Dr. Gökay Bilgin, hair transplant surgeon in Istanbul

Written by Dr. Gökay Bilgin, MDHair transplant surgeon · Istanbul University-Cerrahpaşa Faculty of Medicine · Co-founder of Smile Hair Clinic (2018) · 5,000+ proceduresLast updated: October 2026 · More about me

Key Takeaways

✓Every modern hair transplant has the same three steps: taking grafts out, opening channels for them and placing them. Each named technique changes only one part of that process.
✓Sapphire FUE changes the blade that opens the channels. DHI changes the tool that places the grafts. Unshaven and Long Hair FUE change how the hair is prepared. Body hair transplant changes where the grafts come from.
✓No technique is best for everyone. The right one depends on your stage of hair loss, your donor area, your hair type and whether you can be seen with a shaved head.
✓The name of the technique matters far less than who designs the hairline, who opens the channels and how carefully each graft is handled.
✓FUT (the strip method) still has a place, but it leaves a linear scar, and I do not offer it as a standard option.

When patients first contact me, many have already decided on a technique. They have read that DHI gives more density, that sapphire heals faster or that an unshaven procedure is the most advanced. Then they ask me which one I would choose for them, and my answer usually surprises them: I choose the technique last, after I have seen the donor area, the size of the bald area, the hair type and how the patient lives.

This page explains what each hair transplant technique really changes, how the techniques compare, which one tends to suit which patient and where the marketing goes further than the medicine. Each technique also has its own page with more detail, linked below. If you are new to the subject, my hair transplant guide covers candidacy, recovery and risks first.

What Is a Hair Transplant Technique?

A hair transplant technique is a particular way of carrying out one or more steps of the operation. Whatever the name on the brochure, a modern hair transplant moves follicular units (natural groups of one to four hairs) from a permanent donor area to a thinning area in three steps. Once you see the three steps, the long list of technique names becomes much easier to understand.

1ExtractionGrafts are taken from the donor area at the back and sides of the head, one by one with a micro punch (FUE) or as a strip of skin (FUT).Techniques that change this step: Manual, motorised or robotic FUE; FUT; body hair transplant (a different donor source).
2Channel openingTiny incisions are made in the bald area. Their angle, direction, depth and spacing decide how natural the hair will look.Techniques that change this step: Sapphire FUE (sapphire blade instead of steel). In DHI, the pen opens the channel while placing the graft.
3ImplantationEach graft is placed into a channel, with forceps or with an implanter pen, keeping it moist and handling it as little as possible.Techniques that change this step: DHI (Choi implanter pen instead of forceps).
And a fourth layer: preparationUnshaven and Long Hair FUE do not change any of the three steps directly. They change how the hair is prepared: how much is shaved, and whether the grafts are moved with the hair still long. That affects how many grafts can be moved in one day and how the operation is planned.

This is why two clinics can use different names for almost the same operation, and why the same name can hide very different quality. In this short video I show the stages of an FUE procedure, which is the base that Sapphire FUE, DHI and unshaven procedures are all built on.

Video: preparation, extraction, channel opening and implantation in an FUE procedure.

The Hair Transplant Techniques I Use

All of the techniques below are forms of FUE. I use them alone or together depending on the plan, and each has its own page where I go into the procedure, the results and the limits in more depth.

Sapphire FUEChannels are opened with a fine, smooth sapphire blade, which lets me control the angle, depth and size of every incision. This is the technique I use most.Often suits: most stages of hair loss, from a receding hairline to large sessions.Read more →DHI Hair TransplantA Choi implanter pen opens the channel and places the graft in a single movement. It is precise in small areas but slower per graft.Often suits: hairline refinement, dense packing in small zones, partly unshaven cases.Read more →Unshaven Hair TransplantThe recipient area is not shaved, and the donor area is shaved only in hidden strips or not at all. Grafts are placed between the existing hair.Often suits: early hair loss and patients who cannot be seen with a shaved head.Read more →Long Hair FUEGrafts are extracted and implanted with the hair still long, so you can see a preview of the new hairline on the day of the operation.Often suits: hairline work and patients who want to keep their look from day one.Read more →Body Hair TransplantBeard or body hair is used as an extra donor source when the scalp alone cannot give enough grafts.Often suits: advanced hair loss, a weak donor area and repair cases.Read more →

The beard, eyebrow and female hair transplants I perform use these same techniques in different areas. You can read about them on my beard transplant and female hair transplant pages.

