August 7, 2019 In the most recent episode of Masters of Beauty we talked to Oggie Petrovich and Eric Selvik of ARTAS Restoration Robotics. These two robotic experts have a combined 30+ years of experience with ARTAS. They have bene there from the start and have seen many different versions of the ARTAS robot. They have truly changed the game of hair transplants. Below is the full transcript of our conversation. Don’t have time to read through it? Listen to the podcast on any of the platforms below!SpotifyApple PodcastsYoutubePodbean If you or anyone you know is interested in a hair transplant in Chicago, IL please contact us here to set up a consultation!*Disclaimer* Hey everyone! Below is my most recent podcast transcript and video featuring Oggie Petrovich and Eric Selvik of ARTAS! We used the best available transcription service. Please ignore some of the misspellings, and vocal pauses. We hope you enjoy this very insightful discussion about hair transplantation, hair technology, and hair robotics! Oggie Petrovich: (00:00) I’m introducing two special guests today. We have Oggie Petrovich and he’s been with restoration robotics for over 10 years. He’s seen ARTAS evolve from harvesting 40 grafts in one case to now doing over 40,000 grafts in one case. His current role is the director of research and development for ARTAS Robotics. He’s worked all over the place, including Motorola, Intel, IBM.. His background is in technology and robotics and all that cool, futuristic stuff that all of us guys dream about.Oggie Petrovich: (01:25) Thank you.Oggie Petrovich: (01:27) We also have Eric Selvik. He is the director of product management at ARTAS Restoration Robotics. He’s worked in the technology and device space for almost 20 years! You look, young enough to maybe be a son of mine. So I don’t know how that’s possible. Maybe you started when you were like one or two.Eric Selvik: (01:46) Yeah. They got me started real early!Oggie Petrovich: (01:49) Prior to working restoration robotics, you worked at intuitive surgical, which is also kind of in that robotics space as well. So it’s been kind of something it’s been in your DNA, so to speak.Eric Selvik: (02:03) That’s right. Actually, you know, I was trained as an engineer and the first job I had out of college was designing robots for the semicon industry. And since then I’ve moved on to medical devices and more in, in roles in, a marketing and stuff. So I’ve, I’ve kind of come full circle. I’ve married my love and passion for medical devices with my passion for robotics.Oggie Petrovich: (02:25) The robots I see my six year old use are purely for destruction. Did you ever make any of those types of robots or involved in those robot wars? Was it mostly to help humanity?Eric Selvik: (02:39) Well, for my part, I, it’s always been to help humanity. I don’t know. Oggie may have done some fun the robot war type stuff with drones.Oggie Petrovich: (02:52) We did some things with drones, but no not really any distractions.Oggie Petrovich: (02:55) It’s interesting though because robots are being taught more and more to our youth as kindof where we think the world is going, where the future’s going. It’s interesting to see how that’s evolved. ARTAS, if I’m not mistaken, it’s the only robot in the aesthetic space and the only robot in the hair space.Eric Selvik: (03:22) That’s correct. That’s correct. This technology is quite unique in the aesthetic medicine spaces, the first robotic solution. And in terms of, you know, when you compare it to other hair transplantation, hair restoration technology, it is far and away the most advanced piece of equipment that you’ll find.Oggie Petrovich: (03:41) Let’s talk about the roots of ARTAS. How was it conceptualized? Where did it start and how did it come along?Oggie Petrovich: (03:57) Yeah, so this started more than 10 years ago, probably about 15 years ago. Our founder was part of a company called Accuray, They do radio surgery with Robots. They were looking for another medical application to handle tedious and difficult procedures: where accuracies are required. One of the doctors mentioned, “Hey, there is a hair transplant procedure, which meets all of these requirements. You should check this out and try it.” Our founder got a robotic arm and started a company basically in the garage. It’s like a many other silicon valley startups. That’s how it all started.Eric Selvik: (04:38) Some of the best work is done in people’s garages!Oggie Petrovich: (04:42) Well, it worked for Steve Jobs!Eric Selvik: (04:45) Hewlett and Packard and everybody else!Oggie Petrovich: (04:48) So the first robot comes into the market. What was it like when it first came on the market and what were some of the initial challenges?Oggie Petrovich: (05:13) Yeah. So when we initially released the product, it was able to do a hair transplant. It was able to harvest hair and it was able to assist the surgeons. The number one thing that we got from the doctors is that is very difficult to use. So you can do a big case, you can do your, you know, 2000, 3000 graft case. But it took a lot of effort on part of the surgeon. They didn’t have to actually make the incisions and do individual harvests by hand, but they had to tweak the Robot Angles. They had to tweak a needle. It was quite a bit of work, different work, but it’s still quite a bit work. That’s when, when we decided to invest more time on machine learning, AI, to help doctors with those problems. The machine now is way more automated than it used to be in 2011.Oggie Petrovich: (06:15) I think that’s interesting. What were the size of the punches?Oggie Petrovich: (06:29) 18 gauge. It’s about a bit larger than a one millimeter punch. It’s the same concept, needle in a punch and that that particular technique has not changed that much. We did in improve the punch over time. However, the whole clinical workflow and the software around it including the mechanism, and the robotic arm has been improved tremendously over time.Oggie Petrovich: (06:55) Is it the same arm in the 2011 robots? Is it the same base robot?Oggie Petrovich: (07:08) Oh No, we have moved to a much more modern, robot last year. Which has seven degrees of freedom. It has built-in sensor. It’s designed for medical applications. Our original robot was actually an arm that was also used for automation in factories for example. We had to do a lot of with advocations to fit it in surgeon’s role. The current robot is designed for medical applications.Oggie Petrovich: (07:36) I think there’s so many things to talk about like, you know, design wise, the technique, the robot, the harvesting, but the thing I like about it is the, the fact that you have a cutting burn, dull burr and that really helps with the harvesting and preserving the hair follicle. I’m guessing you model that off the Harris Punch. Is that, is that right? The original one as the Dr. Harrison in Colorado. He has a similar type of harvesting system because you need to have something sharp when it’s going through there. And if he tests some things, y’all, the doctors who do only sharp and there are some devices on the market that do only sharp, they tend to transect the hairs. The doctors who only do dull tend to like scoop up all the hairs around them. Have you guys noticed anything as you tweak the device?Oggie Petrovich: (08:27) Yeah, we worked with the Dr. Harris for many, many years. So he was our