DHI vs. FUE: A Marketing Scam?
The first step of a hair transplant is hair extraction. Currently, there are two techniques for this: the first is FUT, or the traditional method, and the second is FUE, or the punch method. This is established by the International Society of Hair Restoration Surgery (ISHRS). The first method involves removing a strip of skin that is then dissected to produce follicular units, which are natural groups of hair. With FUE, these groups are obtained directly with a punch tool, meaning individually, through thousands of tiny incisions.
Worldwide, FUE is the most commonly used method, as it offers the advantage of not leaving a linear scar on the back of the head but rather small dots that, being widely spaced, are not noticeable to the naked eye.
So, where does DHI come into all of this? The term “DHI hair transplant” was not introduced by the ISHRS; in fact, DHI stands for “Direct Hair Implantation,” a method that, like FUE, extracts follicular units one by one. However, in the graft placement step, an implanter pen is used instead of tweezers. In reality, DHI is classified as a form of FUE but with a more eye-catching name. In the past, this method was called CHOI, which had very low graft survival rates and a bad reputation among leading hair restoration clinics, hence the need to “rebrand” it. Nowadays, graft survival rates have improved; however, in 3 out of 10 patients, the method is not suitable due to the “popping” effect. This situation means that grafts can be expelled from the recipient area during the procedure, forcing the team to reduce the density of the hair transplant. If you’ve ever seen a very sparse hair transplant result, this is probably the reason.
Is DHI a scam? When presented as a variant of extraction methods, it is because, as we’ve seen, there are only two methods today. However, if it’s specified that DHI only affects the grafting phase and in no way changes how the hair is extracted, then it is not. In most clinics that “sell” this method, this distinction is not clarified, turning DHI into a marketing tool; an attempt to stand out in a world of clinics that perform hair transplants in bulk, using the same design and approach for all patients.
