ARTAS robotic hair transplant carries low but real risks, including graft transection rates of 3 to 7%, machine limitations with curly or light hair, and the need for experienced surgeon oversight during every procedure. While the system's complication rate is comparable to or lower than manual FUE, the robot introduces unique risks that patients should understand before committing.
Transection and Graft Damage
Transection occurs when the extraction punch damages a follicle during harvesting, rendering it nonviable. ARTAS achieves transection rates of 3 to 7%, which is lower than the 5 to 15% range seen in manual FUE. However, transection is not zero, and every damaged graft reduces your final density.
Why Transection Happens with ARTAS
The robotic system calculates punch angle and depth using surface-level imaging. It cannot see beneath the skin. If a follicle curves below the surface at an angle the camera did not detect, the punch may sever it. This is more common with:
- Curly or wavy hair (follicle curvature below the dermis)
- Previously scarred donor areas
- Very fine hair that is difficult for the camera to track
How to Minimize Transection Risk
Choose a clinic with an experienced ARTAS operator who can override the robot when needed. The surgeon should review extraction quality throughout the session and adjust settings if transection rates rise above acceptable levels.
Machine Limitations
ARTAS is FDA-cleared and effective, but it has specific limitations that do not apply to manual FUE.
Hair Type Restrictions
ARTAS performs best on straight, dark hair against a lighter scalp. The system's machine vision relies on contrast between hair and skin to identify follicular units. Patients with the following characteristics may experience reduced accuracy:
- Light blond or gray hair: Lower contrast makes follicle identification less reliable
- Very curly or Afro-textured hair: Subsurface curvature increases transection risk
- Red hair on freckled skin: Reduced contrast between hair and scalp
Donor Site Limitations
ARTAS can only extract from the scalp. It cannot harvest from beard, chest, or other body donor sites. Manual FUE surgeons can access these alternative sources when scalp donor density is insufficient, giving manual FUE an advantage for advanced hair loss cases.
Graft Count Ceiling
ARTAS sessions typically cap at 1,500 to 3,000 grafts per session. Manual FUE can achieve up to 5,000 grafts in a single mega-session. For patients needing extensive coverage (Norwood 5 to 7), this limitation means more sessions and higher cumulative cost.
Surgeon Oversight Requirements
The ARTAS system is a tool, not a replacement for a skilled surgeon. The robot handles extraction, but a human surgeon and technician team remain responsible for:
- Site creation: Making recipient incisions at the correct angle, depth, and density pattern
- Graft placement: Inserting harvested follicles into recipient sites
- Quality control: Monitoring extraction quality and adjusting robot settings mid-procedure
- Clinical judgment: Deciding graft distribution, hairline design, and donor area management
A poorly supervised ARTAS procedure can produce disappointing results despite the technology's precision. The surgeon's skill in placement and design is at least as important as extraction quality.
For guidance on evaluating surgeon qualifications, see our guide on choosing the right surgeon.
Common Complications
Post-Operative Risks (Same as Manual FUE)
These risks apply to all FUE procedures, whether robotic or manual:
- Infection: Rare (less than 1% incidence), treated with antibiotics
- Swelling: Common in the forehead area for days 2-5, resolves on its own
- Numbness: Temporary numbness in the donor or recipient area, typically resolves within 3 months
- Folliculitis: Ingrown hairs or infected follicles during the growth phase, treatable with topical medication
- Scarring: Small dot scars in the donor area, typically invisible at hair lengths above 2mm
ARTAS-Specific Risks
- Calibration errors: If the system is not properly calibrated for your hair type, extraction accuracy drops
- Algorithm overharvesting: The extraction pattern may thin one zone more than necessary if settings are not adjusted
- Mechanical failure: Rare, but robotic components can malfunction mid-procedure, requiring a switch to manual extraction
Reducing Your Risk
The single most important factor in reducing ARTAS risk is choosing a clinic with extensive robotic experience. Ask your surgeon the following before booking:
- How many ARTAS procedures have they performed?
- What is their measured transection rate?
- Do they have a protocol for switching to manual extraction if the robot encounters issues?
- What hair types do they regularly treat with ARTAS?
For a full overview of the ARTAS system and its capabilities, see the ARTAS overview guide.
Get a Risk Assessment
Not sure if ARTAS is suitable for your hair type and loss pattern? Upload a photo at myhairline.ai for an AI-powered analysis of your Norwood stage and guidance on which extraction method fits your case.
FAQ
What are the main risks of ARTAS robotic hair transplant?
The main risks include graft transection (3-7% of follicles damaged during extraction), limited effectiveness on curly or light-colored hair, inability to extract from body donor sites, and the possibility of uneven donor harvesting if the algorithm is not properly calibrated. Surgeon oversight is critical because the robot handles extraction but not placement.
Can ARTAS damage the donor area?
ARTAS can cause visible donor thinning if too many grafts are extracted from one zone. The AI mapping system is designed to prevent overharvesting by distributing extractions evenly, but calibration errors or aggressive graft targets can override this protection. Moth-eaten donor areas are possible if the operator pushes the system beyond safe extraction limits.
Is ARTAS safer than manual FUE?
ARTAS has a narrower and lower transection rate (3-7%) compared to manual FUE (5-15%), making extraction slightly safer in terms of graft damage. However, ARTAS introduces machine-specific risks like calibration errors and the inability to adapt to unusual anatomy in real time. Overall complication rates for both methods are low when performed by qualified practitioners.