What Is DHI Hair Transplant?

Hair transplant has seen significant advancements in recent years, and the Direct Hair Implantation (DHI) technique, also known as the Choi pen technique or unshaven hair transplant, is indeed one of the notable innovations. DHI is a hair transplant method that falls under the Follicular Unit Extraction (FUE) technique. Much like FUE, it involves extracting individual hair follicles from a donor region and transplanting them to areas of hair loss. Using an implanter pen characterizes the Direct Hair Implantation (DHI) technique. 

In contrast to the conventional FUE, where channels or incisions are created before implantation, these implanter pens integrate channels and the implantation process into a unified single step. One distinctive feature is its ability to minimize or eliminate the need for shaving in the recipient area (although the donor site may still require shaving for extraction). This contrasts with specific traditional hair transplant methods, making DHI attractive to individuals who wish to preserve long hair in the recipient area throughout and after the procedure.

How Does DHI Technique Work?

To summarize a DHI hair transplant procedure; once the donor site has been completely numbed through individual hair follicles are extracted using a mechanized micro-punch tool. Subsequently, the extracted follicles undergo preparation for transplant. This process includes assessing the follicle quality to ensure viability and categorizing them based on their thickness and the number of hairs they carry. 

The follicular units obtained from the donor area are then inserted into the Choi needles/pens. While pressing the plunger, the tool makes its tiny incisions and simultaneously places the graft into the incision, affording greater precision over the depth, angle, and direction of the implanted hair. As it is seen, Choi’s pen seamlessly integrates the two phases: incision opening and implantation. This distinction is why DHI hair transplant in Turkey is characterized as a two-step procedure, unlike other techniques that typically involve three steps. The DHI technique also allows the protection of existing hairs and the grafts that were transplanted in the previous sessions.

What Pens Are Used In a DHI Hair Transplant?

The Choi Implanter Pen, often called the DHI pen, is a specialized Direct Hair Implantation (DHI) 

technique device. In hair transplant, this pen-shaped tool plays a critical role by facilitating the precise implantation of hair follicles. To understand how the DHI technique works, it is essential to take a closer look at the design of the Choi Pen.

The Choi Implanter Pen is usually designed with a slim, cylindrical shape, similar to a pen. It incorporates a sharp tip for incision creation and a tube for loading the hair follicle. The tube has a designated diameter matching the follicle size intended for implantation. After loading grafts into this tube within the pen, the plunger is pressed gently to push the graft out of the needle and into the targeted recipient site. While the sharp tip creates a tiny cut on the scalp, the tubular structure places grafts into this incision. This contrasts traditional FUE techniques, where channels are created first, and hair grafts are placed into those incisions. The Choi implanters are available in a range of sizes, varying from 0.6mm to 1.2mm, allowing surgeons to employ different sizes of pens to implant grafts of different thicknesses.

What Is the DHI Procedure? How Does It Apply?

Before a DHI hair transplant, a thorough examination should be conducted. This includes following general surgery protocols to ensure no health issues could hinder the procedure. Simultaneously, essential blood tests are carried out, and the donor site is carefully examined. A detailed personal consultation, considering the patient’s age and the type of hair loss, is crucial for understanding possible future hair loss and patient satisfaction in hair transplant.

The process starts with shaving the donor region, followed by sterilizing the donor site using alcohol or iodine. Local anesthetics, both short and long-acting, are injected into the donor area for prolonged numbness. A local anesthetic ointment or jet gun may be used before needle injections to minimize discomfort. After numbness, a tumescent solution is injected under the scalp to reduce bleeding and facilitate healthy graft extraction. Some surgeons may include adrenaline in the solution to further minimize bleeding and corticosteroids to mitigate post-operative swelling.

With the DHI method, follicles are extracted individually, just like in FUE hair transplant, avoiding the outdated “plug” look associated with older instruments. FUE punches, usually less than 1 mm in diameter, replace older, more significant punches, preventing the undesirable “doll hair” appearance from removing multiple hairs together. Harvested grafts are collected with microforceps to prevent tissue damage, proceeding rapidly to minimize storage time and ensure patient comfort. Grafts are organized by hair count and temporarily stored in a sterile solution on surgical pads until the implantation stage.

