Common techniques in hair transplantation

Hair transplantation was first performed using crude techniques that produced glaringly visible unnatural results but since then, a lot has changed. The grafts (transplanted hair follicles) have shrunk, the procedures have gotten simpler, and the techniques have become more precise overall. The scars from the surgery can be very subtly visible thanks to modern technology, and the result will look natural. However, what does contemporary technology mean? What precisely are the various techniques for hair transplantation? In this article, we would be looking at some of the common techniques in hair transplantation

Follicular Unit Transplantation (FUT)

The FUT procedure, often referred to as the Strip Method because a hairy strip of skin is removed from the donor location, which is typically at the back of the head, was created at the turn of the 20th century by a Japanese physician named Tamura. The skin strip is then divided into individual follicular units and prepared for insertion into recipient holes in the balding area. In the entire world, this technique is used in about 30% of hair transplant procedures.

The length and width of the extended skin strip can range from 1 cm to 20 cm, depending on the requirements. Typically, the occipitoparietal region is where the skin strip is removed (between the auricles). Following that, the wound is stapled or sutured. The skin strip is cut into thin strips known as donor strips, which are then further separated into distinct follicular units under a microscope. The follicular units are stored in a Petri dish filled with a chilled sterile solution until they are implanted.

Advantages of the FUT

  • Bigger graft volume

A larger graft volume can be achieved quickly using this technique. Due to this, the procedure is especially suitable for patients who have experienced significant hair loss, particularly in the tonsure area.

  • No shaving is necessary

The patient’s head does not need to be shaved completely bald, unlike the FUE procedure.

  • Faster rate of growth

In comparison to the FUE method, the growth rate of the transplanted hair follicles is typically higher.

Disadvantages of FUT

  • Scarring at the site of donation

Visibility of the scar is dependent on the wound margins, wound closure, and width of the skin strip. Therefore, the affected physician must labour diligently and conscientiously. In the majority of cases, however, surrounding hair will hide the scar

Follicular Unit Extraction (FUE)


The FUE (Follicular Unit Extraction) technique is currently the gold standard in hair transplantation, and it is performed with local anaesthetic. It lays the groundwork for future hair transplant methods. All hair transplant techniques share the same fundamental steps. Collecting hair follicles, opening canals, and inserting the follicles into the new openings are all part of the process. The most crucial component in growing hair that seems natural is to cut it at a little different angle in different parts of the head. In the final step, the harvested follicles are delicately inserted into the canals.

Advantages of FUE

  • Tissue-friendly

Since the removal of the natural hair groups is more tissue-friendly than the FUT procedure, the chance of shock loss is significantly reduced

  • No obvious scars

The removal area’s micro-wounds heal without leaving any scars.

  • Accurate graft collection

The FUE method, as opposed to the FUT approach, enables the precise amount of grafts to be harvested

Disadvantages of FUE

  • Extended removal period

The FUE method’s removal phase lasts longer than the FUT method’s because the hair groups are removed one at a time. By utilising a hair transplant robot, the FUE method can speed up the removal process. The FUE procedure is especially effective in restoring the hairline.

  • Slower rate of growth

When compared to the FUT method, the growth rate with the FUE method is frequently lower.

  • Shaving is necessary

For the hair removal, the donor location, which is often the back of the head, must be completely hairless.


In contrast to the fully manual FUE procedure, the NeoGraft transplantation approach uses a semi-automated version of the procedure. It is promoted as an improvement over traditional FUE since it is meant to lessen the scope for human mistake. It does this by utilising a “wand” of sorts to selectively remove the hair grafts with suction rather than a surgeon manually removing them. The hair follicles will be subjected to less stress thanks to this approach, which should increase their chance of survival. Furthermore, the NeoGraft approach minimises the removal time for the transplantation, which also boosts the survival rate as the grafts are withdrawn from the blood supply for a shorter time.

ARTAS Robot – Robotic hair transplantation

Robotic hair transplantation utilising the ARTAS robot has gained popularity in recent years, as has machine hair transplantation. The removal phase is mechanically supported in this evolution of the FUE procedure. Unfortunately, shaving the donor area is necessary even when employing the ARTAS robot to allow for highly precise hair follicle removal. The quantity and calibre of the transplanted hair will determine the size of the donor area.

