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 complete numbness at the donor site through local anesthetic injections, 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.