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Eyebrow Hair Transplant

Can your eyebrows keep up with the trends?

From the '90s skinny brow to the thick brows of the 2010s and now back, you might find yourself going through cycles of overplucking and filling in with eyebrow stencils. Unfortunately, sometimes eyebrows simply don't grow back. People can lose eyebrow hairs due to overplucking as well as different medical conditions. 
 
As a solution, some people opt for an eyebrow hair transplant since the results are permanent and continue to look natural over time. Today, we will look into eyebrow hair transplant harvesting, implantation, and after-care.
 

How are the hairs harvested?

FUT is often the preferred harvesting method for this procedure since it allows for the hairs to be kept long. The length is important because the curl of an eyebrow hair should be turned towards the face, and the hair's natural curl can be observed when the shaft is kept longer. Keep in mind that it is still possible to do this using the FUE technique if that is the patient's preferred method. 

How many grafts are transplanted?

When no hair is present, a result with good density usually requires 300-350 grafts per side, on average. This number is lower when the patient already has more hairs in the area. 

What does FUT for an eyebrow transplant look like?

Grafts are typically harvested from the back of the head. First, the surgeon marks out an area, scores around those markings, and makes deeper cuts.
 
Scissors or a blade may be used to pry apart the area at the perimeter so that the bulbs of the hair follicles on the perimeter aren't damaged. The hair follicles need to be intact for the hair to grow once transplanted. 
 
To close the area, Dr.Linkov uses a combination of 3-0 and 4-0 PROLENE suture. These are non-dissolvable sutures and must be taken out 10-14 days after the surgery.
 
Although FUT is a minimally invasive surgery, surgeons should have an electrocautery device on hand in case they encounter excessive bleeding.

How are the grafts implanted?

Implantation of the grafts will depend on the surgeon doing the procedure. Here we will review what the process may look like. 
  • Numbing the area
The patient is awake during the procedure and kept comfortable because the area is numbed.
 
Lidocaine is used to numb the area. The surgeon places the needle underneath the skin starting at the tail of the brow and moving medially.
  • Making the recipient sites
The surgeon can make recipient sites with a needle or a blade, but a blade allows for flatter angles which is better for an eyebrow hair transplant. Angling the blade within the blade holder allows the surgeon to get acute placement while holding the instrument more vertically. 
  • Implanting the grafts
After the recipient sites are made, the surgical team begins implanting the grafts. An eyebrow hair transplant surgery can last for 4-8 hours, and requires a highly skilled hair transplant team.

What are the eyebrow shape options?

The patient's current eyebrow shape is used as a base around which the new eyebrow is built. Surgeons take into account the following:

  • the symmetry of the face, 
  • relationship to the eye, 
  • the density and direction of the hairs.
  • patient preference
  • Symmetry 
Both eyebrows can never be completely identical since faces are inherently asymmetrical. For example, if the left side of the patient's face is higher, the left eyebrow will be too. Still, we want to ensure that both brows have more or less a similar length and shape.
  • Relationship to the eye

The peak of the eyebrow, where it starts to go downwards should be between the lateral limbus and the lateral canthus of the eye. The lateral limbus is the line between the iris and the sclera (the white outer coating of the eye). The lateral canthus is the outer corner of the eye where the upper and lower eyelids meet.

  • Density and direction of hairs

It's not just the shape and length of the brow that plays a role in how natural the final outcome looks. There's usually a fishbone design to how the surgeon makes the recipient sites.

  • Hair density

Also, the thickness of the brows is different throughout. The natural pattern of the brow has more density in the middle compared to the head and tail of the brow.

How should I take care of my eyebrows after surgery?

Patients shouldn't get the eyebrow area wet for six days after the surgery. On day six, the area can be washed and crusts should start to be removed gently.

When can I expect results?

The placed shafts of the hairs fall out at about three weeks, which is normal. The regrowth process will start after three or four months, and you can judge the final results after 10-12 months. 

Maintenance

Regular maintenance is required for the implanted hairs as they will grow like they would on the back of the head - long. These hairs usually need to be trimmed every two weeks. 

The content of this newsletter is for entertainment and educational purposes only. This content is not meant to provide any medical advice or treat any medical conditions. Patients must be evaluated by an appropriate healthcare provider on an individual basis and treatment must be tailored to meet that patient’s needs. Results and particular outcomes are not guaranteed.

Written by Aleksandra Božović | Edited by Dr. Gary Linkov
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