principal investigator when we were developing the harvesting system. And he gave us a lot of good inputs. you know, our, the sharper needle that we use only goes about a couple of millimeters in the skin, so that way we minimize a chance for transection. And then the Dow Punch goes around the needle, of course, are the follicles. So just as you, that, that keeps the true protection, rates down.Oggie Petrovich: (09:00) I’m going to segue that to some of the suction based, punches and, I’m not going to talk, there’s so many differences, but there’s the first question is sometimes people think, okay, I’m talking, I’m not going to name a brand, but we know there’s a couple of suction based box punches out there. and one of the fundamental problems, I have a lot of problems with, the way the, you know, the basic science works on this and how that aspect of it works. But one of my biggest palms is as simple as the punch, how it works because it’s only sharp and if you do only sharp, you’re going to have so many more transections. It’s just a fact. I think that’s one of my biggest issues with this suction based devices. I have a whole list of issues I have with them, that I’d maybe I could talk more freely about then you guys can. but, that’s, that’s one of those things that it’s an underestimated part about the ARTAS is how well designed that punches the sharpen and dealt with how safe that is and how it really lowers your, that transection rate. I’m going to define transection rate for our listeners because not everyone knows what a transection is. So essentially when we’re harvesting hair, hair is kind of like, it has a root to it in a ball. And if you damage the ball or damage to the root, the hair is basically useless. You’re taking out nothing. And basically what we’re talking about is you have to be precise enough to take off. It will have a little illustration showing this. You have to be precise enough to take the hair out without damaging that ball. Because if you do, you basically doing nothing. You’re damaging the patient’s hair, you’re losing hair. so this is, this is the problem is because when you’re trying to harvest hair by hand, which is called a FUE or follicular Unit Extraction, most of the time, I say most of the time, I’m not exaggerating. Most of the time I think people are transecting the hair, and they’re not taking the hair off properly. so that’s that aspect with suction base versus with that aspect. So that’s the cutting part. The other aspect is this suction itself. I think it dries out the hair. I know lots of people off the record who don’t use the suction part with it. It can desiccate the hair and have issues with it. Was ARTAS ever conceptualizing suction or was that sort of ruled out right away or during that process?Oggie Petrovich: (11:17) I want to mention and talk about the ARTAS punch . So we did go through dozens, probably even maybe up to a hundred, revisions of a punch and finding the best possible punch that works on, all kinds of skin types. It’s, it’s quite a bit of a science and art actually to find good punch. It takes, you know, material matters, you know, the machining process matters. A lot of the angles of, the very tip matters. It matters how it’s been stored. There’s a lot of variables that go into, into making a good punch. So, we pay, that’s, that’s a very important part of our system. And then, we do use suction. Yes. So, we use the suction to elevate the grafts a bit before, the technician, picks it up. I want to, mentioned that our system has vision. You can see on the camera those grafts that are being elevated by the needle and the punch. And then you have direct feedback how good that follicle looks without using loops or anything like that. Because we have high magnification system. So we, elevate the grafts so you can see what the quality is and you can also easily pick it up.Oggie Petrovich: (12:42) I think it’s a different level of suction if I’m not mistaken. Because when you’re using the suction on the ARTAS, it’s merely to elevate it.Oggie Petrovich: (12:51) Yeah. Gentle suction. Yes,Oggie Petrovich: (12:53) Exactly. Versus when you suck it up in a tube. I mean you can do that in an ARTAS if you’re a withyou’re cutting aspect of it and, but if you suck all of your grafts, your I think you’re desiccating that cause it suctions too hard and the way those come out, it is a difference I think between leaving your hair in there and lifting it up. Again, this is me talking about that. Maybe we can talk a little bit about that versus when you strip the hair out. I’ve seen the grafts on the suction based devices and they see when they come out there, they’re kind of really, they call them skinny grafts. They’re super skinny. I mean, they’re like, oh my God, how are we going to put this grafts in? Because it’s so skinny versus what you can design a graft on ARTAS, depending on the age and the 19 versus an 18, and you can create a chubby grafts, you can trim it down. We tend to trim it down and looking at the scope. so I think it’s nice to have that flexibility versus that, that stripped down grafts that tends to get suctioned out with a pure cutting section apparatusEric Selvik: (13:49) That’s correct. Really you’d like to see grafts that have a lot of soft tissue around them, all the way down to the bottom, that fatty tissue and some of the stem cells and all the good mesenchymal cells that are in there. So we try to preserve as much tissue around the graft as we can. You know, our system we could use, we could suck it all the way into the system, but, what we found is that just elevating it in the field, letting it stay in the surgical field and then having a technician very gently remove that with a nice technique preserves the grafts structure. it’s very quick and easy to do as well.Oggie Petrovich: (14:24) And also to mentioned for, there are some grafts that still may be pulled out because we do have, you know, some patients it’s easy to separate the pollical from the Scout. We have a full sail in plush system, which provides a clue. It’s for the grafts to survive. So it’s not as if we are just letting, letting it die. it goes in the follicle trap. It has a plenty, plenty of sailing there or starts solution as well.Oggie Petrovich: (14:52) I think one of the other parts about ARTAS, which is interesting, there’s, there’s lots of hair blogs and hair podcast and they always talk about how do you know, how many hairs are getting, how do you know what your transection rate is? And if you have an ARTAS, it’s actually like a lot of this like counting and dealing with the mathematical and quantitative aspects of it are actually taken care of for you. so for in my aspect of my practice, I’ve always been into quantification because you don’t know what your outcomes are because everyone always says, I think I’m doing better. and then you look and you look at numbers and that can really drive your decision making. So for me and my practice, I look at something called the t rate, the transection rate. I also look at empty sites, which can happen with anything. Then I look at, this is kind of two factors I’m looking at. So everything is quantified because, and then from a patient’s perspective, they’re stories of patients going somewhere and saying, hey, guess what? I signed up for a thousand grafts or whatever, grafts. And then who knows how many you had with the handheld