improvements' and 'updates' are made based on robot learning etc. no doubt though, i give props to folks that go under that robot as sacrificial test bunnies for better updates. Apparently, it seems questionable these things were not discovered in the clinical phases + trials of the robot where hundreds of supposade folks were under the Artas as subjects for FDA approval.

 

Maybe some docs should consider changing their clinic names to "Dr so and so and Dr Artas" because Artas will be doing surgery designed for those with medical degrees.

 

Until I see lots of wow and comparitively better results with Artas vs Human skills, id say a doctor who extracts and does FUE work themselves is a +1 in a matchup.

[recedingboy]

While informative, what this video fails to acknowledge is that some clinics that have demonstrated home run successes time and time again use motorized punch tools, namely PCID.

 

How much does Feller charge for a manual punch procedure? As I recall $11/graft was a few years ago for his motorized assisted procedure. One can only assume, due to his statements of non motorized procedures requiring more time and effort, that it is greater than $11 per graft. While he is perfectly entitled to charge what he wishes, the point - is that practical for most folks to spend? I'm sure a great salesmen type rebuttal to that would be, "what is the value of your appearance," or "what is the value of your confidence."

 

After years of shifting through lots of data on here, studying pictures, reading on different forums, in the end I realized one thing: the HD videos, HD pictures, and in person results 1 year+ later, in other words the OUTPUT of a clinic is what counts at the end of the day. Everything else is B.S.

 

Those of us that live in the U.S. know that malpractice insurance is high for a reason here- doctors are commonly held accountable for their actions. That is not the case in Belgium or Turkey. Patients do not have strong rights and medical qualifications in order to open up shop in those countries have lower bars than in the U.S. So for those of us Americans that wish to preserve our right to sue (and actually win - which incentivizes U.S. doctors to do well) and get it done in the U.S. what are we left with? If that or the higher medical bar in the U.S. is not an important consideration for someone, and the numerous well documented cases of successful patients/in person meetings with former patients instills sufficient confidence to where the legal or medical component becomes a moot point - great for them.

 

It seems to me that, while most of us on here are well aware that manual FUE is the gold standard for FUE, it is not easily attainable in the U.S. Practically speaking, if manual FUE prices were to drop in the U.S., it would not be in a place like NYC, rather probably out of a lower cost of living (southern?) state that is able to find talent amongst at a lower wage.

 

On the point of medical qualifications, I have visited and thoroughly researched a number clinics around the world and I will say that the most medically qualified individual I have probably met his Dr. Konior out of Chicago. I am tremendously impressed with his medical qualifications, almost OCD obsession he is known to have for his work, and the fact he does it all by himself. Just wish he did manual FUE.

[Bald36]

I don't know what you mean by "major" hairline work but this looks major to me. It was done by Dr. Arocha.

 

 

 

This s a nice crown result by Dr. Cohen.

 

 

 

 

 

I don't know what you're talking about. What forums? I'm talking about here and just searching on real self and Google.

 

 

I read through your links and it doesn't look like you were happy with a human hand in your own case so you're not making sense with your points. I don't know much about the robot but I do know that I have not seen much evidence that tells me it is a bad idea. I don't know about what people say offline because I don't know where these people are so you've presented a mystery to me. If you have cases that I can look at then let me know but for now I am not seeing anything really bad. I see complaints here about bad growth and other problems from human hands.

[Sean]

I don't know what you mean by "major" hairline work but this looks major to me. It was done by Dr. Arocha.

 

 

 

This s a nice crown result by Dr. Cohen.

 

 

 

 

 

I don't know what you're talking about. What forums? I'm talking about here and just searching on real self and Google.

 

 

I read through your links and it doesn't look like you were happy with a human hand in your own case so you're not making sense with your points. I don't know much about the robot but I do know that I have not seen much evidence that tells me it is a bad idea. I don't know about what people say offline because I don't know where these people are so you've presented a mystery to me. If you have cases that I can look at then let me know but for now I am not seeing anything really bad. I see complaints here about bad growth and other problems from human hands.

