Regular Member Bernstein Medical Posted October 11, 2017 Regular Member Share Posted October 11, 2017 Bernstein Medical - Center for Hair Restoration Patient RSI had a Robotic Hair Transplant using the ARTAS Robotic Hair Transplant System, consisting of 1,930 grafts. He was a Norwood Class 4A with brown, wavy, medium-fine hair and a donor density of 2.7. Overview: Before / After: Before Hair Transplant After One Hair Transplant Detail of Hairline: The images below demonstrate the various steps in an FUE procedure. The patient elected to have his head shaved for the procedure but the marketing to definite the recipient area was made before his head was shaven because the existing hair serves as a guide to the doctor as to where to place the newly transplanted hair. Before Transplant Position of Hairline Hair Clipped Grafts Placed 11 Days Post-op 1 year After Hair Transplant Donor Area: The images below show the donor harvest using the ARTAS Robotic Hair Transplant System. The first IMG shows a slanted scar in the donor area that he patient had as a child. The ARTAS robot has been programmed to avoid this scar while harvesting. As displayed in the second photo, grafts were placed into the scar to camouflage it. The third photo illustrates the donor area 11 days after the surgery. Donor Area Showing Scar After Harvesting and Placement of Grafts 11 Days Post-op See patients with similar characteristics in the Bernstein Medical photo galleries: Norwood Class: 4A Surgical Sessions: 1 Session Hair Character: Brown, Wavy Hair Weight: Medium-fine Donor Density: 2.7 hairs/mm2 Additional Resources: View Patient RSI's photo profile at Bernstein Medical Visit our comprehensive overview of the ARTAS Robotic System. Visit our Hair Transplant Photos galleries or browse our patients by their Norwood Class Interested in a consultation? Click here to schedule a consult or here to read about our consultations New to hair restoration? Read our comprehensive guide to Hair Transplant surgery or our Hair Transplant FAQ Visit the Bernstein Medical YouTube channel Bernstein Medical - Center for Hair Restoration Schedule a consultation HERE to request a graft estimate and quote. Follow us on Instagram, Facebook, Twitter, and YouTube. The health and safety of our patients and staff is our top priority. For a more detailed look at our safety measures, click here. Got questions? Call us at 212-826-2400 _____________________________________________ Dr. Bernstein is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member SADbutTRUE Posted October 11, 2017 Senior Member Share Posted October 11, 2017 This is a amazing result, low graft count ,huge change in appearance,great coverage, great job by doc and staff, Link to comment Share on other sites More sharing options...
Senior Member TakingThePlunge Posted October 11, 2017 Senior Member Share Posted October 11, 2017 Thank you for sharing this case! Great documentation and impressive result. David - Former Forum Co-Moderator and Editorial Assistant I am not a medical professional. All opinions are my own and my advice should not constitute as medical advice. View my Hair Loss Website Link to comment Share on other sites More sharing options...
Senior Member Gasthoerer Posted October 11, 2017 Senior Member Share Posted October 11, 2017 Honestly, the result is good but I do not like the extratction pattern. It is very "concentrated" and even. The human eye is very sensitive for such patterns. With short hair or when he ages it might be visible. A have seens These "extraction Patterns quite often in "Artas Cases". 400+ grafts in 2018 and 2900 grafts in 2020 via FUE with Feriduni Link to comment Share on other sites More sharing options...
Senior Member Gasthoerer Posted November 18, 2017 Senior Member Share Posted November 18, 2017 Weird, no further comment from the clinic? How can you have such an extraction pattern? If there is no medical reason this looks like a serious drawback of the artas or a mishandling of the machine to me. 400+ grafts in 2018 and 2900 grafts in 2020 via FUE with Feriduni Link to comment Share on other sites More sharing options...
