Disclaimer: the text below has been rewritten due to a request from a product manufacturer, who felt that my comments were misleading and false. So, the revised text does not contain any commercial or trademarked names. These are my own opinions, based on more than 20 years of experience in hair restoration surgery alone, and intended only to educate consumers, who are free to make up their own minds and decide accordingly.

If you are looking to choose your hair restoration surgeon, look beyond the technology they offer. Machines, robots, etc., do not perform procedures. Surgeons do. Robots and other devices are nothing but tools to assist us. So look past the flashy images of devices and look for true credentials IN HAIR RESTORATION SURGERY. This is the true measure of the likelihood of a successful procedure. Read further to understand the reasons.

The cons of some of the heavily advertised, new technology available for hair transplantation (suction-assisted, easy-profit devices and robotic technology) are rarely discussed. Marketing campaigns make the unaware consumer think that unless a doctor has one of these devices, he or she is not up to par with the science. Even worse, they lead the consumer to think that if a practice or doctor owns one or more of them, he or she automatically knows what they are doing and will provide good results. Neither could be farther from the truth.

Behind these devices there needs to be a competent doctor, and with the doctor, a competent team. Otherwise, no robot or vacuum-assisted gizmo will help you. But here is the big problem: these companies are advertising, selling and promoting these devices to doctors all over the country and the world who have no training in the complex procedure of hair restoration surgery. And they couldn’t care less. Their investors need to make their money, so therefore machines need to be sold … to whoever is buying.

Over the years, it would be fair to say that I’ve developed a unique perspective on these machines. I closely follow their development and release in our industry. First, they were aimed to experienced, competent hair restoration surgeons. Then, since many of us did not see the advantages of having them, the number of machines sold was too small to sustain business and profit, and they started advertising to cosmetic surgeons, plastic surgeons, family practitioners and others who had no training and no experience in hair restoration surgery. These doctors are pitched a quick-profit procedure that they really do not have to understand, since one company supplies the technicians to do all of the work, and the other will train them on how to operate the robot and its software—as if this did not require good cosmetic sense and a deep understanding of hair loss and hair restoration. The result? Many unhappy patients.

My practice has always been very busy with patients coming in for repair of procedures performed by other doctors. But in the last few years, I have seen a sharp increase in patients coming in for me to repair or replace hair transplants that were not done by experienced hair transplant surgeons, but by robots and/or by unqualified people under poor or no supervision of a qualified physician. In some cases, patients did not even know the name of the doctor they chose, but they knew that they had a robotic “procedure” or the new FUE device “procedure.” This is so wrong, it makes my skin crawl.

I meet with patients almost every day who have trusted doctors and practices because they had these devices, only to find out later that they would need me to fix what’s been done to them. Sometimes I can help them, but sometimes I can’t. A bad liposuction or a bad breast surgery can at least be hidden from view. A bad hair transplant cannot. And what is even worse, is that these patients are coming to me not only with poor results on their hairline, but also scarring and thinning of their donor hair (the limited supply of permanent hair we use for transplants) caused by taking too many hairs with incisions that are too close together and/or larger than they should be.

As mentioned before, one of these company’s business model involves recruiting doctors with little to no experience in hair transplantation and selling them a machine that they don’t even have to bother to learn how to use—your entire procedure at these practices will be performed by technicians sent by the company. Instead of an accomplished hair surgeon, someone with possibly less medical training than a dental hygienist will be sucking hair out of your skin and sticking it in your scalp. In my opinion, technicians performing these aspects of hair transplantation surgery are effectively practicing medicine without a license. Florida and a few other states in the U.S. have passed legislation which deems that harvesting hair and making incisions on a patient are functions that only a physician, a Physician’s Assistant (not the same as a technician or nurse) or a Nurse Practitioner are allowed to perform. Therefore, the doctor who allows others to do it in their practice is also aiding and abetting the illegal practice of medicine and may lose his or her medical license and/or face felony charges.

Many doctors have also bought a robotic device that assists in FUE procedures. A robotic arm makes incisions in the skin to remove follicles from the donor area. The new version also makes recipient incisions and places the removed hair grafts. But robots are machines, and if the person behind the controls does not know basic rules of hair transplantation, the results may be bad. Sometimes, the robot can’t see the hair very well (the best case for the robot is dark, straight hair against light skin) and the surgeon has to switch mid-procedure to a manual extraction. Well, what if the surgeon does not know how to do this?

In non-ideal patients, hair follicle damage (transection) rates can be higher than manual extraction done by an experienced surgeon. Also, manual extraction and an experienced surgeon allow the use of very small diameter punches (0.8mm or smaller), which creates very small incisions. The robotic device uses a two-step punch (a sharp punch scores the skin, and a slightly larger, dull punch dissects the hairs). This limits how small the punches can be. Bigger punches create larger incisions, which in turn create larger scars. Finally, a robot is a machine, and cannot provide the constant small adjustments needed to create a natural-looking transplant, which is the outcome you’re looking for.

The Bottom Line for Your Hairline

When it comes to your body, the caveat “buyer beware” is crucial. Don’t look for quick fixes for your appearance, and don’t consider a practice that sees you as less of a patient and more as a means to make money. When you come for your hair transplant, you can rest assured that I, as a medical professional with over 20 years’ experience in these procedures alone, will perform your surgery personally—and will personally guarantee your safety, your comfort AND your results.

Learn more from the International Society of Hair Restoration Surgery about the serious risks when unlicensed personnel perform hair restoration surgery.