better choi 3Follicular Unit Transplantation and Follicular Unit Extraction (FUE) are complex and delicate procedures designed to restore naturally growing hair to the balding scalp. Because of this, hair transplant surgeons are frequently looking for methods to help improve the technique and maximize results. One way hair restoration innovators continually improve the procedure is by inventing new harvesting and implantation tools. One controversial tool that’s been discussed on our hair loss community is the “Choi Implanter” pen. But what is the Choi Implanter? What are the advantages and disadvantages of the tool? Most importantly, is this device suited for all hair transplant candidates?

What is the Choi Implanter? 

choi 1The Choi Implanter originated at the Kyungpook National University (KNU) in Korea. The idea behind the implanter device was simple: to combine the act of making an incision site in the recipient area and the implantation of an extracted graft into one act. The Choi Implanter is a pen-like device featuring a hollow needle attached to a tube and plunger apparatus. During a hair procedure with the Choi Implanter, the hair restoration physician and/or technicians loads harvested follicular units into the implanter pen. Using forceps, the graft is placed gently into the hollow needle (at the end of the implanter) and handed back to the physician. The surgeon then inserts the needle at an appropriate angle in the scalp (making the incision site) and implants the graft by pressing down on the plunger.  Normally, anywhere from 2-6 Choi implanters are used concurrently during a procedure, and the device comes in a variety of needle sizes to fit single, double, and triple follicular unit grafts.

Advantages and Disadvantages of the Choi Implanter Pen? 

According to some hair restoration experts, there are distinct advantages and disadvantages to the Choi Implanter device:

Advantages

-Adequate graft survival rates

-Decreased bleeding during recipient site creation

-Reduced trauma during graft handling

-Decreased time of surgery (with an experienced Choi Implanter team) due to the combination of graft site creation/implantation

Disadvantages

-Increased training time for physician and staff

-Surgery time can be increased if the team is unfamiliar with the device

-Generally more expensive procedures

-Reports of needles dulling pre-maturely during procedures

-Large needle sizes and recipient sites (triple hair FUG needles are 18 gauge and leave a 1.1 mm incision site, which some feel is too large for the grafts)

-Grafts may be implanted too deep because of combined needle site creation/insertion method

-Hair in the donor region is usually only trimmed to 1-2 cm in length, and the longer hair makes extraction more difficult and can increase the rate of graft transection.

Are all Patients Good Candidates for hair transplantation with the Choi Implanter?

choi 2According to these same hair loss experts, not all individuals are ideal candidates for FUE with the Choi Implanter device.  After its invention (at KNU in Korea), the tool began producing solid results in Asian hair loss sufferers and became a popular device in Asian countries. However, although the implanter offered adequate results in Asian individuals, physicians found less success in other races. Experts researched this phenomenon and came to the following conclusion: Asian hair shaft diameter is generally thick and straight, and the curly characteristics and thinner diameter of other races is difficult to properly load into the implanter and place in the scalp. This can lead to inappropriate graft bending, incorrect graft placement, and excessive trauma to the graft. Thus, most likely, not all patients are ideal candidates for use of the Choi implanter pen during surgery.

Conclusion

It’s important to remember that the physician, not the tool he/she uses, determines the outcome of the hair tranpslant procedure. Even the most advanced tools can create poor results in the hands of a neophyte surgeon.  The Choi implanter can produce satisfactory results when used by a trained surgeon who is familiar with the device. Before investigating surgery with the Choi Implanter, patients should be aware that the device is associated with a series of advantages and disadvantages, and that not all individuals (especially those of non-Asian descent) are good candidates for surgical hair restoraiton with the implanter tool.

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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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