DHI Hair Transplant Abroad: Choi Pen Technique, Costs & Top Clinics

What Is DHI Hair Transplant?

Direct Hair Implantation (DHI) is an advanced hair transplant technique that represents the next evolution in minimally invasive hair restoration. Developed from the principles of FUE, DHI eliminates the step of creating pre-made recipient channels before implanting the grafts. Instead, DHI uses a specialized patented instrument called the Choi Implanter Pen (originally developed by Kyungpook National University in South Korea) to simultaneously create the recipient site and implant the hair follicle in a single motion. This approach offers unparalleled control over the angle, depth, and direction of each implanted graft.

The DHI technique was originally developed to address some of the limitations of conventional FUE, particularly regarding graft handling and the precision of implantation. In standard FUE, after grafts are extracted, the surgeon creates hundreds or thousands of tiny incisions (channels) in the recipient area, and then assistants place the grafts into those pre-made channels. This two-step process means the grafts are handled multiple times and spend more time outside the body. In DHI, the graft is loaded directly into the Choi pen immediately after extraction and implanted directly into the scalp, reducing handling and out-of-body time significantly.

DHI has gained immense popularity in recent years, particularly for patients seeking hairline restoration, increased density in existing hair (without shaving the head), and more precise aesthetic outcomes. The technique is performed by a team of specialists — while one technician loads the extracted follicles into Choi pens, the surgeon implants them. Multiple Choi pens are used simultaneously, with each pen pre-loaded with a single graft, allowing for a smooth, continuous implantation workflow. Typically, a DHI procedure uses 6-15 Choi pens rotating between the loading team and the implanting surgeon.

The Choi Pen Technique in Detail

The Choi Implanter Pen is a hollow, pen-shaped instrument with a fine needle at its tip, ranging from 0.6mm to 1.0mm in diameter, matched to the size of the follicular unit being implanted. The process works as follows: after a follicular unit is extracted from the donor area using the FUE technique (manual or motorized micro-punch), a trained technician carefully loads the graft into the hollow needle of the Choi pen. The follicle sits securely inside the needle, protected from mechanical damage.

The surgeon then positions the Choi pen at the precise location on the recipient scalp where the graft should be placed, adjusting the angle (typically 40-45 degrees for a natural growth direction) and depth. With a click of the pen's plunger mechanism, the needle penetrates the scalp, creates a tiny channel, and simultaneously deposits the follicle into the channel — all in a single motion lasting less than a second. The needle retracts, and the graft is securely in place. The surgeon immediately moves to the next pre-loaded pen and repeats the process.

This single-motion technique offers several critical advantages. First, the graft spends minimal time being handled and exposed to air, which improves viability. Second, the simultaneous channel creation and implantation means there is less bleeding at the recipient site, since each tiny wound is immediately sealed by the implanted graft. Third, the surgeon has real-time control over the placement — they can adjust the density, angle, and direction of each graft on the fly, which is particularly important for creating a natural-looking hairline that mimics the patient's original growth pattern.

One of the most distinctive aspects of DHI is the level of precision it offers in hairline design. The surgeon can create extremely natural, irregular hairline patterns with single-hair grafts at the very front, graduating to multi-hair grafts behind — exactly mimicking how natural hair grows. The fine Choi pen needle also allows grafts to be placed very close together, achieving densities of 60-80 grafts per square centimeter in the frontal zone. This high-density implantation capability is one of the primary reasons patients choose DHI over standard FUE for hairline work.

DHI vs FUE: Key Differences

While DHI is technically a variation of FUE (both use the same extraction method), there are several meaningful differences in the implantation phase that affect the patient experience, results, and cost. Understanding these differences is essential for making an informed decision about which technique is right for you.

In standard FUE, the surgeon creates all recipient channels before any grafts are implanted. This channel-first approach allows the surgeon to design the overall pattern of hair distribution methodically and ensures consistent spacing and depth across the entire recipient area. The grafts are then placed into these pre-made channels by the surgical team. While effective, this approach means the channels can close slightly or bleed during the waiting period before grafts are inserted, potentially affecting graft survival.

In DHI, channels are not pre-made. Each graft is implanted directly into the scalp as the surgeon works, meaning every channel is created and filled immediately. This reduces the risk of channel closure and minimizes bleeding, potentially leading to higher graft survival rates. However, the trade-off is speed — DHI is a slower process because the surgeon must focus on one graft at a time, making each placement decision individually. A 3,000-graft FUE procedure might take 6-7 hours, while the same number of grafts via DHI could take 8-10 hours.

• Extraction: Same technique in both (FUE micro-punch extraction)
• Channel creation: FUE creates channels first, then implants; DHI creates channel and implants simultaneously
• Implantation tool: FUE uses forceps; DHI uses Choi implanter pen
• Shaving required: FUE typically requires full donor area shaving; DHI can be done without shaving (no-shave DHI)
• Density: DHI can achieve higher density (60-80 grafts/cm2 vs 40-60 for FUE)
• Procedure time: DHI takes 20-40% longer than FUE for the same graft count
• Cost: DHI is typically 20-40% more expensive than standard FUE
• Recovery: DHI generally has slightly faster healing due to less tissue trauma at recipient site
• Best for: DHI excels in hairline work, high-density areas, and no-shave procedures

No-Shave DHI: Discreet Hair Restoration

One of the most compelling advantages of the DHI technique is its compatibility with no-shave procedures. In traditional FUE, both the donor area and recipient area are typically shaved before surgery. This means patients leave the clinic with a visibly shaved head covered in tiny red dots and crusts — making it obvious that they have had a procedure. For many patients, particularly women, professionals who cannot take time off work, and those who value privacy, this visible post-operative appearance is a significant deterrent.

