DHI and FUE Question

[TheGreatPretender]

So obviosuly I know that when opting for these proccedures surgeons extract the folicles either manually (DHI) or through techs (FUE depending on clinic), dissect them before placing it back on the recipient area.
Since there might be a transection between extraction and implantation is there a way that the surgeon or techs are able to identify possible transected folicles? 

If so, are they still planted back to the recipient area or do they get simply discarded? I have done some reesearch on this and there is some evidence that corroborates that even if there is some damage to the folicle there is still the prospect to grow back so logically doesnt really make sense to discard it, unless its really bad and even then.

Obviously different clinics have different guidelines howeaver I am just looking for the general consensus. 

[jackiema]

I am a little confused on your usage of DHI vs FUE. My understanding is that the extraction is no different in either technique, the difference is how they implant grafts in the recipeient site. 

With that being said, after a graft is implanted, a good clinic will have microscopes they use to assist them dissect the grafts and it is under the microscope they can see if the graft still has a good root bulb or its just a hair shaft in their. Bad clinics can't tell the different and they just insert their rootless hairs in the recipient area that obviously don't grow. I know that sometimes there might be damage to the root and I would imagine they would at least just put it in on a less critical area (like the crown) to at least have a chance to grow. But that's just me guessing. 

Edited February 14, 2022 by jackiema
grammer

[TheGreatPretender]

5 minutes ago, jackiema said:

I am a little confused on your usage of DHI vs FUE. My understanding is that the extraction is no different in either technique, the difference is how they implant grafts in the recipeient site. 

With that being said, after a graft is implanted, a good clinic will have microscopes they use to assist them transect the grafts and it is under the microscope they can see if the graft still has a good root bulb or its just a hair shaft in their. Bad clinics can't tell the different and they just insert their rootless hairs in the recipient area that obviously don't grow. I know that sometimes there might be damage to the root and I would imagine they would at least just put it in on a less critical area (like the crown) to at least have a chance to grow. But that's just me guessing. 

I believe DHI is when the surgeon makes the extraction and the implantation, in FUE techs may get involved with at least one out of the two. Please correct me if I am wrong but this is my understanding. 

But yeah, I would guess that it would still be a waste to just dump the transected folicle instead of trying to put somewhere were they might see use for it. I mean, good clinics are supposed to try and maximize the results of a transplant so placing a few folicles in places where it might fit would only make sense. 

[jackiema]

4 minutes ago, TheGreatPretender said:

I believe DHI is when the surgeon makes the extraction and the implantation, in FUE techs may get involved with at least one out of the two. Please correct me if I am wrong but this is my understanding. 

But yeah, I would guess that it would still be a waste to just dump the transected folicle instead of trying to put somewhere were they might see use for it. I mean, good clinics are supposed to try and maximize the results of a transplant so placing a few folicles in places where it might fit would only make sense. 

So in regards to DHI vs FUE, whether the surgeon or tech extracts has nothing to do with it. Here's a video explaining the difference. 

Also, I don't want you to misunderstand. If a follicle is not good, like it was completely transected (which means that the hair bulb was completely cut during extraction), then they should NOT be putting that in and should be discarding it. I think you may have a misunderstanding of some of the terminology. Transection is NOT a good thing, and there is a spectrum on how bad the transection is. A good clinic can make a judgement whether the hair is a good graft to put in or not a good graft and should be discarded. A bad clinic will put all the grafts in, regardless of whether they are good are not. Keep doing research and through the forums as I am sure most of your questions have been answered in one way or another. 

[TheGreatPretender]

4 minutes ago, jackiema said:

So in regards to DHI vs FUE, whether the surgeon or tech extracts has nothing to do with it. Here's a video explaining the difference. 

Also, I don't want you to misunderstand. If a follicle is not good, like it was completely transected (which means that the hair bulb was completely cut during extraction), then they should NOT be putting that in and should be discarding it. I think you may have a misunderstanding of some of the terminology. Transection is NOT a good thing, and there is a spectrum on how bad the transection is. A good clinic can make a judgement whether the hair is a good graft to put in or not a good graft and should be discarded. A bad clinic will put all the grafts in, regardless of whether they are good are not. Keep doing research and through the forums as I am sure most of your questions have been answered in one way or another. 

