Eyebrow Defects Research Articles

Evaluation of Surgical Outcomes and Patient-reported Outcomes of Eyebrow Defect Repair with "Kite Flap".

There is no consensus on the surgical options for repairing mild-to-moderate eyebrow defects due to burns, trauma, and skin tumors, and the outcome of the surgery is unclear. In this study, the authors evaluated the surgical outcomes and patient-reported outcomes of eyebrow defect repair with the "kite flap" in a cross-sectional study. Case data and imaging data of twelve patients with eyebrow defects undergoing repair from July 2018 to June 2021 were retrospectively analyzed, and the surgical outcomes were statistically analyzed by the Face-Q subjective evaluation scale and the surgical objective evaluation scale. In the postoperative objective evaluation, 66.67% of the patients were "very satisfied," and the scores of the Face-Q scale for the assessment of appearance and psychosocial function were significantly improved compared with those of the preoperative period, with a statistically significant difference in the data changes (P<0.05). The study showed that the "kite flap" is an excellent surgical method for repairing mild-to-moderate defects of the eyebrow, and it can meet the requirements of both function and appearance after surgery.

Eyebrow reconstruction by simple elliptical excision with beveled incision – A case series of twelve patients

Patients seeking reconstructive facial surgery desire aesthetically pleasing outcomes with minimal visible scarring. For scalp incisions, bevelled angle of 45° is typicallypreferred to preserve hair follicles. However, no consensus exists regarding the ideal incision angle for the brow area. This observational study analyzed the surgical outcomes of 12 patients with eyebrow defects treated using a simple elliptical excision with a bevelled incision, addressing various indications such as posttraumatic scars, post-burn scars, and tumors. Outcomes were evaluated using the Physician Global Esthetic Improvement Scale at 7 days and 3 months post-surgery. At 7 days, 50% of patients showed very good improvement, and the other 50%showed moderate improvement. By 3 months, 33% of patients exhibited exceptional improvement, 50% showed very good improvement, and 17% demonstrated moderate improvement. This study concludes that direct excision and approximation with an angled incision along the hair follicle direction provide favorable aesthetic results for eyebrow reconstruction.

The Role of CT Angiography in Designing a Hair-Bearing Superficial Temporal Artery Flap for Eyebrow Reconstruction.

The hair-bearing superficial temporal artery flap is one of the traditional options for total eyebrow reconstruction. The anatomical variation of the superficial temporal artery has been well discussed; however, the anatomy of the superficial temporal vein is highly diverse. The authors report the use of preoperative computed tomography (CT) angiography in a 27-year-old man with a total eyebrow defect caused by thermal burn injury. The authors harvested a 6×1.5-cm pedicled hair-bearing superficial temporal artery flap from the area where the parietal branches of the superficial temporal artery and vein were running in close proximity, according to the CT angiography findings. Postoperatively, the flap survived completely without any vascular compromise. The authors believe that preoperative visualization of the superficial temporal vessels with CT angiography is highly beneficial in performing safe eyebrow reconstruction with a hair-bearing superficial temporal artery flap.

Follicular unit extraction combined with fractional carbon dioxide laser therapy for post-traumatic eyebrow scar with defects: A prospective and comparative study.

Eyebrows play a crucial role in the human body. While Follicular Unit Extraction (FUE) is a widely utilized and highly effective treatment for typical eyebrow deficiencies, it may not yield satisfactory outcomes for patients with post-traumatic eyebrow scars and defects. A prospective comparative clinical study was conducted to explore the treatment outcomes of post-traumatic eyebrow scars accompanied by defects using a combination of ablative fractional CO2 laser therapy with FUE. Between January 2019 and January 2023, we enrolled 30 patients with post-traumatic eyebrow scars and accompanying eyebrow defects, randomly assigning them to experimental and control groups. Patients in the control group received FUE treatment exclusively, whereas patients in the experimental group underwent CO2 fractional laser therapy on the eyebrow scars prior to FUE treatment. Alongside the patients' baseline data and the quantity of transplanted follicular units during surgery, we will compare the follicular survival rates between the two groups at 6 and 12 months post-treatment. Prior to FUE, there were no notable variances in baseline data between the two-patient groups. At 6 and 12 months postoperatively, the follicular survival rate in the experimental group was significantly higher compared to the control group. Additionally, patients in the control group were more prone to experiencing postoperative asymmetry between their eyebrows and developing curly hair. For patients with post-traumatic eyebrow scars accompanied by eyebrow defects, we applied ablative fractional CO2 laser therapy in combination with FUE treatment. This approach not only resulted in a higher follicular survival rate postoperatively but also led to the achievement of a well-defined eyebrow shape.

