DHI Hair Transplantation | Cost, Stages, Advantages

DHI hair transplant or direct hair transplant (DHI: Direct Hair Implantation) is a hair transplant method based on FUE. In FUE method, hair follicles are removed separately from donor area or hair donor area. Then, holes are created in planting area and harvested follicles are placed inside these holes.

In DHI hair transplantation, at same time as follicles are harvested, holes are created in planting area and extracted follicles are placed inside these holes. In fact, in direct hair transplantation, follicles are extracted from harvesting area and immediately placed in planting area.

How to perform DHI hair transplant

In DHI hair Implantation, grafts are harvested using micropunches. The harvested grafts are placed in a nutrient-rich solution; thus, the grafts remain healthy during time interval between harvesting graft and its implantation. In this method, grafts are planted using a special tool called Choi Pen. The main difference between DHI and FUE hair transplantation is use of a Choi pen in implantation. For this reason, sometimes DHI method is also called Choi method.

The Choi pen is a precise and effective tool, and it is used to perform excellent hair transplantation that gives a more natural appearance. It is a surgical tool resembling the shape of a pen, it has a 0.5 mm–1.5 mm hollow needle located at its tip and a micro motor that enables the graft extraction very easily.

DHI Implanter is a hollow needle of various dimensions that is connected to a reservoir through a tube. Small holes are created in receiving area with use of a Choi pen and harvested follicles are placed inside these holes.

This needle is placed on scalp at an angle of 40-45 degrees and makes a small incision in skin. Then piston embedded in its upper part is compressed and follicles are released inside and placed in created incision.

Important point: The main difference between this method and other implantation methods is in the way of implanting grafts: that is, instead of creating a hole first and then placing graft inside cavity, at same time as creating cavity, graft is inserted into scalp with using a choi pen.

who is good candidate for DHI hair transplant

People who have androgenetic alopecia or male pattern hair loss are best candidates for DHI hair transplantation. It is not recommended to use this method in people who do not have a suitable hair donor area.

Hair transplantation will have a better result in some situations, which is as follows:

• Age: The ideal age for hair transplantation is over 27 years old. Because hair loss continues in people before this age. In other words, bald area extent and condition of donor area at less than this age have not yet been established.
• Hair thickness: Another effective factor in result of hair transplant is hair thickness. People with thick hair get better results from hair transplantation than people with thin hair.
• Hair density: hair transplantation is not recommended for people whose hair density in harvesting area is less than 40 follicles per square centimeter.
• Hair color: In people whose hair color is close to skin color or have light hair color, hair transplant result is more favorable.

Therefore, if a person has a suitable hair donor area, it is possible to use DHI hair transplantation. However, the existence of some conditions mentioned above will make hair transplant to have a better result.

The main stages of DHI hair transplantation

As mentioned, DHI hair transplantation is similar to FUE, except that follicles are placed immediately after harvesting. Therefore, the general steps in this method are similar to FUE method.

Initial examinations by a doctor and anesthesia injection

The first stage of hair transplantation is to see a doctor and perform initial examinations. In this session, the condition of patient's scalp and donor area is checked. The doctor becomes aware of patient's expectations. According to patient desired density, bald area size and condition of donor area, the number of follicles required for implantation is determined at this stage. The cost of hair transplantation and time required for implantation are also determined in this meeting.

Another important point regarding examination session is that in this session, the doctor chooses most suitable method of hair transplantation according to patient's condition. If a particular method is desired by patient, the doctor checks whether that method is suitable for patient or not. The patient will be informed about advantages and disadvantages of selected method and will make an informed decision.

Before starting to harvest and implant grafts, the scalp is numbed and disinfected. As skin is numbed, patient does not feel pain during removal and implantation of grafts. Disinfection before hair transplantation is mandatory to prevent infection.

Harvesting and planting follicles

As mentioned, in direct hair transplantation or DHI, harvesting and implantation of follicles is done in one step. Follicles are harvested using a micropunch and transferred to implantation area. Grooves are created in planting area with use of a Choi pen, and when device piston is compressed, the follicles are released and placed inside created cavities.

