Who doesn’t want thicker, longer eyelashes? If you’re among those with sparse or short eyelashes, you now have real hope to grow healthy real lashes by having an eyelash transplant. This hot new plastic surgery procedure can be used to replace eyelashes that have been lost or damaged through trauma, or to enhance existing eyelashes that are short and/or sparse. The use of the single-follicle hair transplantation technique enables new, living and growing eyelashes to be permanently restored to the eyelid using microsurgery.
Dr. Alan Bauman is among the leading surgeons in the
Make Me Heal: What is an eyelash transplant and how is it performed as far as incisions, anesthesia, and other technical details. How long does an eyelash transplant take to perform?
Dr. Bauman: Eyelash transplantation is a procedure that adds new, living and growing lashes to the eyes, enhancing their appearance. The eyelash transplant procedure is a minor procedure comfortably performed under local anesthesia in an out-patient setting. Hair follicles are harvested from the back of the scalp and carefully implanted into the eyelid. On average, 30-40 lashes are implanted per eye in a single session.
- Local anesthesia is applied to a tiny area of scalp in the back of the head where approximately 100 follicles are undetectably ‘harvested.’
- The harvested follicles are carefully prepared under a microscope.
- Local anesthetic is applied to the eyelid area using techniques that avoid injury to critical structures.
- The follicles are carefully implanted using a delicate microsurgical technique.
Make Me Heal: We learned that you have your own eyelash transplantation technique. Please tell us how your technique is unique and how it improves the aesthetic outcome of the procedure?
Dr. Bauman: The technique I demonstrated at the International Society of Hair Restoration Surgery’s First Regional Eyelash Transplant Live Surgery Workshop is a new refinement of an older procedure. It allows for extremely safe and accurate orientation of the curl of the implanted lashes—which is critical for the aesthetic outcome. Part of the technique requires a computerized anesthesia delivery device called ‘The Wand.’ The refinement also allows a higher number of follicles to be implanted.
Make Me Heal: What are the different reasons (aesthetic and reconstructive) someone may have an eyelash transplant?
Dr. Bauman: Eyelash transplantation may be used to restore lashes for patients who have had damage to their lashes, those who have naturally shorter, thinner or sparse lashes, or those who have noticed that their lashes have ‘weakened’ over time.
Damaged or weakened lashes can occur as a result of car accidents, burns, medication (chemotherapy) or even self-induced trauma (such as trichotillomania—the hair-pulling disease). I have noticed that overuse or misuse of eyelash extensions and eyelash perms can cause both temporary and permanent eyelash loss as well.
Make Me Heal: Is the eyelash transplant a relatively new procedure or has it been around for some time?
Dr. Bauman: Eyelash transplantation has been described in the medical literature since the 1980s and 1990s. However, years ago, the procedure was mainly used for ‘reconstructive’ purposes because of the small number of lashes that could be implanted. Newer techniques allow accurate orientation of the lashes and a larger number of lashes implanted per session. Today, eyelash transplants have been referred to by some as a ‘must have’ cosmetic procedure.
Make Me Heal: When did eyelash transplants start to become popular? What is your estimation on how many women have had eyelash transplants?
Dr. Bauman: Eyelash transplantation for cosmetic reasons became more popular along with the dramatic increase in cosmetic surgery in the
I have no way of knowing how many women have had eyelash transplants, but I have noticed that the number of inquiries and procedures have more than tripled this year and are continuing to increase. For example, I received over 100 inquires over the span of just the past month or two.
Make Me Heal: What types of doctors (i.e. hair loss specialists, plastic surgeons, etc.) typically perform eyelash transplants? Who do you think are the best qualified to perform eyelash transplants? What should a patient desiring an eyelash transplant look for in a physician?
Dr. Bauman: Because the procedure is so specialized, there are very few hair transplant surgeons who perform this procedure on a routine basis. There are only a handful of surgeons who perform this procedure worldwide, so patients should be prepared to travel.
Eyelash transplantation, like any advanced microsurgical hair transplantation procedure, requires a combination of surgical skill (on the part of the hair transplant surgeon and his team in order to perform the procedure safely and effectively) and ‘artistic flair’ (to ensure the most aesthetic outcome possible).
Patients should look for a surgeon with extensive hair transplant experience and an eyelash transplant ‘track-record.’ How many cases has that surgeon performed? How long has the surgeon performed hair transplantation? How long has the surgeon been performing eyelash transplantation? How often does the surgeon perform eyelash transplantation (once a year, once a month, once a week, etc.)? Has the surgeon attended any ISHRS-sponsored eyelash transplant live surgery workshops? Has the surgeon taught the procedure at ISHRS-sponsored eyelash transplant workshops? Check the surgeon’s professional affiliations: ISHRS (International Society of Hair Restoration Surgery) membership, IAHRS (International Alliance of Hair Restoration Surgeons) membership. Is he/she a diplomate of the American or International Board of Hair Restoration Surgery?