punch. You have no idea. And how many were successful. There’s no, there’s no data behind that. In ARTAS, everything is sort of photografts and captured. You know, how many were empty, how many were not empty. You know, how, how successful the machine is, it’ll give you a smiley face. And so I think patients, from a quality standpoint, you can tell what’s going on. And I think from you, me knowing it as, as a patient as well, I’ve had myself, I’ve had ARTAS done. It’s nice to know what are my steps.Oggie Petrovich: (16:20) Like what did I, what did we bring to the table? How successful we are, what we did great, who cares? How many transactions do they have? how many, grafts were stuck there. So, you know, that number. I’m a quantified guy. I think most of my guys who do, hair are, they’re into numbers, they know stats and baseball players and all that aspects of it. So I think that’s an underestimated part about that, about, what we’re talking about. So, another aspect of that that I’m going through there, how accurate our, for me as a user, when I’m looking at that, how accurate are those stats? If I’m looking at that and saying, hey, guess what, I am empty. I had that, I mean they seem super accurate when I’m looking at it and counting it. But your, your data pool, I mean, you have an instrumental Deadpool. So how accurate do you think they are?Eric Selvik: (17:05) I think that the measurements are pretty accurate. So, you know, of course we count all the harvests and you know, in order to, to, you know, quantify the amount of transections and things that at this point still needs a human to look at it and to say how many of you transected and things. but we have a things that will count empty sites and all that. It’s quite accurate. We have the vision system on this device is quite, precise. It has a resolution of like 44 microns, which is on the order of half the width of a hair. So, the, the, the system can see, things, that, we sometimes can’t and that allows it to be quite accurate when you’re talking about things like counting hairs, counting follicles, counting empty sites, things like that.Oggie Petrovich: (17:51) Let’s talk about that vision. So when you’re looking at the vision of that, if we compare to someone wearing Luke’s to someone with ARTAS, just the vision aspect. So we have the, the robot, we’re going to compare those two. So let’s do that kind of as a thought experiment as saying, so that way people can kind of understand the differences. So first we’re going to go vision. So we have, and I’ve done this experience, but by the way, I’ll tell you my results at the end of this. but so first of all, we’re going to take the best fue hair harvester in the world. I had the supposedly the best fue person in the Midwest. I’m doing this. so we’re first going to do vision, vision on a person wearing loops versus vision with an, with ARTAS with its vision topics. So we’ll kind of compare those two first.Eric Selvik: (18:37) Oh yeah. so, you know, I think that, what would you have to have like at least 10,10x loops to see at that level? Or can you even like what,Oggie Petrovich: (18:49) yeah, I mean the, the beauty of Rx is that you don’t need loops anymore. First of all, it’s very hard to write. So I can see the big screen.Oggie Petrovich: (18:58) It’s beyond 10 x, I believe. I believe it would be my, my understanding was that it would be like 12 or 14 experts. I don’t even think they make thatOggie Petrovich: (19:05) what that’s about there. So, you know, we, we like to talk to you. So in terms of resolution, so the system can see a, it has a resolution of about 44 microns, which is just half of the hair. So you can see the hair on the screen. Here it is. Yet that’s only like about a hundred microns. It’s very highly zoomed and very, very, you can, you can see the, the shape of the follicle, the caliber, you know, what kind of angle it, it is so, it’s, it’s much as much more pleasant to work then with loops, that’s for sure.Oggie Petrovich: (19:40) Yeah. And I think it captures it better than you can see with a, with loops because there’s something about it where you don’t see that quite the same with loops. And I think the number I have acquainted is anywhere from, it’s probably around a 12 x loop, which I don’t think exists. the highest loop. some people say they’re wearing eight x loops, but if you actually measure them out, and I’ve done that with a couple of, with manufacturers, I don’t think that some of those, the cheaper ones that float down are actually eight X. we’ve measured a couple of them and some of those are closer to 2.5 and three extras, nowhere near eight X. so if you’re looking at the screen looking at that, so I’m going to give the vision to ARTAS because it’s just clear that aspect. the other aspect we looked at is kind of comparing the two things is steadiness.Oggie Petrovich: (20:25) This is one of the hardest things to do. I’m a surgeon, I work on the face, so I’m used to working with my hands. I wear loops when I work. and I’m used to working in the face and harvesting hair. What it takes in harvest to here is extraordinarily difficult because you have a spinning device trying to go to a small thing. We’re talking about microns thick, you know, about 60 to 70 microns thick. You have to see the hair on the outs that you ask to often understand where the hairs on the inside that angle came to is as the spinning device hits your skin, it’s going to move your hand. If your patient’s breathing, it’s going to move. which we could talk about how the ARTAS, handled people with breathing. so all of these factors when you’re dealing with micron type surgery, all of these factors affect it.Oggie Petrovich: (21:10) Once you hit the skin, the hair is at a different angle than what you see on the oxide. What your IC oftentimes, and most people are looking with loops actually don’t see stereoscopically, which is what the ARTAS’s sees. They actually see, I’m kind of with a two dimensional aspect to it. So they’re missing the, the three dimensional relationship and it hits it. So I think comparing the world’s best FTE person manually versus ARTAS a, I’ll go back to you on your thoughts. You have to assume that this is the best fue harvester ever in the planet we can use instead of the Midwest.Eric Selvik: (21:44) I mean they were there to be sure there are some extremely talented doctors and surgeons who have amazing skills with their hands and, and do quite well. you know, manually. I think it’s, it’s, it’s a very difficult thing to do. I don’t think everyone, has those skills. And we also have to remember it’s not just once, twice, this is you’re doing this 2000 times. And so, can you say that the 1550th time you do it is the same as the second or third time you do it? I think it’s really difficult. There’s a sort of a repeatability aspect with the robot that is just built into the robot. It’s repeatable and its efficiency is what you get from, from a robotic. And just the ability to, maintain focus, concentration and that sort of, physical dexterity over that amount of time is very, very difficult. you know, there are some, you know, outstanding surgeons who, who get very, very good results. But I think for most doctors, it’s hard to compete with a device that sees so well. It has such a precise movements and is extremely repeatable. over thousands and thousands of these very small repetitive moments