A tension grid is made for the patient, denoting a square removal region, before the ARTAS robot begins the removal process. After completing this first stage, the robot punches out a few hair follicles. Typically, a square centimetre of hair will only have 15–25% of its volume removed. The hair transplantation resumes as usual once the follicles have been extracted by the ARTAS robot. The hair channels in the bald areas are opened, the hair roots are preserved separately in a concentrated nutrient solution, and the grafts are placed in the direction of normal growth.

Advantages of Robot

  • Saving time

Contrary to hand graft removal, the ARTAS robot can remove hair more quickly while keeping the same level of quality.

  • No observable scars

The subsequent microscopic incisions in the donor area heal without leaving scars.

  • Precise transplant

Taking into account the quality of the hair, only the precise amount of grafts required are taken.

Disadvantages of Robot

  • Higher prices

It is not unusual for ARTAS-assisted robotic hair transplantation to cost more than entirely manual hair transplantation.

  • Slower rate of growth

The FUE approach with the ARTAS robot still has a slower growth rate than the FUT method.

  • Shaving is necessary

For the excision of the hair groups, the donor site, which is often the back of the head, must be shaved.

Direct Hair Implantation (DHI)

Direct Hair Implantation, or DHI (also known as CHOI), is the most recent development of the FUE technique. As was previously noted, a hair transplant procedure consists of three interconnected phases: graft harvesting, graft storage, and graft placement. Hair follicles are extracted using a medical pen called choi, and then implanted into the skin without first making an incision or opening canals. Essentially, the pen simultaneously dilates hair follicle channels and transplants them to other locations. Further, the follicles have a better probability of survival because they are outside the body for a shorter period of time when harvested this way.

Advantages of DHI

  • Possibility of partial shaving

This form of hair transplantation allows for partial or no shaving with the DHI technique.

  • No apparent scars

In the donor location, the resulting microwounds heal without scarring.

  • Increased hair thickness

The DHI method permits a higher hair density due to the ability to transplant, on average, more hair per square centimetre.

Disadvantages of DHI

  • Costlier prices

Typically, DHI hair transplantation costs a little bit more than FUE or FUT.

  • Limited accessibility

The DHI approach is still a recent development. Because of this, not many suppliers employ this strategy. The majority of them are overseas.

  • Reduced graft count

The DHI approach requires a lot of time. Consequently, fewer grafts can often be transplanted. A reasonable threshold is roughly 3000 grafts each session.

Sapphire, diamond and gold hair transplant

Most clinics have recently expanded their offerings to include “newer and better” hair transplantation techniques. The Sapphire, Diamond, or Gold Methods are only a few of the evocative names given to the hair transplant operations. However, it essentially consists of a standard FUE hair transplant. The employment of a “tool” constructed of a different substance, however, distinguishes the known from the established procedures. Because, as the name implies, the associated hair transplantation variations employ tools with, for instance, a gold, diamond, or sapphire blade. On the other hand, conventional techniques rely on steel or titanium. The aforementioned tools’ purity, hardness, and sharpness ought to result in a more accurate and well-tolerated hair transplant.

Body Hair Transplant (BHT)

One of the more recent hair transplantation techniques is called body hair transplantation, or BHT. This is an additional type of FUE transplant. Although body hair differs structurally and frequently also in colour from hair on the head, BHT has shown to be effective as a hair transplant technique. There is often not enough hair in the donor area to cover bald areas on the top of the head because many patients have such severe hair loss. In less noticeable places, body hair can be inserted if the donor area is used up. The region in the middle of the top of the skull, for instance. Additionally, it is now believed that after being implanted in the scalp, the architecturally unique body hairs function like typical hair.


Every technique has benefits and drawbacks. Patients who have severe hair loss (Norwood scale 4+), such as at the crown, might consider the FUT procedure, however, the FUE procedure doesn’t leave any noticeable scars and is better for the tissue. The initial meeting is the optimum time for the specialist to assess which approach is appropriate for your needs. However, in the majority of cases, a hair transplant must be combined with a medically approved hair loss treatment, such as finasteride or minoxidil.


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