ARTAS Robotic Hair Transplant: FUE vs DHI for This Technique

ARTAS handles extraction, not implantation. The choice between FUE-style placement (forceps into pre-made sites) and DHI placement (Choi implanter pen) determines your hairline precision, maximum graft count, and cost. Both methods achieve 90-95% graft survival with ARTAS-extracted follicles, but they serve different clinical purposes.

This guide explains how each implantation method works with ARTAS extraction, when to choose one over the other, and whether the hybrid approach is worth the extra cost.

Understanding the Two Phases of Hair Transplantation

Every hair transplant involves two distinct phases:

1. Extraction: Harvesting follicular units from the donor area
2. Implantation: Placing those follicles into the recipient area

ARTAS automates the extraction phase. The implantation phase is always performed by a human surgeon and technician team, regardless of whether extraction is robotic or manual. The question for ARTAS patients is which implantation method their surgeon will use.

ARTAS + Standard FUE Implantation

In standard FUE implantation, the surgeon creates recipient sites (tiny incisions in the scalp) with a blade or needle, and technicians then place harvested grafts into those pre-made channels using fine forceps.

How It Works

1. ARTAS extracts follicular units from the donor area
2. Extracted grafts are stored in a holding solution
3. The surgeon creates recipient site incisions using a slit blade or sapphire blade
4. Trained technicians place individual grafts into the pre-made sites using jewelers' forceps

Advantages of Standard FUE Implantation

• Faster placement: Technicians can place grafts quickly because sites are already created
• Higher graft volume: Supports up to 3,000 grafts per ARTAS session (the robot's limit, not the implantation method's)
• Established technique: Most hair transplant teams are highly experienced with this method
• Lower cost: Does not require specialized Choi implanter pens or additional training

Limitations of Standard FUE Implantation

• Two-step process creates a time gap: Grafts wait in storage while sites are created, then wait again while being placed
• Less precise angle control: The surgeon sets the angle during site creation, but the technician placing the graft may not match it perfectly
• Wider spacing required: Pre-made sites need enough separation to avoid channel collapse, limiting packing density

Cost with ARTAS

ARTAS with standard FUE implantation costs $6-10 per graft in the US, which is the baseline ARTAS pricing.

ARTAS + DHI (Choi Pen) Implantation

DHI implantation uses a Choi implanter pen to combine incision and graft placement into a single step. The surgeon loads a follicular unit into the pen, then inserts it directly into the scalp.

How It Works

1. ARTAS extracts follicular units from the donor area
2. Extracted grafts are loaded one at a time into a Choi implanter pen (0.6-1.0mm diameter)
3. The surgeon uses the pen to create the recipient channel and place the graft simultaneously
4. Each graft is implanted at a specific angle, depth, and direction as the pen penetrates the scalp

Advantages of DHI Implantation with ARTAS

• Precise angle and direction control: The Choi pen allows the surgeon to control the exact angle, depth, and direction of each follicle as it enters the skin
• Denser packing potential: Because the channel and placement happen simultaneously, grafts can be placed closer together without channel collapse
• Reduced graft exposure time: Grafts spend less time outside the body because they are placed immediately after loading
• No-shave option for recipient area: DHI can be performed without shaving the area where grafts are placed
• Superior for hairline work: The precision of the Choi pen creates a more natural, irregular hairline edge

Limitations of DHI Implantation with ARTAS

• Slower placement: Each graft must be individually loaded into the pen and placed by the surgeon, which takes more time per graft
• Maximum 3,500 grafts per session: DHI's slower pace limits how many grafts can be placed in a single day
• Requires specialized surgeon skill: Not all surgeons are trained in DHI technique
• Higher cost: The combination of ARTAS extraction and DHI placement typically costs $8-12 per graft

Cost with ARTAS

ARTAS with DHI implantation costs $8-12 per graft in the US, a premium of $2-4 per graft over standard FUE placement.

Side-by-Side Comparison

When to Choose Standard FUE Implantation

Standard FUE implantation is the better choice in several scenarios:

Large Coverage Areas

If you need to cover a large area (mid-scalp, crown, or both), standard FUE implantation is more practical. The faster placement speed allows the team to handle higher graft counts within the ARTAS session window. For cases requiring 2,500 to 3,000 ARTAS grafts, FUE placement is more time-efficient.

Budget Considerations

At $6-10 per graft compared to $8-12, the savings from choosing standard placement add up. On a 2,500-graft case, you could save $5,000 to $10,000 by choosing FUE implantation over DHI.

Adequate Density Goals

If your goal is general coverage improvement rather than maximum density in a specific zone, standard FUE placement delivers sufficient density. Most patients achieve 25-35 FU/cm2, which provides good visual coverage.