Hair Transplant Techniques Compared Side by Side

This is how the main techniques compare on the questions patients ask me most: what actually changes, whether you need to shave, who each one suits and what to watch out for. FUT is included for reference, because it is still offered in some countries.

Classic FUEWhat it changesBaseline. Grafts taken one by one with a punch; channels opened with steel blades or needles; grafts placed with forceps.ShavingDonor area shaved; recipient area usually shaved.Often suitsMost stages of hair loss.Watch out forThe result depends almost entirely on the team’s skill.
Sapphire FUEWhat it changesChannel opening: a sapphire blade replaces steel.ShavingUsually a full shave.Often suitsMost stages, including large sessions of 3,000+ grafts.Watch out forThe blade does not make the result by itself; who holds it does.
DHIWhat it changesImplantation: a Choi pen opens the channel and places the graft in one move.ShavingDonor shaved; recipient can sometimes stay longer.Often suitsHairlines, small zones, partly unshaven work.Watch out forSlower per graft, so very large sessions take longer.
UnshavenWhat it changesPreparation: no shaving of the recipient area; donor shaved in hidden strips or not at all.ShavingNone visible.Often suitsSmaller sessions, early loss, people who cannot take time off.Watch out forFewer grafts per day and a longer operation.
Long Hair FUEWhat it changesPreparation: grafts moved with the hair left long.ShavingLittle or none.Often suitsHairline cases, an immediate preview.Watch out forTechnically demanding and limited in graft numbers.
Body HairWhat it changesDonor source: beard, chest or other body hair.ShavingBeard or body area trimmed.Often suitsAdvanced loss, weak scalp donor, repair.Watch out forBody hair is finer and grows differently; beard hair matches best.
FUT (strip)What it changesExtraction: a strip of skin is removed and divided into grafts.ShavingNo shave at the back.Often suitsVery large lifetime needs with a loose scalp.Watch out forLeaves a linear scar; not one of my standard options.

The table shows tendencies, not rules. A patient with early hair loss can have an excellent Sapphire FUE, and a patient with advanced loss can have DHI at the hairline as part of a larger plan.

Which Hair Transplant Technique Is Right for Me?

Four things decide most of my technique choices: how much hair has been lost, whether the patient can be seen with a shaved head for a few weeks, how strong the donor area is and the hair type. Choose your answers below and the finder shows the technique I would most likely start from, and why. No contact details are needed.

About you

Likely starting pointSapphire FUE

This is a starting point based on general patterns, not a diagnosis. The final choice depends on photos or an examination of your scalp.

The finder follows the same reasoning I use in consultations, but it cannot see your donor density, the miniaturisation of your existing hair or the shape of your face. Those can move the plan in either direction, which is why I always ask for photos before recommending a technique.

DHI vs FUE vs Sapphire FUE: What Actually Differs

These three are the names patients compare most, and the comparison is often presented as a contest. In reality, DHI and Sapphire FUE are both forms of FUE. The grafts are extracted in the same way; the difference lies in how the channels are opened and how the grafts are placed.

DHI vs FUE

In classic FUE and Sapphire FUE, all the channels are opened first, then the grafts are placed into them with fine forceps. In DHI, each graft is loaded into a Choi implanter pen, which opens the channel and places the graft in one movement.

Where DHI helpsVery precise placement in small areas such as the hairline or temples, close packing between existing hair, and less need to shave the recipient area.
Where FUE helpsFaster and more flexible in large sessions; the full design of the channels can be seen and adjusted before a single graft is placed.
Graft handlingDHI grafts are loaded into pens by the team, which adds a handling step. Forceps placement depends on equally careful hands. Neither method protects grafts by itself.
DensityThe density that survives is limited by the donor area and the blood supply of the scalp, not by the tool. DHI does not create more hair than the grafts contain.
Session lengthDHI is slower per graft, so large sessions take longer. That matters, because time outside the body is one of the things that affects graft survival.

So when a patient asks me which is better, DHI or FUE, I ask in return which part of the head we are working on and how many grafts we need. For a delicate hairline refinement, DHI is a fine choice. For 3,000 or more grafts across the front and mid-scalp, Sapphire FUE is usually more practical. Read the full comparison on my DHI hair transplant page.

Sapphire FUE vs DHI

Both have the same aim: small, clean, precisely angled channels. Sapphire FUE achieves it with a sapphire blade cut to the size of the grafts; DHI achieves it with the needle of the implanter pen. In my hands the hairline results are very similar. The deciding questions are the number of grafts, how much shaving the patient accepts and whether the work is in a small or large area.