movements.Oggie Petrovich: (23:03) I would say it’s impossible for a human to compete with that. It’s not going to happen. I just don’t think it’s possible because it’s not possible for someone to do that. And if you did it on one case and you did it over and over again, most of the people are actually going to get some sort of wrist issue or elbow issue cause it’s that aspect, that repeated motion. Even if you could do it, I have not seen a person who can do it yet, whether it’s a surgeon or technician, whoever. I have not seen a person who can do that repeatedly. Like as good as an ARTAS. I’ve never seen a person who’s good as the ARTAS. That aspect is me looking at lots of docs and looking under scopes and microscopes and looking at t’s, looking at data.Oggie Petrovich: (23:40) That’s the big thing. I have not seen a human that can do it as well as an ARTAS. Okay. So you were talking about harvesting the mechanics of harvesty. We’re talking about the division of harvesting, which I think are two really important parts about that. And I think the part that you mentioned is non fatigability reproof, reproducibility. These are things that people don’t take into account. So you know what you’re going to get with an ARTAS. you, again, I’m, I measure myself. This is a looks like a wedding ring. although I wear it on my, I’m married. it’s actually an orange, so I know what my sleep and my suite number was good last night. But let’s say I had a bad sleep number. I know that I’m prepared. I was prepared today. My sleep readiness score was like, you know, way in the 80s.Oggie Petrovich: (24:20) I tried to make myself as zoned in as possible, as reproducible as possible, so I’m always on, but I’m a human being and we can’t always be, you know, you know, we can’t be always as perfect. At least we know what the ARTAS, we are going to get something that’s super reproducible. It’s never gonna have, a restless night of sleep. and again, I try not to, I try to make myself as, as much like a w like a robot. What I’m saying that, with those aspects of, of that so I can be as reproducible and have everything. I like that. Okay. So I think if you’re comparing, we’re were talking about best case scenarios with that, that’s harvesting next, getting the hair out. and I think my experience has been, it was mind blowing when I looked at data.Oggie Petrovich: (25:04) I used to do things by hand. This is me and this is me having other people assist me in that aspect. The numbers, I think that people report on transactions are probably way, way exaggerated and it’s their guesstimates because people aren’t keeping track of it. And when you, when you look at those data points, people sometimes talk about 5%, 10%. I believe they’re at best case scenario, 30%. Transections that’s my opinion at some, probably higher than that. And that’s why you’re seeing people, use 2000 grafts to try to get a thousand grafts results. That’s where you’re trying to people doing that because they know there’s some waste in there. We have a limited number of hairs here. We only have so many hairs we can harvest. Why waste those hairs? You need to preserve every one of those hairs. So the extra value you get from ARTAS, it’s inserting your results.Oggie Petrovich: (25:57) And one of my, one of my best, results is a patient I did. I think I did 500 grafts on him. And if you look at it as result with 500 grafts, people like how the heck could you get a 500 grafts a result with him? There’s no possible to do that. His t rate was zero, so I had to zero rates he rate and he had karafilis this stuff like that. But that’s not the point where we got to care from. Every grafts I put in I’m sure survived because there’s no way it’s possible to do that with 500 grafts. So, he was quoted 2000 grafts, 2,500 grafts. I did 500 grafts on him. And you can tweak the ARTAS in so many different ways, including skipping ones and doing that so you can maximize the number of hairs and minimize the number of grafts.Oggie Petrovich: (26:43) And having control as a physician and having control of the patient I think is especially an underestimated part about this technology. so again, that’s my core, so my staff and myself, by the way, I could have had my hair done probably 15 years ago. my first option was stripped and I never would put a scar on my head. so it’s one thing to, I just don’t believe in that. So I, I just don’t even offer that as an option in my practice. I would never do it to myself. The issue with that is, some nerve numbness, some issues with that aspect. even in females, ARTAS is not approved. It’s not FDA approved for females. I do ARTAS on them off label. even for eyebrow patients, I use ARTAS. Again, it’s not FDA approved for that. I use it as an off label indication about even in African American patients.Oggie Petrovich: (27:30) I use ARTAS for that. It says off label. This is stuff that you guys can’t talk about, but I can talk about. I use it awkward. I use it for every application of hair because I’m a believer in the aspect of other technology, how it works for that. I don’t believe in the scar in the back. So that’s number one. my second option was fue manually and again, knowing some pretty good surgeons across the country. That was not an option for me because if t rate and transection rate, I want to get to the least amount of hairs out. So I had a thousand heres placed in my head. and everyone always wants to know like, how many hairs are transected. It’s a stat. I can see that you’ve got people upstairs. I had one here that was transected, which was like, I mean, there’s no one in the world who can do that. It’s like, it’s not even close to that aspect of it. And it’s one thing to see in another patients, but when you experience it yourself, you’re like, I mean, this is the, this is the game changer. Game Changer Technology. And here, 2011 was not the game changer technology. It was the beginning. It was the saft lean. It was the truck with the child that needed to be nurtured. And thankfully it was nurtured to where it is right now, which is this, this prodigious giant, so awesome.Eric Selvik: (28:40) Yeah.Oggie Petrovich: (28:40) Okay. So, a couple of things on ARTAS. We talked about some of the technical aspects for it. let’s, let’s talk about some stats on this. Cause you guys know some stats that I don’t know. What’s the most hairs that have been harvested in an hour on an ARTAS and you guys know off the top of your head? I don’t know that number.Eric Selvik: (28:58) I think it’s probably 1400. Around 1400. Yeah, we have some, we have some. there are some ARTAS, users that pretty regularly can harvest, over 1200, per hour and as high as 1400. I think we’ve seen in an hour.Oggie Petrovich: (29:16) Of course that depends, you know, on the, on, on the donor area of the patient, on the training level and experience level.Eric Selvik: (29:25) A lot of is also a, you know, some doctors are very, you know, have a very tight surgical workflow and other doctors not maybe as tight. You know, some doctors are very, every single, it’s, everything is sort of scripted and choreograftsed within the, within the procedure. So everyone kind of needs to know what they have to do at, we’re at time and they’ve saved. They’re much more efficient that way. So these are some doctors that have really mastered the surgical workflow and they can, you know, come up with these rates. You