Regular Member Bernstein Medical Posted November 21, 2017 Author Regular Member Share Posted November 21, 2017 Weird, no further comment from the clinic? How can you have such an extraction pattern? If there is no medical reason this looks like a serious drawback of the artas or a mishandling of the machine to me. In what way? Bernstein Medical - Center for Hair Restoration Schedule a consultation HERE to request a graft estimate and quote. Follow us on Instagram, Facebook, Twitter, and YouTube. The health and safety of our patients and staff is our top priority. For a more detailed look at our safety measures, click here. Got questions? Call us at 212-826-2400 _____________________________________________ Dr. Bernstein is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member Gasthoerer Posted November 23, 2017 Senior Member Share Posted November 23, 2017 In what way? Thank you for the reply. My understanding is, that the FUE extraction is performed in a way that (despite the produced scar tissue and thinning) it cannot be detected. Therfore, the top clinics distribute the pattern evently starting from the safe zone and fading out on the sides. The Artas results I know (including this one) show a smaller (especially on the side) extraction area and a very (!) hard edges (no transition from extraction to non extraction area). From my standpoint this lead to a much higher risk to detect the surgery. The human eye is trained on such unnatural patterns and there will be a sudden change in density. Actually I wonder, if the patient would feel the difference when touching/cimbing the area. 400+ grafts in 2018 and 2900 grafts in 2020 via FUE with Feriduni Link to comment Share on other sites More sharing options...
Regular Member Bernstein Medical Posted December 1, 2017 Author Regular Member Share Posted December 1, 2017 Thank you for the reply. My understanding is, that the FUE extraction is performed in a way that (despite the produced scar tissue and thinning) it cannot be detected. Therfore, the top clinics distribute the pattern evently starting from the safe zone and fading out on the sides. The Artas results I know (including this one) show a smaller (especially on the side) extraction area and a very (!) hard edges (no transition from extraction to non extraction area). From my standpoint this lead to a much higher risk to detect the surgery. The human eye is trained on such unnatural patterns and there will be a sudden change in density. Actually I wonder, if the patient would feel the difference when touching/cimbing the area. Excellent comments. Feathering of the extraction zone in FUE is a technique where the distance between the extractions gradually increases as one reaches the border of the extracted zone. When this technique should be used depends upon the short- and long-term goals of the patient. If the patient’s main goal of the FUE procedure is to wear their hair very short, then the technique of feathering and rounding the edges to have a less distinct border is appropriate, as this will decrease the visibility of the harvested area. However, if a person does not wear his hair very short (nor plans to) and maximizing the donor supply is paramount, then a more organized pattern, with less feathering, will give a greater long-term yield and a more even distribution. The reason is that the healing of FUE wounds distorts adjacent follicular units making subsequent extraction in the same regions more difficult and increases the risk of transection. For this reason, in subsequent procedures we generally prefer to harvest in new areas. If we need to harvest more hair from the same area, we rarely go back more than once. When one feathers extensively in the donor area, this utilizes a larger surface area of the scalp with less graft yield, so it may become necessary to go back over the same area to obtain additional grafts, often multiple times. This risks increased transection and an uneven, mottled appearance to the donor area. If a person wears his hair very short, then feathering is critical (even though it makes subsequent extraction more problematic). It is very easy to feather and round edges with the ARTAS robot, but we make the decision to do so based upon the specific needs and goals of the patient. Bernstein Medical - Center for Hair Restoration Schedule a consultation HERE to request a graft estimate and quote. Follow us on Instagram, Facebook, Twitter, and YouTube. The health and safety of our patients and staff is our top priority. For a more detailed look at our safety measures, click here. Got questions? Call us at 212-826-2400 _____________________________________________ Dr. Bernstein is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member HG1 Posted December 1, 2017 Senior Member Share Posted December 1, 2017 Great comment from Gasthoerer, and what would appear to me (I'm no expert) to be an excellent explanation from Dr Bernstein. Thanks guys, feel I have expanded my knowledge in the dizzy world of HT. 5024 grafts with Asmed Clinic. Dr Koray 25th & 26th Oct 2017 Those who spend their time looking for the faults in others usually make no time to correct their own. –Art Janak http://www.hairrestorationnetwork.com/eve/187649-countdown-my-hair-transplant.html Link to comment Share on other sites More sharing options...
