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Eyelash Transplant

Eyelash Transplants: Window Dressings for the Eyes

Rachel Dauod, 32, of Oceanside, California, had not seen her face with eyebrows and eyelashes since she was 11 years old.

Rachel developed a hair pulling compulsion, "Trichotillomania," (trik-uh-til-o-mania) known to its sufferers as just "Trich."

During times of stress, trichotillomania victims feel a compulsion to pull on their hair, including eyelashes and eyebrows with fingernails or tweezers. Hair pulling is usually followed by a feeling of stress relief and pleasure, making it difficult to stop. Many pluck their eyelashes and brows completely bare as did Rachel.


From her teen years on, Rachel used heavy makeup to hide her lack of lashes and eyebrows. When she was older, she tried a variety of medical treatments but nothing worked until her late 20s when behavioral therapy treatments stopped the compulsion.

However, Rachel was still left with no eyelashes or brows of her own. At 31, while searching the Internet for information about eyelashes, Rachel stumbled onto the Web site of Alan Bauman, M.D. a board certified hair restoration surgeon and -- of all things -- eyelash transplant expert in Boca Raton, Florida!

"Until that moment, I did not know a cure existed. I suddenly found an answer and it was a dream come true," says Rachel. "The thought that popped into my head when I discovered a permanent cure was: 'Where do I have to go and what do I have to do to get it?'"

She met Dr. Bauman in nearby Los Angeles and later underwent a four-hour procedure in which hair was taken from the nape of her neck and transplanted into her bare eyelids. Between two and four percent of Dr. Bauman's eyelash transplant patients are former Trichotilomania patients.

Eyelash and Eyebrow Transplant Before Photo Eyelash and Eyebrow Transplant After Photo

Rachel Dauod shows her bare eyelashes and brows, left. The after picture, right, shows her eyelash growth two weeks, post-op. Rachel’s eyebrows are marked for surgery to guide the surgeon. (Photos, courtesy of Alan J. Bauman, M.D.)

Rachel also had her eyebrows restored in the same visit which is a separate procedure similar to restoring the hairline on the head, according to Dr. Bauman. Typically, a few hundred grafts are used for each eyebrow while a standard eyelash transplantation will implant anywhere from 20 to 60 hairs per lid. The procedure is usually done under local anesthesia and light sedation; in some cases, more than one session may be required.

"Eyelash transplantation is something like sewing," says Sara Wasserbauer, M.D. a board certified Northern California hair restoration expert who specializes in eyelash transplantation. "Once I have harvested and prepared the donor hair, I use a curved needle with donor hair attached and sew it into the eyelids. In about two to three weeks, those hairs fall out but the hair follicles are left. New eyelashes grow out in three to six months."

Plastic Surgeon

Because an eyelid is like a sandwich, with a layer of fat and muscle between two layers of very thin skin, the surgeon injects saline and an anti-pain medication to puff up the eyelids. That gives the doctor more room to insert the tiny pieces of prepared donor hair but leaves the patient with swollen eyes, as if she had just been in a fist fight. (The swelling usually subsides within two days.)

Of course, modern women are not the first to be concerned about the appearance of their eyelashes.

Eyelash Transplant Procedure Eyelash Transplant Post-Operative Treatment

The surgeon “sews” a donor hair into her patient’s eyelid. The lashes are left long in the right hand picture because the doctor wants to make sure the hair is curving in the correct direction, away from the eye. The lashes are later trimmed to a length between one-half and three quarters of an inch. (Photos, courtesty of Sara Wasserbauer, M.D., Walnut Creek, California.)

People have been fascinated with thick, long eyelashes since the time of the ancient Egyptians," says Dr. Bauman. "Enhancing eyes and eyelashes are even mentioned in the Bible.

"But today, if the eyes are the windows to the soul, then the eyelashes are the window dressings," says Dr. Bauman. "With the techniques we have developed, eyelashes do for a woman's face what breast augmentation can do for her figure."

