“What should you do if your eyebrows look even more unnatural after three eyebrow transplants?”
An eyebrow transplant is a procedure performed on a small area, but the factors that determine how natural the result looks are more delicate than you might expect. This is because which hairs are selected, the direction and angle in which they are placed, and how the curl of the hair is matched matter more than simply transplanting a large number of hairs.
In 2026, the dermatology journal Actas Dermo-Sifiliográficas published a case of a patient who had undergone three eyebrow transplants for cicatricial eyebrow hair loss following an accident, yet required further correction because the transplanted hairs were thick and pointed in inconsistent directions.
Hello. I am Director Yoo Hwa-jung of Modi Hair Plant Clinic. Today, based on this published case, I will explain why hair can look unnatural after an eyebrow transplant and what the Preview Long Hair FUE technique used to correct it involves.
This is an AI-generated image created to aid understanding and is not a photo of an actual patient.
Key Summary
- How natural an eyebrow transplant looks is influenced not only by the number of hairs but also by hair thickness, direction, angle, curl, and donor site selection.
- In conventional FUE, the hair is trimmed short, so there can be limitations in checking the actual curve and flow of the hair as it appears when long.
- Preview Long Hair FUE is a method in which the hair is kept long so that donor hairs are selected and placed while checking their thickness, curl, and direction.
- For eyebrow revision surgery, it is important to first assess the condition of the existing transplanted hairs, scarring, and the remaining donor area rather than simply adding more hairs.
Why Hair Can Look Unnatural After an Eyebrow Transplant
The eyebrow is an area of the face where hair direction and angle are arranged with particular precision. The inner part of the eyebrow points relatively upward, and as it moves from the center toward the outer end, the hair gradually flows more sideways, as if lying flat.
Therefore, in an eyebrow transplant, how naturally the hairs are placed to connect with the existing eyebrow matters more than simply filling in empty space. The typical causes of an awkward-looking result can be broadly divided into direction and curl, and the thickness and characteristics of the donor hair.
1. When It Is Difficult to Match the Direction and Curl of the Hair
In conventional FUE, the donor hair is trimmed short before follicles are extracted one by one. In this case, it can be difficult to directly confirm, from the short remaining hair alone, in which direction the hair actually curves and what kind of curve it grows in when long.
On the scalp, a small difference in direction may not be very noticeable, but in the eyebrows, even a few degrees of angle difference or a slight difference in curl can make hairs appear to stick upward or look out of place among the surrounding eyebrow hairs.
2. Which Hairs Are Selected Also Matters
Even within the same scalp, hair thickness and the composition of follicular units can differ depending on the location.
In the central occipital area, follicular units containing relatively thick hairs or multiple hairs may be distributed. If such hairs are considerably thicker than the existing eyebrow hairs, they can stand out among the eyebrows or give a stiff impression.
On the other hand, finer and softer hairs can sometimes be found around the ears or at the nape, so these areas may be considered as donor sites for eyebrow transplants.
However, this does not mean that hair from a specific area is unconditionally suitable for every patient. In actual surgery, the process of individually selecting single hairs whose thickness, curl, and direction match the existing eyebrows is important.
In an eyebrow transplant, “which hairs are chosen to match the existing eyebrows and how they are arranged” matters more than “how many hairs are transplanted.”
A Published Case: Why the Result Was Still Unnatural After Three Eyebrow Transplants
The paper describes the case of a 30-year-old male patient who developed cicatricial hair loss in one eyebrow following an accident.
The patient had undergone eyebrow transplants at other medical institutions on three occasions—in 2015, 2017, and 2020—but the shape of the eyebrow still did not look natural, and he sought further correction.
In the case report, the following issues were observed in the previously transplanted area.
- Transplanted hairs thicker than the existing eyebrow hairs
- Directions and angles that did not match the surrounding eyebrow hairs
- Hairs with differing curls
- Multi-hair follicular units producing several hairs from one unit
- Some hairs growing beyond the original eyebrow border
This is a case reported in the literature, not a photo of our clinic's patient. Source: Mir-Bonafé et al., Actas Dermo-Sifiliográficas, 2026
In other words, the issue was not simply an insufficient number of transplanted hairs, but rather a state in which the selection of donor hair and the directional design did not harmonize with the existing eyebrows.
How Can Incorrectly Placed Eyebrow Hairs Be Corrected?
Eyebrow revision surgery may not be resolved simply by adding new hairs. If hairs that are already too thick or pointing in the wrong direction are in place, part of the transplanted hair may need to be removed first and a new direction designed again.
In the published case, a substantial portion of the follicular units growing unnaturally was individually removed, and a new eyebrow direction was then designed.
This is a case reported in the literature, not a photo of our clinic's patient. Source: Mir-Bonafé et al., Actas Dermo-Sifiliográficas, 2026
Removing all of the previously transplanted hairs at once and re-transplanting after a certain period is another option to consider, but this patient did not want a period with empty eyebrows, so the approach of removing the existing transplanted hairs and performing the new hair transplant on the same day was chosen.
As such, eyebrow revision surgery requires consideration of the position and angle of the existing transplanted hairs, the condition of scarring, the skin condition, and the available donor area, so the planning can be more complex than for a first procedure.
What Is Preview Long Hair FUE?
The key method used in this case was Preview Long Hair FUE.
The essence of Preview Long Hair FUE is not simply that “the head is not shaved.”
Because the follicles are harvested while the hair is kept long rather than trimmed short, the thickness, actual curve, and growth direction of the hair can be confirmed even before extraction.
The hairs are then placed according to the inner, central, and tail portions of the eyebrow, taking into account the curl and direction each hair has.
In other words, the name “Preview” is used in the sense that the actual flow of the hair, which is difficult to confirm when the transplanted hair is cut short, can be checked in advance during the procedure.
