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    Tweeze rehab

    Hair restoration transplants fill in the gaps


    Dr. DiBiase
    Years of tweezing and shaping can leave many an eyebrow patchy. If lifestyle does not rob youthful brows of their hair, trauma or a birth defect could be the culprit. No matter the cause, patients are looking toward hair restoration to fill in the gaps. Anthony P. DiBiase, M.D., a general, vascular and cosmetic surgeon and hair restoration specialist in New York City, has performed in the range of 50 to 75 eyebrow transplants to date. He says that fuller brows on stars — the likes of Brooke Shields, Denise Richards and Demi Moore — are driving the growing demand for eyebrow transplants.

    "Most of our patients have lost their eyebrow hair due to overzealous tweezing, where the eyebrow hair stops growing because of follicle loss," Dr. DiBiase tells Cosmetic Surgery Times . "Then there are people who either — on a congenital or familial basis — have a very weak-looking eyebrow."

    GRAFT FOR GROWTH Surgeons have performed eyebrow transplantation for approximately three decades, Dr. DiBiase says.

    Eyebrows are restored employing a follicular unit grafting technique in which single hair-containing follicles are harvested from the donor site and planted in tiny apertures in the brow. "That lends the ability to create a natural-looking eyebrow and also allows us to get the follicles planted very closely together so that you can approximate the brow's natural density," he explains.

    Dr. DiBiase uses a 21-gauge hypodermic needle to create tiny openings into which the follicles are implanted. He also points out that patients don't undergo any special preparation for the in-office procedure. "It is a simple procedure done under local anesthesia, with a little sedation. It takes about two to three hours," he says.

    Dr. DiBiase notes that most of his patients have a good idea of what look they want to achieve, so he begins by drawing the patient's eyebrows according to their desires and what he thinks is aesthetically pleasing. After he and the patient discuss the possibilities with drawings in hand, they arrive at the patient's ideal brow.

    "Some people just want to reshape their brows or add a little here and there, while others want very large Brooke Shields-type restorations," he says.

    One critical aspect of the pre-procedure consult, according to Dr. DiBiase, is counseling patients that the hair transplanted to the eyebrows is "programmed" to grow to the length of the donor hair on the scalp, so they will need to regularly trim and groom it to maintain shape and appearance.


    50-year-old female patient shown before and approximately 5 months after eyebrow transplantation. (Photo credit: Anthony P. DiBiase, M.D.)
    BROW TIPS The procedure is straightforward and without a lot of potential for technical glitches, says Dr. DiBiase. However, one critical aspect of the technique, he advises practitioners, is to angle and direct hair follicles properly. "They have to be placed at a very flat angle along the supraorbital ridge, so that they do not protrude perpendicularly from the skin. The density should be enough so that it allows for the eyebrow to look as natural as possible," he emphasizes.

    Patients who dye the hair on their heads, can also dye their brows. The belief is that African Americans can use hair relaxing agents to straighten unruly transplanted brow hair — although Dr. DiBiase notes that this is anecdotal.

    Patients' recoveries tend to be relatively comfortable, according to Dr. DiBiase. Some patients experience ecchymosis over the eye, but not as severe as it would be from eye trauma. They also generally get some itching, which he treats with a topical petroleum-based ointment.

    CANDIDATES ABOUND Ideal candidates for the procedures have a mature outlook and a realistic goal, realizing that eyebrow transplantation is not going to result in a God-given eyebrow, but will improve the look of the brow. Potential patients also need a good amount of donor hair and must be able to tolerate sitting under local anesthesia for a few hours. Dr. DiBiase says the discomfort is similar to that experienced during a long dental appointment.

    The amount of donor hair, he says, is usually not a problem. "I use about 250 follicles per eyebrow, so it would have to be an extreme case of low density in the donor zone [to be problematic]." Another consideration and potential preclusion might include a patient who "might need that donor hair for scalp restoration, which could take cosmetic priority in their mind in the future," he adds.

    High patient satisfaction is what keeps Dr. DiBiase recommending the procedure. Patients who have been burn victims or have lost the symmetry of their brows or an entire brow from surgery, in particular, find great satisfaction after brow transplantation, he says.

    For more information
    Anthony P. DiBiase, M.D.
    [email protected]

    Lisette Hilton
    Lisette Hilton is a writer in Boca Raton, Fla., who heads up her company, Words Come Alive.

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