 

This was no argument against you btw. I didnt say im not happy with human hands in general. I think if a doctor has strong surgical protocol and does the work him/herself without pawning it off to a rookie fue tech, then human hands can work very efficiently for FUE in most cases. If someone seems to be learning fue on you, the human hand can be dangerous. Regarding my case, well i am a repair case needing repairs and solution at the moment where the doc says he is willing to cover my repair in full, but im waiting for that to happen. So lets see if promises are delivered and exactly when after repair surgery is scheduled.

 

Where on real self and google, can you share those Artas links privately?

 

Im also looking to see massive reconstructions of hairlines with Artas, where minimum grafts are used? You know where like 3000 grafts cover like front half of the head, not just the 1st cm distance in hairline and in between native hairs. Id like to see standalone growth achieved from Artas showing great coverage with adequate yield. You know, like the yoeld that Lorenzo, Konior, Umar, Bhatti, Lupanzula, Vories, etc etc other docs can deliver without the robot?

 

Close up photos are very helpful too.

 

The way i look at it is If robotic fue is better then surgeon skills, then all surgeons should buy artas. But it isnt happening and some surgeons even stopped using it as disclosed on this forum and others. So, its not just me saying it. But there are folks pushing it to the point that this is the new miracle machine. But this machine keeps needing updates and etc. these fixes and updates should have been done in clinical trials, (thats where docs had hundreds of supposade subjects), why now?

 

You are right, you wont personally hear from much patients or sufferers privately but if you are a repair patient that's very well known across forums, you tend to get 1000's of messages and inquiries. Lots of these folks i spoke to, do not want to be behind a robot, but have a human do it. Its not argumentative against you, but im just mentioning what i heard from the number of users that contact me. I also know a few folks screwed over by artas too. You do not have to take my word on it at all and i am not expecting you to whatsoever. I really could careless. I am just mentioning facts from my own discussions.

 

But by all means,if you are comfortable with it and it would be great to see who you go with and if you do get Artas, to showcase it in very high resolution, close ups and all. That would be nice. But if Artas floats your boat, then by all means go for it. Go with your gut and i wish you a great surgery.

[Bald36]

I do not believe I can get a reliable answer from you.Why should I send you private links? How does that help anyone? I tried to ask why the robot is bad because no one is showing bad photos and then I'm supposed to find out about some secret group of people that talk bad about the robot for me to get to the bottom of whether it is good or not? That is stupid because that means that this forum is useless which I don't believe. I'm not anticipating a need to use ARTAS myself, I'm just trying to get to the bottom of this because I am researching my options. I have seen bad results with the Neo Graft and the bad comments about it appear legitimate. I read that it causes the grafts to dry out and that there are travel techs that use it. I showed ARTAS results that I think look good. Here is another one and it was by your doctor and I can't seen anything wrong with this.

 

 

I think it is normal for updates. Did these top doctors start out knowing exactly what to do and how to do it? No. Why should the robot be any different? Even if you heard from a lot of people in the secret society that they do not want to get in front of a robot that still does not answer the question why? If you can't show me why the robot is bad then please do not bother responding as it is a waste of time for us both. Thank you for trying to help and I hope you find your own solutions but I don't want to debate this.

 

Can anyone show why the robot is so bad please?

[Melvin- Admin]

I do not believe I can get a reliable answer from you.Why should I send you private links? How does that help anyone? I tried to ask why the robot is bad because no one is showing bad photos and then I'm supposed to find out about some secret group of people that talk bad about the robot for me to get to the bottom of whether it is good or not? That is stupid because that means that this forum is useless which I don't believe. I'm not anticipating a need to use ARTAS myself, I'm just trying to get to the bottom of this because I am researching my options. I have seen bad results with the Neo Graft and the bad comments about it appear legitimate. I read that it causes the grafts to dry out and that there are travel techs that use it. I showed ARTAS results that I think look good. Here is another one and it was by your doctor and I can't seen anything wrong with this.

 

 

I think it is normal for updates. Did these top doctors start out knowing exactly what to do and how to do it? No. Why should the robot be any different? Even if you heard from a lot of people in the secret society that they do not want to get in front of a robot that still does not answer the question why? If you can't show me why the robot is bad then please do not bother responding as it is a waste of time for us both. Thank you for trying to help and I hope you find your own solutions but I don't want to debate this.

 

Can anyone show why the robot is so bad please?

 

The fact that Dr. Rahal still owns artas but no longer uses it says it all. There are plenty of poor results if you search, no one is going to do the research for you.