know, other doctors aren’t as, you know, aren’t as picky about that. And so maybe they don’t go quite as fast.Oggie Petrovich: (30:02) Yeah, I think the fastest I’ve been with was I got 1100. Again, a lot of it varies. I think my experience on it is going to be patient selection. it’s not, patients have, you know, it just like with anything with surgery and for me, it’s not a race. You want to get the best outcome from that. but I also want to minimize the time that someone’s in the chair because I think out of grafts time that something, I emphasize to patients, and I’m just going to kind of clarify that is to our listeners. So autografts time is the amount of time your grafts is out of your head. And so we always try to minimize how long that hair is out of your head so we can put the hair right, put it back in. And, I think I view here when you take out a hair and a political unit out as an Oregon.Oggie Petrovich: (30:43) And so kind of like when you take what people do hair transplants and they do kidney transplants, you really have to nurse that hair and everyone has their own proprietary thing that they nurse their hair with to prevent it from going into shock. and I think that, you know, you know, for me it’s really important to get the hair back in because just like we wouldn’t want to put a hairt in two weeks later, we probably don’t want to do that to hair. kind of going with that, how many ARTAS procedures do you know that have been performed to date? kind of worldwide? Do you know that number off the top of your head?Eric Selvik: (31:15) Yeah, it’s probably, we, we estimate over 30,000 to date.Oggie Petrovich: (31:22) That’s a lot of hair.Eric Selvik: (31:24) Lots of follicles.Oggie Petrovich: (31:27) Now, is this true? I’ve noticed I’ve had it. I love it from the get go, but I’ve noticed even in the last year, it seems like it’s just even smarter than it was like a year ago. Not like a lot, but just a little bit more consistent. A little. It just, I mean, it was, I mean, I did my hair like almost a year ago. but, again, I’ve loved it up, got to get go. But I’ve noticed that it’s been less variability from patient to patient. and it’s just, I’m smarter than it was even a year ago. Was that possible?Eric Selvik: (31:59) Definitely. You know, I know, Oggie can speak to this, but I, you know, I’m just, maybe he doesn’t what they, they worked incredibly hard all the time and trying to improve the system. So, you know, when he’s talking about how we started with doing 40 hairs in a case and now 4,000 at the same thing is true. You mean you’re talking about, well, they developed the automation to make it faster and that’s a continuous improvement cycle that we do. We’re always looking at ways to make it, to get better outcomes for the patients to make it a faster, easier for the er, for the doctors, more accurate. And so it’s an ongoing, you know, this is an ongoing, you know, activity for us.Oggie Petrovich: (32:38) I think one of the things with ARTAS too is that it’s not just in anyone’s hands. Like I can’t just go to someone and say, I’m going to buy an ARTAS. You have to, you have to buy it from restoration robotics and enjoyed that aspect of it because, you have to get trained with it because this is a piece of technology that’s not like me buying a laser and say, hey, we’re going to have a one day seminar on it. I think one of the coolest things about it, and this is me from being, you know, an ARTAS’s user and a lover of the product is that, there’s a lot of dedication and a side of restoration for products where your company, trains people. You physically send people over and say, Hey, we want you to be comfortable with this robot and you have to reach a certain level of competence just to use this device because you can’t, you know, we don’t want you using this device.Oggie Petrovich: (33:23) It provides a sort of consistency throughout the brand and the product. I think that speaks volumes to it because, if there’s a problem, and this is what I tell my staff, it’s not probably the robot, it’s probably us. And if that, it sounds strange, but it’s kind of one of those things, like I always say like, you know, something against stent. I don’t think the computer made the mistake. We probably made the mistake. What did we need to do better? And I think they think the same thing with ARTAS. I think we have to think like a computer, like did, what did we doing to make this so it’s consistent from patient to patient. So the experience, so from someone with blonde hair, you know, so from, Eric and August, if you look at their hair and you’ll say, how can we make your hair? But if you guys have fantastic care, by the way, I’m not telling you you should be on the, under the ARTAS thing yet. but you both have autumn care, but making sure that your hair results, your case. If you have two patients similar hair, you’re going to get the exact same experience. And so we’ve tried really hard to make sure that that’s the issue because I don’t think it’s the ARTAS, it’s the, it’s us doing that aspect, which I found to be true too.Eric Selvik: (34:28) Yeah. No, I think that that consistency is a really important thing. And, and you know, I, I sometimes think of ARTAS as like a, as like a surgical fellow that, is always there. It’s, it always shows up. It’s the best fellow you could ever have because it’s, it’s always happy to be working. It’s never gets tired. It does exactly what the attending physician says. And it’s always accurate, always precise. every single time.Oggie Petrovich: (34:55) It kind of, a trend I’m seeing inherit now too, is I’m seeing people getting FUE elsewhere. Sometimes they’re going overseas, they’re going people handheld fue and then what’s happening to the back of their head is, you see an obvious not my hair. I have an ARTAS that you can’t see anything. So I can say that in the back. But what you see is this. It’s like a shotgun went off in their head and you could see these obvious areas where they’re missing here. Obvious things. There’s obvious patterns of hair loss. And again, I can’t speak to that cause I don’t do handheld like that, but, can, can you explain why are ARTAS, prevents over, overharvesting and prevent that visibility? So what’s built into it? What’s baked into it to prevent that? That look, cause I’ve never seen it, one of my ARTAS’s patients, but I see it all the time in these outside patients and it’s really, it does a disservice to FUEEric Selvik: (35:45) Yeah. I mean the ARTAS can be programmed to harvest whatever, you know, number of hairs and there it has intelligence to sort of choose hairs in a way that, that sort of leaves and then the actual, so if you just set it up and you set certain parameters on that, like how much, you know, how much density you want to leave or you know, what’s kind of spacing you that you want to get, as a doctor between your harvested hairs, the robot will do that. And I’ll do it in a way that leaves a natural result. If you’re doing it just by hand, you’re sort of a kind of picking and choosing and, it’s sometimes hard to see the forest through the trees and that type of situation. So there may be cases where someone just doing it by hand and over a harvest scenario. ARTAS will never do that. unless the doctor programs it in and says, yes, I want you to harvest every single hair in this area, which, you know, they wouldn’t do. But, there