For a comprehensive overview of the ARTAS system, see the ARTAS overview guide.

When to Choose DHI Implantation

DHI implantation paired with ARTAS extraction excels in specific situations:

Hairline Refinement

The hairline is the most cosmetically sensitive zone of any hair transplant. The Choi pen gives surgeons fine control over the angle, direction, and density of each graft in the first 2-3 rows. This produces a more natural, irregular edge that avoids the "pluggy" appearance that can occur with less precise placement.

Dense Packing Requirements

If you are at Norwood 2-3 and want maximum density in a focused area, DHI placement achieves 35-45 FU/cm2, compared to 25-35 FU/cm2 with standard FUE placement. The Choi pen's ability to place grafts closer together without channel collapse is the primary driver of this advantage.

No-Shave Procedures

If concealing the procedure is a priority, DHI allows the surgeon to implant grafts between existing hairs without shaving the recipient area. This makes the procedure less visible during recovery. Note that the donor area still requires shaving for ARTAS extraction.

Combination of ARTAS Extraction Consistency with Precision Placement

Patients who want the best of both technologies choose this hybrid approach. ARTAS delivers consistent, AI-guided extraction with low transection rates, while DHI provides the most precise implantation available.

The Hybrid Approach: Is It Worth the Extra Cost?

The ARTAS + DHI hybrid costs approximately $8-12 per graft, making a 2,000-graft session $16,000 to $24,000. The question is whether the additional $4,000 to $8,000 over standard ARTAS pricing delivers proportionate value.

When the Hybrid is Worth It

• You are at Norwood 2-3 and the procedure is primarily hairline-focused
• Maximum density in the transplanted zone is your top priority
• You want a no-shave recipient area to conceal the procedure
• Budget is not your primary constraint

When Standard ARTAS is Sufficient

• You need coverage across a large area (Norwood 4+)
• You want the most cost-effective robotic option
• Your density goals are standard (25-35 FU/cm2)
• Hairline design is straightforward (receding but not severely)

Alternative Combinations to Consider

If the ARTAS + DHI hybrid is outside your budget, consider these alternatives:

Manual FUE + DHI Implantation

Skip the robot and pair an experienced manual FUE surgeon with DHI placement. This combination costs $5-8 per graft in the US, delivering comparable placement precision without the ARTAS premium.

ARTAS Extraction + Manual FUE Placement with Sapphire Blades

Some clinics use sapphire blades for recipient site creation with standard FUE placement. Sapphire blades create finer channels than steel, improving healing time and allowing slightly denser packing, at a lower premium than full DHI.

Full DHI (Manual Extraction + DHI Placement)

In a standard DHI procedure, extraction and placement are both manual. This avoids the ARTAS premium while retaining DHI's placement advantages. Costs $5-8 per graft in the US and $1.50-3 per graft in Turkey.

For a complete overview of DHI methodology, see the DHI guide overview.

Making Your Decision

The choice between FUE and DHI implantation with ARTAS comes down to your priorities:

• Cost-conscious, large area coverage: ARTAS + FUE implantation
• Precision-focused, hairline priority: ARTAS + DHI implantation
• Best of both, budget flexible: Hybrid ARTAS + DHI

Discuss both options with your surgeon during the consultation. A surgeon who performs both techniques can recommend the approach that best matches your anatomy and goals.

Get Your Personalized Recommendation

Not sure which combination of extraction and implantation is right for your case? Upload a photo at myhairline.ai for an AI-powered assessment of your hair loss pattern and personalized method recommendations.

FAQ

Can ARTAS extraction be combined with DHI implantation?

Yes. Some clinics offer a hybrid approach using ARTAS for robotic extraction and DHI Choi pen for implantation. This combines the consistency of AI-guided harvesting with the precision of direct hair implantation. The hybrid approach is more expensive (typically $8-12 per graft) and limited to clinics that operate both technologies.

Is FUE or DHI implantation better with ARTAS extraction?

Standard FUE implantation (forceps placement into pre-made recipient sites) is faster and allows higher graft counts per session. DHI implantation with the Choi pen enables denser packing and better angle control, making it superior for hairline work. For full-coverage cases, FUE implantation is more practical. For hairline refinement, DHI placement produces a more natural edge.

Does DHI implantation improve ARTAS graft survival?

DHI implantation does not significantly improve graft survival rates over standard FUE implantation when both are performed by experienced surgeons. Both achieve 90-95% survival with ARTAS-extracted grafts. DHI's advantage is in placement precision (angle, depth, direction control) rather than survival rate improvement.