However, being able to see how the long hairs lie immediately after surgery does not mean that the long-term result is guaranteed in advance. The final outcome may vary depending on the graft survival process, skin condition, scarring, and individual hair growth characteristics.
Key Surgical Points of Preview Long Hair FUE in the Paper
In the case introduced in the paper, the follicles that had been growing incorrectly were selectively removed, and fine single hairs suited to the eyebrows were selected from around the ears and harvested while kept long.
- Selective removal of a substantial portion of the unnatural transplanted hairs
- Redesign of the new eyebrow direction and angle
- Harvesting of 180 fine single-hair follicles from around the ears
- Maintaining hair length to directly check the curl and direction of each hair
- Placement of the transplanted hairs in line with the flow of the existing eyebrows
The paper reported that, one year after surgery, this patient's eyebrow shape, symmetry, and the direction of the transplanted hairs were improved compared with before. However, this is the result of a single case and does not mean that the same result occurs in all patients.
This is a case reported in the literature, not a photo of our clinic's patient. Source: Mir-Bonafé et al., Actas Dermo-Sifiliográficas, 2026
Differences Between Conventional FUE, Strip Harvesting, and Preview Long Hair FUE
| Category | Conventional FUE | Strip (incisional) follicle harvesting | Preview Long Hair FUE |
|---|---|---|---|
| Harvesting method | Non-incision | Incision of part of the scalp | Non-incision |
| Donor hair length | Trimmed short | Long hair can be used | Hair kept long |
| Checking hair curl | Limited in checking curl in the long state | Possible | Possible |
| Donor hair selection | Possible | Selection within the harvested area | Selection while checking thickness, curl, and direction in the long state |
| Considerations for eyebrow application | Donor hair selection and directional design are important | Linear scar and harvest site must be considered | Detailed selection and a high level of technical skill are required |
It is difficult to say that any one method is absolutely superior for all patients. It is important to determine the surgical method by evaluating the shape of the eyebrows, the condition of previous transplants, the presence of scarring, and the characteristics of the donor hair together.
How Does Modi Hair Plant Clinic Approach Eyebrow Transplants?
At Modi Hair Plant Clinic as well, there are two main points we consider important in eyebrow transplants.
- First, direction and curl — We analyze the flow of the existing eyebrows and design the direction and angle so that the transplanted hairs connect naturally.
- Second, hair quality — Rather than simply using hair from a specific area, we select fine single hairs whose thickness and curl match the existing eyebrows well.
In particular, for revision patients who have already undergone one or more eyebrow transplants, it is important to first analyze why the existing transplanted hairs look unnatural, rather than simply adding more hairs.
The revision method may differ depending on whether the issue lies in hair thickness, direction, angle, or existing scarring.
Eyebrow revision surgery is not a matter of “transplanting a lot of hair again”; what matters is the process of first identifying why the previous result went wrong and then redesigning it.
Frequently Asked Questions
I've had several eyebrow transplants but they still look unnatural. Is revision surgery possible?
It may be possible depending on your condition. After first checking the thickness and direction of the existing transplanted hairs, scarring, skin condition, and the remaining donor area, a decision is made on whether to remove some of the existing follicles or to supplement the deficient areas.
Why is hair from behind the ear or the nape used for eyebrow transplants?
Relatively fine hairs can sometimes be found around the ears or at the nape, so these areas may be considered as donor sites for eyebrow transplants. However, rather than the location itself, what matters more is actually selecting single hairs whose thickness, curl, and direction match the existing eyebrows well.
Can't the previously transplanted follicles simply be extracted and re-implanted as they are?
If the existing transplanted hairs themselves are excessively thick or their quality does not suit the eyebrows, the same unnatural appearance may recur even if they are re-implanted with only the position changed. Therefore, in revision surgery, whether to reuse the existing hairs or select new donor hairs must be judged on an individual basis.
Is Preview Long Hair FUE simply the same as non-shaven FUE?
They may share the feature of not shaving the donor area extensively, but the essence of Preview Long Hair FUE is that the hair is kept long so that donor hairs are selected and placed while checking their thickness, curl, and direction.
Do the transplanted hairs keep growing long after an eyebrow transplant?
Hair harvested from the scalp can retain the growth characteristics of the original hair to some extent even after transplantation, so it may grow longer than the existing eyebrow hair. Therefore, periodic trimming may be necessary after the transplant.
Is a transplant possible on eyebrows with scarring?
Whether it is possible depends on the thickness of the scar, skin condition, blood flow, and whether a previous transplant was performed. Areas of cicatricial hair loss may have different conditions from normal skin, so it is advisable to determine whether a transplant is possible and the extent of surgery after a consultation.
In Summary
To achieve a natural result in an eyebrow transplant, the process of selecting hairs that suit the existing eyebrows and precisely matching direction, angle, and curl matters more than simply transplanting a large number of hairs.
In particular, if you have already had an eyebrow transplant but are considering revision surgery because thick hairs stand out, the direction is off, or there is left-right asymmetry, the first priority is to accurately assess the condition of the hairs currently in place rather than simply transplanting again.
A revision plan should be established after comprehensively evaluating how much of the existing transplanted hair needs to be removed, which donor hair can be used, and whether re-transplantation into the scarred area is possible.
Results and the recovery process may vary depending on individual condition, skin, and hair characteristics, so please confirm the method suitable for you through sufficient examination and consultation.
Modi Hair Plant Clinic Consultation Information
References
Mir-Bonafé JM, Mir-Bonafé J, Mir-Bonafé M. “Preview long hair FUE” technique in eyebrow transplantation. Actas Dermo-Sifiliográficas. Published online 2026. doi:10.1016/j.ad.2026.104699.
This article was written under the review of medical professionals.