Advantages of DHI hair transplant

The difference between method of planting grafts and use of a Choi pen in DHI method, has increased quality of hair planting with this method. Some of most important advantages of this hair transplant method are stated below:

• Grafts harvested in this method are directly placed in planting site after harvest. Therefore, the possibility of their loss in period between harvesting and planting is reduced. In this method, about 95% of harvested grafts remain healthy and continue to grow after planting.
• Direct implantation of grafts after harvesting has increased hair implantation speed with this method compared to FIT hair implantation.
• This method is an invasive method with minimal complications. Scars are minimized and recovery time is very short.
• Since harvested follicles are directly implanted by implanter, the possibility of transmission of infection in this method is very low.
• The high growth rate of follicles is another advantage of this hair transplant method; in 90-95% of people who use DHI hair transplant, hair growth speed is high.
• By using a Choi pen, the doctor can be more precise in creating holes and angle of grafts. Due to this issue, in hair transplantation with this method, the hair has a much more natural appearance. All efforts are made in using more advanced technologies and newer methods of hair transplantation, in order to have more natural hair with greater density after transplantation.

Disadvantages of DHI hair transplant

In order for patient to make an informed decision, it is necessary to know disadvantages of a hair transplant method in addition to advantages. In this way, the patient's expectation from hair transplant will be more realistic.

Here we have listed some disadvantages of DHI hair transplant as follows:

• Higher cost: In this method, by using more precise planting tools, planting accuracy has increased and hair has a more natural appearance. Therefore, the cost of hair transplantation with this method is also higher than FUE.
• Longer hair transplant time: Due to greater accuracy of this method, it takes a little longer than SUT hair transplant.
• Allergy to anesthetics: There is a possibility of allergic reaction to anesthetics in all hair transplant methods such as DHI hair transplant.
• Complications such as bruising, swelling and numbness: some complications of hair transplantation are unavoidable and are observed in all methods; Of course, the severity of these side effects is different in different methods. Side effects such as swelling, bruising, itching and numbness are also observed in this method. Many of these side effects resolve on their own with time.

Recommendations before hair transplantation

Following recommendations before hair transplantation helps patient to get a better result from hair transplantation. Some essential care before hair transplant is listed below:

• It is necessary for patient to have a light meal before hair transplant.
• Hair should be washed with shampoo night before surgery.
• The patient must inform doctor of all medicines, medicinal supplements, herbal medicines and vitamins he is taking;
• If patient uses medicine due to other diseases such as cardiovascular diseases, diabetes, asthma or other diseases, it is necessary to take medicine according to doctor's instructions, unless doctor ordered to stop drugs or replace them with other drugs.
• If patient is allergic to antibiotics such as cephalexin, azithromycin, penicillin or any other type of medicine, it is necessary to inform doctor.
• Some patients are afraid of operating room, it is necessary for doctor to find out about this before starting surgery.
• Stop using blood thinners such as warfarin and aspirin at least 10 days before surgery. These drugs disrupt blood coagulation process and patient may have bleeding problems.

In this section, we have given some general recommendations before hair transplantation. After patient goes to hair transplant clinic and doctor performs initial examination, the doctor gives necessary recommendations to patient according to his condition. Compliance with these recommendations is necessary to maintain patient's health and will result in a better quality of final result of hair transplantation.

Tests before hair transplantation

One of the basic measures before hair transplantation is to perform tests prescribed by doctor. The doctor prescribes some tests to check patient's health. It is essential that these tests are done on time and results are presented to doctor before hair transplantation at specified time.

Conducting tests before hair transplant is done for several reasons. The most important reasons for performing tests before hair transplant are as follows:

• Investigating cause of hair loss in patients: Hair loss in people has many reasons. Genetic characteristics, poor nutrition, lack of minerals and hormonal abnormalities are some of common causes of hair loss. By conducting tests before hair transplantation, the cause of hair loss is identified and it is resolved. If cause of hair loss is not resolved, hair may fall again after implantation.
• Identifying infectious diseases such as hepatitis and AIDS is another reason for conducting tests before hair transplantation. Identifying these diseases makes it possible to prevent transmission of diseases to treatment team by performing preventive measures during surgery. In such a situation, the medical team should be more careful to avoid cutting hands with razors and surgical tools or use thicker multi-layer gloves.
• Examining patient's blood coagulation status: In a situation where patient has a blood coagulation problem, this issue may cause bleeding problems during surgery. It is necessary for surgeon to be aware of this issue before surgery.

