Eyebrow Restoration in Deep Facial Burn: Follicular Unit Extraction Hair Transplantation after Nanofat Graft

Eyebrows play an important role in protecting the eyes, and also transmit facial expression. Restoration of eyebrow loss after deep thermal burns is a challenging task because a scarred recipient area may affect the success rate of the hair transplantation outcome. Trials to improve this outcome via preparation of pretransplantation recipient area are mandatory.

Seventeen patients (20 eyebrows) with partial or total postburn eyebrow loss were recruited. Nanofat injection was done as a preparatory step before hair transplantation. Patients were followed up monthly for 6 months after follicular unit extraction. The outcome was assessed both objectively by phototrichoscopy and patient satisfaction, and by incidence of complications.

The mean eyebrow density of the recipient side was found to be 88.60 ± 29.96 hair follicle per cm², compared with 133.95 ± 38.38 on the control side. The mean eyebrow thickness of the recipient side was found to be 0.07 ± 0.01 mm, compared with 0.06 ± 0.01 on the control side, The overall satisfaction was 60% regarding the density, 80% regarding direction, and 65% regarding symmetry. However, when it comes to texture, 45% were satisfied.

Restoration of eyebrow loss after deep facial burn is a challenging procedure. Improving the recipient area before hair transplantation is recommended to achieve a satisfactory outcome. Waiting until maturation of the scarred tissue of the recipient area and preparation of it with nanofat can achieve a satisfactory outcome.