High arched, softly angled, thick, and flat. The anatomy of an eyebrow can convey your signature look. "Eyebrows have been gaining increased attention and for good reason," says Vanessa Coppola, a board-certified nurse practitioner and the founder of Bare Aesthetic Medical Spa. "Historically, eyebrows serve as a focal point of the face and provide a frame for the upper eye region and the lateral cheek area." If, however, in your journey to achieving the perfect brow for you, you've overplucked and your brow has since diminished, you might want to consider an eyebrow transplant. An eyebrow transplant involves replacement of eyebrow hair by transferring hair from the scalp (usually above the ears) to the eyebrows.
People who have experienced trauma or an accident to the eye area are also excellent candidates for this restorative treatment. Do note that people diagnosed with alopecia areata or an autoimmune disease resulting in hair loss are not particularly well-suited to this treatment, as it won't be effective. The ideal candidate is someone who has overtweezed, has thinning of the brow due to genetics or aging, or is seeking reconstructive surgery.
Below, we break down everything you should know before scheduling an eyebrow transplant.
Meet the Expert
Vanessa Coppola, APN-C, FNP-BC, is a board-certified nurse practitioner and founder of Bare Aesthetic Medical Spa. She is a doctoral candidate at Yale University who specializes in facial aesthetics.
Amir Karam, MD, is a double board-certified plastic surgeon who specializes in facial procedures.
Oren Tepper, MD, is the director of aesthetic surgery at Montefiore, and an assistant professor of plastic surgery at Albert Einstein College of Medicine. He is a board-certified plastic surgeon offering a wide spectrum of plastic surgery procedures.
What Is an Eyebrow Transplant?
People may opt for an eyebrow transplant for either reconstructive or cosmetic reasons. Oftentimes skin conditions, injury, or trauma might make someone a good candidate for this procedure. Tepper says the most common reason for cosmetic patients is "recurrent and excessive tweezing." He says in cases of cosmetic patients, many times "the eyebrow may be thin or absent."
According to Karam, an eyebrow transplant is performed "just like it is on the top of the head, the difference being the placement of the hairs." He goes on to explain that the technique of hair application is what makes it unique. "The hairs are inserted at a much sharper angle to create that natural look, as if they're sweeping across the forehead, as opposed to coming straight up and out."
In the past, hair transplants involved taking large pieces of tissue from the scalp called flaps or skin grafts. These were known to give an unnatural plug-like appearance when used to treat hair loss on the top of your head.
Today, skin grafts are still used, but they are much smaller than in the past, and allow for a more precise result. These same advances in hair transplant innovations make eyebrow transplants a viable solution to filling in brows using grafts. "Current medical techniques employed involve the transfer of single hairs (follicular unit transplant, or FUT). Or even more recently," explains Tepper, "through transplanting single hair follicles (follicular unit extraction, or FUE)."
Coppola adds that the FUT and FUE methods have their pluses and their minuses, and candidates should consult with their surgeon about which one is right for them.
Although eyebrow transplants are considered a non-medical procedure, if you're undergoing treatment because of an underlying medical condition or due to hair loss from an accident or trauma, insurance may cover it. The cost of an eyebrow transplant, including anesthesia, ranges from $3,000 to $6,000. If you opt for additional implants after recovery, these are performed at an extra cost.
Certain people may not be suitable candidates for eyebrow transplants, including those with bleeding disorders, alopecia areata, or trichotillomania. Always disclose your full medical history with a plastic surgeon during the initial consult.
Benefits of an Eyebrow Transplant
A major benefit of this procedure is that once the hair is transplanted, it continues to grow. "You’ll be able to trim it on a regular basis," explains Karam, adding that in his opinion, an eyebrow transplant is preferable to microblading or tattooing.
Tepper adds that the procedure is ideal for creating a new shape to your brow if that's what you desire. "Eyebrow transplantation not only enables someone to fill in the eyebrow, but also to obtain a customized look. For example, the treatment plan can include an arch to the eyebrow." Coppola adds that eyebrow transplants provide a "permanent solution to sparse and thinning eyebrows that can be groomed and shaped according to an individual’s preference and suited to their facial shape and features."
How to Prepare
Once you've scheduled your treatment, there's little preparation. "The only precaution to take is to avoid anticoagulants like aspirin or Motrin prior to the surgery," Karam advises. Adds Coppola: "Practical considerations may include the avoidance of any exfoliative or potentially irritating cosmetic procedures or products to the eyebrow area prior to the surgical date, as well as to avoid excessive sun exposure."
Always seek out a board-certified plastic surgeon for a free consultation, during which you can request to review a portfolio of his or her work. The American Society of Plastic Surgeons offers a database of reputable providers. Look for a surgeon who has performed hundreds of eyebrow transplants for best results.
What to Expect During the Treatment
An eyebrow transplant is usually performed in a private facility or medical spa under local anesthesia. Full sedation is also an option upon request.
In the FUT technique, Coppola explains, "an excision would be made to the occipital region and a strip of skin would be removed and harvested as the donor site. The eyebrow transplant recipient site would be mapped out according to the desirable aesthetic proportions and the donor graft transplanted to the new eyebrow site. In the FUE technique, individual hair follicles are harvested and transplanted to the eyebrow donor site, which has been stenciled according to the desired aesthetic."
Expect anywhere from 50 to as many as 400 grafts per eyebrow, depending on the preferred density. "During the surgery, the grafts are placed meticulously," says Karam. Each hair is transplanted into a recipient site by the surgeon and checked for symmetry. The entire process takes three to four hours. It's a relatively simple procedure that our experts describe as "well-tolerated."
Side Effects of an Eyebrow Transplant
Because the nature of the procedure is so delicate, if done in the wrong hands, there's the potential the grafts won't take, and you'll be left with, Karam says, "a field of scars." You want to obtain a good yield where the hairs continue to grow, so it's vital to seek an experienced surgeon. "It’s always important with these types of procedures to make sure you’re with somebody who has the expertise."
Other harmful potential side effects include nerve damage and excessive bleeding. Coppola notes that asymmetry can be a potential side effect "due to the mass, strength, and pull of the surrounding muscles."
To minimize the chance of potential adverse side effects, always disclose any medications or supplements you're taking to your surgeon before your treatment.
Post-operatively, there’s very little discomfort, and patients are usually prescribed antibiotics, painkillers, and oral steroids. Karam says you can expect "minimal swelling above the region, possibly some black and blue depending on the nature of things. But overall, it's very easy to tolerate." Tepper adds that bruising and swelling can last for a few days. Crust will probably form around each recipient site. This is normal, and you should avoid picking to prevent infection.
Coppola notes that after the procedure, it's crucial to keep the area dry for five to seven days. "In the immediate post-operative period," she says, "it is common and expected that the hairs will fall out due to the follicular cycle and regrow slowly over the next three to four months." She adds that results can be seen around eight to 10 months post treatment. "It is important to counsel patients that a secondary procedure may be necessary to achieve the desired fullness and hair density of the eyebrows," she says.
Once you've had an eyebrow transplant, you maintain your brow's shape by trimming, never plucking.
When it comes to electing a cosmetic procedure, only you, guided by a medical professional, can judge whether it's the right call. If you can achieve the look you want without surgery, there's no dearth of products on the market for every brow type. On the other hand, if your heart is set on an eyebrow transplant, the procedure is considered minimally invasive for one that promises permanent results. As when undergoing any cosmetic procedure, realistic expectations are critical.