Single-stage eyebrow reconstruction with a double opposing forehead flap: a case report

The authors describe an alternative option for reconstructing an eyebrow defect following excision of a squamous cell carcinoma using a single-stage, double opposing forehead flap.

Partial Lateral Eyebrow Defect Reconstruction Using the Contralateral Orbicularis Oculi Muscle Pedicled Skin Island Flap: A Case Report

The reconstruction of scarring eyebrow defects is a challenging task for plastic surgeons as the eyebrow is an important cosmetic landmark of the face. Various methods are used for eyebrow reconstruction; free hair follicle transplantation, scalp composite graft, local flap transposition, and hair-bearing island scalp flap have been widely reported in the past and are applied according to the size and position of the eyebrow defect. For partial eyebrow defects, the best option is the use of local flaps from the remaining ipsilateral eyebrow, which have characteristics highly similar to those of the recipient site. Herein, we present a case in which an orbicularis oculi muscle pedicled flap from the contralateral eyebrow was used as a donor site with good results.

Eyebrow Reconstruction With Temporal Hairline Relay Flap.

Eyebrow is one of the most important features of the face; the absence of eyebrows will cause a heavy psychological burden to patients. Existing brow reconstruction techniques are not perfect for every case of eyebrow defect. In this study, a patient who suffered from eyebrows loss after radiotherapy for hemangioma underwent eyebrow reconstruction with the relay transfer of a temporal hairline flap. The entire procedure was performed in the outpatient operating room. The temporal hairline flap was transferred to the eyebrow region in a relay and survived well without necrosis. In the 2-month follow-up, the shape and density of the reconstructed eyebrows were satisfactory. The operation showed this technique was innovative, economic, and recommended as a suitable choice for eyebrow reconstruction, especially in those patients with poor hair transplantation recipient area.

Clinical effects of fine follicular unit extraction and transplantation in repairing cicatricial eyebrow defects

Objective: To observe the clinical effects of fine follicular unit extraction (FUE) and transplantation in repairing cicatricial eyebrow defects. Methods: The retrospective observational study was conducted. From September 2013 to January 2020, 58 patients (36 males and 22 females, aged 12-40 years) underwent fine FUE and transplantation to treat cicatricial eyebrow defects in the First Affiliated Hospital of Air Force Medical University. The hair survival rate in 10 months post operation was observed and calculated, and the curative effect was graded. Visual Analogue Scale was used to evaluate patients' satisfaction in one year post operation. The adverse reactions during operation and within one year post operation were recorded, and the adverse reaction incidence was calculated. Results: The hair survival rate of 58 patients in 10 months post operation was (84±5)%. Four patients (6.9%) had good curative effect, 54 patients (93.1%) had excellent curative effect in effect evaluation. Four patients (6.90%) were moderately satisfied, 5 patients (8.62%) were fairly satisfied, and 49 patients (84.48%) were very satisfied in satisfaction evaluation. Twelve patients had 14 adverse reactions, with an incidence of 24.14%. Conclusions: Fine FUE and transplantation can provide good cosmetic results for patients with cicatricial eyebrow defects, with high satisfaction of patient and few adverse reactions.

Tunneled island flap for reconstruction of eyebrow defect

Tunneled island flap for reconstruction of eyebrow defect

Analysis of Asian Male Eyebrow by Trichoscopy for a Better Reference on Eyebrow Transplantation

Introduction: Eyebrow transplantation has become a more popular non-scalp hair transplantation request. For Asian males, eyebrows influence face impression, sometimes even more than hair loss, since make-up or tattoos usually cannot conceal eyebrow defects. Thus, Asian males who wish to have a pair of nice eyebrows come for eyebrow transplants. However, compared to Caucasians, Asian males have straighter and coarser donor hair that makes eyebrow transplantation more difficult to be soft and pleasing at first glance. We often consider fine hairs more compatible for the eyebrow transplantation. However, how to define the most appropriate caliber is rather ambiguous. This author evaluated more than 51 patients with nice eyebrows to find a better reference for eyebrow transplantation. Methods: From February 2015 to March 2018, the author used a digital trichoscope to get a general concept of caliber and density in the body of eyebrow hairs of Asian males between the ages of 25 to 47 years. Results: After statistical analysis, we determined the average caliber and density of Asian eyebrow hairs. The hairs are thicker in the medial part and thinner in the lateral part of the eyebrows. By using our data as a reference for donor hair selection, we could create a more natural hair distribution. Patients were satisfied with the results. Conclusion: By using digital trichoscopy, we could get a better understanding of normal eyebrow hairs. As a reference, we could use this data to provide a more aesthetic approach to Asian male eyebrow transplantation.