False Eyelashes

1920-era film stars popularized long and lush eyelashes by glopping on mascara; flirty but false eyelashes had a heyday in the 1940s while the 1960s saw eyelash extensions becoming a common offering in many beauty and nail salons. Other spread-on concoctions, lotions and creams promise to deliver heavy eyelash growth.

But the downsides are plentiful: mascara is messy, false eyelashes fall off and eyelash extensions require strong glue, a steady hand and sharp instruments very close to the eyeballs. As for the widely ballyhooed growth products, an inverse ratio usually exists between a company's glowing promises and the customers' dismal results.

By the same token, eyelash transplantation also has a few downsides: because it is hair taken from your own head, it continues growing. So transplanted eyelashes must be trimmed and curled every six weeks to make sure the new lashes curve away from the eye aesthetically. Moreover, very coarse or kinky hairs do not make the best eyelashes, leaving some Asians, African-Americans and other ethnic groups out in the cold.

But, judging by the public response, the downsides are not all that steep.

While Dr. Bauman says he was performing one eyelash procedure during most months only several years ago, he now receives about 25 inquiries monthly with actual procedures up about 300 percent this year.

"Until that moment,
I did not know a cure
existed. I suddenly found
an answer and it was a
dream come true."

It's hard to know if eyelash transplantation will become the next big thing in cosmetic surgery because statistics are difficult to find. But, according to a 2006 survey done by the International Society of Hair Restoration Surgery (ISHRS), eyelash transplantation accounts for 1.4 percent of all hair transplant procedures. But in 2004, eyelashes were only .35 percent of hair transplants. Moreover, in a culture where instant gratification takes too long, a full year is required before the final results come into view.

Cosmetic Surgeon

Less than a dozen practitioners like Drs. Bauman and Wasserbauer are currently found in the United States; worldwide, there are about 20 surgeons schooled in the intricacies of performing the delicate cosmetic procedure which is classified as microsurgery. Eyelash transplantation is also expensive, with each lid costing anywhere from $2500 to $3000 and more.

Eyelash transplantation was first reported in the 1980s, with most patients coming to surgeons as burn, accident or disease victims. According to Anna Murchison, M.D. an ophthalmologist at the Emory University School of Medicine in Atlanta, Georgia, chemotherapy, high doses of vitamin A and radiation treatment can also cause eyelash loss.

"The risk of permanent corneal damage makes this procedure a poor choice for patients with normal eyelids and eyelashes," wrote Dr. Murchison in a technical journal.

Moreover, eyelashes are prone to the following ailments which include:

  • Madarosis -- a permanent loss of eyelashes
  • Trichiasis -- ingrown eyelashes
  • Blepharitis -- irritation of the lid margin where eyelashes join the eyelid.
  • Infestations -- parasites can attack eyelashes
  • Styes and chalazions, small tumors of the eyelid

Eye Lash

You may never think about eye winkers until one falls into your eye, but eyelashes do have a serious function. They protect the eye from dust and other debris while performing some of the same functions as whiskers on a cat or a mouse. Because eyelashes are sensitive to touch, they provide an early warning that a foreign object -- like a dust mite or other insect -- is hovering near the eye.

"I think eyelash extensions have had something to do with the increase in transplantation," says Dr. Bauman who performed Rachel's surgery pro bono. "While the extensions are widely available, they are expensive to maintain and can damage your real lashes. Plus, women in general are more accepting of cosmetic surgery and want to look good and feel better about themselves."

Rachel Dauod put up a website -- -- about her procedure and has traveled at her own cost to distant locales to be interviewed about eyelash transplantation.

Self Confidence

"For one, I can go swimming again without worrying myself into a nervous wreck about my makeup washing off," Rachel says. "Without eyelashes and brows, I made sure my makeup -- my security blanket -- was applied first thing every morning, even before coffee. Now, having natural brows and lashes takes a weight off my shoulders.

"It was just too embarrassing to explain why I had no eyelashes or brows. Now, I don't feel nearly as self-conscious," she says.

And that could explain why Rachel could appear on Good Morning America and other television talk shows without so much as -- forgive the expression -- batting an eyelash.

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