Techniques & Procedures

4/25/20253 min read

When choosing a hair transplant method, it’s important to remember that it's not just about the technique—it’s about the care, precision, and individual approach tailored to your unique needs. Different techniques like FUE, DHI, and Sapphire FUE offer varying benefits depending on the patient’s hair type, donor area, and personal goals. But understanding which method is best for you can make all the difference.

🔸 “Is DHI always better?”
Not necessarily. While DHI can be a great option for certain patients—especially those who need precise control over hair direction and angle—it’s not always the best fit. The right technique depends on your donor area, hair characteristics, and desired results. A well-executed FUE might be more suitable in some cases, especially when the goal is to achieve a natural density and hairline.

🔸“Do I get better results if the graft count is higher?”
More grafts don’t always mean better results. The quality of the hairline and density is far more important than the sheer number of grafts. Sometimes, 5000 grafts might not create the natural look that 3000 grafts can, depending on how they are strategically placed. It’s not about quantity—it’s about precision and proper planning. The real skill lies in how and where those grafts are placed, not just how many.

🔸FUE (Follicular Unit Extraction)

What it is:
A method of harvesting follicular units one by one using a punch tool, typically 0.7mm to 1.0mm in diameter. These grafts are then implanted manually or using implantation tools.

What matters most:

  • The depth and angle of the punch must align with natural follicle growth to avoid transection (cutting the graft).

  • Overharvesting from the donor area can cause permanent thinning and visible patches.

  • The experience of the technician or surgeon operating the punch tool is critical—this isn’t a job for someone newly trained.

Common misconception:
Many think FUE is a complete procedure. In fact, it only describes how grafts are extracted, not how they’re implanted.

🔸DHI (Direct Hair Implantation)

What it is:
An implantation technique where follicles are inserted directly into the scalp using an implanter pen (like the Choi Pen), allowing for single-step placement without pre-made incisions.

Clinical advantages:

  • Better control of angle, direction, and depth, especially in hairline and temple areas.

  • Reduces graft exposure time, which may enhance survival rates when performed efficiently.

  • Can result in a more natural density and flow when done by a skilled team.

Limitations:

  • Not ideal for very large sessions (e.g., 4000+ grafts) as it’s time-intensive.

  • Requires a well-coordinated, highly trained team; otherwise, graft trauma is more likely.

  • Not inherently “superior” to FUE—it’s more of a tool than a separate technique.

    Sapphire FUE

What it is:
A variant of FUE where incisions for implantation are made using sapphire blades instead of steel.

Clinical perspective:

  • Sapphire blades are finer and allow for smaller, more precise incisions, which may contribute to denser packing and slightly faster healing.

  • However, the blade alone does not ensure a better result. Technique and planning matter far more.

Manual vs. Motorized Punches

Manual: Offers greater tactile feedback and is gentler on tissue—but requires more time and experience.
Motorized: Faster and consistent, ideal for high-volume cases—but increases the risk of graft transection if mishandled.

🔸What Actually Influences a Great Result?

Technique is important, but here’s what often matters even more:

  • Donor Management: Harvesting should be evenly distributed. Poor donor planning is irreversible.

  • Implantation Design: Especially in the frontal zone, the shape, spacing, and angle of each follicle affect whether the result looks natural—or artificial.

  • Graft Survival: Time outside the body, storage solution (e.g., HypoThermosol vs. saline), and handling technique determine how many grafts actually grow back.

  • Anesthesia Technique: Local anesthesia should be minimal but effective, without causing unnecessary swelling or tissue trauma.

  • Bleeding Control: Excess bleeding reduces visibility and increases risk of misplacement or improper depth.

🔸Common Pitfalls

  • "The more grafts, the better": Not always. Overloading the recipient area can lead to poor blood supply, necrosis, or poor survival rates.

  • "DHI always gives better results": Not true. Without technique, DHI can be just as problematic as any other method.

  • "Robot-assisted systems are safer": Robotics can extract with precision, but lack the ability to assess individual follicle quality or adjust to scalp variation mid-procedure.

  • "Results are only about technique": No. They’re about how technique is applied, by whom, and under what conditions.

🔸Final Word from the Field

At the end of the day, the best outcomes don’t come from choosing the fanciest-sounding method—they come from deep technical expertise, meticulous planning, and a commitment to aesthetics that goes beyond graft counts.

As professionals, we don’t just look at how a procedure is done—we evaluate why it’s done a certain way, for whom, and how it fits into the broader picture of scalp health, facial symmetry, and long-term goals.

The best results aren’t produced in flashy showrooms or in one-size-fits-all clinics. They’re created by teams who treat hair transplantation like the nuanced, high-precision discipline it is.

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