DHI is the acronym for Direct Hair Implantation
DHI (Implanter Pen Technique / Choi Implanter Pen Technique) is the transplantation of the harvested grafts into the recipient area by using the implanter pen.
The implanter is a pen-like instrument with a hollow needle on one of its ends. The hair follicles are implanted one by one directly into the transplant area in a specific direction, angle and depth, providing 100% natural results and maximum viability.
The use of the implanter pen eliminates the need for channel incisions, which results in decreased trauma and blood loss during the transplant. Decreased trauma means faster healing and significantly higher graft survival rate.
A major advantage of the DHI technique is the ease of increasing hair density by planting grafts between existing hairs.
Step by step procedure
- Following the registration at the hospital, the blood sample will be taken for the analysis. While waiting for the results, the Doctor will be performing the hair and scalp analysis, understanding the patient´s needs and expectations, discussing the patient´s medical history, alopecia level, design and planning of the hair transplant operation.
- Once the blood test results come in, the patient´s head will be shaved. The Doctor will mark the donor area to determine the extraction areas. Subsequently, the design of the transplant is finalised, where the Doctor will mark the implant areas and the frontal line design. The patient’s opinion will also be taken to determine the final design of the implant.
- At this time the patient is ready to enter the operation room where the surgery will take place.
- Firstly, the local anaesthetic is administered in the donor area. The effect of local anaesthetic is immediate. However, if the patient wishes, a pre-anaesthetic (without a needle) can be used without any additional cost or patient can be provided with sedation.
- The extraction of the follicles can be carried out manually or semi-manually (with micro motor punch). NOTE: The cost of both procedures varies. The manual extraction is carried out with the manual punch, by which the Doctor makes a circular incision around the follicular unit with a perpendicular angle. Once the incision has been made, the follicular unit is removed with forceps. In the case of semi manual extraction, the circular incision is carried out with a micro motor that performs the same function as the manual punch but mechanically.
- Manual extraction produces less damage to the donor area, however, the extraction process is much longer. On average, 1000 follicular units are removed in about 3 hours by manual extraction; or in 1 hour by semi-manual extraction. NOTE: There are factors that affect the extraction speed: white, thin, curly hair causes the extraction to slow down.
- Once the follicular units have been extracted, they are classified according to the hair by follicular unit. To increase the follicular survival rate, once 1000 – 1500 follicular units have been extracted, they are implanted by using the implanter pen (a-k.a. choi pen). The objective and one of the advantages of DHI technique is to reduce the time that the follicular unit stays outside its natural habitat (scalp). After the first part of the implant there is a break so that the patient can rest and have lunch.
- After lunch, the process repeats itself. It must be taken into account that Dr. Turan, aiming to maximize the result of the implant, does not perform hair transplants of more than 3000 follicular units in the same day. In implants that exceed this number of follicular units, the operation will be carried out on two consecutive days. The second day begins at the same time of the first day. On this second day, the entire process flows faster by several factors: knowledge of the process by the patient, knowledge of both donor and implant areas by the doctor.
- The implanter pen used during the implant process is a tool specially designed for this technique of hair transplantation and has the following advantages:
- Smaller incision diameter than with other methods.
- It allows to implant a higher density per cm2 than other methods.
- It provides the doctor to use different angles – providing a more natural looking result of the hair transplant.
- Simple and modern medical procedure with 100% natural results.
- Better control of the angle and depth of implanter pen, which allows a more natural appearance.
- There is less damage to the follicular unit during the transplant. With the DHI method, between 90-95% of the extracted grafts survive.
- We can achieve a higher density: In the DHI technique, high density is 70-90 grafts / cm2. In FUE, this ratio is 50-60 grafts / cm2.
- Incision holes are not required since the hair follicles are transplanted using a special DHI implant tool. Therefore:
- The existing hair is not damaged.
- The transplant area bleeds less, heals faster and leaves no scar.
- There is a higher survival rate for the tissue.