When starting the implantation, the hair grafts must be placed in the tip of the Choi implant. The pen’s tip is designed so the grafts are not harmed during implantation. The Choi implanters are available in various sizes, varying from 0.6mm to 1.2mm. Larger Choi implanters are employed for transplanting two to four hair grafts, whereas smaller implanters are used for delicate single hair grafts. The smallest Choi implanters are designed explicitly for delicate procedures such as eyebrow and eyelash reconstruction, involving excellent single hair grafts. This size differentiation allows precision and customization in the Choi hair transplant procedure, serving different graft types and implantation needs.

The Choi hair transplant method involves separating grafts based on their size and loading them onto multiple Choi implanters. A physician rapidly implants a single graft with one implant, which is then passed to an assistant for recirculation. This process requires at least seven loaded implanters and the assistance of four to seven technicians. The method demands experienced technical support, with technicians separating grafts and supplying a constant feed of loaded implanters to the physician. The physician has complete control over graft position and spacing with the DHI method. Ready and loaded Choi pens contribute to a smoother implantation process, and medical assistants facilitate efficiency by loading 5-6 pens of different sizes with hair follicles. For an aesthetically pleasing and natural-looking result, the distribution of ultra-micro-grafts, the implantation angle, and depth should be carefully managed during implantation. Single-hair grafts are preferably placed on the front edge, while grafts containing more than two hairs are strategically positioned in the middle and toward the back. This thoughtful placement ensures a harmonious and natural distribution of hair, enhancing the overall outcome of the hair transplant procedure.

Furthermore, the grafts should be implanted in the same direction as the natural growth direction; typically, on the frontal region, grafts are implanted at an angle of 30-35 degrees. As the procedure progresses towards the crown, the implantation angle gradually increases. In the crown area, implantations are artfully performed in a whirl shape, reflecting a meticulous approach to achieving a natural hair growth pattern. This is important for achieving a natural-looking hairline and ensuring that the transplanted hair grows in the same direction as the existing hair.

After the completion of graft implantation, final checks are conducted to ensure proper placement and overall satisfaction with the distribution. After cleaning the recipient and donor areas with sterile saline spray, the donor region is covered with a medical dressing, whereas the recipient area is left open. Now, the patient is ready to be brought back to the hotel or home for rest after giving the first-day instructions.

What Is the Difference Between FUE And DHI Hair Transplant?

The remarkable % success rate of 95% achieved by both FUE (Follicular Unit Extraction) and DHI (Direct Hair Implantation) underscores the safety and efficacy of both hair transplant techniques. Regardless of personal preference, individuals can rest assured that both methods offer high reliability. However, it’s crucial to note notable differences between these two techniques.

The extraction process is identical for both DHI and Sapphire FUE methods, involving the one-by-one harvesting of grafts using follicular unit extraction; the difference starts in the incision phase. The Choi Implanter Pen, a vital element of the DHI method, stands out for its unique capability to create recipient incisions (channels) and implant hair follicles in a single step. This contrasts with traditional FUE techniques, where channels are first created, followed by the placement of hair grafts into those incisions. Additionally, the DHI method distinguishes itself from FUE by eliminating the need to shave the recipient site. This difference allows surgeons to see existing hairs and implant grafts on bald spots to increase the density without causing harm to existing hairs or previously transplanted grafts.

While DHI offers the advantage of not requiring recipient site shaving, its implantation process is more time-consuming. A team of technicians loads Choi pens individually, with one surgeon handling the graft implantation. This longer process results in a graft number limitation for DHI (up to 4000 in one session) grafts, making it particularly suitable for addressing regional hair loss, such as cases involving scarring, alopecia, or skin diseases. 

On the other hand, Sapphire FUE is designed for larger areas with higher graft numbers (up to 5000 if the donor region is good), offering a more versatile solution for varying degrees of hair loss. However, the procedure cost might be higher with DHI, there needs to be more grafts to implant in one session, and finding a skilled medical team can be challenging.

The choice between DHI and Sapphire FUE depends on factors such as the extent of hair loss, the desired implantation area, and the specific goals of the individual undergoing the procedure. It is strongly recommended to consult with a qualified and experienced hair transplant surgeon to determine the most appropriate approach based on individual circumstances. This personalized approach ensures that the chosen technique aligns with specific hair loss patterns, concerns, and desired outcomes.

What Are the Benefits of DHI Hair Transplant?

DHI and FUE are popular hair transplant methods, each with advantages. DHI, in particular, may be appealing to individuals facing specific conditions. For those experiencing regional hair loss, where a high graft count is unnecessary, DHI offers the advantage of not requiring shaving of the entire scalp. This can be a significant benefit for those who wish to avoid the aesthetic impact of a fully shaved head.