Application of controllable hair density of eyebrow reconstruction with the treatment of scar baldness during the same operation stage

Objective To explore a method of eyebrow reconstruction which can control eyebrows, and to repair scar baldness in the same operation stage. Methods Operations were performed in two stages. In the first stage, an expander was placed under the scalp at the same side of the defect eyebrow through the direction of the superficial temporal artery. Other expanders were placed around the scar baldness. After the incision healed, water was injected into the expander. During the expansion, the scalp hair density was approaching the uninjured eyebrow side. Then the second stage operation was prepared: an island flap with superficial temporal artery as axial artery was harvested and the expander was extracted. The subcutaneous tunnel was made in the temporal region of the eyebrow defect side. The expanded superficial temporal artery island scalp flap was passed through the tunnel and transferred to the defect eyebrow area to repair the eyebrow. After incising the scar baldness, the left expanded scalp flaps were transferred to cover the wound. Results 12 patients underwent this method of eyebrow reconstruction with scar baldness, all island scalp flaps survived, with no case of flap necrosis. After 6-24 months of follow-up, the hair density of the reconstructed eyebrows was very close to that of the uninjured side, without excessive thickening or excessive rarefaction. The scalp scars were small and can be shaded by the hair. All patients were satisfied with the operation. Conclusions The method of controllable hair density of eyebrow reconstruction with the treatment of scar baldness has good effects on reconstructing eyebrow defect and scar baldness. It is simple, economic and suitable for further application. Key words: Eyebrows; Cicatricial alopecia; Surgical operation; Eyebrow reconstruction

Surgical effect of eyebrow plasty combined with hair grafting technique

Objective To observe the effect of eyebrow plasty combined with hair grafting technique. Methods From January 2011 to April 2015, 19 patients with eyebrow defect by eyebrow tattooing, operation or trauma received eyebrow plasty. The removed eyebrow tissue was separated into hair follicle units, and the eyebrow shape was redesigned. The hair grafting method was used for repairing eyebrow defect. Scalp was used as a supplement to get enough hair follicle units. Results All but one patients with eyebrow defect obtained good results, and the grafted hairs were growing well with satisfied direction and shape. One patient sustained folliculitis and was cured after inunctions with 75% alcohol. Conclusions Eyebrow plasty combined with hair grafting technique is a safe and effective method for repairing eyebrow defect, with reducing the number of operations and shortening the treatment time. Key words: Hair grafting; Eyebrow defect; Eyebrow plasty

Efficacy of follicular unit extraction in the repair of scarring eyebrow loss: a clinical observation

Objective To evaluate the efficacy of follicular unit extraction (FUE) in the repair of scarring eyebrow loss. Methods A total of 30 patients with scarring eyebrow loss were treated with FUE technique in the Department of Plastic Surgery of Zhengzhou First People′s Hospital, including 18 females and 12 males with 41 eyebrow defects. Fine soft hairs with a length of 5-10 mm were extracted from the back of the ear and temporal region of the patients, and then were split into individual follicular units under a microscope at 6 × magnification. The transplant density ranged from 20 to 30 FU/cm2. Results During the 3-18 months of follow-up after the surgery, eyebrows in the recipient areas grew in a natural direction and showed good appearance. The survival rate of hair grafts was up to 90%, and the patients were satisfied with the results. Conclusion FUE may be an ideal method for the treatment of scarring eyebrow loss with less injury and high survival rate of hair grafts. Key words: Cicatrix; Eyebrows; Follicular unit extraction; Eyebrow defect; Single hair follicle transplantation

