Eyebrow transplantation is performed by transferring the hair follicles taken from the donor area (around the nape and ears) to the brows that have lost volume, under local anesthesia.
FUE(Follicular Unit Extraction) is also the most popular method in eyebrow transplantation. FUE which is used in eyebrow transplantation allows hair follicles to be removed one by one and allows transplantation to be one by one. Therefore FUE allows the transplantation to look more natural.
Evaluation of the patient
- Firstly it is questioned whether the patient has a condition that prevents hair transplantation and then the patient is evaluated in detail.
- It is investigated whether the patient has a disease such as hepatitis B, C, and AIDS by the blood tests made in the laboratory.
- It is questioned whether the patient has chronic diseases like hypertension, diabetes, psoriasis. If the patient has these diseases, they must get approval from their doctor before the transplantation.
- The patient is asked whether he/she is taking medication for psychological diseases.
Planning the brow design
- As in hair transplantation, planning is the priority in eyebrow transplantation. The eyebrow design is made with a pencil and got approval from the patient.
- While planning in women, a form that narrows towards the ends is followed, in men, a thicker and more dense form is preferred.
- Since brows have a flatter and lower shape in men, the planning process is usually made with following the letter T. In women the letter C is followed in the planning process. (image 1)
- The design that created based on the person’s nose is another planning method considered in brow transplantation planning. In the nose based design, first the tip of the eyebrow and then the point where the brow rise and the start of the brow will determine. (image 2)
- After determining the place where the follicles to be used for brows will be taken and placed, the operation process is started.
Application of local anesthesia
- The first step of the operation process is anesthesia. Anesthesia is applied locally to the donor area and to the brows where the transplantation will be performed.
- With anesthesia, isotonic and adrenaline are also applied to the roots. Isotonic is used for comfortable removal and placement of hair roots and adrenaline is used to reduce bleeding.
- After the injection of serum consisting of a mixture of anesthesia, adrenaline, and isotonic into the scalp, the area is locally numbed in several minutes.
- Because of the area is numbed with anesthesia the patient does not feel any pain during transplantation.
Operation process(which technique is used)
After the anesthesia of the transplantation zone, the patient is ready for the operation. The operation begins with the removal of the hair follicles from the donor area and ends with the opening of the canals and placement of the hair roots. While all this is being done, FUE is preferred as a method in brow transplantation operations. Apart from FUE, Choi(hair transplantation pen)
is also a preferred application for brow transplantation. With Choi also known as DHI(direct hair implant) method, the roots are placed directly in the transplantation area as they are removed from the donor area without a separate grooving process.
Removing and collecting roots from the donor area
- The donor areas used for brow transplantation are usually just above the nape and around the ear. The hair follicles from the donor area are removed with the help of punches in the device called micromotor.
- The Micromotor ensures that the punches automatically rotate around the hair follicle, separating the roots from the skin and loosening them.
- After the hair follicles are loosened, the hair follicles are removed one by one with a medical tool called forceps and according to the number of roots, they are placed in a dish full of a serum called Petri.
- The serum is thought to prevent the hair follicles from being damaged and helps to heal faster.
Opening of ducts in the eyebrow region(direction and angle)
- Grooving operation in eyebrow transplantation is more difficult than the grooving process in hair transplantation.
- For eyebrow aesthetics, the ducts opening to the middle parts of the brow are opened vertically, the ducts opening to the sides and the ends are opened horizontally.
- In the grooving process, 0.9-1.1mm tips are often used, although it varies depending on the hair and brow structure of the patient.
Placement of the collected roots
- For eyebrow aesthetics and not to get a hard and artificial look, while roots are placed thicker hair should be transported to the middle part and thinner hair should be transported to the brow edges and the ends in order.
- As the eyebrows are three-dimensional, the bristles on the edges of the brows are placed in the form of a fishbone(image 3).
- In eyebrow transplantation, grafts with a single hair follicle are preferred. These grafts are placed vertically on the head and middle part; it is placed horizontally on the edges and ends.
- Since eyebrows have a single hair structure, grafts containing single hair follicles should be preferred during the placement to get a natural result.
Things to Know Before Eyebrow Transplantation
- 2 to 3 days after the eyebrow transplantation, brows, and the donor area should be washed.
- Washing should be done delicately and harsh intervention to the transplantation area should be avoided.
- During sleep, the patients should lie on their back for about 1 week so that grafts don’t come off.
- If the crusts formed on the brows do not fall after the washing process performed after 3 days, the crusts must never be removed by hand.
- Bruising and slight swelling on the upper eyelid usually takes 3 to 4 days to heal, patients should not worry. If bruising and swelling are increasing, the transplantation doctor must be informed.
- Itching may occur in hair follicles after the crusts have completely fallen. In such cases, the itchy area can be relaxed with the palm, without pressing.
- If the itching is very severe, itching relief cream or gel can be used after the approval of the transplantation doctor.
- Eyebrows will have a visible shape in about 3-4 months. They gain a thicker and healthier appearance between 6-8 months. They reach the final result after 1 year.
- Eyebrows experience shock loss approximately 3-4 weeks after transplantation. Hair roots, which defend themselves, go to sleep. There should be no worries as it is a natural result of transplantation.
