There is probably not a single doctor in the world that has performed more eyebrow restoration procedures over the past 10 years than Dr. Epstein. Dr. Epstein performs on average three to four of these procedures every week in his Miami and NYC offices on patients, many of whom travel in from throughout the world. His work has been featured in numerous media reports and he also is frequently the featured speaker at meetings on his technique where his expertise is sought after from doctors throughout the world.
Transplantation to the eyebrows, also known as eyebrow restoration is a procedure designed to restore growing hair to eyebrows that are overly thin, scarred, or completely missing. The absence of hair can be due to genetics, prior electrolysis or laser hair removal, overplucking, thyroid or other hormonal abnormalities, or trauma due to surgery, burns or other types of accidents. Some patients seek to have restored full, thick eyebrows, others a subtle thickening, while others to have a scar made less visible.
Donor Hairs for Eyebrow Transplantation
The donor hairs come from the scalp which, when transplanted into the eyebrows, continue to grow for a lifetime and therefore need to be trimmed typically once a month. To provide a natural appearance, the hairs are transplanted primarily one and occasionally two at a time, the natural way eyebrow hairs grow. This is a very delicate procedure, requiring perfect placement of these hairs into tiny (half-millimeter) incisions that are angled at just the right direction and positioned to mimic natural growth. The use of all-microscopically dissected grafts allows their placement into the smallest possible incisions so as to minimize scarring and damage to already existing hairs. These grafts are obtained by one of two techniques, both those in which Dr. Epstein has extensive experience: FUE (follicular unit extraction) whereby each graft is removed one at a time; and FUG (follicular unit grafting) where the grafts are all dissected under microscopes from a single donor “strip” in the back of the head. FUG is more popular particularly in women, but for men who wish to have the ability to shave their head and or know that there is no linear fine line scar, the FUE technique is preferable.
Procedure & Results
A procedure performed by Dr. Epstein typically involves the placement of 50 to as many as 375 hairs into each eyebrow, depending upon the existing amount of hair and the desired size and density. Performed usually under a mild oral sedative, the two to four hour procedure is essentially painless, as is the recovery period.
For the first four days after the procedure, tiny crusts are around each transplanted hair. By five days, other than some occasional mild pinkness which fades out by the first week, patients are able to return to normal activities without any sign of having had a procedure.
If FUG was performed, sutures that are placed in the donor area are dissolvable so there is no need to return to the office for removal. If FUE was performed, there are no sutures at all. The transplanted hairs fall out at around twoweeks, and then start to regrow at four months, where they will continue to grow for a lifetime.
There are few risks with the procedure, and most are those associated with standard hair transplants. If FUG was performed, the donor site incision, usually one to two inches long, typically heals as a 2 mm wide incision, easily concealable with existing hair in the area. With FUE, there is no linear donor site incision scar. Occasionally a few hairs grow in less than the ideal direction- these few hairs can be plucked out if desired or sometimes trained to grow in just the right direction.
Dr. Epstein performs more than 150 of these eyebrow transplant procedures annually, and his work in this area has been featured in such publications as the NY Post and Elle magazine. He is also frequently the featured speaker at the International Society of Hair Restoration Surgery meeting on his techniques and he is sought after by doctors from throughout the world who want to learn more about his area of expertise.