• Post published:April 16, 2023

Manual FUE vs Robotic FUE: Advantages, Limitations, and Costs

One of the most popular hair restoration techniques is follicular unit extraction (FUE). This technique involves removing follicular units from a donor area and transplanting them to the balding area. Within FUE, there are two main ways to do it: manual FUE and robotic FUE with the ARTAS system. Let’s dive a little deeper into each method and compare them so you can become familiar with how each one works. 

FUE Hair Transplant Surgery (Manual FUE)

As you might expect, manual FUE is performed entirely by hand, and at Ziering Medical, our surgeons use the SAFE System for extracting hair follicles. This specialized instrument allows our surgeons to manually extract follicular units, one graft at a time, while minimizing damage to the follicular units during extraction. 

Once the donor follicles are harvested, a skilled Ziering surgeon creates recipient sites corresponding to the hair transplant plan and design. Then, a hair surgery technician meticulously places each harvested follicular unit into the recipient sites at the correct angle, one by one. This ensures a precise and natural-looking outcome for the patient.

One of the main benefits of traditional FUE is that it allows for a more customized approach. Because the surgeon has total control over the process, the surgeon can adjust their technique based on the patient’s unique hair characteristics and adjust their movements as necessary during the procedure.

However, manual FUE can also be a time-consuming process, as each follicle must be extracted and transplanted one by one. This can be tedious for both the surgeon and the patient. And because the FUE technique relies heavily on the surgeon’s skills and experience, there is always a risk of inconsistent results. 

The surgeon’s ability to accurately extract each graft can vary, which can lead to differences in the thickness, angle, and direction of the transplanted hair. This is why you’ll want to work with hair transplant surgeons who are the best in their fields like the Ziering Medical Team. 

ARTAS Robotic FUE Hair Transplant Surgery

The ARTAS Robotic System is a robotic hair transplant system that uses an optical guidance system to extract follicular units during the donor harvesting step of the hair transplant procedure. The system eliminates the guesswork and fatigue of manual methods and the scarring, complications, and downtime of existing invasive surgical techniques. 

The process of extraction is similar to manual FUE and the main difference is that we’re relying on the robot to select and extract follicular units. After the extraction of healthy hair follicles using robotic technology, these follicles are carefully implanted into the designated recipient sites that your surgeon has created in areas where hair is thinning or balding. 

One of the main advantages of Robotic FUE is that it is a more efficient process. Because the robotic arm can extract follicles more quickly and accurately than a human hand, the procedure can be completed more quickly than with manual FUE. 

Limitations of Robotic FUE

Despite its growing popularity and many benefits, Robotic FUE also has its own limitations. So we asked Dr. Kinler, one of our hair transplant surgeons at Ziering Medical, about the drawbacks of Robotic FUE. 

Dr. Kinler points out that one issue she has for ARTAS is that they stopped focusing on getting better at harvesting and started focusing on site making and implantation. The sites were too variable and shallow and only the front, with no temporal peaks, mid-scalp, crown, eyebrows, or beard.

The maker of ARTAS also started focusing on selling machines to non-hair transplant surgeons to do all parts of the surgery, which may be one of the reasons for the increase of just tech doing the surgery. “The machine is expensive, and should be meant to supplement a good hair transplant surgeon’s work and not do the entire surgery,” Dr. Kinler exclaims.

Dr. Kinler also mentions that the procedure takes too long, the position is uncomfortable for the patient, and the machine needs to be monitored carefully for transections. Added time in the robot finding the grid then extracting the grid can also prolong the procedure. Plus, it leaves a block-like appearance in the back if it’s not properly feathered. It also tends to harvest closer together with the potential for over harvesting. “Dr. Ziering and I calculated it was harvesting on average 25% of available hairs in a grid vs manually much less like 10-15%,” she says.

Manual FUE vs. Robotic FUE Comparison

 Manual FUEARTAS Robotic FUE
Harvesting MethodHandheld FUE Device Follicular Unit Extraction (FUE)Robot Follicular Unit Extraction (FUE)
Transplant MethodManual by Technician or SurgeonAutomated Robotic Arm which uses computer-driven graft selection.  Supervised by Technician or Surgeon
Punch Size0.8-1.2 mm0.8-1.2 mm
Best Candidate for ProcedureMen with available donorNobody 
AnesthesiaLocal Local
Average Time for SurgeryHarvest 1-3 hours1-6 hours 
Recovery Time3-5 days3-5 days
ScarringMinimalMinimal but may appear block like 
Transection (Failure of Hair Graft to Grow) RateUser dependent
Less than 2%
User dependent. Higher with AA or Afrocentric hair
Patient ComfortLaying flat or on sideIn the chair with head strapped in
Average Cost$6+ per graftHigher because pay is per harvest attempt not graft

 Which One Is Best for You?

The best hair restoration technique is the one that best fits your needs, and the only way to know that is to schedule a consultation with one of our surgeons at Ziering Medical. Dr. Ziering and the rest of the Ziering Physicians are among the best hair restoration surgeons in the world so you can rest assured that you’re getting your procedure only from the best. Call us to schedule your appointment today and start your journey to having hair that you can wear in any style with confidence. 

If you’re wondering whether you’re a good candidate for an eyebrow transplant, call us to book a consultation at Ziering Medical. We serve patients in Beverly Hills, Newport Beach, New York, and Greenwich.