Some people are putting down their brow pencils for good in favor of a more permanent solution.

Ariana DiValentino
Jul 07, 2021 @ 5:55 pm
eyebrow transplant photos
Credit: Courtesy of Marzia Prince

First, there was Anastasia Beverly Hills, then came microblading, and now, brow-minded folks can have theirs permanently enhanced via surgery. Let's clear up this timeline, though: when I say "the beginning," I mean the late '90s when Anastasia Soare opened her Beverly Hills salon and in 2000 started selling her line of cult-classic brow products. 

Microblading, technically, has been around much longer—the basic semi-permanent tattoo technique of making fine incisions in the skin and inserting pigment has been used for over 5,000 years (albeit usually not for eyebrows). Eyebrow transplants, too, aren't exactly a new thing. Hair transplantation, including for eyebrows, dates back to the 30s in Japan, where the technique was pioneered as a treatment for burn victims who had lost the ability to grow hair in affected areas. 

But eyebrows, as we know them, are a phenomenon of the new millennium, a reversal from the super-thin plucked styles of the '90s. By 2015, our brow obsession had blown up, thanks at least in part to Anastasia Soare's work with celebrities, such as the Kardashians who sported fuller brows. Soon after, microblading exploded in popularity. Now, transplantation might be next in line.

For those who have lost eyebrow hair due to over-plucking, injuries, aging, or other causes—as well as those who just aren't satisfied with the thickness or position of their natural brows—the non-invasive surgery is the most permanent and expensive option available. According to some, it's also completely worth it. 

Marzia Prince, an Austin, Texas-based health coach, is among them. Around eight or nine years ago, Prince went in for a laser procedure to minimize her acne scarring and came out with a particularly bad side effect. 

"The lady who was doing the face laser burned off my eyebrows and they never grew back," Prince tells HelloGiggles. The experience, she said, was "heartbreaking." After four years of penciling them in and trying other treatments, such as Latisse, to little effect, she was ready to find a more permanent solution. Through some investigative Googling, she learned that eyebrow transplantation was a thing. She first looked into surgeons in the area where she lived at the time, but ultimately decided to fly to Los Angeles to have specialist Marc Dauer, M.D., do the procedure. 

"I wanted to go to a specialist," she said, and hair restoration is the focus of Dr. Dauer's practice. She found his work to be the most "aesthetically beautiful" of the practitioners she researched. Plus, she was impressed to learn that many staffers in Dr. Dauer's office had had their brows done by him, sometimes more than once. 

Having her brows done by the highly-coveted surgeon cost upwards of $7,000, which Prince says was a fair price to pay to get her confidence back. To this day, she's a happy customer—so much so that she's gone back to Dr. Dauer for a second procedure to achieve an even thicker look.

The phrase "eyebrow transplant" may raise—well, eyebrows—but it's not as bizarre as it might sound. To the uninitiated, it might conjure up images of entire brows being grafted, Frankenstein-style, onto a person's face. Thankfully, the real procedure is more science, less fiction.

Donor hairs from the back of the scalp are harvested either individually, in a process called FUE (follicular unit extraction), or in strips that are later divided into sections of just one-four follicles, which is called FUT (follicular unit transplantation). Precision is required to carefully shape a natural-looking brow, as surgeons need to pay attention to the direction in which each hair grows. Typically the surgeon will harvest and transplant around 250 hairs per brow, which as you can imagine, is a lengthy process. Marzia's transplants took eight hours each time.

To be clear, it's not a quick fix. About a week after the procedure, the newly transplanted hairs will fall out and the follicles go into a sort of hibernation period. They'll start growing back again after three-four months, and patients see full results eight months to a year post-op. Since the follicles are transplanted from the scalp, the new hairs usually grow longer than eyebrow hairs typically do, and therefore need to be trimmed. But over time, they start to acclimate to the area and behave more like natural brow hair. 

Marzia said Dr. Dauer also instructed her to wear an Ace bandage around her forehead for a combined total of  eight hours a day, for 12 weeks, in order to train the hairs to lie flat. Typically, about 90% of the transplanted follicles take, but it's still common for patients to have the procedure done a second time to fill in gaps and get the thick, full look they want.

Craig Ziering, M.D., another prominent Los Angeles surgeon specializing in hair restoration, spoke about the creative aspect—designing the shape and placement of the new brows. "People come in and will bring pictures of models and say 'I want to look like this.' What we want to do is what's most appropriate for their facial features, bone structure, the shape of their eyes, etc.," Dr. Ziering says. 

Celebrities have an undeniable impact on beauty trends and tastes. Ziering says clients will often cite the Kardashians, the Hadids, and of course, Brooke Shields as their brow inspiration. However, Dr. Ziering urges clients not to get stuck on a look that may not work with their own features.

"Someone's a good candidate if they have realistic expectations," Dr. Ziering explains. Face shapes, hair thickness and texture, eye and eyelid shape all vary person-to-person. Even your own two eyes, and brows, probably aren't exactly identical. Dr. Ziering preaches the "sisters, not twins" school of thought. 

In many cases, Dr. Ziering says clients—especially women—already know exactly what they want as they already pencil it on every day. Often, he'll perform transplants on people who already have tattooed or microbladed brows but are looking for a more naturalistic, 3D look. When patients are less sure of what they want, he'll help guide them toward a design they're happy with.

There's more to consider than you might think. Surgeons factor in the horizontal length of the brow, which Dr. Ziering says he often lengthens to better frame a client's features. The placement of the brow matters, too. Sophie*, one of Dr. Ziering's former patients, was looking to thicken her faint brows, damaged from years of over-plucking, and he suggested transplanting the brows a bit higher than their natural placement. When he sketched a mock-up on her, Sophie was impressed by how the slight adjustment seemed to "open up" her eye area and she agreed to the suggestion.

"It's the kind of thing that, with just makeup, I'd never be able to pull it off. It would look like Sharpie brows," she tells HelloGiggles. But the naturalistic effect of transplanted brows made it work. The shape of the brow can also contribute to a more feminine (highly arched) or masculine (straight across) aesthetic, which is why brow reshaping, as well as hairline adjustment, are procedures often sought out by transgender patients as a gender-confirming surgery. 

Dr. Ziering said he noticed an uptick in eyebrow transplantation interest about five years ago when pop culture seemingly rediscovered brows. But outside of these doctors' offices, eyebrow transplantation is a relatively unknown procedure, especially compared to other cosmetic procedures like Juvederm and Botox

Sophie theorizes that it's just a matter of time until brow transplants hit the mainstream. "I'm a person who usually discovers things that are novel. So I figured, this is probably gonna catch on." And it just might. Despite the high price tag, lots of people are willing to shell out for a permanent solution to their thin brow woes, particularly because the effect is more subtle and realistic than microblading or tattooing can achieve.

Sophie and Marzia both still use some kind of makeup on their brows on a regular basis to get the strong, highly-defined look they prefer. If thick brows fall out of fashion again someday, they can always go bare-faced. As far as anyone will be able to tell, they just have naturally thick, healthy-looking brows—and that's a look that transcends trends.

*Not her real name—patient preferred to speak anonymously for the sake of privacy