Technical notes for a method of eyebrow reconstruction by retroauricular scalp graft: problems and countermeasures

To describe a technique using retroauricular scalp graft for eyebrow reconstruction, along with problems encountered and countermeasures in treatment.

We present a patient with eyebrow loss following resection of a malignant schwannoma. We initially covered the defect from the upper eyelid to the eyebrow area with artificial dermis for hemostasis and to increase the granulation of the graft bed. Considering hair texture, aesthetic unit and color match, the eyebrow area was grafted with a scalp harvested from the retroauricular region. The skin from the subclavian area was used for the upper eyelid defect. Tie-over fixation was performed.

After a slightly longer immobilization period of 8.5 days, the tie-over fixation was removed. All grafted scalp and skin were fully engrafted. The reconstructed eyebrows had natural hair flow and softness. The texture of retroauricular hair closely resembled that of natural eyebrow hairs. The color and texture the upper eyelid grafts were also matched well. Surgical scar at the retroauricular hairline was effectively concealed by surrounding hair.

Eyebrow reconstruction could be successfully achieved using from the retroauricular scalp with some ingenuity in order to be successful. These include improving the hemodynamic status of the grafted bed, considering aesthetic units, and extending the fixation period.