No-shave DHI (also called unshaven DHI or U-DHI) allows the procedure to be performed with the patient's existing hair remaining at its full length. Only the individual follicular units in the donor area are trimmed at the point of extraction, while the surrounding hair remains long enough to cover the extraction sites immediately. In the recipient area, the Choi pen is used to implant grafts between existing hairs without any shaving required, and the fine needle creates minimal visible disruption to the scalp.

The result is that patients undergoing no-shave DHI can return to social and professional life within just a few days, with their existing hair concealing the treated areas. Swelling (which typically peaks at days 3-5) is the primary giveaway during the initial recovery period, but this can often be managed with a hat or head band. No-shave DHI is particularly popular among women experiencing diffuse hair thinning, as it allows density to be added between existing hairs without any visible signs of treatment.

There are some limitations to no-shave DHI. The maximum number of grafts that can be transplanted in a single no-shave session is generally lower than a fully shaved procedure — typically 2,000-3,000 grafts compared to 4,000-5,000+ for a shaved session. The procedure also takes longer and may cost more due to the added complexity. However, for patients prioritizing discretion, the trade-offs are well worth it.

Who Is the Best Candidate for DHI?

DHI is an excellent technique for many patients, but it is particularly well-suited to certain profiles. Ideal candidates for DHI include patients who need hairline restoration or temple reconstruction, where precise angle and direction control is essential for a natural result. Patients who want to add density to thinning areas without shaving their existing hair (no-shave DHI) are also excellent candidates. Women with diffuse thinning who want to increase overall density without a visible procedure are particularly good candidates for no-shave DHI.

Patients with Norwood stage 2-4 hair loss patterns typically achieve outstanding results with DHI, as the technique excels in the frontal and mid-scalp zones where precision hairline work and high density are most critical. For patients with more advanced hair loss (Norwood 5-7), a combined approach is often recommended: DHI for the hairline and frontal zone where natural appearance is paramount, and standard FUE for the crown and mid-scalp where coverage over a larger area is the priority. This hybrid approach leverages the strengths of both techniques.

DHI may be less ideal for patients needing very large graft counts (5,000+ grafts) in a single session, as the slower pace of DHI implantation can extend the procedure time beyond what is practical in a single day. In these cases, the procedure may need to be split across two consecutive days, or the patient may opt for standard FUE for the bulk of the work and DHI for the critical hairline area. Patients with very limited donor supply should also discuss their options carefully with the surgeon, as DHI uses slightly more donor area per graft due to the need for precise individual extraction.

DHI Costs Worldwide

DHI is universally more expensive than standard FUE due to the specialized Choi implanter pens (which have a limited lifespan and must be replaced regularly), the additional trained personnel needed to load the pens during the procedure, and the longer surgery time. In the United States, DHI pricing ranges from $5 to $10 per graft, meaning a 2,500-graft DHI procedure can cost $12,500 to $25,000. In the UK, prices are similarly steep at $8,000 to $15,000 for a standard DHI session.

Turkey remains the most cost-effective destination for DHI, with prices ranging from $2,500 to $5,000 for an all-inclusive package covering the procedure (unlimited grafts), hotel, airport transfers, PRP, medications, and post-operative care kit. India offers competitive DHI pricing at $1,800 to $3,500, while South Korea — where the Choi pen was originally developed — charges $6,000 to $10,000 for DHI procedures performed by highly experienced surgeons.

DHI Hair Transplant Cost Comparison (2025)

DHI is typically 20-40% more expensive than standard FUE due to the specialized equipment and longer procedure time. Turkish packages often include hotel and transfers.

Top Clinics for DHI Abroad

When choosing a clinic for DHI, it is essential to select one where the surgeon has extensive experience specifically with the Choi pen technique, not just general FUE experience. DHI requires a different skill set and surgical approach, and the best results come from surgeons who perform DHI regularly and have mastered the nuances of the technique.

Acibadem Maslak Hospital in Istanbul is one of the leading facilities for DHI hair transplant in Turkey. As part of the Acibadem Healthcare Group — the largest private healthcare network in Turkey — it offers JCI-accredited facilities, experienced dermatology and hair transplant departments, and comprehensive all-inclusive packages for international patients. The hospital's hair transplant team performs hundreds of DHI procedures annually and specializes in natural hairline design for both men and women.

Liv Hospital Istanbul is another top-tier option for DHI procedures. Known for its modern facilities and technology-driven approach to medicine, Liv Hospital has established a dedicated hair restoration unit staffed by board-certified dermatologists and plastic surgeons. The hospital offers both standard DHI and no-shave DHI procedures, with detailed virtual consultations available for international patients before travel. Their DHI protocol includes PRP treatment and post-operative follow-up for 12 months.

For patients considering DHI in a non-Turkish destination, leading clinics in India, Thailand, and South Korea offer excellent DHI programs. The key is to verify the surgeon's DHI-specific experience, review before-and-after photos of their DHI work (paying particular attention to hairline naturalness), and ensure the clinic uses genuine Choi implanter pens rather than lower-quality imitations.

DHI gives us the ability to paint with hair — each follicle is placed with artistic precision, creating results that even a close examination cannot distinguish from natural growth.

Dr. Emrah Cinik, DHI Specialist, Istanbul

Frequently Asked Questions