Some of common tests before hair transplant are listed below:

• FBS
• CBC
• BUN
• Creatinine
• PT
• PT
• HIV
• HbsAg
• HbsAg
• HCV

Care after hair transplantation

Attention and care after hair transplantation has a great impact on final result. Even if one of best methods of hair transplantation such as DHI is used for hair transplantation and hair transplantation is performed by experienced doctors, it is still necessary to pay enough attention and care to doctor's recommendations regarding care after hair transplantation.

Some care after hair transplant is listed below:

• It is recommended to avoid smoking, hookah and alcoholic beverages for two months after hair transplantation. By constricting blood vessels and reducing blood flow, these substances reduce blood supply to wounds and slow down their healing process.
• Use shampoo prescribed by doctor to wash hair.
• In order to prevent infections, antibiotics should be taken at time specified by doctor.
• Considering that this hair transplant method is a minimally invasive method, from the day after surgery, the person has possibility of daily life; But he must be careful to do sports activities. Heavy sports activities are prohibited for 2-3 weeks after hair transplant. If you are a professional sportsman, it is better to consult your doctor regarding time to start your activities. Keep in mind that early start of heavy sports activities will damage newly implanted follicles.
• It is better that examination sessions after hair transplant be done on time. In these sessions, the doctor examines process of hair growth and improvement of complications after hair transplantation. Complementary treatments may be needed to create better density or doctor may use different treatment methods to improve surgical complications.
• Usually, 7 to 10 days after hair transplantation, it is possible to wash hair in usual way.
• It is necessary to keep scalp moist in first 5 days after hair transplantation. It is recommended to use a moisturizing spray to keep scalp moist.
• Avoid exposure to direct sunlight. Sunlight has harmful rays for newly implanted follicles. If a person's job and living conditions are such that he/she has to be exposed to sun, he/she must wear a hat.

DHI hair transplant cost

Various factors affect cost of hair transplant, which we will discuss here.

• Hair transplant method: Usually, the cost of hair transplant increases in newer and better-quality methods that require more precise and specialized tools. In DHI method, due to higher accuracy and faster speed of this method, the cost is slightly higher than FIT method.
• Individual characteristics: The larger planting area and more severe hair loss, the more follicles are needed to create maximum density, and the time required for planting increases. The cost of hair transplant will also be higher in such conditions.
• Considered density: Some people tend to create more density with hair transplant, which requires harvesting and planting more follicles and increases cost of hair transplant.
• Expertise and knowledge of doctor: Undoubtedly, the impact of doctor's decisions and his performance in all cosmetic surgeries, including hair transplant surgery, is very high. On the other hand, some methods are not performed by all doctors due to their complexity and newness, and require special courses. Therefore, the doctor's knowledge, skill and experience also affect final cost of hair transplant.
• Number of treatment team members: In some hair transplant methods, the number of treatment team members is more, which causes final cost of hair transplant to increase.
• Hair transplant clinic: The cost of hair transplant in different clinics is also slightly different. In clinics that are located in areas with better facilities in city or clinics that use more advanced facilities and equipment, the cost of hair transplantation will be higher; Of course, higher cost of hair transplant in a clinic does not necessarily mean providing better quality services.

How much time is required for DHI hair transplantation?

In general, due to precision of this hair transplant method, the speed of this method is lower than FUT method, and hair transplant usually requires a 10-hour session; Of course, the time required for hair transplantation does not depend only on method of hair transplantation. Rather, individual characteristics such as bald area size are among factors affecting duration of hair transplantation.

Will the hair fall out after hair transplantation in this way?

In general, hair transplant is a permanent treatment for hair loss. If follicles are harvested and planted correctly and they are not damaged during harvesting and planting stages, they will continue to grow after planting; but it should be noted that hair cycle includes four phases: Anagen (growth), Catagen (transition), Telogen (rest) and Exogen (shedding). After passing through shedding phase, the hair will grow back naturally.

How long does it take to recover from DHI hair transplant?

DHI hair transplant is a minimally invasive procedure. Usually, the patient recovers after 3 to 7 days. The final result is determined 10 to 12 months after hair transplantation.

source : whcl.ir