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Successful hair transplant of eyebrow alopecia areata.

BACKGROUND: Alopecia areata of the eyebrows can be difficult to treat. Intralesional triamcinolone or potent topical steroids are considered the mainstay of medical therapy. This case illustrates the results of an experimental hair transplant to the eyebrows following years of modest response to intralesional triamcinolone. OBJECTIVE: The aim of this study was to ascertain the benefits of a hair transplant for chronic eyebrow alopecia areata not responding to appropriate medical therapy. METHODS: A hair transplant was performed with tumescent anesthesia and a total of 85 mini and micrografts placed in the right eyebrow. Followup after the hair transplant occurs every 8 weeks. RESULTS: The patient was free of eyebrow alopecia areata for 8 months following the initial hair transplant. Although the disease relapsed, hair growth is now manageable with intralesional cortisone injection performed six times per year. CONCLUSIONS: For the first time in years, this patient was given 8 months of reprieve from his eyebrow alopecia areata and is currently well-maintained on monthly intralesional cortisone which originally was of only modest benefit. The patient is pleased with the outcome.

Adult↗

Measurements of upper eyelid and eyebrow dimensions in healthy white individuals.

Facial appearance is influenced by the anatomic relationship of the eyebrow and eyelid, and surgical procedures on these structures attempt to restore or preserve not only symmetry but also normal appearance. To provide useful benchmarks for such interventions, we measured the eyebrow height, upper eyelid crease height, and amount of visible pretarsal skin of 143 white subjects who had no facial abnormalities. An age effect was observed for all measures, indicating a direct relationship with age until the middle age range (41 to 60 years), when mean estimates leveled off or decreased somewhat relative to younger age groups. Within the 41- to 60-year age group, for example, the average (S.D.) values for pretarsal skin height, eyelid crease height, and eyebrow height were 1.4 mm (1.1 mm), 6.4 mm (1.2 mm), and 6.4 mm (1.8 mm), respectively. Eyebrow and pretarsal skin heights were greater in females than males, and eyelid crease height showed similar gender-related trends. With increasing age, variation around the mean estimates for eyelid and eyebrow measurement increased, which may be indicative of variability across individuals in the physiologic response to the aging process. As expected, a high degree of intereye correlation was observed (correlation coefficients of 0.87 to 0.96). These results emphasize the importance of providing a normal anatomic relationship that relates to the patient's age and gender, as well as an outcome that is symmetric, in corrective or cosmetic procedures on the eyelid and eyebrow.

Adolescent↗

The role of eyebrows in face recognition.

A fundamental challenge in face recognition lies in determining which facial characteristics are important in the identification of faces. Several studies have indicated the significance of certain facial features in this regard, particularly internal ones such as the eyes and mouth. Surprisingly, however, one rather prominent facial feature has received little attention in this domain: the eyebrows. Past work has examined the role of eyebrows in emotional expression and nonverbal communication, as well as in facial aesthetics and sexual dimorphism. However, it has not been made clear whether the eyebrows play an important role in the identification of faces. Here, we report experimental results which suggest that for face recognition the eyebrows may be at least as influential as the eyes. Specifically, we find that the absence of eyebrows in familiar faces leads to a very large and significant disruption in recognition performance. In fact, a significantly greater decrement in face recognition is observed in the absence of eyebrows than in the absence of eyes. These results may have important implications for our understanding of the mechanisms of face recognition in humans as well as for the development of artificial face-recognition systems.

Adult↗

Objective changes in brow position, superior palpebral crease, peak angle of the eyebrow, and jowl surface area after volumetric radiofrequency treatments to half of the face.