are a lot of, that’s part of the great automation and the intelligence of the system is that the doctor can sort of set the basic parameters and the ARTAS, we’ll go and we’ll select the right heres and leave a result that is a very natural looking results.Oggie Petrovich: (36:56) We’re going to talk about sight making for a little bit. And so we’ve talked a lot about the harvesting aspect of ARTAS and once we harvested, you talk about making sites where the hair’s gonna go. We’ll talk about that aspect. So with the ARTAS’ system right now, we’ll talk about that making before, probably talk about grafts implantation. and then we’ll talk about where you think that’s going to go in the future and some challenges. so with sight making, essentially what happens is we make little sites throughout the head. and then those are the sites where the hairs that have been taken out are going to go back into, into this, into the hell, into the scalp. So, with sight making, that’s been probably the second phase. Obviously the harvesting is still always being updated, but that was the second pace of the ARTAS system was the site making. so what are some of the challenges of sight making and what are some of the areas that, I currently do started making by hand. I’m a data driven guy. Maybe you’ll convince me this, I have that feature. I’ve, maybe you can make me to, I should use that more. Maybe not more. we’ll go back and forth and talk about that too a little bit. So let’s talk about sight making. What were some of the challenges and where it’s at right now?Oggie Petrovich: (38:12) Inside making is a great option for physicians. so one of the main, feature of decide making is that the doctor is still in fully in control. So we provide software to create a treatment plan so the doctor can choose a where all the hairs are going to be placed in which directions that are going to grow, what are densities. and the, that plan is that being transferred to the system, which executes that plan. When the system creates sites. We can see here, just like when we do harvesting, we also see here existing terminal here and we avoid them. So that can be, that’s easier for us than a person just doing it by hand, of course, for all known reasons that with that we talked about. and you know, our speed is also well over 2000 sites per hour. So it’s quite comparable, probably faster than the human hand.Oggie Petrovich: (39:09) Yeah. And I think my, my use of sight making is if I shaved the head, I’m doing sign making and if I’m, if I leave the hair long, I’m doing it, doing it by hand. And that typically is how I roll with it. and I think the advantage of that, I think the cool thing in the sight making software as you can see the number of hairs that were saved, which is a nice thing for patients to see that and visualize that aspect of it. that’s one of the challenges in sight making. I think, is temple still, hairline and crown, right? That’s still, would you say to couple of areas that kind of designing the front of the hairline, which I get that comes into the surgeon aspect of it, that’s the ARTASic aspect of it. and then, and temples, and do you think that will change anytime soon or you think that’s still always going to be kind of one of those hand touchesOggie Petrovich: (39:59) Hairline a is not a problem. We talked about, you know, the system being improved. So recently we have improved the workflow. So when we do site making, actually patient sits in a, in a nice comfortable position, which also allows the system to have a really good, angle for creating a hairline. And we also provide a very nice software tools for the doctors to replicate exactly what they will do by hand. We have special, algorithms that we developed with together with the, very important doctors how to create, hairline properly. So we, the system can do hairline, nope, not a problem. And in addition, the new robotic arm is, has, is able to maneuver better and we can get to the harder areas that, that were harder in the past so we can get to the temporal areas easier, easier now.Eric Selvik: (40:52) Right. And then the crown, the crown is, is, for future development and we fully expect to be able to do that. you know, it’s, it’s a big challenge, the bigger challenge to, to train a robot to go around in that. there’s a lot of logical things that she had been put in place and will decision making that you have to, you know, allow the, the system to do, teach the systems to do. So. That’s definitely on our roadmap. But I think, you know, supporting what Oggie said is we do have some features, some new features now that, allow for, the establishment of the hairline helps a doctor view design and then of course, it executes exactly that. It’s designed that the doctor wants. So, we’re you, we encourage doctors to try that, but we also know that some doctors really like to do that by hand and that’s totally fine. Inappropriate. It’s just however they feel best.Oggie Petrovich: (41:43) Then, if we’re talking about, implantation, so, you know, kind of implanting hairs how, how has that changed over the last, you know, I probably can say a few months. I’m sure that’s still kind of a rapidly evolving, technology part of that.Eric Selvik: (42:01) yeah. So, so implantation is the newest, functionality that was launched with our most recent platform, which is the [inaudible] system. And, implantation is, you know, in, in some ways, I mean, it started at a really good level, but we’re already seeing improvements and most of those improvements are in the sort of the you and the surgical workflow and the sort of the speeds and rates that we can work at. you know, this is, this is brand new stuff, right? We’re, we’re, we’re sort of creating this, and no one’s done this before. And so there’s always going to be a lot of learnings, but, and what we’re seeing just in the, maybe the, you know, seven or eight months that the systems out there is that we’re able to, doctors are able to more consistently achieve, you know, implantation rates that, rivals a one or two, two, texts like implanting. So we’re talking about the six to 700 grasp per hour implantation. We’re making it just more consistent so doctors can achieve that in a more regular basis.Oggie Petrovich: (43:03) What’s the smallest that you can make with sight making? Can you make it with, can you go down to a 20 with that or is it 19, 18?Oggie Petrovich: (43:15) Oh, for implant. 