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Everything You Need To Know About Direct Hair Implantation (DHI) Hair Transplant Surgery

    If you are looking for a DHI hair transplant- this blog will give you everything you need to know about them. It is important you know the difference between implanter pens and recipient site creation when it comes to FUE hair transplant surgery. We will cover the following points:

    1. What are implanter pens?
    2. How do implanter pens work?
    3. Are implanter pen hair transplants better?
    4. Should you choose to have a hair transplant with implanter pens?

    What is a DHI Hair Transplant?

    A DHI Hair Transplant utilises a specialised implanter pen to re-implant hair into the scalp. The Treatment Rooms London has always specialised in DHI Hair Transplant Surgery. All patients are operated on by our Surgeons using this technique to help attain high quality results that match natural hair direction, angulation and flow. This means results in the end result blends nicely with existing hair.

    If you wanted to find out more and view our results then please navigate the following links:

    1. FUE Hair Transplants
    2. Are You A Candidate For Hair Transplant Surgery?
    3. Who We’ve Helped
    4. Before & After Hair Transplantation
    This patient underwent a DHI hair transplant to repair his frontal hairline. He had surgery previously in another hair transplant clinic with poor results. His result shown here is 1 year post his repair surgery in our clinic

    DHI Hair Transplant Surgery and Implanter Pens

    In a hair transplant, grafts are extracted by Follicular Unit Excision (FUE) or Follicular Unit Transplantation (FUT). The grafts will then need to be re-implanted into recipient sites (holes where hair grafts are put into) and this can be done by 2 main methods.

    DHI Hair Transplant Surgery Using Implanter Pens

    Implanter pens re-insert grafts into the scalp at the same time a recipient site is created or into a pre-made incision. This is also called Direct Hair Implantation (DHI) as hairs are “directly implanted” with a needle/ implanter pen (1). There are two types- Choi Implanter Pens and Lion Implanter Pens- both are very similar and don’t appear to make a difference to the outcome of a hair transplant (2).

    Pre-Made Recipient Sites & Placing of Grafts

    Grafts can be reinserted into the scalp with “pre-made” holes or recipient sites created by a needle. This technique generally occurs 2 stages. The first stage requires the surgeon to create holes or “recipient sites” using a needle. A Surgeon, nurse or a hair technician then comes and places the extracted grafts into each of these sites in the second stage (3).

    How Do Implanter Pens Work?

    Implanter Pen DHI hair transplant
    Lion Implanter- By Hans Biomed

    The image above shows what a Lion implanter pen looks like. They come in different sizes depending on the size of the hair being implanted. Your hair transplant surgeon will decide which size is best for you on your surgery day.

    Implanter pens have a needle with a hollow tip. The graft can be placed into this hollow tip, and when the needle is inserted into the scalp to create a hole, the pen (at the same time) places the graft into the hole. This means the hole is created and the graft placed into it simultaneously- this is demonstrated in the infographic below.

    DHI implanter pen hair transplant information graphic
    Implanter pen hair transplantation infographic

    Are Implanter Pen Hair Transplants Better?

    Surgeon-Led Care

    In order for your hair transplant to be carried out using implanter pens, you will require both a nurse/technician and a hair transplant surgeon to operate on your scalp throughout your operation. Using implanter pens requires a high degree of skill and experience and our Surgeons will only provide this technique. This means you can be assured that you have someone who is a qualified Surgeon performing your hair transplant at all times- giving you the best possible chance of a result you are happy with.

    We have historically always used implanter pens when carrying out hair transplant surgery in our clinic. We find patients recover faster and have better quality results with the technique. Whilst the technique is more laborious, we don’t mind and are happy to go the extra mile for our patients

    Dr Vara, Hair Transplant Surgeon and Director at The Treatment Rooms London

    Depth, Angulation and Density of Hair Transplantation

    A Surgeon will be able to control the depth, angulation and density of the implantation meticulously using an implanter pen. This also leads to natural results blending new transplanted grafts into existing hair.

    Increased Survival Rate of the Graft during Hair Transplantation

    As the graft spends less time outside the body and are handled less there is an increase rate of its survival (4). This means the transplanted follicle is given every chance to survive the operation.

    Better Healing Times after Hair Transplantation

    With less trauma to the transplanted grafts there is less incidence of shock loss and shedding of transplanted hair compared to grafts re-implanted using forceps.

    Implantation Between Hairs

    As the implanter pen allows a surgeon to be more precise in his placement of the graft, if you wanted transplantation into a zone of thinning hair this can be achieved. This allows for even better coverage and precision when it comes to hair transplantation.

    However, there are some considerations with regards to DHI hair transplant surgery:

    • Higher price for the patient
    • Longer surgery time

    DHI hair transplant surgery tends to be more expensive. This is because the surgery requires the presence of 1 or 2 surgeons and the surgical process can be more time- consuming. Whilst you have extra assurance that your transplant is being given every chance to be natural and successful, these two factors mean the surgery comes at an increased price and can take longer to complete.

    Should you choose to have a DHI hair transplant with The Treatment Rooms London?

    At The Treatment Rooms London we have historically always used implanter pens for our transplants. This has resulted in dense, natural results for our patients with better recovery times. We have an open conversation with each of our patients around the different techniques of hair transplant surgery. Below you will see an example of a hair transplant result by using implanter pens.

    DHI implanter pen hair transplant result
    10 months post DHI, implanter pen, hair transplant

    As a guide for patients looking to choose between the two techniques, one of the main considerations is the size of transplantation. As implanter pens transfer each graft individually into the recipient site the surgery takes longer. As a result, if you require a large area to be transplanted you may be required to have your transplant over 2 sessions.

    Choosing to undergo a hair transplant should be based on a number of considerations. You can find out more by reading our page on whether you are a candidate for an FUE hair transplant or, for more information about costs, take a look at our hair transplant cost page.

    If you wanted to book a consultation with our hair transplant surgeon, please feel free to contact us today.


    1. Sethi and Bansal, 2013, Direct Hair Transplantation: A Modified Follicular Unit Extraction Technique, J Cutan Aesthet Surg, 6(2):100-105
    2. Marwah and Mysore, 2018. Recipient Area, J Cutan Aesthet Surg 11 (4): 202-210
    3. Zito and Raggio 2021, Hair Transplantation
    4. Lee et all, 2001, Evaluation of survival rate after follicular unit transplantation, Dermatol Surg Aug 27 (8): 716-20

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