As the article’s headline declares, it is time to call in the professionals. The author of the article, Ms. Catherine St. Louis, turns to hair transplant pioneer Dr. Robert M. Bernstein for guidelines on performing a cosmetically-pleasing eyebrow transplant.

Here is a portion of the article:

Chronic repeated plucking is now a common reason why women have eyebrow transplants, which entail using hair from the scalp, arms or pubic area. A more timeless reason that spans the sexes is the gradual thinning, especially on the outer parts, as we age.

AND the number of such transplants is growing. In 2008, 3,484 eyebrow transplants were performed nationwide, up from 2,544 in 2004, the International Society of Hair Restoration Surgery says.

Dr. Robert M. Bernstein, a hair restoration specialist in Manhattan, said that the most natural-looking transplants for eyebrows followed a few rules. Hair has to lie flat; single-hair transplants, not units of multiple hairs, are used; hairs should follow a curve and be planted to account for changes in direction. (In general, Dr. Bernstein said, the upper hairs point down and lower ones face up slightly to create an interlocking ridge that gives brows their body.)

Visit our eyebrow transplant page for more information on eyebrow transplant and restoration procedures.

See another article by Ms. St. Louis on the topic of hair restoration and hair loss in women.

A: The crown can be transplanted first in patients who have very good donor reserves (i.e., high density and good scalp laxity). Otherwise, after a hair restoration procedure to the crown you may not be left with enough hair to complete the front and top if those areas were to bald.

Cosmetically, the front and top are much more important to restore than the back. A careful examination by a trained hair restoration surgeon can tell how much donor hair there is available for a hair transplant.

For more information on this topic, see my publication on surgical planning of hair transplants, “Follicular Transplantation: Patient Evaluation and Surgical Planning.”

A: When the scalp is tight, it can be useful for either the first or the second hair transplant.

Keep in mind, however, that the scalp will naturally stretch between hair transplant procedures, so that if exercises were not needed for the first procedure, they will generally not be needed for the second.

In our practice, we generally wait one year between hair restoration sessions so that we can see the full cosmetic impact of the first procedure and give the scalp laxity a chance to return to normal on its own.

In addition, there is a risk that active massage after the first procedure may widen the donor scar. Therefore, before considering massage before a second hair transplant, make sure that enough time has elapsed between procedures so that stretching of the scar will not be a be a problem.

In general, since the scalp will normally continue to relax for up to a year after a procedure, it makes sense that when there is a tight scalp, one should wait at least a year before considering the next hair transplant session. If massage is contemplated, it should be started one year after the prior procedure. This will give the scalp a chance to loosen naturally and will ensure that the massage will not stretch the donor scar.

In my opinion, it is a mistake to plan hair restorations sessions too close together in patients where scalp laxity is a constraint.

A: The answer depends upon the patient’s baldness. If they are very bald, the first session will be the most noticeable, since going from no hair to hair is much more dramatic than going from some hair to more hair. In addition, if someone is very bald, the first session is generally the largest, with less hair being transplanted in the second.

The situation is different if someone has had a hair transplant with only a limited amount of hair loss. In this case, the first session may be small (since that is all they need at the time) and the second session, performed after the person has lost additional hair, may be significantly larger.

In addition, while the impact of the first session was lessened by the progression of the person’s hair loss, the second session was superimposed on existing, permanently transplanted hair and may be more dramatic.

A: As with other medical therapies for hair loss, once the treatment is completely stopped, any benefit should subside.

It is anticipated, therefore, that periodic treatments will be needed after than the initial treatment course.