• #12-2. Hair transplantation in pubic hypotrichosis, eyelash and eyebrow


    ▶ Previous Artlcle : #12-1. Hair transplantation in pubic hypotrichosis, eyelash and eyebrow


    Eyelash restoration


    I have treated patients who wanted eyelash transplantation presenting very short eyelashes or (Figure 3), local eyelash loss (Figure 4) caused by recurring stye. The patient with a latter condition did not have complaints on the aesthetic outcome, however, the patient with short eyelashes experienced temporary eyelid scarring and transplanted hair irritated the cornea. Another problem was that transplanted hairs grew in different directions and looked unnatural. Complete removal of all transplanted hair was necessary in this case. As mentioned earlier regarding surgical eyebrow restoration, unnatural appearance following the eyelash transplantation cannot be improved using camouflage and poses a problem for the patient (Figure 5).


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    Figure 3. A: 1 year after procedure B : Transplanted hairs growing in different directions


    Figure 4. A: eyelash loss due to recurring stye. B: Immediately after procedure. C. 2 weeks after procedure.


    Figure 5. A: Showing tenting. B: Transplanted hairs point downward.


    Moreover, the procedure of eyelash transplantation is more complicated and more often followed by serious side effects compared to the eyebrow transplantation. Therefore, surgical eyelash restoration should only be carried out with appropriate indication. If the procedure is deemed necessary, it may be advisable to transfer the patient to a doctor with extensive experience in the procedure.


    Eyebrow restoration


    For a novice, eyelash transplantation using only 200-300 hairs may be more appealing as it seems simpler than scalp hair transplantation involving 2000-3000 hairs. However, eyelash transplantation requires a lot more experience, expertise and concentration than scalp hair transplantation and should not be regarded as a simple procedure. Surgical restoration of scalp hair has the advantage of using camouflage in the forms of a wig, hair loss concealer or hat, if the outcome is not aesthetically pleasing. On the contrary, eyebrow cannot be disguised or camouflaged. Use of an implanter may damage the existing follicles of the eyebrow leading to an unnatural appearance (Figure 6). In one patient with graying hair, I extracted only black hairs from the donor site in the back of the head, however, a great deal of regrowing hairs in the recipient site of the eyebrow turned white. This posed quite a conundrum for both the patient and doctor. Opinions may vary, but from my clinical experience, transplantation of the entire eyebrow rarely result in aesthetically ideal outcome. However, restoration of only 1/2 or 1/3 of the outer eyebrow is more likely to bring satisfactory outcome.



    Figure 6. A: Before procedure, B: Immediately after procedure, C: 1 year after procedure


    -To be continued-

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