I want my eyebrows transplanted. A new plastic surgeon just came to town and is offering eyebrow transplant. Should I trust him?
Eyebrow hair transplants are very difficult to perform. The hair grafts for the eyebrow must to placed flat against the upper bone of the eye socket. Unfortunately getting this done correctly, is not easily accomplished and should not be attempted except for the most experienced surgeons who have created many of these reconstructions with good results. I have seen the eyebrow hairs stick out forward as they were not placed flat or in the correct direction. Plucking them out work, but why should you have to pluck after having it done? Good question!
Restoring eyebrow hair is a rewarding endeavor, as this structure is so important to a person’s appearance, perhaps even more so than scalp hair. The secret to eyebrow transplantation (as in other types of hair restoration) is to closely observe nature. Unlike scalp hair, the eyebrows consist of only one-hair follicular units, so that if the source of hair is the larger follicular units obtained from the permanent zone in the back of the scalp, these units (of 2, 3, and 4-hairs) must be carefully split up into individual follicles under the microscope.
Replicating the unique directional changes of eyebrow hair is also critical to a successful restoration. The hair points upward in its medial aspect (near the nose) and then fans outwards as one moves towards the temples. However, the angles are not quite so simple. As one moves laterally (towards the temples), the hair in the upper half of the brow points to the side and down and the hair in the lower half points to the side and up. The upper and lower hairs interdigitate causing the central part of the eyebrow to slightly rise and form a gentle ridge which gives the eyebrow its unique shape. This interlocking also keeps the eyebrow hair orderly and “neat” in appearance. All of the eyebrow hair emerges from the skin at a very acute angle (almost flat), so the recipient sites must be made with the needle actually lying on the skin surface.
Just as the outer edge of the female hairline is often comprised of finer hair, so are the outer boarders of the eyebrows. In a sense, each eyebrow can be viewed as a cosmetic unit, just as the scalp, with transition zones of fine hair around much of the perimeter. As with the frontal hairline and temples, this fine hair may be replicated by removing or producing controlled, intentional damage to the bulb (cutting off part or all of the bottom) of a normal terminal follicle. The practice of using all fine hair for the eyebrows is incorrect since the eyebrows, like the scalp, require a central area of greater density, and bulk, and this is best accomplished with intact (but in this case individual) hair follicles. In all cases, multiple sessions are needed for a complete eyebrow restoration.