Make Me Heal: How fast can a patient expect to see eyelash growth?
Dr. Bauman: Sometimes, eyelash growth starts immediately after implantation, producing long lashes noticeable as early as six weeks from the procedure. However, in most cases, the transplanted initially shed within two weeks, taking approximately 6-12 weeks to ‘kick-in’ and grow. Normally it can take up to a full year to see the final result from a single session of transplantation. Because the follicles are harvested from the scalp, they grow long and will need to be routinely trimmed and curled.
Make Me Heal: How long do the results of an eyelash transplant last? Eyelash transplants are considered permanent, as long as the implanted lashes are not traumatized in some way (like from a recurrence of trichotillomania or eyelash extension misuse). What can a patient expect 4-5 years and then 10 years after an eyelash transplant?
Dr. Bauman: Long-term studies have not been done, but like the results of all types of hair transplantation, they are considered permanent.
Make Me Heal: What is the type of patient who makes a good candidate for the procedure?
Dr. Bauman: A good candidate for eyelash transplantation will have short, thin, sparse, missing or otherwise ‘weak’ lashes.
Make Me Heal: What kind of patient makes a bad candidate for the procedure?
Dr. Bauman: Patients with a medical condition that would harm the implanted lashes (like active trichotillomania) or a condition that would jeopardize the safety of the procedure (a blood clotting or healing problem, etc.).
Make Me Heal: How long is the recovery process? What symptoms can a patient expect (i.e. bruising, swelling, eye irritation, watery/dry eyes, numbness) and how long do they persist?
Dr. Bauman: The healing process is relatively quick, taking just a few days for the implanted lashes to become healed completely. Swelling typically lasts a few days to two weeks. Bruising is rare, but it can take up to two weeks to completely resolve, if it occurs.
Make Me Heal: Is there any period of time the patient should expect to be resting and not be active or at work?
Dr. Bauman: Minimal activity is recommended for twenty-four hours after the procedure. No eye-makeup for one week, no mascara/lash curlers for two weeks. Goggles or sunglasses should be worn for four days (especially while sleeping) to protect the implanted lashes. When the lashes start to ‘kick-in’ and grow, some patients experience temporary styes (small, tender red bumps) on the eyelid. Usually, these resolve in a matter of days, if they occur.
Make Me Heal: Can someone wear contacts or glasses after an eyelash transplant?
Dr. Bauman: Glasses (as opposed to contacts) are recommended in order to minimize manipulation of the eyelids over the first few days.
Make Me Heal: Are there any scars following an eyelash transplant? If yes, then can they be seen to the eye? If yes, which products can be used to minimize scars or heal them.
Dr. Bauman: While no one can predict every patient’s ability to heal, scarring in the scalp and eyelids from eyelash transplantation is typically not detectable with the naked eye. Since the scars are typically not noticeable to the naked eye, scar-reduction creams are not recommended. Usually, we recommend Squalane—made from refined olive oil for moisturization of the lid and donor areas post-operatively.
Make Me Heal: What are the potential risks and complications following an eyelash transplant?
Pain and tenderness: Pain after the procedure is variable and, for some, may be more significant than others. Most people experience very little discomfort or interruption in their daily routine.
Swelling: Most patients can expect to have swelling of the upper lids for a few days after the procedure. You can expect that your lids will be numb, puffy and feel ‘heavy’ after the procedure. After just a few hours, the swelling will start to subside. Some swelling may last up to two weeks.
Bruising: Bruising is common on the eyelids after eyelash transplantation. In more severe cases, it extends onto the surrounding skin. Very rarely, patients experience bruising that extends on to the surface of the eye. If it occurs, bruising may be visible for up to two weeks.
Bleeding: The eyelids and the area around the eyes have a rich blood supply. Small scabs and/or tiny drops of dried blood will be seen in the middle of the lid, at the lash-line and the sutured area (back of scalp) immediately following the procedure.
Infection: This is a rare but potentially serious problem that can be easily treated. If bleeding occurs beneath the skin (hematoma), infection may be more likely to develop. Infection in the donor area is extremely rare.
Styes/Hordoleum/Chalazion Cysts: Temporary blockage of the oil ducts in the edges of the lids can result in a fluid-filled hordoleum or “stye.” This is one of the more common issues after eyelash transplantation. A stye appears as a small, round red bump on the eyelid, like a pimple. Usually this kind of localized infection or inflammation is temporary, and resolves on its own within a few days or with the application of hot compresses. Rarely, drainage of the fluid with a needle (by a physician), or rarely, removal of the fluid-filled sac, is necessary.
