The procedure for the eyelashes—and eyebrows—is very similar to the scalp techniques with mild variations. As a plastic surgeon, eyelid surgery—both aesthetic and reconstructive (BCC, SCC skin cancers, etc.), is a very common procedure so plastic surgeons understand completely the eyelid and eyebrow anatomy.
Once the surgical plan and the number of follicular unit eyelashes and eyebrow donor hairs have been selected, the procedure is performed under local anesthesia and as an outpatient. Dilute local anesthetic is inserted into the area of the donor site, FUE harvest region.
We carefully extract hair follicles with our FUE technology, SmartGraft, for all transplantation procedures.
The difference with eyelashes is that we do protect the eyes first with a corneal protector and eye lubricant and topical eye anesthetics (same as I do during eyelid surgery, laser to face, etc.) and the hair is grafted as single follicle, not group of follicles (usually a mix of those in scalp hair restoration). This is done under the same local anesthesia as is done with scalp hair transplantation, under my supervision and with my nurses and technicians.
The donor site hair is matched to the recipient hair (the eyebrow or eyelashes) both in caliber and diameter; these are often from the sides of the scalp above the ear. A small patch of donor hair needs to be shaved very short to facilitate the FUE harvest technique (same as scalp hair techniques) and prevent clogging of the SmartGraft harvesting system.
The density of the eyebrow and eyelash hair loss will determine the number of single hair FUE grafts to be harvested. It may be only a few follicular units to several hundred single-unit FUE grafts. Once the requisite numbers of single hair follicular unit extraction shafts and bulbs have been removed, the donor site of the eyebrow and eyelash is prepared and cleansed and under local anesthesia (and corneal protectors for lid procedures), tiny little recipient slits are made into which the FUE grafts are placed. The single hair FUE graft placement is scientific and artistic and needs to be in the right density. Angulation is also key in those 2 applications. The new follicular unit extraction grafts pick up a blood supply and start to produce the hair shafts. The hair shafts can grow quite long so they need to be cut and trimmed regularly with eyebrow and eyelash care.
Single hair FUE graft hair transplantation from the scalp to the eyebrow or eyelashes takes 2 to 4 hours to perform depending on the number of grafts required and the amount and number of eyebrow or eyelash hairs to be repaired. The procedure is performed under local anesthesia comfortably as an outpatient and patients can often return to work in a few days.