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Difference Between DHI and FUE Hair Transplantation Techniques

Let us first briefly discuss the history of hair transplantations. The first known hair transplant attempt was carried out in Germany in 1822. An attempt was made to transplant hair follicles obtained from a piece of tissue to the desired area. By the year 1939, Japanese dermatologist Okuda had started carrying out transplant procedures for local areas with wounds and burn scars. In 1952, Dr. Norman Orentreich and his team performed the first hair transplantation on an individual who was experiencing male pattern hair loss in the United States.

The tissue obtained from the donor area (the nape area between the two ears) was large in size in all FUT (Follicular Unit Transplantation) transplant procedures performed until 2001. Moreover, not all of the hair follicles obtained from this area were used. For this reason, this procedure led to excessive tissue loss, significant post-operation wounds and stitches scars, and numbness in the area the tissue was extracted from. What's more, since the desired number of hair follicles was not transplanted, the bald area was not entirely covered. On top of all this, the hair that was transplanted did not look natural. Naturally, individuals still wanted to get hair transplants using this method since there was no better method at the time. This is because there were a handful of people whose appearance changed and who managed to get strong hair that did not fall out.

In 2001, the advent of the pen implant technique marked a new era in hair transplant procedures. This implant method is commonly known as the DHI (Direct Hair Implantation) or CHOI method. This method involved removing individual hair follicles and a small piece of tissue from the donor area using special tips with a diameter of 1.0 mm, 1.1 mm, 1.2 mm, and 1.3 mm by hand or with a motor. Because they were individually extracted and because millimetric tips were used, this procedure sometimes took very long depending on the number of grafts to be implanted. For this reason, the implant procedure was divided into 2 or 3 sessions according to the size of the implant area, the sufficiency of the donor area, and the quality of the tissue. As the implant area was made smaller through the division of the procedure into multiple sessions, procedures in which the hair was cut locally or narrow strips of hair were cut (without requiring a full hair cut) were adopted. Since individuals did not want others to know they had gotten a hair implant and since they wanted to avoid a particular appearance, they started to opt for this method. This method resulted in fuller looking hair compared to the FUT method since more hair follicles were implanted. The disadvantage of this method in those years was that it took a long time to achieve the desired result. The reason for this was the fact that it generally took more than one session to achieve results. This was because only a certain number of hair follicles could be implanted in a single session. When a large number of hair follicles was attempted to be transplanted in a single operation, the hair follicles that were extracted would become deformed and die since the operation would take very long. Because of this, the hair follicles extracted from the donor area would go to waste and result in a reduction of the hair follicles that would be needed later.

Since 2006, in parallel with the development of micro motor technology, the FUE (Follicular Unit Extraction) method has become more actively used. Initially, the size of the micro tips used in the extraction of hair follicles from the donor area in this method varied between 0.9 mm and 1.0 mm. However, in the following years, the size of the tips decreased and hair follicles began to be extracted with tips that had diameters of 0.6 mm, 0.7 mm, and 0.8 mm depending on the thickness of the hair. Thus, hair follicles could be extracted from the donor area without causing scarring. Thinner tips are used in the FUE method than in the DHI method. Because thicker tips are used in the DHI method, scars similar to small dents form near the roots of the hair that is implanted. On the other hand, the FUE method which is carried out with the micro motor technique does not cause such scars and results in a natural appearance. Another advantage of the FUE procedure performed with the micro motor technique is the fact that it has a short operation duration. Thanks to this, even though the number of hair follicles that is extracted is high, they can be transferred to the desired area without being deformed since the operation duration is short. Thus, an area that would normally require more than one session to be covered with the DHI method can be covered in a single session.

It is important to note that even though hair transplantation is a small procedure, it is still a surgical operation. This procedure must be performed by experts in hospitals under certain conditions. If it is not performed properly, the patient may carry a risk of infection and the implanted hair may not grow out. Moreover, if the hair follicles in the donor area are not properly extracted, then sporadic bald spots may occur, resulting in an unfavorable appearance. This is because, regardless of the method that is used, the hair that is extracted from the donor area is removed together with its follicle and hair will no longer grow in that area. For this reason, irrespective of the method that is opted for, what bears significance is whether the individual performing the procedure is a professional. Our institution, together with its expert team that has years of experience, guarantees that the highest possible amount of hair will be implanted in a single session and that the hair which is implanted will grow out, will not fall out, and will look natural.

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