FUE and DHI hair transplant: who it suits, how it is done and what to expect

A hair transplant is usually not the first step in treating hair loss, but an option considered after a home treatment plan (Hebrew) or when the response to conservative treatment is partial. On this page we explain how it works, who is a suitable candidate, and what happens over time.

Unlike non-invasive treatments such as PRP or phototherapy (Hebrew), this is a one-time surgical procedure (or sometimes done in two sessions) that moves existing hair from one place to another. It is not a treatment that stimulates new hair growth in areas that have already lost that ability. This distinction is important for understanding what to expect from the result.

How does a hair transplant work?

The central principle is called “donor dominance”: follicles moved from the back of the head, which is usually relatively resistant to hereditary balding, keep their genetic characteristics even after they are transplanted to another area. In practice, surgeons remove single hair follicles, or a strip of skin, from the donor area and implant them in thinning areas. The two main methods are FUE, extraction of individual follicles directly from the skin, and FUT, in which a strip of skin is removed first and the follicles are then separated from it¹².

Who is a hair transplant suitable for, and who is it not?

It suits people who have enough healthy donor hair and whose thinning area still has growth potential. The European guideline states that a transplant can be considered in men and women with sufficient donor hair, and recommends (as a positive recommendation) combining it with finasteride in men with male pattern hair loss (Hebrew)⁴. Factors that make someone unsuitable include body dysmorphic disorder (BDD) and unrealistic expectations of the result⁴. A transplant is not suitable in active alopecia areata. In scarring alopecia, for example lichen planopilaris, a transplant can be considered only when the disease is inactive, and the proportion of grafts that survive over time gradually declines: 82.7% after one year, and only 39.6% after 4 to 6 years, according to a meta-analysis⁶.

FUE or DHI: what they share and how they differ

In both methods the follicles are extracted the same way: one by one, with a tiny hollow needle, from the donor area at the back and sides of the head. The only difference is in the implantation stage. In FUE (Hebrew), tiny recipient channels are first opened in the thinning area with a blade or needle, and the follicles are then placed into them. In DHI (Hebrew), each follicle is loaded into a dedicated implantation pen (Implanter), which opens the channel and implants the follicle in a single motion¹⁵⁷. For a detailed comparison and how to choose, see FUE or DHI (Hebrew).

There are no studies showing that one method gives a better result than the other in general. What determines the result is mainly the quality of the donor area, the planning, and gentle handling of the follicles during the transplant⁵⁷. The International Society of Hair Restoration Surgery (ISHRS) points out that FUE is not “scarless”: it leaves tiny dots, and hair extracted from the donor area does not grow back there⁸. That is why the clinic chooses the method according to the size of the thinning area, the hair density in the donor area, the pattern of hair loss, and whether there is a wish to implant between existing hair, not according to the name of the method. Sometimes both are combined in the same procedure.

And what about FUT? In this method a single strip of skin is removed from the back of the head and the follicles are separated from it. It leaves one linear scar, and in recent years most transplants have been done with FUE and its variations¹².

What is “donor dominance”, in plain language?

Donor dominance means that follicles from the back of the head keep behaving like back-of-the-head hair even after they move to the thinning area. In most people, hair follicles in the lower back of the head are less sensitive to the hormone that causes hereditary balding. When they move to another place on the scalp, they “take with them” this genetic trait and stay less sensitive in their new location as well¹². This is why a transplant can give a relatively stable result over time, unlike hair that was not transplanted.

What happens on the day of the transplant?

A transplant is a one-day procedure under local anesthesia, and you go home the same evening. The steps are similar in both methods²⁹:

1. Planning and marking: the hairline and the areas to be transplanted are marked, according to what was decided at the preliminary examination.
2. Preparing the donor area: full or partial shaving of the back of the head, depending on the method and the extent of the transplant.
3. Local anesthesia: in the donor area and in the recipient area.
4. Follicle extraction: one by one, with a tiny hollow needle.
5. Sorting and storage: the follicles are checked, sorted by the number of hairs in each, and kept in a solution until implantation.
6. Implantation: in FUE into channels opened in advance, in DHI directly with an implantation pen. The angle and direction of each follicle are set to match the natural direction of growth.
7. Dressing and instructions: you receive written instructions for the first days, and a follow-up appointment is scheduled.