19, it’s 19 gauge for a side making and implant. Yes. That’s what the company offers slightly under a millimeter.Oggie Petrovich: (43:27) So again amazing product. I think that anyone thinking about hair, and this is myself included, I’m, I’m an ARTAS person. I love my hair.Eric Selvik: (43:46) It looks great by the way. I was really happy to hear that you had an ARTAS procedure because your hair looks fantastic.Oggie Petrovich: (43:53) It’s not Photoshop, it’s not a filter you’re looking at !Oggie Petrovich: (43:59) Where do you see ARTAS in the future? So it’s so many different areas. I use it off label. I talked about some things that I use it for, which I probably not. I don’t know if those are areas that you guys are studying. I use it for eyebrows. I love it for eyebrows. It’s amazing because you can pick ones, you can do different things with it. We used it on African American hai with great success. and we have a lot of patients with traction, particularly African American females. and we were a little nervous. Usually they this in the beginning and it’s, it actually, we don’t actually have to alter the angles too much. I was talking to a lot of people before we, we were starting to do this. It’s actually super, adept at doing that aspect of it. and so, white hair, which is off label blonde hair. We’ve used that. Obviously there’s, there’s alterations to this. Where do you see this product, in the future? Any future directions of where this is going?Eric Selvik: (45:02) In my opinion we’re going to continue to press the boundaries of the, the functionality and the technical ass expects. To me, I see the cases becoming faster and more efficient. you know, we’d like to get insights down so a doctor can, can consider doing two cases in one day on a system, many typically a hair reservation cases a full day. we think that we can get it to a point where, we can get it fast enough and efficient enough so a doctor can do two a day. And that just really helps, you know, get with their, with their throughputs and you know, if they’re having technicians there, it sort of makes it’s, more worth the while of having that technician there. I think we talked about some of the expansion to be able to do the crown.Eric Selvik: (45:51) So I guess providing it just a complete solution for, be able to do hair everywhere. I think, you know, speaking to the, you know, the off label and things, of course, you know, our, our, we’re, our indication is for straight dark hair. males. That’s a product of, of the study that we did. So we had to do a clinical study to get our clearance for hair transplantation. And, and, and, on that study we used males with dark hair. you know, if we, if to expand that, that indication, we would need to go back and Redo that study for every other single type. And, you know, that’s something we’ll consider. But, those, that’s a very difficult study to do because you’re literally counting hairs and you have to wait a year after you do the patients. You have to follow them quite a long time. So, you know, there, there are some issues around that, but, we, you know, the, the same tools, you know, the, the, the system is the system and the doctor, is licensed to use that and the way that he or she thinks is best. And what we have definite indications that, that we stick to when we talk about it. Yeah.Oggie Petrovich: (46:57) Yeah. I totally agree with Eric. I think a company as a company, we are quite focused right now on delivering, harvesting and implantation, completely done in a much more reasonable time than right now. I mean it’s pretty difficult both for the patient and for the doctor to do a hair transplant whole day. So we are committed to to lessen that pain and that’s beneficial for the patient. It’s good for the, for the doctors as well. And we’re on good, path to deliver that.Oggie Petrovich: (47:33) I don’t like the word hair transplant and that sounds strange because I actually think it’s an antiquated term and it’s used from people using strips. And I actually think when the way people think of hair transplants I think is kind of different because people used to think of this, hey, guess what? I’m going to do a strip and you need a minimum number of hairs. You need a thousand hairs or 2000 hairs. I think a lot of people, especially the oldest surgeons, think in those terms. And I don’t, I don’t like that word hair transplant. I’ve had it done. I don’t like saying I at her test plan. So I actually say hair redesign. and I, I have a lot of patients who come in and say, Hey, guess what? This bothers me. I have a little issue with my temples.Oggie Petrovich: (48:14) I have a little issue with this aspect. If you want to throw 500 hairs it’s not a big deal to harvest 500 Harrison, put 500 Harrison, someone to do bro. So you’re redesigning your hair. And that’s the aspect of it. So I think of this almost as this fluid plastic. Again, this is meet me in a facial plastic and hair surgeon. I’m not a big fan of the word hair. I’m a hair transplant. I like hair redesign because I just don’t think it’s helpful. And going along those thoughts. when people do a hair transplant, they’re limited because they have a scar in the back of their head. And a lot of my patients, they want to wear their hair really short and it’s kind of underestimated that you can’t do that anymore. It’s never emphasized to them. And they they cut their hair down to a two guard then they see a scar!Oggie Petrovich: (48:56) How do I get rid of it? and so you want to have more hair flexibility, not less flexibility. You want to have, be able to do more things with your hair. Part of the reason I did it was because I wanted to do some crazy haircuts, but my hair actually, I didn’t do anything crazy. Am I hearing that proponent Mohawk? But you want to be able to do an under whatever you want to do with your hair, you can do that. And I think that’s the whole point of, of this. so, yeah, so fascinating stuff with that aspect.Oggie Petrovich: (49:23) I think another interesting thing is how ARTAS is dedicated to their users. And you guys had a B user meeting typically every other year. Every year we’re all the people with ARTAS come together. So it’s not just, you know, the AI to part where people are the computers, you’re getting the data. It’s actually people talking about things.Oggie Petrovich: (49:53) It’s interesting because, you see this collaboration of what people are talking about, what’s working, what’s not working. And you see a lot of people kind of taking notes of, you know, within the company itself and say, “what can we do to make this better?” Because this is not like a static product that’s fixed. It’s a product that’s always evolving, always getting better. And that’s been my experience with, with even within the last year, actually at the meeting I was actually telling, Oggie about this a little bit earlier. they had a magician, it was in Las Vegas the last meeting. and they randomly me up to go on stage. and so one of the Magicians Act, he had a knife and he said, I want you to hold this board and don’t move. And so we threw a knife. I have it on video and the PR, I think it’s a real knife. I’m not sure if it was a real knife. And I was like, oh my God, if you hit the hair at least like we can repair that and put some more hair up there. But, don’t hit my hands or hit my, hit hit my face.Eric Selvik: (50:51) Yeah, no, I mean I think your, your points there are, you know, appreciate them and, and you know, we are always looking at making it better. And I think the other thing you touched on before was sort of the training, the educational aspects like this. Yeah. This is a different procedure than to say a laser procedure where you buy the box and then you send a technician in. You know, you are a, you basically, you’re taking tissue from him, placing a body movements to another. It’s a surgical procedure. So, it’s very important for us that we provide all the support that we can to our customers that’s in training. And then users meeting are a great way to share best practices and for us to be able to communicate those and then have the users talk amongst themselves and, and compare. It’s like, how do you get these, you know, how do you do your procedure? How do you become more efficient? Things like that. So, we’re super dedicated to the support aspect. and you know, we