Eyebrow Transplant
Eyebrow Transplant in Chicago, IL
Eyebrow restoration has become one of the hottest areas of hair transplantation recently. The rise in fuller brows has led to a revolution in microblading, henna, tattooing, and other options to create fuller brows. Eyebrow transplantation has the main advantage of being a permanent option. Even though transplanting hair in the eyebrows seems like the most extreme option, it can actually create the most natural appearing eyebrows.
There has been recent controversy on eyebrow shape, position and size. Take note, not all eyebrows will fit each face and facial shape.
Eyebrow Position of the Arch
Figure 1: Eye Anatomy
The position of the eyebrow arch should be over the lateral portion of the eye. In this diagram, we can see both the Lateral Limbus (side part of the iris) and the Lateral Canthus (where the eye connects with face).
Roth Method
The ideal arch varies from person to person, but ideally should be the direct difference between the Limbus and the Canthus known as the Roth Modification (see Figure 2).
Westmore Method
Cook Method
The Westmore method and the Cook method are either too central or too lateral for most facial shapes. Obviously, personal preference plays a large role here.
Eyebrow Height – Lateral vs Central vs Medial Brow
The lateral brow ideally should be slightly elevated between the medial brow and the lateral brow. According to Anthony P. Sclafani, MD, et al in an article from Archives Facial Plastic Surgery The medial brow should be at the medial orbital rim, the central brow should be at the orbital rim and slightly elevated at the Lateral Canthus. Special consideration should be made to patients who will receive either a chemical brow lift (Botox) and/or actual brow lift to brow position.
Where Do Brows Start and End?
The medial brow should not go past the Medial Canthus (see Figure 1). The Lateral Brow should slightly extend past the Lateral Canthus and can be drawn by placing a straight line from the edge of the nostril to the Lateral Canthus.(see Figure 2)
The Process of Designing the Brows
For many patients, the design of the brows is as big of a deal as the procedure. Dr. Chughtai and Dr. Shah take pride in the technical aspects of brow design. Aside from measures, we utilize customized facial stencils to help identify facial asymmetry and help to create as exacting a designed brow for each patient. As this diagram shows, this patients brows look relatively normal in position. However, almost every patient has some asymmetry which precise facial stencils can help identify. With the stencil in place it is clear that the brows are quite different and an adjustment can be made. We don’t use the stencil to dictate the design process but rather assist in the artistic endeavor.
The Procedure – Harvesting the Hairs
There are various options for harvesting hairs for brows with both strip (incision) and FUE (removing individual hairs) being viable options for eyebrow transplantation. The Strip method will result in a scar, which is typically not a major issue for most female patients since the majority of females have longer hair in the back. There is a minor risk of numbness from the Strip procedure as the nerves may be transected in this location. The sutures are removed usually at 1-2 weeks after surgery.
The FUE method is where individual hairs are removed by the individual hair follicle. This is traditionally done by hand but has a higher transection rate (grafts cut) due to a number of reasons including human error and fatigue. Robotic harvesting for eyebrow hair transplantation has the advantage of a lower transection rates. The area that is harvested (the donor area) is typically shaved but long hair can easily and stealthily cover the shaved area.
Implanting the Hair and Hair Direction
Hair design for eyebrows plays a particularly important part in eyebrow transplantation. The hair along the superior aspect will often direct inferiorly while the hair along the inferior aspect of the brow will often direct superiorly. The angulation of the brow is critical as it must direct laterally and not up from the face. Since brow hairs appear in nature as single hairs, only single hairs are implanted. Brow recreation is extraordinarily technical requiring small sites and smaller grafts for implantation.