Senior Member Gasthoerer Posted December 1, 2017 Senior Member Share Posted December 1, 2017 Thank you very much for the detailed explanation. To sum it up: - According to you "feathering" would be possible with Artas - You didn't perform this method for this particular case, as you want to save virgin donor area - This requires longer hair in the donor region - You would have done similiar with Manual extaction, correct? This explanations sounds logical, even though I am sure there are other opinions (as always). Also, I would really like to see a "feathering" donor with the Artas. Furthermore, if you use a concentrated pattern, wouldn't FUT be the prefered option. If there is no Intention to wear the hair short... 400+ grafts in 2018 and 2900 grafts in 2020 via FUE with Feriduni Link to comment Share on other sites More sharing options...
Regular Member dan26 Posted December 1, 2017 Regular Member Share Posted December 1, 2017 a more organized pattern, with less feathering, will give a greater long-term yield and a more even distribution. The reason is that the healing of FUE wounds distorts adjacent follicular units making subsequent extraction in the same regions more difficult and increases the risk of transection. For this reason, in subsequent procedures we generally prefer to harvest in new areas.. Has there been any studies on this or is it more just an observation doctors have made? And when you say distort do you mean the adjacent follicles are actually damaged/compromised post-op or just that when you try to extract them in the future it may be more risky? Would be really interested to hear from docs who've done multiple medium-large size FUE sessions and if they notice a lower yield the second time around. Link to comment Share on other sites More sharing options...
Regular Member Bernstein Medical Posted December 4, 2017 Author Regular Member Share Posted December 4, 2017 Thank you very much for the detailed explanation. To sum it up: - According to you "feathering" would be possible with Artas - You didn't perform this method for this particular case, as you want to save virgin donor area - This requires longer hair in the donor region - You would have done similiar with Manual extaction, correct? This explanations sounds logical, even though I am sure there are other opinions (as always). Also, I would really like to see a "feathering" donor with the Artas. Furthermore, if you use a concentrated pattern, wouldn't FUT be the prefered option. If there is no Intention to wear the hair short... Yes, FUT would be the preferred option, but some patients just don’t want a strip. And patient’s may change their minds in the future and may want to cut their hair short. It is much easier to create additional feathering than to have to camouflage a linear donor scar. Has there been any studies on this or is it more just an observation doctors have made? And when you say distort do you mean the adjacent follicles are actually damaged/compromised post-op or just that when you try to extract them in the future it may be more risky? Would be really interested to hear from docs who've done multiple medium-large size FUE sessions and if they notice a lower yield the second time around. This is from observation. More difficult to extract. Bernstein Medical - Center for Hair Restoration Schedule a consultation HERE to request a graft estimate and quote. Follow us on Instagram, Facebook, Twitter, and YouTube. The health and safety of our patients and staff is our top priority. For a more detailed look at our safety measures, click here. Got questions? Call us at 212-826-2400 _____________________________________________ Dr. Bernstein is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Regular Member Bernstein Medical Posted December 4, 2017 Author Regular Member Share Posted December 4, 2017 Photos taken from Patient RSI's two year follow up showing the detail of his donor area and the change in hair texture from the first to second-year post-op. 2 Years After Hair Transplant 2 Years After Hair Transplant - Donor Area Hair Combed Up Showing Detail of Donor Area[/size Bernstein Medical - Center for Hair Restoration Schedule a consultation HERE to request a graft estimate and quote. Follow us on Instagram, Facebook, Twitter, and YouTube. The health and safety of our patients and staff is our top priority. For a more detailed look at our safety measures, click here. Got questions? Call us at 212-826-2400 _____________________________________________ Dr. Bernstein is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member Gasthoerer Posted December 4, 2017 Senior Member Share Posted December 4, 2017 Again, thank you for the answers and the follow up. Much appreciated. I think this discussion will help many (future) patients in their decision making. 400+ grafts in 2018 and 2900 grafts in 2020 via FUE with Feriduni Link to comment Share on other sites More sharing options...
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