Why robotic hair transplants are much costlier than manual FUE?

While we often think of machines and robots being 'smarter' or more 'accurate' than humans, this is not the case when it comes to hair transplantation. The use of robotic tools during hair transplant surgery actually increases the patient's risk of excessive scarring, damage to the graft, and low graft survival rate. The robotic technology has not advanced enough to match the quality that is capable from a skilled and experienced hair restoration surgeon's hand. Some things to look out for with robotic transplantation is an oversized punch tool, an over quotation of grafts, and little surgeon involvement. Due to the lack of preciseness, the oversized punch which increases scarring, and the damage caused to follicles from inexperienced staff typically results in poor results, I do not use any of the robotic tools such as Artas or Neograft. From my experience, these machines are not only extremely expensive (resulting in the higher cost you see) but yield poor results. The surgeon most likely chooses a robotic option when they are not confident in their skills or abilities to perform hair transplantation by hand. 

Thank you for this great question that many patients contemplating hair transplantation are sure to ask. The other surgeons who have responded to this question have alluded to the common misconception that Robotic FUE is not like a fully automated assembly line or car wash that completely replaces a surgeon or hair transplant technician team for the hair restoration procedure. Like any surgical technology, it is a tool that is meant to be used cautiously and by trained-hands to accomplish a goal more rapidly and precisely than a human hand ever could. 
Sure, the cost of the capital equipment, maintenance and upgrades certainly contributes to the overall cost of robotic hair transplantation. However, this is not the only reason why Robotic FUE is priced higher than manual FUE. Remember that the FUE procedure is broken down into 3 main steps. 1) Graft harvest, 2) Recipient site creation and 3) Graft transplantation/implantation. The robot, which is in its 9th iteration from original conception, is specifically designed with highly complex algorithms to select healthy follicular units only in a very specific area designated by the surgeon and is programmed to harvest in an evenly distributed pattern so as not to over-harvest from any one particular area and to avoid other adjacent healthy follicular units or previous harvest sites. It does so with impeccable accuracy, from the very first follicular unit harvested, to the 3000th. One would be amiss if you expect the same sort of accuracy from a human hand in the same time frame. For the recipient site creation, the same concept applies. The newest robot, 9X, can also help create recipient sites based on a hairline design created by the surgeon, and in the process, recognizes and avoids normal hair follicles during site creation so you're not injuring the vital hair that's still on your scalp in the process of adding new hair. Remember, fatigue, having a bad day, relationship problems and/or events to attend to are not something a Robot has to deal with on the day of your procedure (rare, but certainly possible for us humans), which is certainly a compelling argument for the use of Robotic FUE.
Finally, the ARTAS robot is a physician-assisted technology. The surgeon has to adjust all dynamic parameters (puncture depth, coring depth, density of harvest, angulation of harvesting punch, diameter of harvesting punch etc) of the Robot throughout the procedure to make sure the harvest of follicular units proceeds smoothly. In in-experienced hands, the Robot can result in just as many transected grafts as manual or even more. Again, it is a surgical tool which requires great expertise and familiarity with the anatomy of the scalp and functionality of the robot. The quality of the hair restoration technician team is also just as if not more important to a successful outcome. 
Hope this helped! Best, Dr. Roy.