Eyebrow Transplantation Complications
After eyebrow transplantation, complications such as wrong hair direction, weak growth, curl, asymmetrical appearance, or swelling may occur. These complications which completely occur according to the patient’s body can be exemplified through two separate studies to understand the subject.
In the study called Eyebrow Transplantation İn Asians, 5 people who have eyebrow transplantation observed for one year. In this observation, the most common complication in these people was the wrong hair direction and asymmetrical appearance. But curl and intertwined hair was not seen.
In the study called Eyebrow Transplants: The Use of Nape and Periauricular Hair in 6 Patients 6 people who have eyebrow transplantation observed. None of the complications such as curl, weak growth, asymmetrical appearance were observed in these individuals.
Using hair follicles for eyebrows may cause different rates of growth compared to the existing brows. For this reason, it is recommended to cut the transplanted eyebrow hairs more frequently.
Brief Information About Eyebrow Transplantation
These are the other titles that wondered about eyebrow transplantation.
When will it heal?
Typically the donor area will be healed in 6 weeks to four months.
How many hours is eyebrow transplantation done?
Although it varies according to the condition of the brow, eyebrow transplantation operations usually take approximately 2-3 hours.
Will there be a scar on the place where the follicles are taken?
Since few grafts are used, an aesthetically unpleasant appearance does not occur in the donor area.
How Long Does Shock Loss Take In Eyebrow Transplantation?
Depending on the patient’s body and the last phase of the hair removed from the donor area, the duration of shock loss may change. But it usually takes one month.
How many days should eyebrows be cut after hair transplantation?*
For maintaining the desired length, the eyebrows should be cut once a week. Since transplanted hair follicles and eyebrow hair growth stages are different, the planted brow hairs should be kept under constant control in order not to get an unpleasant appearance.
How many grafts are planted in eyebrow transplantation?
Although this number varies depending on each eyebrow, an average of 30 to 150 grafts(with a single hair root) are planted.
What are the Harms of Eyebrow Transplantation?
No damage is detected in eyebrow transplantation operations.
May eyebrow transplantation be done over a tattoo?
Yes. In a study published in the journal Dermatol Surg, a woman with an eyebrow tattoo at the age of 54 was transplanted without needing to remove tattoos .
Reviews of Those Who Have Eyebrow Transplant in Scientific Studies
In the study titled “Restoration of the Eyebrows by Hair Transplantation”, 10 people aged between 18 and 59 years, who had eyebrow transplantation on different dates, were asked whether they were satisfied with the result.
All 10 people who wanted to find a solution to burn, disease, or congenital sparse eyebrows expressed that they were satisfied with the natural density of their eyebrows after eyebrow transplantation and stated that they obtained a satisfactory result in cosmetic appearance .
In the study titled ” Single Follicular Unit Hair Transplantation to Restore Eyebrows ”, 14 of 17 people aged between 18 and 66, who examined between January 2007 and June 2009, were very satisfied with eyebrow transplantation, 2 were only satisfied, and one person was not satisfied due to too thick eyebrows .
If we consider two different studies, we can see that the people examined are satisfied with eyebrow transplantation. Of course, these answers are relative since each person’s structure and expectations will differ.
REFERENCES Marco Toscanı, ‘’Single Follicular Unit Hair Transplantation to Restore Eyebrows’’ American Society for Dermatologic Surgery Dermatol Surg, 37,1153,( 2011).  Müzeyyen Gönül and Others, ”Alopesi Areatalı Hataların Geriye Dönük Değerlendirilesi”, Turkish J Dermatol, 5,44, (2011).  Hair transplantation for therapy-resistant alopecia areata of the eyebrows: Is it the right choice? Evrem civaş and others, Journal of Dermatology, 37, 823–826, (2010). [4-5] A Technique for Reconstruction of Eyebrows and Eyelashes, Marcelo Gandelman, 19,155, (2005). [6-7] Sanusi Umar, ‘’Eyebrow Transplants: The Use of Nape and Periauricular Hair in 6 Patients’’, Dermatol Surg, 40, 1417, (2014).  Selma Sönmez and others, ‘’Eyebrow Transplantation’’, Ann Plast Surg, 51, 584-586 (2003).  Kongkiat Laorwong, ‘’Eyebrow Transplantation in Asians’’, Dermatol Surg, 35, 50, (2009).  Sanusi Umar, ‘’Eyebrow Transplants: The Use of Nape and Periauricular Hair in 6 Patients’’, Dermatol Surg, 40, 1418, (2014).  Selma Sönmez and others, ‘’Eyebrow Transplantation’’, Ann Plast Surg, 51,584-586 (2003).  Sanusi Umar, ‘’Eyebrow Transplants: The Use of Nape and Periauricular Hair in 6 Patients’’, Dermatol Surg, 40, 1416, (2014).  Coen Gho, ‘’Restoration of the Eyebrows by Hair Transplantation’’, Facial Plast Surg, 30, 217, (2014).  Marco Toscani, ‘’Single Follicular Unit Hair Transplantation to Restore Eyebrows’’ American Society for Dermatologic Surgery Dermatol Surg, 37, 1153,( 2011).