Eyebrow restoration is a unique specialty in itself & requires a lot of expertise. For starters, it is important to establish the causes of loss of eyebrows & ways of restoring eyebrows under different scenarios.
Causes of loss of eyebrows-
Some of the common causes of loss of eyebrows include,
1) Over Plucking
2)Trauma following injuries or burns
3)Alopecia areata or totalise
4)Medical conditions including under or over active thyroid, anaemia or other hormonal conditions
5)Post chemotherapy
There are 2 popular treatment options available for thinning eyebrows
1) Medical tattoo – This has remained a very popular option for clients with thinning eyebrows.
Advantages-
- Procedure can be performed in one sitting
- Nearly all clients will be suitable for this procedure
Disadvantages –
- It can be an uncomfortable experience
- The colour can fade over time
- If done by an inexperienced person, it can look extremely unnatural
2) Surgical restoration – This is becoming an increasingly popular option as the outcomes are getting significantly better.
The grafts needed to restore the eyebrows can be extracted using FUE or FUT(Strip) technique.
I personally prefer FUE as I can pick finer hair follicles from the back of the ears or the nape of the neck. Besides, I believe FUE is a lot less painful and the outcomes are much more predictable than a strip surgery.
Advantages-
1) Aesthetically a lot better than tattoo as it looks very natural
2) As the clients own hair follicles are transferred, the client can treat & manage the eyebrows as they would have done their own
Disadvantages –
1) It takes a lot of expertise to perform this surgery & hence the client has the exercise a lot of caution in choosing the surgeon
2) It involves a local anaesthetic and hence the client encounters a bit of discomfort during the process of the anaesthetic being administered.
3) The transplanted follicles have a tendency to grow like the donor hair and hence the client needs to find trim and style the eyebrows at regular intervals.
4) Though the outcomes with experienced surgeons has improved significantly, I counsel my clients that they might need a small touch up to achieve exceptional density.
Procedure – Most of the protocols applicable for hair restoration surgery apply to eyebrow restoration.
I prefer extract the grafts from the back of the ears or the nape of the neck. This would yield grafts with finer hair to mimic those of the eyebrows. I prefer to use a 0.9 mm titanium tipped punch.
Once the grafts are extracted, local anaesthetic is administered to the eyebrows. The next step, incision making, is possibly the most important step and requires utmost attention to dictate the angles.
Once the incisions are made, I use a 0.8 mm choi implanter to replace the grafts.
The client is advised to spray the grafts with saline spray for 72 hours and once the 72 hours have passed, the client can treat her eyebrows like the rest of her hair.
The eyebrows go through phases of shedding and growth for around 6-9 months and by the end of 9 months, most clients notice70-80 % of the transplanted hair grow through.
Dr. Raghu Reddy
FUE Hair Transplant Specialist
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