“Eyes are the window of soul”. Eyes are the focus of facial beauty. Every woman wants their eyes to be “glamorous”. Glamorous eyes have to be large and eyelashes have to be long and curled. In women with single eyelids, double eyelid operation can enlarge their eyes. But for women with short eyelashes, how can they have longer and curled eyelashes? They can use mascara. But it is not so effective for women with short eyelashes. They can tape artificial eyelashes, including eyelash extensions, on natural eyelashes. But some women are allergy to the adhesive material. It is possible that, after a period of time of using artificial eyelashes, natural eyelashes fall down and become shorter and looser. Eyelash transplantation (ET) surgery is another consideration. The case shown below was a patient whose eyelashes were loose after a period of time of using eyelashes extensions. Left picture is the picture one year after ET surgery.
Who is indicated for ET?
1)Eyelid trauma or surgery( such as surgery for tumor on eyelashes) which induced eyelash lose. Using ET technique, the lost part of eyelashes can be restored.
2)Congenital atrichia-congenital absence of hairs on all parts of the body.
3)Cosmetic reason. But patients should fully understand the operation and the post-operative care.
Preparation:
1)Some drugs will affect blood coagulation, such as anti-coagulants, Vit. E, etc. You should inform doctor of the drugs you are taking. It is better to stop taking Vit. E two weeks before operation.
2)The “stunning “effect of ET on single eyelid women will be less than on double eyelid women. It is our recommendation that it is better to undergo double eyelid operation before ET or undergo ET and double eyelid operation at the same time for women with single eyelid. If patients choose to undergo ET before double eyelid operation, they should inform the surgeon not to injury the implanted hair follicles when surgeon is performing double eyelid operation.
3)In the first 2-3 days after operation, there will be swelling on eyelids. It will begin to subside on 4th day after operation. Most of the swelling will be subsided around one week after operation. Patients should consider the affect of eyelid swelling on their jobs.
4)In the first few days after operation, it is better not to wash hairs. Patients should wash hairs before operation.
How is ET going?
Before we introduce the procedure of ET, we will introduce the anatomy of hair briefly. Hair is a dead tissue, similar to corny layer of skin. Hair is surrounded by tubular structure of skin called hair follicle which is a alive tissue. Growth of hair originates from two sites of hair follicle: One is located at the base of hair follicle (called papilla), the other is located in the middle of hair follicle. Hair follicle is the structure we are going to transplanted. In scalp, the exit site of hairs out of skin is so closed that they seem to form a group. We called the hair group “follicular unit” ( Please see the below left picture, the circles mark “follicular unit”). In one follicular unit, it usually contains two hair follicles. Sometime it contains 3 ,4 or 1 hair follicles. When treating baldness, the follicular units of occipital hairs are transplanted into the baldness area. Eyelash structure is different from scalp hairs. Eyelashes do not form group. In ET, the follicular unit of scalp have to be dissected into single hair ( called “single hair graft”) before transplanted into eyelid (Please see the below right picture. Left follicle is single hair graft ).
The hair follicles were dissected delicately under microscope, as shown below, for better hair survival.
The procedure of ET
The procedure can be divided into three steps. Step 1: Take a small pierce of scalp from the back of scalp ( about 2 cm in width). The wound will be sutured. The scar is well hidden in the hairs. Step 2: Using delicate technique, we will dissect the hair follicles of scalp into single hair grafts. Step 3: Using the assistance of hair transplanter, the single hair grafts are transplanted into the eyelids. We will implant single hair grafts as dense as possible. Usually we will implant about 50 hair grafts in one side of eyelid. When implanting hair grafts, we will imitate natural eyelashes and follow their angle. The angle of implanted hairs can not be too low to irritate eyeball. Below is the cosmic of ET procedure.
The implanted hairs come from scalp. They still keep the character of scalp hairs : 1) The implanted hairs will keep growing. Patients should trim the implanted hairs. 2) Comparing with natural eyelashes, most of the implanted hairs are straight. Patients can curl the implanted hairs. In Step 2 of ET procedure, we will choose hair graft with better quality. We will not choose hair grafts which are too-curled or graying.
If you are quite sensitive to injection, you may discuss with us the necessity of intravenous anesthesia ( intravenous injection of drugs to make you sleep when undergoing operation). The other way of ET is : Taking a small strip of scalp and putting it into the wound on eyelids, just as the pictures shown below. The scalp hairs does not have to be dissected into singe hairs, but the disadvantages are 1) Adding the thickness of scalp strip, the upper eyelids will become thick. 2) The direction and density of hairs are different from natural eyelashes. Using this technique, the result will be unnatural comparing with the technique we used.
Postoperative Care
1)Ice packing in the first 72 hours will help to reduce the eyelid swelling. 72 hours later, ice packing should shift to hot packing. Before putting the pack on your eyelids, you should put a wet towel to separate implanted hairs with pack. Moisture can prevent the curst formation around the implanted hairs and prevent the adherence of implanted hairs with pack.
2)some bleeding from the scalp wound can be noted in the first day after operation. You may wash your hairs after three days. The stitches will be removed on 7th day after operation.
3)We will prescribe some pain killer. If necessary, you may take one tablet every 4-6 hours.
4)The implanted hair follicles will be stable after two weeks. Do not pull the implanted hairs before that, otherwise you may pull out the implanted hair follicles.
5)Usually the implanted hairs will fall around 2-3 weeks(but the implanted hair follicles will not fall). 2-3 months later, new hairs will grow again from the implanted hair follicles. It takes around six months to achieve final result. Part of implanted hairs will not survive. Secondary operation to increase the density of implanted hairs or to fill up the space between implanted hairs may be needed.
6)Patients may use incisor to trim the growing implanted hairs. There are two ways to curl the implanted hairs. One: buy electric curler and curl the hairs yourself, just like the pictures shown below left. The effect lasts only a few hours. Two: ask the aesthetician to curl hairs for you ( they use eyelash wave lotion ), just like the picture shown below right. The effect lasts for 2-4 weeks.
Due to technique consideration, we do not implant hairs into lower eyelids.
Medical treatment for eyelash enhancement?
In medical reports, eyelash may be enhanced after using eyedrops to treat the increased eyeball pressure of glaucoma. It needs further research to determine the safety of the eyedrops for cosmetic use.
Below is the before and after pictures of ET.
Eyebrow transplantation
Using the same technique, the single hair grafts can be implanted on the eyebrows for enhancement. The first case shown below wanted to enhance his lateral parts of eyebrows. Right picture was the appearance four months after eyebrow transplantation. Whole eyebrows of second case shown below were thin. Right picture was the appearance six months after eyebrow transplantation.
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