BACKGROUND: Radiofrequency application through a proprietary device has recently been used for facial tissue tightening. Uniform volumetric heating of the dermis is created by passage of electrical current, while protection of the epidermis is maintained by concurrent cryogen cooling. OBJECTIVE: To objectively quantify the effectiveness of volumetric radiofrequency application on the face, we treated 10 patients on the left side of the face with radiofrequency and evaluated the changes in brow position, superior palpebral crease, angle of the eyebrow, and jowl surface area. METHODS: Uniform treatments were applied at 134 J/cm(2) to the left side of the forehead and 1 cm past midline, at 115 J/cm(2) to the left side of temple and cheeks, and at 97 J/cm(2) to the left side of the jaw line and inferior postauricular surface. Patients were evaluated at monthly intervals up to 3 months with digital photography. Morphologic changes were evaluated with the "measuring tool" and "angle tool" of the Mirror Suite imaging system for aligned frontal-view photographs (for eyebrow position, superior palpebral crease elevation, and eyebrow angle changes) and the "outline tool" for aligned oblique-view photographs (for jowl surface area changes). RESULTS: At the end of 3 months on the side that was treated, patients exhibited on average 4.3 mm of brow elevation and 1.9 mm of superior palpebral crease elevation along the midpupillary line and an average of 2.4 mm of brow elevation along the lateral canthal line. There was no significant improvement of brow elevation along the lateral canthal line on the contralateral side. The peak angle of the ipsilateral eyebrow became slightly more acute by an average of 4.5 degrees after treatments. Moreover, the jowls on the lower part of the face, displayed a mean decrease of 22.6% in surface area after treatments. The nontreated side displayed a lack of eyebrow angle and jowl surface area changes. CONCLUSIONS: The application of radiofrequency to the face provides quantifiable changes. The brow along the midpupillary line is elevated to a greater degree than the lateral brow. This is consistent with acute angle changes seen in the eyebrow. Improvements in the lower part of the face with radiofrequency application can be quantified by demonstrating a decrease jowl surface. Moreover, these measurement techniques can be useful tools for evaluating other treatment parameters with radiofrequency application.

Adult↗

Interpretation of facial expressions of emotion: the influence of eyebrows.

The contribution of the eyebrow component (eyebrow density and eyebrow position) in interpretation of facial displays of emotions was explored. In Study 1, college students (N = 60) and children (N = 60), ages 6-9 years, listened to vignettes consisting of one or two sentences and selected the facial expression that best matched the vignette. A main effect for eyebrow density as well as interactions for Density x Age and Density x Emotion were found. Also, a main effect for eyebrow position and interactions for Position x Age, Position x Emotion, and Position x Age x Emotion were significant. Study 2 was conducted to better understand whether findings regarding eyebrow position were a function of mistaking the intended emotion portrayed in the vignettes. Using a within-subject design, responses from 60 children, age 6-9 years, were compared for trials when the emotion was designated and when emotion was not designated. A main effect for designation of emotion was not found; however, an interaction effect for Designation x Emotion was significant.

Adolescent↗

[Comparison of the common fragile sites and G-banding patterns of chromosomes among rhesus monkeys, white-eyebrow gibbons and human being].

The peripheral lymphocyte cultures from Rhesus monkeys (Macaca mulatta), White-eyebrow gibbons (Hylobates hoolock) and human being were treated with BrdU (bromodeoxyuridine), FrdU (fluorodeoxyuridine) and MTX (methotrexate). A number of 22 Common fragile sites for Rhesus monkeys and 20 for white-eyebrow gibbons were found. Chromosome homology and the relationship between fragile sites and chromosomal evolution were discussed. Several common fragile sites of human chromosomes have been found at the homologous chromosomal regions in Rhesus monkeys as well as in White-eyebrow gibbons. Furthermore, the fragile sites at 1q14, 1p32 of Rhesus monkey chromosomes may correspond to the homologous fragile sites at 1p21, 1q31 of White-eyebrow gibbons. All of these fragile sites at the homologous regions of chromosomes are evolutionarily conserved and may be the indicators of common origin of chromosomes as genetic markers. Combined with G-banding patterns of chromosomes, the conservative fragile sites at homologous regions of chromosomes may be useful for the study of chromosome homology and evolution in closely-related animals. Out results show that the differences of chromosome 1 between Rhesus monkeys and human may involve a pericentric inversion and a paracentric inversion. However, the differences of chromosome 1 between Rhesus monkeys and White-eyebrow gibbons may caused by a pericentric inversion, a pericentric inversion, and a deletion or a translocation. The main differences of chromosome 3 between Rhesus monkeys and human may involve a pericentric inversion. Out results indicate that the differences of chromosome 7 between White-eyebrow gibbons and human may involve a paracentric inversion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Eyebrow injuries. Classification and therapy concept].

