A Deep Dive Into FUE Hair Restoration

Hair restoration is an art better done with cutting-edge technology. People seeking to patch up bald spots are often looking for a resolution that will be easy, effective and seamless, and that’s what Pittsburgh plastic surgeon Brian Vassar Heil, MD offers through ARTAS and NeoGraft. According to Dr. Heil, both technologies are far superior to the strip harvesting hair restoration of the past.

“Strip harvesting is like putting something on a rack and stretching them in the dungeon to make them fuller,” says Dr. Heil, while FUE (follicular unit extraction) is giving “them a shot of growth hormone once a day.” He educated us in the art of hair restoration using two of the foremost technologies available.

What is the difference between ARTAS and NeoGraft?

“So NeoGraft was the foremost technology in automated FUE. We brought that to the tri-state area in western Pennsylvania, Pittsburgh, over 11 years ago, and we quickly became one of the top five in North America for NeoGraft. Over the last 10 years, while NeoGraft was revolutionizing hair restoration, ARTAS was developed and perfected. ARTAS brought to the forefront robotic FUE, so it’s taking automated FUE and elevating it into the operating system of a robot and a computer with artificial intelligence.

We have taken the ability to extract the follicles from the back of the head with no knives, no sutures, no linear scars and almost no downtime, and we put it in the hands of a very advanced robot, the only robot in the world that can do this. Much more precisely, much more consistently and rapidly, with even less trauma and to be able to extract follicles at rates up to 1,500 grafts an hour. These graphs of hair are extracted to move them to the top or the front or the crown of the head, just like NeoGraft does. However, the robot is able to decide between the different follicles to choose the best optimal follicles for the restoration so it can choose a group of three instead of a group of one. Bringing more hair forward for the same amount of little pokes in the back of the head. This is done under local anesthesia. Patients awake feeling no pain whatsoever, and it’s all done in one day.”

Who is a good candidate for ARTAS versus NeoGraft?

“If a person is a candidate for hair restoration, they almost always are a candidate for NeoGraft hair restoration. It is very versatile. It can be used in many areas. It can be used regardless of scar tissue and however many previous treatments a person may have had. It’s simple to use for very small cases. It also can be used for large cases.

A person who is a candidate for ARTAS is always a candidate for NeoGraft. However, over 80% of patients are also good candidates for ARTAS. Someone is a good candidate for ARTAS if they have relatively unscarred tissue in the back, if they don’t have extensive scarring in the donor site, if they have straight or wavy hair versus short tight versus tight curly hair, which can pose some challenges for the robotic harvest. If a person has multiple scars across the back from being cut up with the strip method, then they’re better candidates for NeoGraft than they are ARTAS.”

How many appointments do patients need on average for ARTAS?

“The number of procedures necessary to restore hair loss depends primarily on the extent of the hair loss. Frontal hair loss often can be restored in one procedure, but more extensive hair loss that extends further back to the top of the head or extending into the crown can take two or three total sessions, even four total sessions, just depending on how much surface area needs to be covered with new hair. I would say for the majority of patients, one major treatment can satisfy 85 to 100% of their presenting need at the time of the procedure. Some patients go on to lose additional hair further back, and they may come back for future treatments.”

What is recovery like? Is there pain or downtime?

“The recovery is very easy for patients. The restored area is normally itchy for a few weeks, and the harvested area where the hair is borrowed from in the back of the head is sore and sensitive for about a week, like a mild sunburn. The patients are able to lay directly on the area that the hair was taken from without discomfort. They usually are able to manage the soreness with Tylenol by the day after the procedure. The only additional recovery involves gentle care while the grass heals for 10 days, camouflaging the little baby stubble as it heals and letting the slip tear at the back of the head grow back out to a crew cut over five to seven days. They also need to restrain from heavy-duty exercise for the first 10 to 14 days.

Many patients will lay low and avoid some social and professional interactions for five to seven days. But they’re very functional. I’ve had cardiac surgeons back in surgery in four days and know people working virtually in two days.”

What are signs of good hair restoration?

“A good hair restoration is undetectable because it has a hairline that is appropriate for someone in their 50s and 60s. The features of good hair restoration include a very natural hairline that is not positioned too low or too straight and that has natural delicacy of single follicles on the front edge with an irregular arrangement avoiding an artificial alignment. An irregular arrangement of the delicate follicles across the front hairline that does not look like a typewriter. The hairline should be designed with aesthetic proportions in mind. The density should be an appropriate even density over the majority of the restored area. Anywhere there was operation there’s feathering of the follicles so that there’s not an abrupt transition to other areas of the scalp that may still be without hair. The other factor of good hair restoration is no visible scar tissue to the restored area and no visible scar tissue to the area where the hair has been taken.”

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