DHI Hair Transplant | Dr Erkam Caymaz Hair Transplant Turkey

The DHI (Direct Hair Implantation) Implantation Method & Choi Implanter Pen

Some define it as the new method in hair transplantation, some say there is no ‘recognized’ technique called DHI (Direct Hair Implantation), others claim that it is just a marketing gimmick, while a fraction explains the method as; FUE with implanters.

The debate goes further, where the two methods at their simplest form stand out to be; ‘different ways to harvest the grafts’ combined with ‘conducting different implanting procedures’.

However, our aim for this study is to remain objective and to have a brief and clear understanding of how the procedure actually works.

Unlike the FUE method, during the DHI implantation method, site creation and graft implantation are performed simultaneously, i.e. extraction and implantation are combined as part of a one or two-step process, embedding the extracted hair follicles directly into the receipt areas without the need of creating channel incisions in the donor area via utilizing an implanter (Choi) pen that features a hollow needle connected to a tub and plunger device. This is why the DHI procedure is also referred to as the Choi method.

The DHI method procedure

1. During a hair transplant procedure operated with the Choi implanter, the specialized physician/surgeon or technicians transmit the harvested grafts into the implanter pen.
2. The graft is inserted gently within the hollow needle, which is positioned at the end of the implanter pen, to be handed back to the specialized physician.
3. Subsequently, the needle is inserted at an accurate angle of 40-45 degrees into the scalp by the surgeon, as the incision site is made and then the graft is implanted by pressing down on the plunger.
4. During a procedure, normally an amount varying from 2-6 Choi implanters and approximately 15-16 needles are concurrently used, with the device coming in a variety of needle sizes to fit the follicular unit grafts.

The Choi method naturally has its advantages as well as its disadvantages over the FUE technique.

Advantages of DHI Technique

Among its advantages indicated by some hair restoration experts are as follows;

• Reduced time of grafts remaining outside the body, thus ensuring strong and healthy placement of the grafts.
• Adequate hair follicle survival rates.
• Reduced bleeding during the creation of the recipient area. Reduced trauma during graft handling, thus leading to less damage in the blood supply to the implanted area.
• Fast recovery during the postoperative phase, the patient can return back to his/her normal routine quicker.
• The recipient site does not have to be shaved, as it is a more suitable procedure that enables this condition.

Disadvantages of DHI Technique

On the other hand, the disadvantages in comparison to the FUE method include;

• The physician and staff members are exposed to a long-term training period so as to specialize in utilizing this technique.
• It is generally a more costly procedure when compared to other hair transplantation methods.
• This method requires more attention as well as accuracy during the procedure.
• Due to the fact of the limitation of access to the operative area- this technique can cause the operator stress, which could likely affect both the extraction as well as the implantation process, causing possible damage while handling the grafts.

The Stages of DHI Hair Transplant

After mentioning the highlights of this special technique, we will make one final remark on this topic through a question.

Are all candidates qualified to undergo this hair transplant surgery utilizing the Choi Implanter pen?
With the creation of this method by specialists at the Kyungpook National University in Korea, as the Choi Implanter is generally considered the ‘original’ implanter pen device, experts operating within the field started to conduct research so as to gain an in-depth understanding of this new technique. According to the results of their studies, they had identified that not all people were ideal candidates for utilizing the Choi implanter pen during the hair transplant surgery.

It was observed that the initial version of the Choi Implanter pen provided better results on Asian patients with hair loss compared to other ethnicities. The experts that studied this phenomenon came to the following conclusion: Asian people’s hair, in general, is distinguished with thick straight hair, and the curly characteristics and thinner diameter of other races, makes it difficult to be loaded properly into the implanter and place in the scalp, as the main sizes of the needles that were used in the early stages ranged between 0.8-0.9 mm.

As a result, this may lead to inappropriate bend in the follicle, incorrect graft placement, and excessive trauma for the follicles. Therefore, not all patients are ideal candidates for the utilization of the Choi implanter pen during their hair transplant surgery. SIn opposition to the proposed findings, some physicians disagreed with this statement, indicating that with increased training and experience with the Choi implanter pen, effective graft placement with any type of hair characteristics could be possible.

With scientific and technical advancements, hair restoration procedures have improved over the past decade, reaching a point where it is now possible to conduct hair transplants utilizing the Choi Implanter Pen with any kind of hair characteristics, creating a new era that produces consistent, effective, predictable, safe but most of all natural-looking results.

Doctor Caymaz will decide which technique should be used.