DHI Hair Transplant: What You Need to Know

Pros

• DHI is an effective hair restoration procedure for people with thinning hair or areas of baldness.
• In the hands of an expert, the new hair can look very natural. 
• Results are very long-lasting.
• Implantation with DHI reduces the time the grafts spend outside the body, which may increase their survival rate and improve treatment results. Grafts are also handled less with DHI, which may aid in graft preservation. 
• The tiny, dot-like scars are often barely visible, even if you keep your hair short. 
• Healing is relatively fast. Patients can return to their daily routine within a day or two. Usually, by the third day, the donor area is completely healed. 
• DHI can be used to restore eyebrows, beards, and other thinning areas.

Cons

• Because it requires specialized tools that add to the cost of the procedure, DHI tends to be more expensive than FUE. Insurance doesn’t cover hair transplants.  
• DHI isn’t superior to hand placement of grafts by a skilled provider. Despite claims that implanter pens improve the outcomes of hair transplantation surgery, no studies prove that. 
• The risk of newly transplanted hairs “popping” (medical jargon for coming out) is high with DHI, according to a recent article, which advocates overcoming this problem by preparing the recipient sites with pre-made slits. 
• There’s a learning curve with DHI. “Although the sharp implanter method can be easily mastered, it still requires cumulative experience to skillfully perform the procedure,” says the authors of a recent article on DHI. If you opt for DHI, it’s still crucial to choose an experienced provider. (Also be aware that some providers may use implanter pens to cut corners, using fewer skilled technicians to assist in the surgery.)

A DHI hair transplant is usually recommended for younger people with mild hair loss. The maximum number of grafts implanted with DHI varies by provider, but it’s usually less than with traditional FUE.  

“DHI is perfect for stages 3-4 on the Norwood scale,” says Dr. Cinik, referring to the classification system used to measure the extent of male pattern baldness. Stage 3 is often the first indicator of male pattern baldness (your hairline will start to develop a pronounced “M” shape when viewed from above), while stage 4 shows clear signs of hair loss at the temples and crown.

Like all hair transplant techniques, DHI is performed under local anesthesia (with or without sedation). 

A hair transplant with the DHI method starts out in the same way as a traditional FUE procedure:

• Before harvesting the grafts, the donor area is shaved to increase visibility and access to the hair follicles. 
• Patients are sedated and areas of the scalp are numbed with a local anesthetic.
• Individual hair follicles are removed from areas of the scalp (and possibly the beard, back, and chest) for transplantation into the scalp via a punch. Many punches are used in hair transplantation, but they’re often a version of the original FUE instrument—a small circular hollow scalpel used to incise the follicular unit (aka graft) from the surrounding tissue. 

With the FUE technique, the surgeon then makes the recipient sites, using a blade or needle to create tiny holes into which they implant grafts of one to three hairs using needles and forceps.

With DHI, providers use an implanter pen to place follicular grafts. The Choi Implanter Pen, the original device, is still the most commonly used. The device features a hollow needle and a spring-loaded plunger, similar to a ball-point pen. A graft is placed inside the needle, which is used to pierce the skin and create a recipient site. The spring-loaded plunger is then engaged to push the graft through the end of the needle into the newly made recipient site. The device is withdrawn from the new recipient site, leaving the graft behind. 

As with traditional FUE, each graft is individually placed. The procedure can take up to 8 hours, depending on how many grafts are implanted. You may need two or more sessions to create your desired result.