Difference between Follicular Unit Extraction and Direct Hair Implantation - Dr. K Prapanna Arya

There has been a buzz these days that direct hair implantation or direct hair transplantation technique being more effective than follicular unit extraction. On the contrary direct hair implantation is a subtle modification of follicular unit extraction as the extraction process remain the same in both the techniques. Coming to the steps, in follicular unit extraction, the patient is made to lie in the prone position and local anesthesia is administered in the donor area. Therefore the follicular units are extracted using follicular unit extractor. After scoring the follicular units with the help of the forceps, the follicular units are harvested, then segregated in single units, 2 units, 3 or 4 units and then stored in a solution which maintains the integrity of the follicular units. Later the hairline area is marked and the local anesthesia is administered in the recipient site. That is where the grafts are administered in the bald area. After local anesthesia is administered slits are made with a number 11 blade and follicular units are placed into these slots. Mini hair transplant surgeons use the implantors which are loaded with the follicular units and later placed into the recipient site. Coming to the steps in direct hair implantation the hairline area is marked and the local anesthesia is administered in the recipient site, slits are made with a number 11 blade, the patient is made to lie in the prone position and local anesthesia is administered in the donor area, the follicular units are scored using follicular unit extractor. About 150-200 follicular units are scored with the help of the forceps, the follicular units are extracted and the patient’s head is positioned so that the extracted follicular units are placed into the recipient area. The advantage of direct hair implantation are the follicular units are directly implanted are minimally exposed from the body. Secondly the handling of the follicular units is very minimal. In follicular unit extraction and then stored in a solution which maintains the integrity of the follicular units and handling of the follicles depends on the operating team. Drawback of direct hair implantation is obtaining the exact direction ad angulation of every hair follicle and also to obtain a good hair density. So the basic difference is the sequence of the steps which are performed during the procedure.