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Women who pluck too much turn to eyebrow transplants

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An eyebrow before transplant surgery. (Photo by Dr. William Rassman)

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An eyebrow after transplant surgery. (Photo by Dr. William Rassman)

The doctor injected a local anesthetic above Norma Ostraco's brow and behind her ear. Ostraco was awake and excited during the two-hour surgery. Follicle by follicle, Dr. Robert Bernstein harvested a tiny clump of hair from the side of her head and gave her new eyebrows.

Ostraco, 56, of New York City, had always been proud of her eyebrows, which she never waxed or tweezed. “Every girl was jealous of my arches,” she boasted. “As the years went by though, one day I looked in the mirror, and thought, ‘Wow, they've gotten so thin and sparse.’”

So Ostraco, a retired New York City police detective, went straight to her computer and looked for solutions. She briefly considered eyebrow tattoos, but her daughter convinced her that it was not a good idea. She didn't want her tattooed eyebrows to droop as she aged. Then she read about eyebrow transplants.

Throughout the country, follically-challenged and over-tweezed women (and some men) are discovering a new solution to their eyebrow woes that does not involve tattoos or makeup pencils.

Eyebrow transplants accounted for just 3 percent of all hair transplants in 2006, according to the International Society of Hair Restoration Surgery, but they grew by 35 percent over the previous two years and appear to be gaining momentum.

Often overlooked and taken for granted, eyebrows actually play a key role in non-verbal communication.

“Eyebrows are the most important part of the face,” said Crystal Thomas, a brow specialist at Red 7 Salon in Chicago. “Without eyebrows, people are expressionless. Even if somebody's got great makeup, if their eyebrows are wrong, it won't look right.”

Women have long sought the perfect accent over their eyes, carefully plucking hairs to get the precise shape and look for a particular era.

Whether from over-tweezing or heredity, some women find as time passes that their eyebrows thin out or completely disappear, leading them to transplants, said Dr. William Rassman, a hair transplant surgeon at the New Hair Institute in Los Angeles.

“But men come to us too,” he added. “They usually want more of an eyebrow. They like bushy eyebrows--not Albert Einstein bushy--but more in that direction. It's very manly.”

Hair transplants to the scalp to combat baldness have been popular since the 1980s. The first eyebrow transplant was performed in the United States in the early 1990s. The procedure takes between two and three hours.

Like most hair restoration surgeries, hair is taken from one part of the body and transplanted in the barren regions where it is needed. However, implantation in the eyebrow is trickier than in other locations because eyebrow hair lies almost flat to the brow--a tough angle at which to insert follicles.

The direction and shape of the hairs are also critical to the final result. Sometimes the surgery can result in a stray hair or two growing in a less than ideal direction. (Of course, they can always be plucked.)

A typical eyebrow requires between 50 and 300 transplanted hairs. The follicles are often taken from behind the ear, but doctors have also used hair from legs and the trunk of the body, wherever finer, more brow-like hair can be found.

One issue is that hair taken from other parts of the body grows at different rates. “Hair from the head grows a half-inch per month--much faster than natural eyebrow hair,” said Dr. Rassman, who performs one or two transplants per month. “After the surgery, the typical person has to trim every two weeks or they’ll end up with eyebrows they can braid.”

Depending on the surgeon, an eyebrow transplant can cost anywhere from $3,000 to $5,000. For some, the price is simply too much.

“I think I'd probably just save my money for another procedure like an eye lift,” said Kathy Putney, 55, a nanny from Costa Mesa, Calif., who opted for eyebrow tattoos nine years ago.

Tattoos, which draw in the shape of the brow, are an older solution that many transplant surgeons now dismiss as inferior.

“People still get tattoos, because they get conned into getting them,” said Dr. Robert Bernstein, clinical professor of dermatology at Columbia University and the founder of Bernstein Medical Center for Hair Restoration in New York. “They think they don't have to put on eyeliner anymore, but after a time the tattoo can take on a bluish tint. No one wants blue eyebrows.”

Putney, the nanny, was surprised to hear about that side effect, but said she would just re-tattoo her eyebrows if she had to. Her only regret is that she over-tweezed in the first place--a lesson she shares with the children she cares for.

“I tell them, ‘Don't pluck your eyebrows,’” she said. “I say, ‘I ruined mine and please don’t touch yours.’ I start telling them that when they're 5.”

To Norma Ostraco, though, the real lesson is that modern science can fix anything, in a more or less “natural” way.

“All the time, my family and friends say, ‘Wow, what a difference it made,’” she added. “My daughter tells me that my eyebrows look fabulous. I guess I'd rather grow older gracefully with my own hair.”

E-mail: jez2104@columbia.edu