A simplified surgical algorithm for flap reconstruction of eyebrow defects

Partial or total eyebrow defects after trauma or tumor excisions have been repaired by several surgical technique and algorithms. However, these algorithms are often complicated and difficult to apply clinically. We therefore established a simplified surgical algorithm for the treatment of eyebrow defects using flap reconstruction. During the period between January 2009 and December 2015, a total of 21 Chinese patients (12 males, 9 females) with eyebrow defects were treated with eyebrow flap reconstruction. The ages ranged from 12 to 51 years. The patients included 13 cases located on the left and 8 cases on the right eyebrow. These defects were caused by trauma (5 patients) and tumor excision (16 patients). Among them, 6 patients were treated using superficial temporal artery island flap, while 15 patients were treated using the V-Y advancement pedicle flap based on the orbicularis oculi muscle. The minimum defect area was 0.8×1.0cm and maximum area was 2.3×4.3cm. All patients were followed up for 6 months to 5 years postoperatively. The clinical effects of eyebrow reconstruction were evaluated using a designated scoring system. All 21 flaps survived without significant complications and the shapes of the reconstructed eyebrows were continuous, symmetrical and with good integrity. According to the rating scale, there were 13 excellent, 8 good reconstructions among all patients. After an average of 9 months of follow-up, all patients had no recurrence of tumors and no infection or scarring. Based upon our experience with 21 patients who underwent eyebrow reconstruction for various eyebrow defects, we believe that our simplified surgical algorithm can serve as a model for the treatment of patients with eyebrow defects.

A surgical algorithm for partial or total eyebrow flap reconstruction

The eyebrow is one of the five aesthetic sub-units of the forehead and it plays a key role in communication and facial expression. Reconstruction of this region can be challenging. Several methods have been described, mostly based on the size of the defect and on the part of the eyebrow that they involve. We describe our experience in 48 patients underlining the importance of a surgical algorithm for repairing eyebrow defects.

Eyebrow reconstruction using a composite skin graft from sideburns.

Wide resection of malignant skin tumors in the upper orbital region often results in soft-tissue defects involving the eyebrow. We used composite skin grafts from the area around the sideburns for 1-stage reconstruction of skin and eyebrow defects. The results were aesthetically satisfying because the hair and shape of these regions were similar to those of the original eyebrow, and donor-site closure was easy with inconspicuous scar. The survival of full-thickness skin graft area of composite grafts from sideburn facilitates revascularization of thicker hair follicles in the graft and allows safe, natural eyebrow reconstruction.

Application of transplanting different diameter single hair in treatment of part eyebrow defect

Objective To explore the effects of implanting different diameter single hair in treatment of part eyebrow defect.Methods 49 patients with part eyebrow defect,including 37 congenital sparse eyebrows and 12 traumatic eyebrow detect,were performed hair transplantation.Single-hair grafts were harvested from the scalp behind ear or the inferior part of the occiput.Single-hair grafts were implanted according to directions of normal eyebrow.22G or 23G needle was used for stick-andplace insertion.The thick and thin hairs were divided.The thin hairs were implanted into the medial and distal ends and the upper edge,the thick hairs were implanted into the center.Results After 3-10 months follow-up.The reconstructed eyebrows growed slowly,about every 5-7 days needed be trimmed.Two sides eyebrows were symmetry.Because a small amount of transplanted hairs were not alive,twelve patients were performed the second operation for thicker eyebrow.All patients were satisfied with the results.Conclusions In treatment of part eyebrow defect,the results of implanting different diameter single hair are natural and vivid. Key words: Defect of eyebrow; Hair transplantation; Single-hair graft

Effect of intact follicle transplantation by punching with syringe needle on eyebrow defect

Objective To explore the effect of the transplantation of intact follicle by punching with syringe needle on defect eyebrow reconstruction.Methods Fifty-two patients with eyebrow defects due to burn,trauma,resection and inappropriate eyebrow trimming were recruited,35 with bilateral defects and 17 with unilateral defect.The scalps strips from the safe donor area or temporal region were taken and made into 1 to 2 cm long hair with intact follicle under 3 fold magnifier.The recipient area was punched with 21G or 22G syringe needle.Then the hair shaft was clamped with mi croforceps and the follicles were transplanted to the defective area.Results Folliculitis were found in two burn patients after the transplantation and cured by alcohol inunction.Hairs of the rest patients transplanted grew well.The direction and appearance were satisfied.The survival rate of hair was more than 90 ％.Conclusions It is feasible to restore the partial eyebrow defect by intact follicular transplantation by punching with syringe needle and clamping the hair shaft with microforceps. Key words: Hair; Transplantation; Eyebrow; Hair follicle

Medial Eyebrow Defects

Medial Eyebrow Defects

Medial eyebrow defects: Reconstruction with whole eyebrow subcutaneous island pedicle

Medial eyebrow defects: Reconstruction with whole eyebrow subcutaneous island pedicle