Hair transplant without shaving

Sometimes it is possible to implant between existing hair without shaving the recipient area, mainly with the DHI method. This mostly suits thickening a defined area or correcting the hairline, and less so covering a large area. Even in a “no-shave (Hebrew)” transplant, narrow strips are usually shaved in the donor area, hidden by the surrounding hair, and the number of grafts that can be implanted in one session is smaller⁵. Suitability is determined at the examination.

Does a hair transplant hurt, and how long does it take?

The surgery takes between 4 and 8 hours and is done under local anesthesia. The patient is awake during the procedure, without general anesthesia³. Some discomfort is possible while the local anesthetic is given and in the first days of recovery; what happens then is described in the next section.

What happens in the first two weeks after a hair transplant?

Initial recovery usually takes one to two weeks. In the first days the scalp feels tight, sore and swollen, and temporary scabs form in the recipient area. According to the UK National Health Service (NHS)⁹:

• On the day of surgery you usually go home, without an overnight hospital stay.
• After 2–5 days the bandages can be removed, but the grafts are not touched.
• From the sixth day you can usually wash your hair gently, by hand.
• After 10–14 days non-absorbable stitches are removed, if there were any (mainly in the strip method, FUT).
• Time off work: one to two weeks may be needed.
• Physical activity: you may be advised to limit it in the first month, to reduce scarring.

Severe pain or any unexpected symptom is a reason to contact the clinic that performed the transplant⁹. The exact instructions vary with the transplant method, so they are given in writing by the surgical team. The long lists of “don'ts” found online (coffee, alcohol, special pillows) were not found in any high-quality source we read.

What happens after one, 3, 6 and 12 months?

Between the second and eighth week, the transplanted hairs fall out, and this is an expected stage of the process, not a failure of the transplant. After about 3 months, the hair may look even thinner than before the surgery³. Sometimes some of the original hair around the transplant also falls out temporarily, a phenomenon called shock loss (Hebrew). The table summarizes what is usually expected:

The table is based on³⁴.

Is the result permanent, and why is medical treatment still needed?

Transplanted hairs keep their original characteristics and are not expected to fall out from the same hereditary process, but this is true only for them. The original hair that was not transplanted remains sensitive to the same balding process, so continuing medical treatment is recommended to slow future hair loss and preserve existing hair³⁴. What to do in the first days and how to maintain the result over the years is explained on the page After a hair transplant (Hebrew), and if you have not yet decided, it is worth reading about hair restoration or hair transplant (Hebrew). In young men, it is sometimes advisable to wait with the transplant and start with medical treatment first, to see how the condition progresses³.

What are the risks?

In most cases the procedure is considered safe, but there are risks worth knowing about. In a review that included 2,353 patients from observational studies, 442 reported some complication. The most common were pain, swelling and edema in the donor area, and scarring in the recipient area. In rare cases more serious complications were reported, such as arteriovenous fistulas, mainly with the punch technique. The review describes the procedure overall as “generally safe”¹⁰. Isolated cases of lichen planopilaris appearing several years after a transplant have also been reported, but a causal link between the procedure and the disease has not been proven¹¹.

Hair transplant for women

A transplant suits women under certain conditions: a specific pattern of hair loss, stable balding, sufficient donor hair and no active diffuse hair loss. The European guideline emphasizes that this suitability is determined individually, and not every female pattern of hair loss is suitable for a transplant⁴.

Hair transplant abroad: what to look out for

Before you fly, it is worth finding out who actually performs the procedure, what follow-up is available at home and what is included in the price. This is a real, practical question for many Israelis who consider traveling abroad for the procedure. For a detailed comparison, see Hair transplant in Turkey compared with Israel (Hebrew). A few practical questions are worth asking in advance: who exactly performs the transplant (the doctor or a team of technicians), what post-operative follow-up is available in Israel if a problem arises, and what exactly is included in the advertised price. Every practitioner, in Israel or abroad, has a different level of experience and training, and this is an important consideration in the choice. A detailed checklist, and preparation before and after the flight, can be found on the page Hair transplant in Turkey and abroad: what to check and how follow-up works (Hebrew).

