Eyelash Transplants: What You Need to Know

Pros

• The procedure can create longer, fuller eyelashes.
• When performed properly, the new lashes should last for the rest of your life. 
• The hairs are taken from your scalp, so they’re real, not synthetic—like some lash extensions.
• Any scarring after the procedure is usually invisible to the naked eye. 

Cons

• Not all transplanted hair will survive. 
• It can take a full year to see your new eyelashes.
• New eyelashes will require maintenance. That includes daily curling (or monthly perming) and regular trimming, since they grow back continuously, like the hairs on your head.
• Eyelash transplantation is more expensive than temporary alternatives like eyelash extensions, and insurance plans don’t usually cover it unless you have hair loss due to a medical condition.
• Very few surgeons perform this procedure on a regular basis, so you may have to travel to find one you trust.

RealSelf Tip: Eyelash hair transplants are very delicate and exacting procedures that can be difficult to get right. It’s not uncommon for transplanted hairs to grow in odd directions. To get a sense of what your results might look like, ask to meet or speak to former patients—especially those with your hair type—before booking your surgery, advises Los Angeles-based hair restoration surgeon Dr. Jae Pak.

Though eyelash transplants for strictly cosmetic purposes are becoming more common, many providers will discourage patients from having the procedure unless they have genetically thin eyelashes or hair loss caused by trauma (from surgery, an accident, or excessive plucking or curling), cancer treatment, or trichotillomania, a medical condition that causes you to involuntarily pull your hair, often leading to permanent hair loss. This impulse control disorder should be treated prior to having eyelash transplant surgery. 

Good candidates include people who:

• Only want to have their upper eyelids done.
• Have already tried Latisse—an FDA-approved prescription serum that can grow lashes longer, thicker, and darker—and aren’t satisfied with the results. 
• Know that regrowth rates are unreliable. “While some patients achieve 90% regrowth, the majority achieve 60–70%, and some lower than 30%,” says Dr. Epstein. After three years, only 20 lashes remained for one RealSelf member, InsertName0991. She reports that her final result is very sparse and spindly. 
• Understand the risks and potential side effects of the procedure. The most common are tiny cysts along the upper eyelid, while a far more unlikely risk is hair growth into the eye that causes corneal damage.

The transplanted hair type and donor site are also factors. “The exact degree of curl needs to be evaluated,” says Dr. Epstein. For instance, curly—but not kinky—hair may be effectively used. In fact, it may actually work better, according to Dr. Alan Bauman, a hair restoration surgeon in Boca Raton, Florida. “Having a ‘strong’ curl to the hair and hair follicle makes orienting the direction of hair growth easier when we implant the follicles.”

Eyelash transplantation is done as an outpatient procedure. It’s a meticulous process that can take several hours. 

Here’s how it works: 

• Both the eyelash area and the donor area are numbed with local anesthesia, so you’ll be awake but won’t feel anything. “It’s just like getting eyelash extensions,” says RealSelf member Sandra224. “I fell asleep cause I was bored.”
• As with traditional hair transplant surgery, donor hairs are first removed from one area of the body. “My preferred technique is to remove a small, 1” donor strip from the scalp with the hairs left long,” says Dr. Epstein. 
• The follicles are dissected out from the strip under a microscope, with most of the desired grafts having two hairs apiece. 
• The hairs from these grafts are individually threaded into a French needle, a specialized instrument that helps the surgeon accurately and efficiently implant the grafts. 
• The needle is inserted along the crease in the upper eyelid and exits at the lid margin, where the desired eyelashes emerge. 
• The final step is to trim the new lashes to the desired length.
• No sutures or dressings are used at the recipient site, but you’ll have stitches or staples at the donor site that will be removed after about 10 days.

The recovery process is typically quite simple. Some RealSelf members report that their eyelashes were pretty much healed after two days. 

That said, it’s not uncommon to experience scabbing or crusting along the lash line, along with some bruising and (sometimes asymmetric) swelling that resolves after a week or so. Cold compresses, arnica, and sleeping with your head raised can help ease discomfort and speed healing.

The grafts take 72 hours to “set,” so take it easy for a few days and avoid touching the area: Manipulating the grafts in the early stages of growth can lead to complications, including infection, scarring, cysts, or the the loss of grafts.

Every provider has their own post-op protocol, so follow your surgeon’s instructions. Dr. Epstein advises his patients to keep their eyelids dry for five days and to apply an antibiotic ointment to prevent infection. 

Other common aftercare advice includes avoiding eye makeup (especially mascara) or contact lenses for a week after surgery, and wearing glasses or soft protective goggles when sleeping for a few nights to protect your new lashes.