Tuesday, January 23rd, 2018

Eyebrow Hair Transplants

Replacing Eyebrows

Eyebrows have been successfully transplanted for many years. Most patients are quite satisfied with eyebrow transplants that are well done, but a poorly done case can be a source of great displeasure. Dr. Straub has a series of 56 eyebrows and mustache transplants that were performed during 19 trips to Saudi Arabia. The women there allow only their eyes to bee seen behind veils and are very conscious about the appearance of their eyes. He has also done many cases here in the U.S.

Head hair is used for the donor hair, and the patient must be told that they will have to trim their eyebrows regularly. A common problem when transplanting eyebrows is getting the hair to lay flat to match the natural eyebrow hair. The recipient incisions are made nearly parallel with the skin surface. The upper and lower edges are transplanted with single hairs angled toward the centerline of the eyebrow. The center grafts can be two hair grafts which follow the curve of the eyebrow. They stop 1cm before the lateral end. This minimizes the chance of getting ragged, shaggy appearing eyebrows. The hair is planted as flat as possible. The new eyebrow hair, however, will grow out steeper because it tends to curl upward, and the patient must be advised that the hair was planted flat and after it grows it must be trained to lay flat. If they push it down frequently and sometimes apply a light coat of petroleum jelly, it will eventually be trained in this position, and this will no longer be necessary.

Most, but not all, eyebrows are done on females. A woman with weak eyebrows is probably used to drawing her eyebrows with an eyebrow pencil. I allow a woman to draw the eyebrows that she would like to have, but I will not transplant a shape that does not appear natural. Just as some men, particularly young men will request a very low hairline, women may request bazaar shapes of eyebrows. Occasionally a female patient may draw high peaked eyebrows or eyebrows that slope upward rather than downward. Requests for these unusual shapes will not be honored, as they are not suitable as a permanent eyebrow shape. The best location and shape is where her natural eyebrow was located. This can usually be located by fine vellus hair.

Most eyebrow hair matches the head hair quite well. Patients with fine head hair have fine eyebrow hair, and people with large diameter hair on their heads have thick hair on their eyebrows. Occasionally there is a difference usually that the head hair appears too strong for the eyebrows. I pull out or cut one strand and match it to the eyebrow; if it appears too coarse, I will take hair from lower, toward the neck. The disadvantage of using neck hair for donor hair is that, because of the movement of the neck, the region tends to scar badly. Only a small amount of donor material is needed for the eyebrows. I make the incision as short as possible and close with a trichophytic closure. To recreate a full eyebrow requires 200 to 300 single-hair and two-hair grafts but most eyebrows have some hair in the nasal bridge region, therefore most eyebrows are transplanted to thicken existing thin hair and will use fewer grafts.

The hair is usually transplanted at the length that is appropriate for the final transplant. The patient can then have a preview of the final result even though we expect the hair fall out and begin to re-grow after three months.

Eyebrow Hair Transplant

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