Eyebrow and beard transplants

Follicles can also be transplanted to the eyebrows and beard, on the same principle of moving donor hair. Follicle transplantation is also used for the eyebrow and beard areas, on the same principle of moving donor hair. This is a field with its own specific considerations, beyond what is covered on this page, which focuses on the scalp. At the clinic, eyebrow and beard transplants are performed by Dr. Dana Buchbut herself. Details on the pages eyebrow transplant and beard transplant.

When is it better to wait with a transplant?

Even someone who is technically suitable for a transplant does not always need to rush into it. In young men, the guidance is sometimes to start with medical treatment and follow the pace of balding, because the future pattern of hair loss is not yet fully clear at a young age, and a hairline designed to suit a 25-year-old may look unnatural at 45 if balding continues to progress in areas that were not transplanted³. Another consideration is the stability of the condition: when balding is still progressing quickly, the result of a single surgery may become outdated relatively soon, so combining it with medical treatment is considered an integral part of the planning, not an optional extra⁴.

Does PRP after a transplant help?

Three controlled studies, with 217 participants in total, found improvement when PRP was added to a hair transplant, but their protocols differed from one another. It is hard to derive a single recommended protocol from this¹². More on PRP can be found on the dedicated page.

When to start PRP around the transplant, what has been studied about graft survival and how it fits into recovery: PRP after a hair transplant (Hebrew).

Glossary

• Donor dominance: the property that allows hair from the back of the head to stay relatively resistant to balding even after it is transplanted elsewhere.
• FUE: extraction of individual follicles directly from the skin.
• FUT: removal of a strip of skin from the back of the head, from which the follicles are separated.
• DHI: a variation of FUE, direct implantation with a dedicated instrument.
• Donor area: the area, usually at the back and sides of the head, from which follicles are taken for transplantation.
• Arteriovenous fistula: an abnormal and rare connection between an artery and a vein, reported as a rare complication mainly with the punch technique.

What's new in research (updated November 2026)

Three new publications deal with what happens around the transplant itself:

• Consensus on graft survival in FUE (2025): a group of surgeons in China published in Plastic and Reconstructive Surgery a consensus, based on a systematic review, on the steps that improve graft survival with the FUE method. The recommendations cover seven stages: preparation before surgery, harvesting, separating and trimming the grafts, preserving them outside the body, implantation, post-operative care and prevention of complications. The main message is that graft survival depends on careful work at every stage, not only on technique¹³.
• Transplant combined with CGF (2026): a small randomized trial assigned 26 men to an FUE transplant alone or to a transplant combined with CGF injections. After nine months, hair density and the proportion of thick hairs were higher in the combination group, and no safety issues were recorded. Because of the sample size, this is a promising direction that still needs confirmation¹⁴.
• Healing of the donor area (2024): in a randomized half-head trial with 98 participants, tissue left around the follicles at the trimming stage was processed into a suspension and applied to the donor area after FUE. Areas treated this way closed faster than areas treated with antibiotic ointment, with less pain and itching in the first days. This is an experimental method, but it highlights how much healing of the donor area affects the experience after a transplant¹⁵.

These summaries describe the study designs and the researchers' conclusions and are not a personal recommendation. Any decision about treatment is made only after an examination.

How does Dr. Buchbut accompany patients before and after a transplant?

Care begins with a trichoscopic diagnosis before any decision about surgery, and continues after the transplant. Dr. Dana Buchbut has worked in hair medicine for 16 years and treats patients with both hair restoration and hair transplants, using the FUE method and the DHI method. The method is chosen after the examination, according to what suits each patient. Before a transplant, a computerized trichoscopy is done to check how many active follicles there are in the thinning area and how the balding is progressing, and every suitable patient receives a personal treatment plan with an agreed treatment goal. The plan may include strengthening existing hair before the transplant, and PRP treatments and medication after it. Patients who had a transplant abroad can receive follow-up and guidance here; see Hair transplant abroad: what to check and how follow-up works (Hebrew).

The bottom line

A hair transplant is an established surgical procedure that can give a natural and meaningful result for those it suits. It is not a magic solution and not a substitute for medical treatment, but a step that works together with it. Suitability depends on the quantity and quality of donor hair and on realistic expectations, and a thorough examination in advance is the way to know whether this is the right direction for you. The final result is seen only after many months, but it is built from the very first appointment.

The information on this page is general and for education only. It does not replace an examination, diagnosis or personal medical advice. Any decision about treatment is made only after an examination.