>>HOME >>QHR System Direct Method Dr. Koichi Inoue, i-Land Tower Clinic This procedure has potential to become the mainstream approach to autologous hair transplantation. While it is generally considered one of the techniques called follicular unit extraction (FUE), the entire process is mechanized and grafts are passed through tubing between two hand pieces (a punch and an implanter) and then immediately transplanted without removing the follicular unit graft. Because the strip method that has been mainstream involves first using a scalpel to acquire donors from the back of the head and then reefing that region, there has been no way to avoid the consequent striated scarring on the back of the head for some time afterwards. This scar has meant longer down times and some degree of pain that is referred to as a stretched sensation. In the direct method, however, donor acquisition is performed with an electrical punch having a tiny blade machined for the size of a single hair follicle, and so the patient experiences no post-operative pain and the scarring all but disappears in a few weeks' time. In short, non-visible scarring and less down time. The use of a punch to acquire the follicular units is an advanced technique, but since one becomes able with proficiency to perform the transplant simultaneously with acquiring the follicular unit, transplants enjoy high survival capability and one may thus expect improved survival ratio. Its more promising applications at present seem to be in transplants of 300 or fewer grafts at a time. It is the strip method that is able to make more efficient use of the donor region in sessions with more than 300 grafts. A patient may undergo transplantation spread across several sessions, each with a different region, however, and so the direct method may be employed for a wide range of transplantations in an approach that increases the number of sessions while decreasing the amount of down time per session, and it also has applications in cases of tautness on the back of the head that make it difficult to perform acquisition as in the strip method. Features of the Direct Method No use whatsoever of conventional scalpels. Procedure takes as little as 30 minutes. (Some individual variation, depending on the number of grafts.) Optimal for transplants to the hairline, part and other areas of fine detail. No resections or lesions to the scalp and so no need for post-operative bandaging. The patient may return directly to the workplace. A specially designed hand piece (an electrical suction punch) is used with New Omnigraft equipment specially designed for autologous hair transplantation (approved by the American Food and Drug Administration) to acquire hair from the back of the head directly by suction one follicle at a time. The follicle is passed pneumatically through a tube, and the graft is transplanted while simultaneously preparing the direct hole (the transplant region). The direct method is especially applicable to areas of fine detail, such as the hairline and the part.