Eyelashes are firstly there to protect the eyes against dust and dirt. Touching eyelashes even lightly will cause the eyes to close reflexively. Eyelashes also have an aesthetic function by framing the eyes and contribute to the overall facial appearance. When eyelashes are completely absent it makes a considerable difference in the appearance of eyes and facial features in general. Loss of eyelashes can therefore cause physical problems with eyes being exposed to excessive dirt and feeling gritty and sore and appearing red and on the other hand it can have an effect on a person’s self-esteem and confidence.

The most common reasons for people undergoing eyelash transplants are as a result of injuries from burns, car accidents and industrial accidents. Surgical treatments for excising tumours resulting in loss of eyelash follicles and result in tissue scarring. Some patients cause Traction Alopecia loss of eyelashes by regular use of false eyelashes. Medical treatments that involve chemotherapy or radiotherapy may result in damage to hair follicles. Some women injure and tear away their eyelashes in the process of removing false eyelashes and others may suffer from compulsive plucking of eyelashes in conjunction with plucking at other body hairs (Trichotillomania) resulting in permanent loss of hair in those areas. Some women may simply want to make their existing eyelashes thicker in order to enhance their appearance.

For eyelash transplants the hair is harvested mostly via FUT strip surgery. The follicles for eyelashes are harvested from the back of the head closer to the side margin where lower calibre hairs grow that have the closest resemblance to normal eyelashes. Hair can also be harvested from arms and legs, but this would mostly be done via FUE technique and will be shorter in length after harvesting. The calibre and growth phases of arm and leg hair have a closer resemblance to normal eyelashes but harvesting those grafts cause a greater challenge during the operation with placement of the grafts. The FUT strip surgery harvested follicle hairs are kept long (4 to 5 cm) on the strip harvest and hair follicles are dissected using Stereomicroscopic magnification but the long hair shaft remains in place because this is needed to thread the hair shaft through the eye of a surgical needle which is used to place the follicle in the right position within the upper eyelid. It is important to note that transplanted eyelash follicles harvested from the back of the head will continue to grow similar to scalp hair, so the patient will have to “trim” their eyelashes on an ongoing basis, weekly or more often to keep at the desired length. Also, the patient has to train the eyelashes to curve away from the eye, similar to natural eyelashes. The purpose is not only for aesthetic purposes, but also to prevent the eyelashes from curling inward towards the globe of the eye (entropion) and scratching the cornea of the eye which may cause serious problems related to corneal scratches, abrasions, ulcers and infections of the corneal surface.

We only transplant hair follicles into the upper eyelid. The average upper eyelid contains approximately 100 lashes.

– Dr. A Nel, hair restoration practice experience


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