Is Sapphire FUE worth paying more for?

A sapphire blade is smooth and sharp, keeps its edge and can be prepared to the exact size I want, so I like working with it. But the blade is a small part of the result. A sapphire channel opened at the wrong angle looks just as wrong as a steel one. If a clinic charges extra for the word ‘sapphire’ but cannot tell you who will open the channels, the extra money is buying a label. More on this on my Sapphire FUE hair transplant page.

In this video, a couple from the United States had their procedures at our clinic and talk about the differences they experienced between DHI and FUE.

Video: a couple from the US compare their DHI and FUE experiences.

Is One Hair Transplant Technique Really Better?

Hair transplantation is a large and competitive market, and new names appear every year: sapphire, diamond, micro, gold, ultra. Many of them describe a small change to a tool rather than a new operation. The International Society of Hair Restoration Surgery (ISHRS) does not recognise DHI or Sapphire FUE as separate procedures; it treats them as variations of FUE extraction and implantation.

My viewI have seen beautiful results with every technique on this page, and poor ones with all of them too. What decides the result is the plan and the hands: a hairline that suits your face and age, channels opened at the right angle and direction, grafts that spend as little time out of the body as possible and a donor area that is protected for the future. When a clinic sells you a technique name instead of telling you who will do each step, ask more questions. Dr. Mehmet Erdoğan and I talk about this and other common misconceptions in the video below.

Video: common questions and misconceptions, including technique names (from 06:55).

That does not mean the techniques are all the same. Each one has real strengths in the right situation, which is why I use several of them. It means the technique should follow the plan, not the other way round. If you are comparing clinics, my guide to hair transplant in Turkey lists the questions to ask about who performs each step.

FUE vs FUT: Why I Do Not Use the Strip Method Routinely

FUT (follicular unit transplantation), also called the strip method, removes a long, narrow strip of skin from the back of the head. The wound is stitched closed and the strip is divided into grafts under a microscope. FUE takes the grafts one by one, leaving tiny round marks spread across the donor area instead of a line.

Donor scarFUT leaves a linear scar across the back of the head, hidden only if the hair is kept at a certain length. FUE leaves small dot scars that are hard to see even with short hair.
RecoveryFUT has stitches and a tighter, more uncomfortable donor area for the first weeks. After FUE, the donor area usually settles within about a week to ten days.
Graft qualityFUT grafts are cut under the microscope, so fewer are damaged during extraction. In skilled hands, FUE damage rates are also low.
ShavingFUT does not require shaving the back of the head. Classic FUE does, unless it is done unshaven.
Hair worn shortNot a good fit for FUT because of the line. FUE suits patients who like short hair or skin fades.

FUT can still make sense for a small group: patients with a loose scalp, a strong lifetime need for grafts and hair they will always wear long. Some surgeons combine FUT and FUE over several sessions to maximise the total number of grafts. Because most of my patients want short hairstyles and a quick return to normal life, and because FUE lets me control where each graft comes from, I do not offer FUT as a standard option.

Manual, Motorised and Robotic FUE Extraction

All FUE uses a small round punch, usually below about 1 mm wide, to free each follicular unit from the skin. What differs is what drives the punch.

Manual FUEThe punch is turned by hand. Slower, but gives a very direct feel for the tissue, which some surgeons prefer for delicate or difficult donor areas.
Motorised FUEA micromotor turns the punch. It is faster and consistent, which helps in large sessions. Most FUE worldwide is now done this way.
Robotic FUEA robot identifies and extracts grafts. It is consistent but much more expensive, and comparative studies showing better results than skilled manual or motorised work are still lacking.

The device matters less than how it is used. Graft damage depends on the punch size, depth and angle, and on how well the person extracting reads the direction of the hair under the skin. Curly and Afro-textured hair curves below the surface, so extraction has to be slower and more careful, whatever device is used. I explain this on my Afro hair transplant page.

Extraction is also where your donor area is protected or damaged. Taking too many grafts from one zone leaves the back of the head looking thin, and that cannot be undone. My hair transplant graft cost page explains how much your donor area can safely give over a lifetime, with a calculator.

Combining Techniques in One Plan

Many of my plans use more than one technique, because different parts of the head have different needs. The aim is always the most natural result for the grafts available.