want, you know, our, our success is tied to our customer success. and we’re just always striving to make it better, faster, easier, for a doctor to give a patient the outcome that he or she wants.Oggie Petrovich: (51:57) And I’ll try to wrap this up a little bit, but I could, question I always get asked is, why aren’t more people, why aren’t more hair surgeons using ARTAS? Because I saw it, I saw the latest version. It was like, it wasn’t even, it wasn’t even close. I mean, we talked about some of the, kind of physical advantages. We talked about some of the stereoscopic advantages, we talked about your kind of, so many things built into it. it’s almost like a chess match. You could see the ARTAS is not only harvesting the haircut to working on it already knows where it’s going next and it already knows where it’s going next. So it’s always a step ahead. so my question is, as a patient, you know, and as a doctor, I know what’s best, why do some docs, so not get it? Like what are some of the obstacles? I’m not sure you guys are on that and you’re more in the development, but wEric Selvik: (52:46) I mean, I think I can probably speak to that a little bit. you know, I think that, like in general, doctors are, fairly conservative and resistant to change and for good reason, right? I mean, they’re science-based and they, want to make sure that, when they get a technique that they believe works in their hands, of course, that’s, that’s the technique that they’re going to use. And it’s, it’s sometimes difficult to change those ways. And I can speak also from experience of, you know, coming from a company like intuitive surgical where you’re training surgeons who had been doing a surgery a certain way to now use a robot. there is a learning curve and someone becomes very, very at doing a procedure and a certain way, and then you say, Hey, look, I’ve got a different way to do it.Eric Selvik: (53:30) They kind of have to go back and learn. And many doctors maybe aren’t as open to doing that. They feel like the, what they do is good for their patients. So I think there’s, you know, from our standpoint, I mean, we’re, we have, you know, a long way to go in terms of, of, educating, the, the community. you know, what, we, we try to, you know, do this through the different societies and things like that. And I think that’s, really, you know, as we, now have a device that provides a more complete solution where it can do, you know, part the implantation as well as the hardest thing in the sight making that doctors will start to see the, the, some of the benefits there. I think, you know, one of the other things that we’ve talked about is some of the physical issues that Chris you do and you know, I think they’ll see that in terms of preserving their, their career and their body and just the pain that they might feel that using a robotic assistant solution is really quite a good thing.Eric Selvik: (54:31) That it actually can prolong their, their career and their practice. they don’t go home aching and having pains, over their bodies because they’re crouched over in certain ways trying to manipulate something thousands and thousands of times. So I think that, you know, we have a very, dedicated base of users that many are our came up as hair surgeons. We also see now that, there are other types of, say, dermatological, surgeons or, other doctors who are adding, the hair hair, how’d you say hair remodeling as a zine, as a, as a, something that they offer. And so, as we sort of get the word out and, and we have sort of add these features, I think the sort of the tipping point is coming where they’re going to say, okay, I see what it takes me to do it this way. I can go over here and do it the other way. And they’re gonna start to choose a robotic assisted. And I, and I think that’s in general, the trend in, in, in the, you know, in, in our, in our world that, we’re seeing the benefits that robotics can bring too many, many little tasks. and this is just the perfect one for a robotic application.Oggie Petrovich: (55:38) Yeah. And in the hair world with interesting that even microscopes, believe it or not, it’s something like when people are looking at hair follicles, which is clearly a, the standard, people were resistant to that in the 90s. And then people say, it’s like you see this resistance. And even with open gallbladders versus laparoscopic people, we’re resistance to that. And I think one of the things you see is when people know a certain way of doing something, they feel like that’s the best way. And they have to be, like you mentioned, it’s open-mindedness to two things that are, are different than they’re used to. And I think that’s one factor is, maybe close-mindedness openmindedness of that aspect. and you know, I always try to embrace technology and I think that, if you deliver better outcomes for your patients, and and the more educated patients right, are seeking this, I think they’re demanding, this technology.Oggie Petrovich: (56:26) I only do ARTAS, but I don’t have people saying, would you please do a Strip surgery on me? I mean, it’s just like not something we would even offer them. That aspect and or would you please not use this hype tech piece of equipment and just use your hand to take it out? I don’t have anyone telling me to do that. So I think that’s, you see where the trend is and if you see where the future of medicine is going, it’s not going to be going back to handheld stuff. It’s going to be going more towards, automated, improvements, that, you know, we can do that. And combining the best of, artistic design with robotic design altogether.Eric Selvik: (57:10) Right. And I think your point about the consumers these days, they’re very educated. They have a lot of information at their fingertips and they, they will go and do the research. I mean, back in the day you go to the doctor and I said, well, here are your two options. And now you know, the patient will come in and say, I know all of the options. I’ve done the research, there’s five. Tell me about these two or here, the ones that I’m interested in. And I think, you know, as we start to get that you said, patients are seeking this type of technology. You’re going to get more doctors who say, okay, I better take a look at what’s going on here because I’m getting more and more people coming in and saying, I’ve done the research, I know about what your strip is.Eric Selvik: (57:49) I know about manual fue, I know about suction devices and I also know about ARTAS and I want you to tell me what’s the best for me. so doctors really kind of need to get on the ball with some of this new technology. You’re also gonna Miss, I think a big part of the patient population, particularly, you know, the younger generations now, the ones who are sort of coming of age and you know, certainly need, you know, maybe you looking for a hair remodeling, they want technology, they embrace technology and they see the benefits of that. You know, some doctors that aren’t really up on that, they’re gonna miss, this whole class or generation of, of patients looking for these types of solutions.Oggie Petrovich: (58:40) Well, thank you so much for educating me and educating our audience on ARTAS and thanks for doing all you do for all of our patients, including myself.Eric Selvik: (58:55) Well, it’s a pleasure. Thank you so much, Dr Shah,Oggie Petrovich: (59:03) Thanks for having us!