FUE Devices including NeoGraft and Artas Explained.

In our Central Florida hair transplant offices we have had many patients come in for consultation that are confused between the terms FUE, NeoGraft, Artas and AlphaGraft. The goal of this text is to “clear the air” since – unlike most of the other hair transplant practices in Central Florida – we perform equally FUE and FUT (also known as the “strip” method) hair transplantation.

Simply put, Follicular Unit Extraction (FUE) is a method of harvesting donor hairs that involves removing individual follicular bundles from the back of the scalp with small 0.7-1.0mm circular punches. The incisions are so small that there is very little visibility of the scars after they heal. This technique offers advantages to some patients, but not for all.

What is the NeoGraft Hair Transplant system?

Calvitron Hair Transplant System

Clever and expensive marketing campaigns have led patients to believe that “NeoGraft” is an actual surgical technique. In reality, “NeoGraft” is nothing more than the name of a device used by some doctors to perform FUE procedures. Think of it as a “Bosch” drill and a “Makita” drill. Same tools for the same job; just with different names.

In fact, the “NeoGraft” device is hardly new or revolutionary. During the early days of hair transplantation, motorized punches were widely used to remove donor hairs and to create the recipient sites in the balding areas. At that time, a device known as “Calvitron” was developed in France by Dr. Pascal Boudjema, which combined an electric hand engine that powers a hollow circular punch and a suction system that sucks the hair graft into a container where the grafts are gathered for later implantation. The “NeoGraft” device uses the same platform, updated to use smaller punches. The concern of many experienced hair surgeons including Dr. Barusco is that the exposure to air flow during suction dries the hair grafts very quickly, which can significantly impact their survival and growth. In addition, suction tears the tiny graft from the connecting fat tissue at the bottom and can damage the graft’s delicate structures. Although the company has developed a device to also insert that grafts, it is rarely used.

ARTAS Robotic Hair Transplant System

Artas was launched in 2011 as the first robotic hair transplant system. The system is sophisticated and utilizes an image-guided robotic arm to select and punch the follicular units from the donor area. Grafts have to be extracted by hand after the robot cores them. Even with all automation and technology, an experienced hair restoration physician has to be present controlling the robot, and the margin of error may be large enough that sometimes surgeries have to be converted to manual extraction with other devices. So having the ARTAS system does not immediately offer a guarantee of quality to the doctor.

The system is very expensive – approximately $250,000 – which increases cost for the practice, and the physician also has to pay $1.00 per attempted hair harvest to the manufacturers of the robot. All in all, it is a very expensive toy that really does not add anything to a hair transplant practice in terms of offering better procedures or less requirement of the surgeon’s time with the patient. To date, it has shown no superiority in hair graft quality or speed of harvest compared to those of experienced hair surgeons using hand operated mechanized FUE devices.

The reasons why Dr. Barusco and Tempus Hair have repeatedly declined acquiring the ARTAS system despite many attempts by the manufacturers are summarized below:

• Overall the transection rate of FUE procedures performed by the ARTAS system is higher than the manual extractions performed by Dr. Barusco and his team.

• Barusco and his team at Tempus Hair are extremely well versed in extracting FUE grafts from every type of hair and skin, and this requires constant small adjustments of angle and depth during the procedure. The ARTAS software cannot deliver this level of surgical finesse.

• The ARTAS device utilizes a punch that is larger in diameter than the punches used by Dr. Barusco. The larger size is used to compensate for potential misjudgments of the robot’s software and to decrease transection. The problem is that larger punches create larger incisions, which produce more trauma and scarring.

• The ARTAS device requires the patient’s head to be repositioned constantly, therefore not allowing the patient to relax during the lengthy process. Dr. Barusco has developed a technique by which patients are asleep during the donor harvesting process, only requiring repositioning once during the entire phase of hair extraction.

• The ARTAS cameras cannot “see” white hair because they look for contrast between hair color and skin color, requiring the use of hair dyes. Dr. Barusco’s trained eyes, lighting and magnification allows him to harvest hairs of every color with the same accuracy, without the need to dye the patient’s hair.

All in all, in our practice, Dr. Barusco feels that acquiring the ARTAS will not add anything to improve the process. It will only add costs, which will have to be passed on to the patient.

AlphaGraft FUE Device

AlphaGraft is a lightweight, battery-operated hand engine that powers a punch for extraction of follicular units. The device is designed to facilitate a hair surgeon to precisely match the angle of extraction to safely harvest the entire follicular unit. Even though it is a small unit, the AlphaGraft allows Dr. Barusco to control the speed and the direction of rotation of the punch, allowing a high degree of customization for every patient’s hair and skin. At Tempus Hair Restoration Dr. Barusco prefers the AlphaGraft because of its smooth operation and flexibility to adapt to varying hair angles and hair types.

What is really important for patients to understand is that follicular unit extraction (FUE) is a PROCEDURE and therefore MUST be performed by a qualified and licensed medical professional, never a TECHNICIAN. If the surgeon and team are experienced and dedicated to the art of hair restoration surgery, any FUE device will product good hair grafts and therefore good results for the patient. Patients should not decide on a surgeon based on the marketing campaign or on the devices they use. After all, the REAL measure of a surgeon’s artistic ability and quality is the naturalness of the results, and the method of harvesting grafts has nothing to do with that.