The aim of primary treatment for eyebrow injuries should be preservation of the original eyebrow under any circumstances. Debridement should be kept to a minimum even when the wound is severe. The treatment of total or partial loss of an eyebrow concerning the exact reconstruction of details and aesthetic aspects is a challenge for the surgeon. The therapy option depends on the type of eyebrow selected for reconstruction. We present a classification for eyebrow injuries, which considers type and size of defects. Based on this, different techniques and methods of reconstruction are recommended. Advantages and disadvantages are discussed and illustrated by several examples.

Eye Injuries↗

Frontal scalp flap for aesthetic eyebrow reconstruction.

The eyebrow is an important subunit of facial aesthetics and expression. Partial or total absence of the eyebrow is an unacceptable and disturbing condition. Aesthetic eyebrow reconstruction is a challenging problem for the reconstructive surgeon. In this paper a simple and reliable procedure for eyebrow reconstruction is presented. An aesthetically satisfactory result was obtained and a perfect match with the undamaged eyebrow was achieved. In selected cases this technique may be a strong alternative to the procedures that had been defined earlier.

Adolescent↗

Eyebrow reconstruction following burn injury.

Facial burns represent between one-fourth and one-third of all burns. Absence of the eyebrows or distortions in their position alter the character of the face. Thus, eyebrow repair or reconstruction can be an important "finishing touch" in the overall reconstruction of a burned face. Generally, there are three ways to reconstruct the eyebrow: use of superficial temporal artery island flap; composite graft from scalp; and mini or micrografts from scalp. This report presents 20 patients reconstructed with the above techniques. Eleven patients (eight male and three female) with superficial temporal artery island flaps; seven patients (two male and five female) with composite grafts from scalp; and two patients (female) with minigrafts. The results suggest that superficial temporal artery island flaps were more suitable for males and composite graft for females who generally require thinner and less dense eyebrows. Our experience with minigrafts for burn alopecia has not been adequate. Here in this article, different methods of eyebrow reconstruction are presented with the greater emphasis on superficial temporal artery flap.

Adult↗

The eyebrow frown: a salient social signal.

Seven experiments investigated the finding that threatening schematic faces are detected more quickly than nonthreatening faces. Threatening faces with v-shaped eyebrows (angry and scheming expressions) were detected more quickly than nonthreatening faces with inverted v-shaped eyebrows (happy and sad expressions). In contrast to the hypothesis that these effects were due to perceptual features unrelated to the face, no advantage was found for v-shaped eyebrows presented in a nonfacelike object. Furthermore, the addition of internal facial features (the eyes, or the nose and mouth) was necessary to produce the detection advantage for faces with v-shaped eyebrows. Overall, the results are interpreted as showing that the v-shaped eyebrow configuration affords easy detection, but only when other internal facial features are present.

Adult↗

Netherton's syndrome: increased likelihood of diagnosis by examining eyebrow hairs.

Netherton's syndrome is a rare autosomal recessive condition with variable expression. It comprises an ichthyosiform dermatitis and erythroderma of variable intensity and manifestations, associated with hair abnormalities. The pathognomonic finding (required for diagnosis) is that of trichorrhexis invaginata identified by light and scanning electron microscopic examination of hair shafts. This may be difficult to establish because the hair is sparse and not all hairs exhibit abnormalities. In one patient, cutaneous and hair problems had existed since infancy, and despite repeated examination of scalp hairs, the definitive diagnosis was made only by examining eyebrow hairs at the age of 30 years. We subsequently compared the number of diagnostic lesions found on scalp and eyebrow hairs from two other patients with previously diagnosed Netherton's syndrome. The density of lesions was greater in eyebrow than scalp hair, and furthermore, all eyebrow hairs had at least one lesion. It is proposed that microscopic examination, if possible, of both scalp and eyebrow hair from patients in whom Netherton's syndrome is suspected would increase the chance of a positive diagnosis.

