How Is Robotic FUE Different At Bernstein Medical?

Dr. Bernstein: We’re often asked how robotic FUE is different at Bernstein Medical compared to other practices. First, keep in mind that the robotic part of FUE (follicular unit extraction) is only one small part of the procedure: the extraction and implantation of the follicular units is a four step procedure. The robot only does the scoring, that is, separating the follicular unit from the surrounding tissue. The follicular unit must then be manually removed; the recipient sites must be created, and then the grafts have to be placed. Because our medical technicians are highly skilled in microscopic dissection, we take each follicular unit that comes out of the back of the scalp; we then examine it under a microscope, trim it to make sure there are no hair fragments, count it to make sure we’re only putting single hair follicular units at the frontal hairline, sort them, and then we place them into the scalp. This process also allows us to count very accurately the number of hairs and intact grafts. The robot we use at Bernstein Medical is also different than robots used at other clinics. First, we don't use a one millimeter punch. Remember, robotic extraction is a two-step procedure: the traditional robot first uses a 1 millimeter cutting tool for the sharp instrument and then uses a 1.2 millimeters tool for blunt dissection. These sizes are a bit larger than what is used in traditional FUE, so our robot uses a 0.9 millimeter punch and it dissects with 1.1 millimeters, so the average size of the dissection is about 1 millimeter, which we found to be ideal with the hand held cutting and dissecting system. So our robot uses a little bit smaller punch, and we find that we get essentially the same amount of hair but the wounding is significantly less and the healing is quicker. The other thing our robot has is the ability to eliminate one hair follicular units: when the robot scans over the follicular units, it will only go for the two three and four hair units. We do this because it doesn't make sense to make a one millimeter incision just to remove a single hair. This is because our microscopic dissection is so good that we can take a larger follicular unit, a two three or four hair follicular unit, and generate the one hair follicular units under the microscope with careful dissection. And we can use these one-hair follicular units in areas like the hairline without having to make an extra hole in the back of the scalp. When you consider eliminating these one-hair holes and also using our smaller spot size, 0.9 millimeter, this makes a significant difference in the amount of wounding to the donor area. Less wounding results in faster healing times and improves the appearance of the donor area.

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