الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 115 |  |  |
| | | from | 115 | | |
Abstract
Objectives: The eyebrows play an important role in conveying emotions, and loss of an eyebrow, either partial or complete, produces variable degrees of facial disfigurement, affects harmony of the face and patient expression. Many causes have been reported leading to eyebrows hair loss. The most common cause is burn. Other causes such as avulsion injury, crushing injury, congenital and trichotillomania are also reported. Surgeons treating such loss focus on the disturbance in facial symmetry and have a clear understanding of the complex anatomy of the eyebrow with respect to the quality, density and growth pattern of the hair. The aim of our study is to asses and compare the three main reconstructive procedures: scalp composite graft, superficial temporal island pedicle flap and follicular unit transplantation and also to select the best method for reconstruction. Patients and methods: 30 patients were included in our study and divided into 3 groups: A,B and C, with 10 patients for each group. They were examined and reconstructive method is decided and explained for each patient. Serial photography is taken pre-operative and 6 months following operation. In group A, composit graft was harvested from lower occipital region of scalp, with defattening of cellular debris and placement at the recipient site. In group B, an island pedicle flap was harvested from the temporal region of the scalp based on superficial temporal artery or its branches, transferred via subcutaneous tunnel to the recipient site. In group C, a strip from lower occipital region was harvested and follicular units were cut by scalpel no.11 blade and they were implanted at holed made by scalpel at the recipient site. Hair growth, density and patient satisfaction were recorded. Complications were detected and managed as early as possible. Results: Composite graft procedure is simple but it’s better to be used in women as they have thin eyebrows. Unfortunately, most of them showed necrosis and major hair loss. The superficial temporal island pedicle flap is a better choice, it has given good hair density and direction and suitable for men due to their thick eyebrows. Regarding the drawbacks, flap complications were documented as obvious donor site alopecia, congestion and donor site haematoma due to dissection of the flap. Brushing appearance also had a negative feed back during measurement of patient satisfaction. It’s also not suitable for partial hair loss. Follicular unit transplantation gives more natural appearance, controllable hair density and direction. It’s suitable for both men and women, partial or complete hair loss. The results showed great satisfaction for both patient and surgeon. Conclusion: The composite hair graft procedure is helpful in unilateral partial defects. The superficial temporal island flap procedure is helpful in complete unilateral defects. Follicular hair unit transplantation is the best procedure for eyebrow reconstruction. It’s suitable for any type of eyebrow defects with the best appearance and hair direction.