Adult↗

Eyebrow analysis after blepharoplasty in patients with brow ptosis.

Fifteen patients and 28 eyes with measurable eyebrow ptosis underwent standard upper eyelid blepharoplasty with or without sub-brow fat excision. The patients were educated about the status of their eyebrow position and the effects of either direct or indirect methods of brow elevation. The patients either refused or chose not to undergo browpexy by any method. Eleven patients and 22 eyes showed an insignificant change in their eyebrow position after surgery. Two patients and three eyes had a mild to moderate descent of the eyebrow and two patients had what was felt to be significant worsening of their eyebrow ptosis in one or both eyes. However, all were pleased with their result. Information as such, after a careful review of the literature, has not previously been published.

Adult↗

Bilateral eyebrow reconstruction using a unilateral extended superficial temporal artery flap.

In cases of the bilateral eyebrow reconstruction in men, two superficial temporal artery (STA) flaps are usually designed for both temporal regions according to the flap movable range and the direction of hair growth. Recently, the authors have successfully reconstructed bilateral eyebrows with normal directions of hair growth using a unilateral STA flap, extended by anastomosis of the STA and the occipital artery, with two hair-bearing skin islands. Using this method, the direction of the hair growth can be optimally selected by changing the direction of the skin islands for each eyebrow. The authors were able to reconstruct symmetric eyebrows with the hair growing laterally and a little upward. The invasiveness, bleeding, and operating time required for this method are less than those for the bilateral STA flap method. For cases in which one temporal scalp could not be used, bilateral eyebrow reconstruction remains possible with this method.

Adult↗

Eyebrow transplantation.

The eyebrow has a powerful influence on the appearance of the orbital region. Because the person without eyebrows has an unnatural look, drawing everyone's attention, eyebrow restoration/reconstruction should be viewed as an esthetic surgery performed to improve the patient's appearance and self-esteem. Although hair-bearing pedicled flaps and free composite strip grafts have been the most widely used approaches in clinical practice formerly, follicular unit transplantation (FUT) has gained more and more importance nowadays in eyebrow restoration because of its more rewarding results. The process and results of FUT have been greatly improved thanks to advances in hair transplantation techniques, instrumentation, and practice. In this article, we discuss the restoration of 14 eyebrows in 8 patients (5 males and 3 females) using FUT. The procedure and the results also are discussed here under in light of literature.

Adolescent↗

In utero diagnosis of trichothiodystrophy by endoscopically-guided fetal eyebrow biopsy.

OBJECTIVE: To describe the prenatal diagnosis of trichothiodystrophy (TTD) through endoscopically-guided fetal eyebrow biopsy. MATERIALS AND METHODS: A 32-year-old patient, gravida 4, para 3, with a history of 2 previous infants affected with TTD was referred at 17(5)/(7) weeks for fetal hair biopsy. DNA repair studies had been normal in the previous children. Four 1-mm biopsies were obtained from the external aspect of the fetal eyebrows under direct endoscopic guidance. Fetal hair samples were assessed with polarized microscopy, electron microscopy, hematoxylin and eosin staining, and were also sent for analysis of sulfur content (cystine levels). RESULTS: The fetal eyebrows were the only adequate source of hair in the early second trimester. The biopsy samples yielded adequate material for all tests. Polarized microscopy showed characteristic banding patterns, but trichoschisis was not apparent. Cystine levels (19 micromol/l) in the biopsy sample were significantly lower than an age-matched (fresh spontaneous abortion) control (368 micromol/l). CONCLUSION: Prenatal diagnosis of TTD is possible in the second trimester through endoscopically-guided eyebrow biopsy. An adequate amount of hair is present in the eyebrows by then, and the disease is already manifest. Analysis of sulfur content of the hair samples is preferred over polarized or electron microscopy, as many classic microscopic findings of TTD may not be present in the early second trimester.