Thanks for answering this. And yes I do agree that transection is bad, howeaver if there is a slight chance for the folicle to grow then it should be placed back, unless its completly damaged beyond growth then I guess discarding its the only choice. 

Edited February 14, 2022 by TheGreatPretender

[NARMAK]

There's really two main methods. FUT which is a strip based procedure or FUE which is the single follicular unit extraction method. 

The DHI etc. is moreso a modified technique of carrying out FUE. It is designed to try maximise survival rates by reducing out of body time for grafts and making it so that generally the roots are traumatised as little as possible to also achieve that survival rate. 

That thread linked above is also a great in depth answer but honestly, you need a combination of doctors and technicians that have a wealth of experience in their roles. Doctors who know how to identify key follicles for hairline and temple placements, designing the hairline with correct angles, depth and density in the areas. Technicians adept at extraction and implementation. 

If any of these form a weak point, the technique used will fall down when it comes to results. 

[Rahal Hair Transplant]

@TheGreatPretender,

The only way to identify whether or not the follicular unit has been transected or damaged after FUE extraction is to evaluate and analyze the grafts under microscopes prior to implantation.  Dr. Rahal is one of the only surgeons that I’m aware of that actually does this for each procedure (FUE).  Thus, at our clinic, transection is measured during each procedure and damage practically nonexistent.

Dr Rahal and his staff uses a “no touch” technique when placing grafts to substantially minimize any potential damage or transection of the follicles. And while there are other physicians and clinics that use a new touch technique as well, I’m not aware of any other surgeons or clinics that actually evaluate and inspect for transection.    

While transaction and damage to the grafts is typically minimal in the hands of an elite surgeon, in my opinion, I believe that every clinic should  further inspect each graft after extraction.  Because ultimately, regardless of how much elite surgeons have improved the technique over time, FUE is still a procedure that involves “blind dissection” and the only way to know for sure whether or not a follicular unit is damaged is to inspect it under magnification.

Note that the above applies for me to FUE because during FUT draft are further treatment under microscopes by default   Most clinics that do FUT will also check for transection and do what they can to minimize any damage while further trimming them   

I hope this helps.

Rahal Hair Transplant 

Edited February 16, 2022 by Rahal Hair Transplant

[Rahal Hair Transplant]

FYI, DHi stand for direct hair implantation.  There is a large hair clinic/chain also named that but essentially, the DHI technique is the same as FUE which refers to a donor harvesting technique.

What happens after harvesting the donor can vary from the clinic to clinic.  DHI actually refers to the implantation part of the procedure.  Typically, an implanter (there are various types by the way) is used so that the technician doesn’t have to use forceps to essentially grab the graft.

If the implanter is used correctly it can reduce the risk of placing too much pressure on the graft and eliminate the risk of crushing it.   Since the surgeon and/or technician use the implanter and don’t have to use forceps or another tool to take and place the graft, it is typically referred to as a “no touch” technique.

I wanted to clarify this because need to understand is that if you FUT/strip and FUE Ashley refers to how the donor hair is harvested and not how the grafts are handled afterwards.  DHI is FUE with a “no touch” graft implantation process.

I hope this helps.

Rahal Hair Transplant

Edited February 16, 2022 by Rahal Hair Transplant

[TheGreatPretender]

48 minutes ago, Rahal Hair Transplant said:

FYI, DHi stand for direct hair implantation.  There is a large hair clinic/chain also named that but essentially, the DHI technique is the same as FUE which refers to a donor harvesting technique.

What happens after harvesting the donor can vary from the clinic to clinic.  DHI actually refers to the implantation part of the procedure.  Typically, an implanter (there are various types by the way) is used so that the technician doesn’t have to use forceps to essentially grab the graft.

If the implanter is used correctly it can reduce the risk of placing too much pressure on the graft and eliminate the risk of crushing it.   Since the surgeon and/or technician use the implanter and don’t have to use forceps or another tool to take and place the graft, it is typically referred to as a “no touch” technique.

I wanted to clarify this because need to understand is that if you FUT/strip and FUE Ashley refers to how the donor hair is harvested and not how the grafts are handled afterwards.  DHI is FUE with a “no touch” graft implantation process.

I hope this helps.

Rahal Hair Transplant

Thanks Rahal, that was very informative. I will add this to my notes as it is important to start understanding each proccedure for what it is instead of having misconceptions before booking a surgery.