As an excellent hair transplant procedure to the scalp can frame an aged-appearing face, strong eyebrows can frame an eye to make it look more attractive and rejuvenated. Eyebrow hair transplants have begun to come into vogue now that techniques and refinements have continued to create better and better results that are seamlessly natural and easy to care for. In this article we will explore some basic ideas of eyebrow hair transplantation including the pros, cons and limitations.

Before a surgical treatment can be undertaken for the eyebrows, it is important to understand what may cause hair loss in the eyebrow region that may preclude or prevent transplantation there. One of the most common reasons for need of eyebrow transplantation is overplucking an eyebrow, especially by a female, with the hair never growing back. Fortunately, this is one of the most favorable conditions for eyebrow hair transplantation with typically excellent results. However, diseases such as alopecia areata, which is a type of autoimmune-based (or at least that is what is speculated) hair loss is not a good condition since hair graft survival is variable and reactivation of disease may lead to loss of the transplanted grafts over time. Other conditions such as a low thyroid level can predispose toward loss of hair in the outer third of the eyebrow and may be reversible with medical therapy alone. Therefore, if this pattern is observed, it may be wise to start with a laboratory workup.

Female woman eyes and brows image collection set

Eyebrow hair transplant involves taking the finest one-hair grafts from the back of the head, typically near the neck area or in the temple where they are finer through a very short incision of a few centimeters, and then dissecting them into individual grafts for transplantation. The sites that will hold the new hairs are created in a shape that resembles a natural eyebrow. Typically, the macro shape is such that there is a thicker club in the portion near the nose tapering to a gentle arc near the outer temple. In the old days, the peak was placed near the lateral limbus (the outer part of the iris) but today the height of the peak of the brow is centered a bit farther out somewhere between the lateral limbus and the lateral canthus (where the upper and lower eyelids join.) The brow then tapers downward a bit from there. For men the brows can be thicker and longer with a less defined peak and taper, although it still does taper toward the outside. The eyebrow hairs themselves must be oriented to match a natural eyebrow: toward the inside the club shape fans in an arc and then moves toward the temple by resembling a fishtail shape or some call it cascading dominoes. These angles must be extremely flat to look natural. Using “coronal” sites in which the blade is angled parallel with the skin surface rather than perpendicular can help accomplish this task.

It takes about 6 to 12 months for the hairs to grow just like following a regular hair transplant. However, hairs transplanted from the back of the head will typically grow faster than a normal eyebrow and will require trimming every week to two weeks for optimal aesthetic appearance. At times after a year to two, a condition known as “recipient dominance” may occur in which the skin of the eyebrow area influences the transplanted grafts to slow down in their growth rate to resemble that of the natural eyebrow hairs. Although this is not a guarantee, it is commonly observed. Sometimes a second hair transplant is necessary for best results since the hairs can be more tightly packed after a second session. This is not always necessary though, but a prospective patient should be aware of this possibility. As in all things in life, choosing the right surgeon to perform an eyebrow hair transplant for you involves finding someone with the knowledge of who is and who is not a good surgical candidate and obviously then a surgeon who has the technical and artistic skills to create an aesthetically pleasing and natural result for you.

Samuel M. Lam, MD, FACS is a board certified, hair restoration surgeon specializing in eyebrow hair transplants. Follow these links to view eyebrow hair transplant photos and eyebrow hair transplant videos, or call 972-312-8105.