Restoring Eyebrows

The most common reasons for performing eyebrow restoration are the following:

  • hair loss from many years of over-aggressive tweezing
  • permanent eyebrow tattoos that don’t look natural
  • skin conditions that cause permanent hair loss (Alopecia areata is the most common, but the doctor must be relatively certain that the condition is stable)
  • scarring from surgery, burns or other injury

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.

Just as the hairline frames the face, the eyebrows frame the eyes. Physiologically, eyebrows function to protect the eye from moisture, sweat, and foreign particles. They also provide a subtle shade from the sun and glare. Aesthetically, eyebrows convey emotion and expression as well as contribute to the supporting beauty or handsomeness to one’s face.

slideshow showing before and after of eyebrow transplants by the new hair institute (nhi) in los angeles

Flaws in the eyebrow may occur for many reasons, not necessarily from the plucking process. Just like scalp hair loss, eyebrow hair loss can be from genetic causes as well. Eyebrows may even disappear, in part or in whole, just as a person ages. For many women, drawing on their eyebrows becomes a burdensome morning routine. Men face the same problem with their eyebrow hair loss as well.

Hair transplantation to the eyebrow is an excellent option for replacing and restoring missing eyebrow hairs. The donor hair usually comes from back of your scalp. Each hair follicle is relocated one by one with each hair follicle representing its own organ. In essence, it is a self-donor organ transplant where each hair follicle is its own organ. Because the hair follicle is your own, there is no issue of rejection. This is the basis of all modern hair transplant surgery.

The method of harvesting the donor hair is carried out under local anesthesia using the Follicular Unit Extraction (FUE) or the Follicular Unit Transplant (FUT) strip harvesting method.

Since the donor hair is from the scalp, once it is transplanted to the eyebrow it will take on the characteristics and grow like regular scalp hair. This means that the transplanted hair will continue to grow like regular scalp hair and you will need to trim your eye brow to a desired length 1 to 2 times a week.

Transplanting eyebrow hair requires unique surgical skills, as the eyebrow lies flush to the brow and does not stick out. The surgeon must know how to place these hairs in the proper direction so that it lies flat against the bony brow, as much as possible. It may take as much as 400 or more single hair grafts to replace a single eyebrow.