What is The Difference Between DHI, Stick and Place, Pre-made Slits?

[Melvin- Admin]

I saw a thread a few weeks ago asking about the preferred method, but I thought it would be great to have a thread that explains the differences between each technique. 

Hopefully this thread will be helpful for those researching. 

DHI: Direct hair implantation creates the recipient site and implants the graft simultaneously using an implanter pen. This method has been promoted and marketed by tons of low-cost clinics claiming the technique guarantees growth. Needless to say, this isn't true. 

Pre-made slits: Surgeons create the sites where the grafts are supposed to placed. The sites are done before the grafts are harvested. The grafts are then placed into the sites with forceps. This method has been the gold standard for decades. 

Stick and Place: In this technique, the surgeon creates the slits using blades. The grafts are placed instantly as soon as the grafts are harvested. The grafts can be placed using forceps or implanter pens. 

What's The Difference Between DHI, Pre-Made Slits, Stick and Place for Hair Transplant Surgery

[DrTBarghouthi]

Very nicely said @Melvin- Moderator

I think it answers many of the uncertainties out there. I think that whatever method the doctor and the team is proficient in is what matters most. 

[Briguy]

For my surgery the extractions harvesting was done first rather than the slits.

Next, all slits were made by the doctor.

Lastly, the grafts were implanted by forceps.

My thinking is then the technician who is performing the extractions doesn't have to worry about any oozing of blood from the slits and keeping it clean.

Edited November 30, 2021 by Briguy

[DrTBarghouthi]

I personally tend to do all extractions first (in most standard cases) as this allows me to leave a gap of time between anesthesia for the donor and recipient areas and allows for the body to metabolize some of the anesthesia before giving more for the recipient sites. Moreover, it gives us more time to sort the grafts and trim any that we need for the hairline as the technicians can start working away on the extracted grafts early on. Finally, if for any reason, the donor doesn’t seem favorable for surgery and the procedure is aborted, at least the patient won’t have thousands of pre-made sites done already. 

[Berba11]

2 minutes ago, DrTBarghouthi said:

I personally tend to do all extractions first (in most standard cases) as this allows me to leave a gap of time between anesthesia for the donor and recipient areas and allows for the body to metabolize some of the anesthesia before giving more for the recipient sites. Moreover, it gives us more time to sort the grafts and trim any that we need for the hairline as the technicians can start working away on the extracted grafts early on. Finally, if for any reason, the donor doesn’t seem favorable for surgery and the procedure is aborted, at least the patient won’t have thousands of pre-made sites done already. 

Great piece of insight Dr behind your preferred method! Thanks

[Melvin- Admin]

7 minutes ago, DrTBarghouthi said:

I personally tend to do all extractions first (in most standard cases) as this allows me to leave a gap of time between anesthesia for the donor and recipient areas and allows for the body to metabolize some of the anesthesia before giving more for the recipient sites. Moreover, it gives us more time to sort the grafts and trim any that we need for the hairline as the technicians can start working away on the extracted grafts early on. Finally, if for any reason, the donor doesn’t seem favorable for surgery and the procedure is aborted, at least the patient won’t have thousands of pre-made sites done already. 

That makes a lot of sense as well.

[deeznuts]

I think Dr. Mwamba talked about why he favors premade slits in his IG live. I can't remember his exact reasons but I think it had something to deal with blood and things getting messy.

The Spanish doctors I think use the Lion implanter pen which would put them in the DHI category. Dr. De Freitas has an article on his site about it which I thought was interesting though how much of it is marketing idk. The article lists the main advantages as being able to implant the graft immediately after extraction and the reduction of scabs due to what I assume might be a small incision (i.e. circular instead of slits)

I also read that the implanter pens seem to work better for thick straight hair (i.e. Asian hair as the implanter pen was invented in Korea) but no clue how true that is anymore. 

I agree though that skill matters the most. That's why you have untrained techs in a hair mill in Turkey doing DHI and botching every other surgery while you've also arguably some of the best results in the world coming out of Spain also done with DHI

Edited November 30, 2021 by deeznuts