Vision Problems: Blindness or vision changes have never been reported in the medical literature in conjunction with eyelash transplantation and are therefore considered a theoretical, extremely rare risk. Similar to blepharoplasty (eyelid lift) or Botox injection procedures, vision problems could be caused by bleeding around the eye or a needle-stick injury.
Make Me Heal: Can the procedure affect one’s vision?
Dr. Bauman: Like a blepharoplasty (eyelid lift), botox injections in crow’s feet, or even the application of permanent makeup/tattoo eyeliner, we are working near sensitive structures. Since the procedure was first presented in 1980’s, there have been no reports in the medical literature of vision problems from eyelash transplantation. However, as with any surgical procedure there are risks.
Make Me Heal: What are your main pre-op and post-op recovery tips for patients?
Dr. Bauman: We have a very detailed set of pre-op instructions and a detailed set of post-op instructions. In general terms, preoperatively, patients should avoid things that are known to prolong healing and interfere with blood clotting. Postoperatively, patients will be instructed on the care of recently transplanted lashes and the benefits of various healing-treatments that can decrease discomfort and minimize downtime.
Make Me Heal: What recovery products can be used following an eyelash transplant to speed up healing, such as eye compresses, scar creams, homeopathic remedies?
Dr. Bauman: In general, I recommend Arnica
Make Me Heal: What do you think of eyelash extensions and can they be bad for eyelash growth?
Dr. Bauman: Eyelash extensions can certainly enhance the length of short lashes. However, just like hair extensions, they put extra ‘traction’ on the eyelash follicles. Extra weight on weak follicles can cause hair growth problems. Also, if the extensions are not removed carefully, trauma to the eyelash follicles can also occur. I have seen that the overuse of eyelash extensions and the misuse of eyelash extensions can cause damage to existing, healthy lashes.
Sometimes, patients will try eyelash extensions first, but then get tired of the long-term expense, time and hassle of having them removed and replaced every few weeks. In the long-run, eyelash transplantation makes more economic sense, since the procedure is a one-time expense. Also, occasional trimming takes much less time than a full eyelash-extension process.
I have some patients that use extensions in addition to having the transplants. I have learned to work very closely with cosmetologists and others who perform eyelash extensions, eyelash tinting, eyelash perming as well as eyebrow care. In fact, I employ a special staff member who is “eye-aesthetics” specialist in these areas.
Make Me Heal: What do you think about eyelash growth products such as Jan Marini Age Intervention Eyelash and Revitalash? Can these products be taken in conjunction with an eyelash transplant or following it to help maintain the results?
Dr. Bauman: The results of eyelash transplantation are permanent—the lashes will live and grow in the lid permanently.
In the few patients I have seen who have used prostaglandin analogs: topical products, like Jan Marini’s and Revitalash; as well as prescription intraocular drops (Lumigan, Xalatan, etc.), some have had dramatic increases in lash length and number. However, some patients tend not to respond as well—for reasons still yet unknown.
Since we are not transplanting the bottom lash-line, many times I’ll recommend the topical products to enhance the lower lashes after the patient is healed from the transplant procedure.
Some patients use the lash-enhancing treatments first, then they’ll decide they want longer thicker lashes and opt for the eyelash transplant.
Make Me Heal: Are there any innovations on the horizon for eyelash transplants that might change the technique and improve the outcome of the procedure?
Dr. Bauman: Innovations in the field of hair transplantation have come fast and furious over the past ten years, so improvements are always happening. Typically, there is no ‘revolution’ or dramatic change, but more of an ‘evolution.’ For example, years ago, we thought that implantation of twelve lashes per lid was a huge accomplishment. Today, we’re often transplanting an average of forty or more per lid!
It is important to be wary of ‘new’ techniques that don’t have a well-established track record of effectiveness, safety and results. As I mentioned, the ‘sew’ eyelash transplant technique has been around since the 1980’s, described in several textbooks and the medical literature.
In my practice, I’ve noticed that there has been a significant improvement in the speed of recovery as well as the comfort during the procedure over the years that I’ve performed eyelash transplants.
Alan J. Bauman, M.D., founder of Bauman Medical Group in Boca Raton, Florida, is a top U.S. medical expert on hair loss and restoration for men and women, including eyelash, eyebrow and scalp transplants, and laser therapy. Roughly 40-percent of his patients are women – four times higher than the average practice.
He is a diplomate of the American Board of Hair Restoration Surgery and is a featured lecturer at major medical conferences and surgery workshops (including the “World’s First Eyelash Transplant Workshop,” October 2006,
Dr. Bauman received his M.D. from
Tags: celebrity, plastic, surgery