Adult↗

A transpalpebral approach to treatment of eyebrow ptosis.

The aging process in the human face most often is first visible in the temporal-orbital region, where the ptosis of the eyebrow edge and pseudoexcess of upper eyelid skin are caused by orbicularis oculi muscle downfall. Through the upper blepharoplasty standard incision, the orbicularis oculi muscle is mobilized widely and suspended into a higher position with a stitch put on the deep temporal fascia. In this way the eyebrow is elevated and stabilized, thus reducing so-called "crow's feet." In some cases, when the skin distance between the temporal hairline and the eyebrow edge is too short or when it is necessary to lift the eyebrow edge more than 3 mm, a supplementary temporal incision is recommended to tighten better, in the same direction as the tension vector, the superficial temporal fascia and the overlying skin, firmly bonded to it.

Blepharoplasty↗

Distribution of human papillomavirus genotypes in plucked eyebrow hairs from Slovenian males with genital warts.

In the present study, the presence and distribution of human papillomaviruses (HPVs) in the plucked eyebrow hairs obtained from 49 Slovenian male patients with genital warts were investigated. Using polymerase chain reaction (PCR) with three sets of degenerate primers targeting all known HPV genotypes, HPV DNA was found in 31 (63.3%) of 49 eyebrow hair samples. Epidermodysplasia verruciformis (EV) associated HPV specific Ma/Ha nested PCR system detected HPVs in 27 (55.1%) and CPI/CPIIs primers that amplify the majority of cutaneous/EV HPV genotypes in 20 (40.8%) of 49 samples tested. The CPI/CPIIg PCR specific for E1 open reading frame of genital HPVs showed the presence of HPV DNA in 10 (20.4%) of 49 specimens. Direct sequencing of the Ha PCR products showed the presence of three putative new HPV genotypes, named SIBX1, SIBX2 and SIBX3. Similarly, three potential new HPV genotypes, SIBX4, SIBX5 and SIBX6, were detected by sequencing CPI/CPIIs PCR products. In total, at least 24 different HPV genotypes were detected in 31 HPV DNA positive samples of plucked eyebrow hairs. The results of our study showed that the use of a combined degenerate primer PCR approach considerably improves the HPV DNA detection over individual primer sets and greatly improves the detection of different HPV genotypes in the plucked eyebrow hairs.

Adolescent↗

Presence of human papillomavirus DNA in plucked eyebrow hairs is associated with a history of cutaneous squamous cell carcinoma.

A role for cutaneous human papillomaviruses (HPV) has been proposed in the development of skin cancer. Well-designed epidemiologic studies to demonstrate an association between HPV infection and skin cancer are extremely rare. To identify HPV infection as a potential risk factor, we investigated the association between the presence of HPV DNA in eyebrow hairs and a history of cutaneous squamous cell carcinoma. A case-control study was designed consisting of 155 immunocompetent individuals with a history of squamous cell carcinoma and 371 controls without skin cancer. DNA extracted from plucked eyebrow hairs collected from the study population was analyzed with a cutaneous HPV subgroup polymerase chain reaction and newly designed HPV type specific polymerase chain reactions for HPV 2, 5, 8, 15, 16, 20, 24, and 38. HPV DNA was detected in 63.1% of the total study population. The presence of HPV DNA was associated with age (p=0.0002) and male sex (p=0.02), but not with sun exposure, skin type, and smoking. After adjustment for age and sex, the presence of HPV DNA in eyebrow hairs was associated with a history of squamous cell carcinoma (odds ratio 1.7, 95% confidence interval 1.1; 2.7). HPV type specific analysis revealed that no HPV type stood out. The high-risk mucosal type HPV 16 and the skin wart type HPV 2 were rarely found in this study (<0.2%). The positive association found between the presence of HPV DNA in eyebrow hairs and a history of squamous cell carcinoma warrants further research into the role that HPV infection plays in the development of cutaneous squamous cell carcinoma.

Age Distribution↗