An implanter pen is an instrument used by physicians to transfer follicular hair unit grafts onto the scalp – a follicular unit typically contains anywhere from one to four healthy hairs. This device was first invented in the 1990s by Yung Chul Chou of the Kyungpook National University, who designed the device to reduce the amount of labor involved during hair transplants as well as to reduce the amount of direct physical contact to the recipient’s scalp. By minimizing the amount of direct physical contact, the scalp experiences less trauma during the procedure and can heal more quickly. An implanter pen also shortens the amount of time that the follicular unit spends outside of the body, which in turn increases its odds of survivability.
During a hair transplant, the physician first removes the follicular units from the donor zone, either as a strip from the back of the scalp (as with Follicular Unit Strip Surgery) or individually (as with Follicular Unit Extraction). These follicular units are then dissected and rearranged into grafts that are ready for reinsertion into the scalp. Once the grafts are prepared, they are then carefully loaded into the needle of the implanter pen using special forceps. Usually an assistant will perform this loading process for multiple pens and hand them to the physician one-by-one as needed throughout the course of the procedure. Next, the physician instantly creates a recipient site by pressing down on the pen’s plunger, injecting the graft through the needle and into the scalp. During this step, the physician must be careful to angle the needle of the pen so that the hair will grow naturally. If the needle is facing at a bad angle, the follicle will be misangled and the resulting hairs will grow noticeably out of place.
Traditionally, a physician performs a hair transplant using a moderate to high gauge needle or blade to create incisions. Many still prefer this method as the use of implanter pens is rare. However, incisions using a blade must be deep enough for the follicular units to take root. This can lead to potential complications such as infections, scarring, and even necrosis. Implanter pens, however, can sometimes reduce these risks in a number of different ways. A main advantage of these devices is that they instantaneously create recipient sites using a fine needle, which minimalizes bleeding and the chance of infection. This also reduces the scarring as well, though scars will be present as with any puncture of the skin. The immediate nature of placement into the recipient sites allows for greater densities to be achieved and with less bleeding as the incision does not have time to ooze after the incision is made. The hairs themselves also have a higher chance of survivability since vital structures such as the dermal papillae are not directly touched. The follicular units themselves fit snugly into the newly created recipient site, and the overall healing time is usually quite short since the donor extraction procedure is almost synonymously FUE.
Although implanter pens have been in existence for two decades they have never become the mainstream tool of choice for graft placement. In the early 2000’s DHI hair transplant company based in Greece used the use of this tool as one of their biggest selling points claiming that the grafts were not touched in any way during surgery. This was later revealed to be untrue due to the nature of the implanter pen to begin with. Dr. Jose Lorenzo of Madrid, Spain uses a slightly modified implanter pen called the “Lion” implanter pen and he has single handedly helped to bring legitimacy to the use of this tool.