Robotic Hair Restoration & Male Aesthetic Market Opportunities

The male aesthetic market has been undergoing tremendous growth over the past decade as new services have become available and as the idea of men actively seeking treatments that improve their appearance has become more socially acceptable. Indeed, these two factors drive each other in a positive feedback loop that is fostered by innovations that improve outcomes.

One driver of growth in the male aesthetic market is increased interest in hair restoration procedures, which by itself represents a roughly $4 billion a year industry—with expectation that this figure will continue to rise over the next decade. Certainly, this suggests tremendous opportunity for aesthetic practitioners to reap benefit from entry to the market. Yet, while patients seeking hair transplant consultations often have discretionary income for the procedure, they are also well researched, educated, and discerning, expecting a quality outcome with minimal downtime or discomfort.

Learning to perform hair restoration procedures takes time and practice as it is equal parts art and science to create a natural looking hairline. However, advances in hair restoration technology used in the clinic may facilitate the ability to achieve accurate and reproducible outcomes. The ARTAS™ Robotic Hair Restoration platform, which is used during follicular unit extraction (FUE) procedures, automates and therefore improves the ability to perform crucial steps of the hair transplant procedure. At the donor site, it performs faster and more accurate harvesting of optimal hairs and dissects them more precisely than the human hand; then, at the transplant site, its artificial intelligence creates ideal patterns for recipient site making that look natural and virtually unnoticeable. Because it assists the surgeon with the repetitive and precise surgical movements necessary to perform hair restoration, the ARTAS Robotic Hair Restoration reduces manual variability and surgeon fatigue that plague other hair transplant techniques, delivering precision, control, and reproducibility to hair restoration procedures.

Top: 1.0mm, 0.9mm & 0.8mm needles. Bottom: Follicular unit grafts using 0.8mm, 0.9mm & 1.0mm needles.

The ARTAS Robot: A Powerful Tool for Hair Restoration

Robotic surgery is already revolutionizing many aspects of medicine, offering the potential to induce less trauma on the body and minimal scarring after surgery, leading to faster recovery times. It is widely used in delicate gynecologic and urologic operations as well as in cancer surgeries. Fundamentally, automating critical aspects of surgery removes a certain degree of uncertainty, which portends more consistent and potentially improved outcomes.

The ARTAS Robotic Hair Restoration System is a tool for performing hair transplant procedures; like many of the technologies used in aesthetic practice, it takes practice to understand the nuances of hair restoration procedures and how to adjust the platform to the many surgical variables involved. But, the ARTAS is also highly intuitive and its user interface has been specifically engineered to provide the surgeon maximal control over parameters such as puncture depth, coring depth, and angle at the harvest site and equally intuitive user controls suitable for making personalized recipient site patterns.

For follicular dissection, the ARTAS features on-board high resolution imaging that analyzes the scalp with micron-level precision in real time to assess each follicular unit site, selecting only the best hairs for harvesting. A two-step dissection system consisting of a bi-beveled inner needle nested inside an outer blunt dissection punch scores the skin surface, after which the outer punch separates the follicular unit from the remaining tissue. With each cut, the system automatically adjusts the calculated angle of approach to minimize transection, resulting in a healthy, intact graft with harvest site limited to size of the inner needle—a process that is repeated with each graft to both preserve the appearance of the donor site and yield consistent graft quality throughout the proce-dure. Performing these crucial maneuvers with manual techniques takes more time and is prone to great variability, especially after fatigue sets in.

Ultimately, these features of the ARTAS Robotic Hair Restoration system flatten the curve, helping inexperienced surgeons produce more consistent outcomes while also serving as a powerful tool to do more than what is possible by hand. Much like the artist switching from pen and paper to a computer-based graphic design platform, a strong foundation in essential techniques will ultimately dictate the quality of the result. However, once that new medium is mastered, the user can delegate repetitive and meticulous tasks and instead focus on plying his or her expertise to creating a beautiful and natural looking outcome.

Considerations for Patient Selection

Most of the learning curve with the ARTAS is in recognizing issues inherent to the hair transplant procedure and being able to correct them in very small amounts of time so that the hair restoration result is optimized afterwards. Fortunately, any patient who is a candidate for a FUE procedure can benefit from robotic hair restoration.

There are situations, such as extensive laxity or dermatofibrosis, that do not lend themselves to virtually any hair restoration procedure, and thus they will likely not be a candidate for robotic hair restoration. As well, wiry hair can be difficult to reconstruct and some individuals with this hair type will not be good candidates, although the unique tissue characteristics of the individual patient will dictate the approach. Nevertheless, the increased accuracy of the precision with robotic transplant procedures often means that patients can wear shorter hairstyles following the procedure and can return to activity sooner than with other techniques.

Top: Advanced touch screen user interface indicates depth and angle of penetration. Bottom: Tensioner in place.

Carefully selecting cases during the learning curve with the ARTAS system may help surgeons new to the device. Cases involving 1,200-1,500 grafts are typically easier to perform regardless of technique, especially if they involve minimal recession in the hairline or small areas of the crown of the head. On the other hand, there are some patients with progressive hair loss states that have truly unrealistic expectations, and they are unlikely to be satisfied with any kind of transplant procedure, whether that is follicular unit transfer (FUT) or FUE.

Surgeons who continue to use ARTAS and perfect the techniques involved are likely to reap benefits in addition to an enhanced ability to perform quality work that patients appreciate. In my own experience with ARTAS, I started with a single platform 7 years ago and have since added two more units in different clinic sites, in large part because hair restoration procedures now constitute over 50% of my procedural volume.

When I started my current practice, I made use of targeted marketing to attract new patients. Over time, though, the importance of those kinds of measures for practice growth have become less important as word of mouth advertising has spread. In fact, many patients now find my clinic specifically because they are seeking a consultation for a robotic procedure. Thus, robotic hair transplantation has been an important driver of practice growth that has certainly paid off the initial investment, and it has since become a crucial differentiator in a market saturated with a plethora of options for men seeking aesthetic procedures.

The ARTAS system has also affected the kinds of patients I am able to bring into my clinic. The patient seeking robotic hair transplantation is typically more affluent and is someone who wants a premium service for their self-betterment. They are also generally receptive to discussing other procedures that fit their lifestyle choices. I have had several patients convert to rhinoplasties, eyelid lifts, and other types of cosmetic services that we also offer after initially consulting with me about hair procedures.

Based on estimates of the prevalence of hereditary hair loss from the American Academy of Dermatology, up to 50 million American men may be candidates for hair restoration, but the long recovery time and discomfort during the lengthy procedure dissuades many patients. With robotic hair transplantation, the clinician has access to a technology that provides minimally invasive hair restoration while delivering consistent and safe results. <

The statements, views, opinions, and analysis concerning Restoration Robotics and its technology expressed in this article are solely the author's and are not intended to reflect the statements, view, opinions, and analysis of Restoration Robotics.