Direct Hair Implantation (DHI) vs. SEP – Is There a Difference?

There has been a good amount of discussion regarding the use of the FUE hair transplant method known as direct hair implantation (DHI). Let’s take a look at DHI and how it compares to the method of Simultaneous Extraction and Placement (SEP) that we perform exclusively in the offices of Parsa Mohebi Hair Restoration. Our examination of the two techniques begins with a look at how each method is performed.

Direct Hair Implantation Examined

The first thing to know about Direct Hair Implantation is that the name is another way of saying it is a Follicular Unit Extraction (FUE) procedure. DHI is marketed as a modification of FUE by some companies.

During Follicular Unit Extraction surgery, the hair transplant surgeon removes hair follicles on an individual basis from the donor area on the scalp (which is usually the back and sides of the scalp). The hair follicles are stored out of body before they can be placed into incisions made in the scalp.

The marketing materials for DHI promote the fact that they use a special pen-shaped tool that can do both steps at the same time. The surgeon extracts the hair follicles using a tool that contains a punch. The hair follicles that were removed by the surgeon are stored out of body before they are loaded into a sharp implanter so they can be implanted into the balding areas on the scalp.

Simultaneous Extraction and Placement Explained

What is the Simultaneous Extraction and PlacementSimultaneous Extraction and Placement (SEP) is a novel FUE hair restoration technique performed at Parsa Mohebi Hair Restoration. The technique is designed to improve the efficiency and growth of hair that has been transplanted by the surgeon. SEP uses advanced extraction and placement equipment to remove and implant the hair grafts into the scalp of a patient immediately after they are extracted. The ability to perform these tasks simultaneously will limit the time the grafts have to stay out of body and also improve the survival of the hair grafts.

There are a number of steps involved in performing SEP such as:

  • The creation of premade sites in the scalp before the extraction begins
  • A chasing method that is used to harvest the hair grafts
  • The placement of the hair grafts in the scalp using Mohebi Implanter

The surgical team uses magnifying loupes (with a longer focal distance), so the technician does not have to be too close to the head of the patient. The grafts can be extracted and placed by three or four operators at the same time. This novel technique means the hair grafts are able to be implanted soon after they are extracted from the donor area on the scalp. SEP minimizes the time each graft stays out of the body which gives a higher viability rate to the grafts. In addition, SEP has also been shown to lower the overall length of a hair transplant procedure.

DHI vs. SEP – An In-Depth Look

Direct Hair Implantation has been created to be a marketing tool as much it is a hair transplant technique. While doctors that offer DHI claim it is one of the most effective and advanced hair transplant options currently available, they have not offered any studies that have compared the results provided by other FUE procedures.

If the two techniques sound familiar, there is a good reason since both techniques follow many of the same steps, but DHI lacks the extensive training that is a required part of performing the SEP method. At Parsa Mohebi Hair Restoration, we exclusively perform Simultaneous Extraction and Placement methods.

When performing the SEP method, the design of the sites is made by the surgeon at the beginning of the procedure. These small incisions are made after the surgeon has designed the hairline and determined where the hair grafts will be inserted into the scalp. In general, our surgeons create the sites at the beginning (premade sites) of SEP because of three distinct advantages:

  1. The grafts will be implanted shortly after they are extracted from the donor area. This means the live tissue does not need to stay out of the body for a long time like other hair transplant methods. Less out of body time increases the survival rate of the grafts.
  2. Since the sites are made prior to the placement of the hair grafts, the healing process of the recipient area has already begun. The expedited healing could facilitate the growth of new hairs.
  3. The placement of the hair grafts can be performed using blunt Mohebi Implanters since Mohebi Implanter minimizes trauma to the hair grafts.

In general, the other methods used to perform Follicular Unit Extraction normally involve the extraction of all of the grafts before placing them in the scalp. These FUE methods can be performed through the use of sharp implanters or forceps.

It should be noted that the use of forceps for the placement of the hair transplant grafts might damage the grafts obtained using Follicular Unit Extraction as they might put too much pressure on the bulb of the follicles.

Here is what patients should know about the use of implanters to place the hair grafts:

  • Blunt implanters are often used when the incisions in the scalp are made ahead of time by the surgeon.
  • When a sharp implanter is used by the medical team, the operator does not need to have premade sites created by the surgeon because the sites are made with the same implanter that is used to place the grafts.

Anyone who is interested in learning more about Simultaneous Extraction and Placement is invited to contact our office for more information or to schedule a consultation appointment.