Eyebrow Transplantation

Before	After

Eyebrow Transplantation is the permanent and beautiful way to enhance your appearance with affordable cosmetic procedure in single visit.

Why eyebrow transplantation works?
The technique for eyebrow transplantation is similar to the artistry and the permanence of hair transplantation. The fast and effective procedure takes only two to three hours. The technique involves taking a small amount of hair from permanent donor area and transplanting them to the eyebrow region. The state-of-the-art follicular unit hair transplantation technique used for the procedure looks natural and is virtually undetectable with the transplanted hairs blending right in with the existing brow. This is a highly artistic procedure in which a brow is individually designed just for you based on your facial type, your features, and what you personally want to achieve.

Surgical Techniques
The surgeon and patient assist in drawing the outline of the eyebrow with marking in the sitting position. Matching the size of existing eyebrow with donor hair is done with micro caliber whenever possible. The donor site is selected from the mid-occipital area to match the caliber of the existing brow (it is least likely to turn gray). The number of grafts depends on the size and feature of the intended reconstruction of the brow. On average 100 to 300 single hair grafts are transplanted on each side. The donor hairs are trimmed 1 cm long. Open technique donor harvesting is applied to minimize transection and the wound is closed with trichophytic donor closure by deepithelized lower edge in single layer using absorbable sutures.

The single hair grafts are carefully dissected under 10 times magnification microscope. Ultra skinny single follicular unit grafts were trimmed out the fat and tissue around the hair shaft but remained outer root sheath to accommodate 23 G needles and sometimes 24, 25 G needles for easy insertion and dense packing. These single hair grafts have not been further partitioned. Follicular units that contain more than two hairs are longitudinally sectioned into one-hair unit. The brow is cleansed with Betadine and anesthetized with 1% Xylocaine with epinephrine. No tumescent fluid is needed in this region. It is preferable to use 3 times magnification loupes performing simultaneous 23G needle stick-and-place in flat angle and dense packing of grafts. This planting technique in these size sites is easily accomplished after training.

Insertion of the grafts is crucial. Thus the surgeon must insert the grafts with the current of the hair shaft in alignment with the axis of the brow; otherwise the hair will flow out of the axis result in an unnatural look. The eyebrow is divided into three portions to help determine how many sticks need to be made in each segment for uniform density and symmetry. When the needle is inserted, the direction in superior edge of medial third will direct down below to the brow axis instead of upward as in the normal anatomy. This modification is needed because the transplanted hairs are thicker than normal eyebrow hairs. Transplanting hairs in an upward direction in the medial part produces growth that may be unnatural. For the other two portions, the plan is to have hairs converge to each other and the needle is inserted in an acute angle to almost flat. The medial and middle portion is transplanted more densely. The lateral border is feathered superiorly and inferiorly. In addition, the borders of the eyebrow must be irregular with finer caliber hairs transplanted in the peripheral area. Just prior to completion the patient examines the transplanted eyebrows to see if any adjustment is needed.

Postoperative Care
Antibiotic eye ointment is used without any dressing for 10 days to help control the hair angle flat to the skin and prevent infection during the wound healing process. Compress dressing used to be done to keep the angle flat, but the results showed no difference.

Bruising and mild puffiness over the upper eyelid usually lasts for 3-4 days. Most eyebrow transplants do not shed and continue to grow in contrast to scalp hairs - thus they need trimming once a week. If the patient requires more density, a time frame of at least 6 months is recommended.

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