  • Sapphire FUE behind a DHI hairline: DHI for the first rows of the hairline, Sapphire FUE for the larger area behind it.
  • Scalp plus beard grafts: in advanced loss, beard grafts can add coverage to the crown while the scalp grafts are kept for the front. See body hair transplant.
  • Unshaven front, shaved donor: the recipient area stays unshaven while the donor area is shaved in strips hidden under longer hair.
  • Surgery plus medical treatment: a transplant moves hair but does not stop the loss of native hair. Medication, PRP and other hair loss treatments protect the hair you still have.

Long-term planning matters as much as the first session. Hair loss usually continues, and a large share of patients with advanced loss end up wanting a second session. Every graft I use today is one that cannot be used later, so I plan the first session so that it still looks natural if the loss progresses, and so that grafts are left for the future.

Unshaven procedures show this planning most clearly: fewer grafts per session, placed between existing hair so nobody can tell. In this video a Danish content creator has an unshaven hair transplant with me.

Video: an unshaven hair transplant, from planning to the end of the operation.

Who Performs Each Step, Whatever the Technique

Whatever technique a clinic advertises, the most useful question you can ask is who performs each step. In Turkey, the hair transplant unit regulation (2023, amended in 2025) says that only physicians may open the recipient channels, and a responsible physician can supervise only a limited number of operating rooms. Because a DHI pen opens the channel while it places the graft, I consider it a channel-opening step too.

Consultation and planMe. I examine the donor area, decide the graft number and choose the technique.
Hairline designMe. I draw the hairline with the patient awake and agree it with them before anything else starts.
ExtractionMy trained team, under my supervision, with me checking the donor area as the work goes on.
Channel openingMe. This is the step that decides the angle, direction and density, so I do it myself.
ImplantationMy team, most of whom I trained, under my supervision.

This applies to the operations I perform myself. The packages, what each includes and who operates in each are explained on my hair transplant Turkey packages page, and the full price picture is on my Turkey hair transplant cost page.

Frequently Asked Questions About Hair Transplant Techniques

What is the best hair transplant technique?

There is no single best technique. Sapphire FUE suits most patients and large sessions, DHI is very precise in small areas such as the hairline, and unshaven or long hair FUE suit people who cannot be seen with a shaved head. The best technique is the one that matches your hair loss, your donor area and your lifestyle, performed by an experienced surgeon.

Which is better, DHI or FUE?

DHI is a form of FUE that uses an implanter pen to open the channel and place the graft in one step. It is excellent for hairlines and small areas. Classic or Sapphire FUE is faster and more flexible for large sessions. Results at 12 months can look the same; the plan and the skill of the team matter more than the method.

Is Sapphire FUE better than classic FUE?

A sapphire blade is smooth and precise, and I like working with it. But it changes only the tool used to open the channels. A well-planned FUE with steel blades and a well-planned Sapphire FUE can give the same result; a poorly angled channel looks wrong with either blade.

Do I have to shave my head for a hair transplant?

Not always. Classic and Sapphire FUE usually involve shaving. Unshaven and long hair FUE avoid a visible shave, but they suit smaller sessions and take longer. With DHI the recipient area can sometimes stay longer. In advanced hair loss, a short shave usually gives the safest result.

How many grafts can be transplanted with an unshaven technique?

Fewer than with a shaved procedure, because extracting and placing grafts between long hair is slower. Unshaven hair transplants are best for early to moderate hair loss. If you need a large number of grafts, I will tell you honestly whether an unshaven plan is realistic.

Is FUT still used?

Yes, by some surgeons, mainly for patients with a loose scalp and a large lifetime need who always wear their hair long. It leaves a linear scar at the back of the head, and I do not offer it as a standard option.

Can different techniques be combined?

Yes. I often combine DHI at the front of the hairline with Sapphire FUE behind it, or add beard grafts in advanced hair loss. Combining techniques lets each area be treated in the way that suits it.

Which technique is best for curly or Afro-textured hair?

The hair curves under the skin, so the main challenge is extraction rather than the technique name. It needs slower, careful extraction with the right punch, and channels planned for the curl. Sapphire FUE and DHI can both work well.

Can I choose the technique myself?

You can tell me your preferences, such as not wanting to shave, and I will take them seriously. But I will only recommend a technique that suits your donor area and the graft number you need, and I will explain my reasons.

Does the technique change the result after 10 years?

Transplanted hair is permanent whichever technique is used, because it comes from the permanent donor area. What changes over 10 years is your native hair, which is why long-term planning and treatment matter more than the technique.

Let Your Plan Choose the Technique

Send me photos of your hair from the front, top, sides and back. I will tell you how many grafts I would plan, which technique or combination I would use and why, and what your donor area can give in the future.Get a Free Consultation