Raymond Konior, MD - Chicago - Brow Restoration with 668 Grafts

[Dr. Raymond Konior]

This is a 57 year old female patient who presented with a complaint of thin eyebrows that occurred following a history of aggressive brow plucking over the course of many years. The patient also had a history of having undergone a neurosurgical procedure which resulted in a permanent left side brow paresis. She was unhappy with the thin appearance and desired to restore a fuller look to her eyebrows. A total of 668 highly refined follicular unit grafts were used to enhance her brow density. On the day of surgery the patient was asked to highlight her desired fill zone with a surgical marker to assure that the shape of the brow would match her expectations. Presented here are preop, day of surgery , one week postop and seven month postop photos.

Edited July 29, 2013 by Raymond Konior, M.D.
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[Nick153452]

Looks great!

[Spanker]

Looks very good and very natural.

[Mickey85]

Great yield but it jumps out at me a bit too much. I think the scalp hairs were too thick in caliber compare to natural eyebrow hair.

[Dr. Raymond Konior]

Mickey

I have attached another close-up view of the preop and postop brow which shows hair shaft caliber comparisons. All grafts placed had a single hair and those were selected to match the characteristics of the native hair population. To my eye the preexisting hair caliber in her central brow looks larger or equal to the caliber of the transplanted hair population. Graft selection and placement were carefully controlled intraoperatively using high power loupe magnification to assure prime graft characteristics. This is very clear on the high resolution photos and during live inspection of the zone. She was quite thrilled with the outcome.

 

Thanks to all for your comments.

[Mickey85]

Was this a strip or FUE case? Thanks for the explanation, for some reason the brows just jump at me, I'm not too sure why...

[Janna]

Dr. K,

 

The brows look beautiful. I can see why she'd be thrilled.

The eyebrows are definately more difficult to produce a natural look in terms of angle and direction of the transplanted hairs, perhaps it's the loose tissue in the brows but this case looks great.

[Nick153452]

Was this a strip or FUE case? Thanks for the explanation, for some reason the brows just jump at me, I'm not too sure why...

 

 

Maybe because the brows are in the middle of the photo and it's an eyebrow case. Maybe if that wasn't emphasized, you wouldn't notice it much.

[Dr. Raymond Konior]

Janna – Thanks for your comments. As you know, female brow restoration is a very difficult proposition as there is little margin for error with respect to producing a natural outcome. Graft selection and placement are critical to offset the vagaries of healing that can taint the final appearance. I did use a very small strip harvest from a zone that seemed to have the best hair shaft characteristics for matching the existing hair. As you might expect, many patients continue to use brow pencils to complement their overall facial make-up regimen, and I’m certain that is the case here. The added hairs provide volume and texture to compliment the aesthetic enhancement of make-up. Attempting too high a density in brows such as these would have increased her risk of shock loss in the residual brow hairs. Additionally, the brow design for this case was complicated by her left brow paresis. The left brow hung lower than the right during involuntary motion, but she could raise it to the same level with voluntary motion. The left brow head and tail also moved asymmetrically. All of this led to her needing about 90 minutes to decide on a placement level that seemed to work best for all situations, i.e. resting, involuntary expression and voluntary motion. I don’t think a perfect placement was possible because of the asymmetric movement, but the end result seemed to suit her well.

Mickey – I do think the subtleties of a restoration like this are not ideally witnessed in photos. The fact that she still uses brow pencils to highlight the area suggests to me that she would like even more of a pop. Nick’s comment about perspective are very appropriate.

[StaggerLee123]

Looks very natural, great looking work.

[Mickey85]

Was this a strip or FUE case?

[Dr. Raymond Konior]

Mickey - Strip, this was discussed in my last post.

[Mickey85]

Ahhh i missed it. Thanks.

[Mick from Farjo]

Dr Konior,

 

Great pictures, result and explaination...

 

Mick

[Jinglealltheway]

fantastic job.

these hairs could technically grow as long as the hairs on her head then right? or do the hairs conform to the predisposed genetic terminal length of the surrounding brow hairs?

[Dr. Raymond Konior]

Jinglealltheway - They will grow at a rate like scalp hair and will require a lifetime of maintenance. Reports from patients suggest that most trim the transplanted brows about once a week and I don’t recall anyone finding any inconvenience with that regimen. Thanks for your comment.