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Eyebrow & Eyelash
Restoration
1) Eyebrow
Restoration
A) Transplantation
B) Scalp-to-eyebrow
pedicle flaps
2) Eyelash
Restoration
Eyebrows and
eyelashes make an
important
contribution to
facial symmetry and
presentation of self
to others. A person
without eyebrows
and/or eyelashes may
feel very
self-conscious about
his/her appearance.
Transplantation or
reconstructive
surgery can often
restore eyebrows and
eyelashes.
Eyebrows and
eyelashes are lost
in a variety of
ways:
1)
Physical
trauma—e.g., auto
accident, thermal,
chemical or
electrical burns
2)
Systemic or local
disease that causes
loss of eyebrow
and/or eyelashes
3)
Congenital inability
to grow eyebrows
and/or eyelashes
4)
Plucking (to reshape
the eyebrow) that
results in permanent
loss of eyebrows
5)
Self-inflicted
obsessive plucking
of eyebrows and/or
eyelashes (trichotillomania)
6)
Medical or surgical
treatments that
result in eyebrow or
eyelash loss—e.g.,
radiation therapy,
chemotherapy,
surgical removal of
tumor.
The cause of
eyebrow/eyelash loss
is evaluated in
medical history and
examination prior to
consideration of
hair restoration:
1)
Systemic or local
disease that causes
hair loss must be
under control to
assure that hair
restoration can
succeed.
2)
Obsessive-compulsive
plucking (trichotillomania)
must be treated to
assure that restored
hair will not be
plucked out.
3)
Trauma, burns or
surgery may have
resulted in
formation of scar
tissue;
reconstructive
surgery may be
necessary before
eyebrow/eyelash
restoration. The
degree of eyebrow
loss may vary from
complete to partial;
the degree of loss
may be a
consideration in
selection of the
restoration
procedure.
Some patients have
no eyebrow/eyelash
loss, but seek
eyebrow/ eyelash
enhancement for
cosmetic reasons.
1) Eyebrow
Restoration
A number of
procedures are
available for
restoration of all
or part of the
eyebrow.
Transplantation of
micrografts or
single hairs from a
donor area to the
eyebrow, and a
reconstructive flap
or graft procedure
that brings a strip
of hair from another
site to the eyebrow.
The patient and
surgeon must agree
on the procedure
best suited to the
needs of the
patient.
Eyebrow and eyelash
restoration
procedures are
usually performed in
an outpatient
setting.
Postoperative
complications are
usually limited to
minor pain and
swelling.
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A) Transplantation
A strip of
hair-bearing skin
and subcutaneous
tissue is removed
from a donor area on
the scalp and
grafted into the
surgically-prepared
eyebrow site. The
transplant procedure
is performed by
selecting a
hair-bearing area of
scalp with hair that
is of appropriate
texture and
orientation to serve
as eyebrow hair.
Micrografts of one
to two hairs placed
into incisions
should be used for
eyebrow
reconstruction.
A purpose of
transplantation of
hair to the eyebrow
is to recreate the
eyebrow in a natural
contour. Patient and
physician must work
together to outline
the eyebrow area to
conform to the
natural symmetry of
the patient’s face.
Depending on the
size of the area to
be transplanted,
more than one
transplant session
may be required; two
or more sessions
several months apart
are common.
Donor hair for the
transplant is taken
from a site that
furnishes finer
rather than coarser
hair; finer hair is
a better "match" for
eyebrow hair. Donor
hair is transplanted
as micrografts of
one to two hairs.
Each graft is placed
into an incision
prepared for it. The
use of single hairs
or micrografts
permits meticulous
adherence to the
eyebrow contour for
a natural
appearance.
As the transplanted
hairs grow in their
new position they
may require
occasional trimming
as well as
"training" with gel
or wax.
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B)Scalp-to-eyebrow
pedicle flaps (Less
commonly used)
A strip of
hair-bearing skin
and subcutaneous
tissue is raised
from the temple area
just in front of the
ear, with its blood
supply (a branch of
the superficial
temporal artery and
vein) attached. This
type of donor graft
attached to a blood
supply is called a
pedicle flap. After
the pedicle flap is
raised, the
recipient area (the
eyebrow) is prepared
to receive the flap.
A subcutaneous
"tunnel" is created
from the base of the
pedicle flap to the
eyebrow recipient
site; the flap is
pulled through the
tunnel and secured
to the recipient
site with stitches.
The pedical flap’s
blood supply
nourishes the
grafted tissue until
the grafted tissue
develops its own
blood supply from
surrounding tissue.
Hairs grown from
grafts and pedicles
may have to be
"trained" with gel
or wax to lay flat
to the skin like
eyebrow hair;
grafted hair also
may have to be
trimmed
occasionally.
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2) Eyelash
Restoration
Transplantation is
the only procedure
used to restore
eyelash hair. This
is a very
specialized
procedure that is
performed by just a
few surgeons. As is
the case for
eyebrows, donor hair
for transplantation
must be finer rather
than coarser. All
grafts are single
hairs meticulously
placed into the lid.
As few as six hairs
per lid may be
adequate to create a
natural effect.
Itching is a common
and troublesome
postoperative
complication. If the
patient gives in to
temptation and
scratches, there is
risk for dislodging
the hair grafts and
initiating
infection.
Eyeglasses may be
worn to deter
scratching. The
dermatologist can
prescribe
medications to
relieve itching.
Training of
transplanted hairs
into eyelash
conformation is
accomplished by use
of lash oil and an
eyelash curler.
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