Moreover, individuals dealing with thinning and a decrease in hair density can find DHI attractive. The method allows surgeons to transplant grafts without disturbing existing hairs. As no shaving is required, the surgeon has a clear vision of the existing hairs, enabling precise implantation between thinning hairs.

Another noteworthy advantage of DHI is its potential to traumatize the scalp less. The procedure involves two steps instead of three, resulting in reduced overall trauma and recovery time. Additionally, DHI is associated with less bleeding compared to FUE, where incisions are made separately. 

In summary, DHI emerges as a compelling choice for specific cases, offering advantages such as minimal scalp disruption and the option to skip shaving for those with regional hair loss. It should be noted that the success of any hair transplant procedure, including DHI, depends on multiple factors. These include the surgeon’s skill and experience, the quality of the donor’s hair, the unique characteristics of the patient, and the adherence to post-operative instructions. 

Who Is Eligible For DHI Hair Transplant In Turkey?

Eligibility for a hair transplant depends on several factors, and consultation with a qualified medical professional is essential for personalized advice. Typically, suitable candidates exhibit a stable donor area with an ample supply of healthy hair follicles suitable for transplant. Maintaining good overall health is imperative, as chronic conditions or specific medications may influence the procedure’s success. Moreover, individuals should be devoid of active scalp conditions or infections and have realistic expectations regarding the results.

Additional considerations arise when preferring the Direct Hair Implantation (DHI) method for a hair transplant. Patients opting for DHI should ideally have relatively small hair loss or thinning area, as a maximum of 5000 grafts can be implanted in one session with the DHI method. For individuals facing localized hair loss or thinning in specific regions where an extensive graft count is unnecessary, Direct Hair Implantation provides the benefit of avoiding shaving. This can significantly benefit patients who want to preserve long hair. This highlights the importance of choosing a hair transplant method that fits the patient’s goals and the specific features of the target areas. It’s also important to note that alternative treatments may be recommended in some instances, as only some may be suitable candidates for a hair transplant.

How Long Does Hair Transplant DHI Last?

Hair transplants through DHI or FUE are typically deemed permanent because the extracted grafts from the donor area are genetically resistant to dihydrotestosterone (DHT), the primary cause of hair loss in androgenetic alopecia. These follicles, taken from DHT-resistant areas like the back or sides of the head, are less prone to hair loss effects. The transplanted hair will retain its original characteristics and continue growing throughout the patient’s lifetime.

Even though the timeline for hair growth and final results varies among individuals, usually in the first weeks post-transplant, a shedding phase is experienced, followed by gradual improvement over several months & permanent hair growth. The primary growth phase typically happens six months and one year after the procedure, with continued enhancement beyond that. While the one-year mark provides a good idea of final results, hair thickness, and density may further improve over time. For the best outcome, having realistic expectations and adherence to post-operative care instructions are crucial. Even though transplanted hair is considered permanent due to its genetic resistance to dihydrotestosterone (DHT), sustaining a healthy lifestyle and managing factors that could contribute to hair loss, including stress and certain medical conditions, remains essential. This comprehensive approach supports the long-term success of the transplant and promotes overall hair health.

FAQs About DHI Hair Transplant

How much does DHI hair transplant cost? 

The cost of DHI hair transplant depends on several factors such as the severity of hair loss, the number of hair follicles required, and the location of the clinic. Typically, DHI hair transplant can cost anywhere from $3,500 to $4,500. It’s best to consult with a DHI specialist for an accurate cost estimate.

DHI hair transplant, what is it? 

DHI stands for Direct Hair Implantation, a hair transplant technique that involves the use of a specialized tool called a Choi pen to extract and implant hair follicles one by one. Unlike traditional hair transplant methods, DHI does not require the removal of a large strip of scalp or making incisions, making it a less invasive procedure with natural-looking results.

How much is DHI hair transplant? 

The cost of DHI hair transplant varies depending on the geographic location, the clinic’s reputation, the number of hair follicles to be implanted, and the level of expertise of the surgeon. The average cost of DHI hair transplant ranges from $3,500 to $4,500. It is best to consult with a specialist to get an accurate cost estimate.

How effective is DHI hair transplant? 

DHI hair transplant is considered one of the most effective procedures for treating hair loss. The technique ensures that the transplanted hair grows naturally, with no signs of the procedure visible to others. The survival rate of hair follicles in DHI is higher than that of other hair transplant techniques. The procedure’s effectiveness depends on various factors, such as the patient’s age, the degree of hair loss, and the postoperative care.