Everything You Need To Know About Eyebrow Transplants

Look no further than your favorite '90s sitcom to see just how dramatically eyebrow trends have changed over the years. From pencil thin arches to bushy brows, what constitutes the ‘ideal’ eyebrow is constantly evolving. Recent years have seen the advent of a full, yet manicured brow aesthetic, and temporary and semi-permanent treatments like brow lamination and microblading have emerged to add volume and shape. But what if you are looking for a more permanent solution to enhance your brow shape and size? Enter: the eyebrow transplant.

What Are Eyebrow Transplants, Exactly?

Much like a traditional hair transplant, an eyebrow transplant is a permanent, surgical procedure in which hair is taken from a donor site (think: the back of the head) and reharvested. In this case, it is transplanted to the eyebrow area, and there are two hair restoration methods to choose from:

• Follicular Unit Extraction (FUE): This option involves transplanting individual hairs from a donor site using manual punch, powered punch, or robotic punch technique. Advantages include the lack of a linear scar and ease of recovery, though the extraction time is longer and the shorter hairs can affect the quality of the transplant.
• Follicular Unit Transplant (FUT): A strip of hair (usually from the back of the head) is excised and the hair follicles are transplanted to form the new and improved eyebrow shape. The excision process is faster than FUE and the harvested hairs are longer, which may help during planting (the length allows you to see the curl of the hair). It should be noted, however, that the technique results in a linear scar and the recovery time tends to be longer.

When it comes to deciding between FUT and FUE, Benjamin Paul, MD, a New York City-based board certified facial plastic and reconstructive surgeon, says it really depends on the case. If the patient plans to wear his or her hair short in the back of the head, he will likely recommend FUE, as FUT can leave a visible scar.

Ideal Candidate for Eyebrow Transplant

Generally speaking, there are two groups of patients who are interested in an eyebrow hair transplant:

1. Those who have had hair loss from over-plucking or trauma (i.e. laser hair removal, scarring)
2. Those who have thin eyebrows naturally or as the result of a medical condition, like hypothyroidism

“Many patients — both men and women — have experienced the effects of over-plucking, undesirable tattoos, or just want fuller eyebrows,” says Gary Linkov, MD, a board certified facial plastic and reconstructive surgeon in New York City. “As this treatment type becomes more mainstream, there has been an increase in popularity.”

While the demographics are broad, patients must have enough donor hair to harvest and transplant. “The ideal candidate has a need for more eyebrow hair and has good matching hair that can be used to donate,” Dr. Paul explains. “These hairs are taken often from the back of the head/nape of the neck. So, if someone has dark brown hair in the scalp and blonde eyebrows, this will not be a fit.”

It is also important to remember that there will be maintenance involved with transplanted brows. “The donor hair does not become eyebrow hair after transplant — the donor hair keeps its genetics and growth habits,” Dr. Paul says, adding that the detail is “crucial” to understand. As such, patients should know that the transplanted hair will grow and require regular trimming. “This continual maintenance is why eyebrow transplant is not for everyone,” he warns.

The Eyebrow Transplant Process

Before undergoing the cosmetic surgery, patients should meet with their provider for a consultation. During this time, the patient can show photos of what they are hoping to look like and their board certified provider can draw an outline of the eyebrows to confirm shape. “The results from eyebrow transplant vary widely depending on the amount transferred, the skill of the surgeon, and the nature of the hair itself,” Dr. Paul explains.

When it comes to the procedure itself, step one involves extracting the hair. Depending on the extraction method, patients will either lay on their stomach or sit upright. “Once the grafts are removed, you will then turn onto your back to allow for recipient site creation and the placement of the grafts,” Dr. Linkov says. “The overall process may take a few hours for smaller cases, up to six hours for larger cases.”

Regardless of whether a patient is undergoing FUE or FUT, Dr. Linkov says anywhere from 100 to 350 grafts are used per eyebrow. Once the hair is removed, it is processed into 1-hair and 2-hair grafts because “thicker grafts can cause an unnatural appearance when implanted,” he shares, adding that, when density is needed, 3-hair grafts may also be used.

Once the eyebrow is numb, the recipient sites are made. Dr. Linkov says the acuteness of these sites is vital to ensuring the new eyebrow hair grows naturally (i.e. not straight out of the skin in what he calls a “perpendicular way”). Once the sites are made, the hairs are meticulously placed and oriented so the curl of the hair faces down.

“Skilled surgeons make sure the angle and direction of hair exit is carefully planned,” Dr. Paul confirms. “Eyebrow hair exits at roughly 15 degrees from the skin. This angle must be respected or the hairs could grow outward at a very unnatural angle. Patients with curly hair may have this difficulty.”

Eyebrow Transplant Recovery & Results

Bleeding, swelling, and bruising are all possible side effects in the aftermath of an eyebrow transplant. When it comes the recovery process, there is one crucial post-op rule to follow: don't get your new brows wet. “The most important precaution in the recovery phase of an eyebrow transplant is not to get the transplanted hairs wet for the first five days,” Dr. Linkov says. “This allows them to set in the proper orientation and to eventually grow.”

At around the three-week mark, Dr. Linkov says patients can expect the shafts of the transplanted hairs to fall out. From there, regrowth usually begin four to six months after the procedure, with final results assessed at one year.

Since transplanted eyebrows grow more quickly than natural brow hair, many patients find themselves trimming their new arches two to three times a month (or as needed). Brow gel, meanwhile, may help to train the hair to grow in the intended direction.

Both Dr. Linkov and Dr. Paul agree that transplant patients may benefit from microblading to futher improve and refine the shading and shaping. In terms of timing, Dr. Linkov says the semi-permanent treatment should either be performed at least two months before the transplant or a minumum of nine months after.

The Takeaway

Eyebrow transplants offer a permanent way to fill in and reshape the brow. Like a traditional hair transplant for the head, this form of hair restoration involves removing individual follicles or a strip of hair from a donor area to be transplanted to the eyebrows. Most people who seek out brow transplants have thinner arches due to heredity factors, trauma, or medical conditions. In order to be an ideal candidate, patients must have donor hair that matches their current eyebrow hairs and be open to routine maintenance, as transplanted hairs grow faster than natural eyebrows.