“What should you do if your eyebrows have become 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 one might expect. Rather than simply transplanting a large number of hairs, which hairs are selected, in which direction and at what angle they are placed, and how the curl of the hair is matched are important.
In 2026, the dermatology journal Actas Dermo-Sifiliográficas reported a case of a patient who had undergone three eyebrow transplants for cicatricial eyebrow hair loss following an accident, but still required correction because the transplanted hairs were thick and pointed in inconsistent directions.
Hello. I am Director Yu Hwa-jung of Modi Hair Plant Clinic. Today, based on this published case, I will explain the causes of hair looking unnatural after an eyebrow transplant and what the Preview Long Hair FUE method used to correct it involves.
This is an AI-generated image created to aid understanding and is not a photograph of an actual patient.
Key Summary
- How natural an eyebrow transplant looks is affected not only by the number of hairs but also by hair thickness, direction, angle, curl, and donor area 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 seen when it is 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, the process of first assessing the condition of the previously transplanted hairs, scarring, and the remaining donor area is more important than simply adding more hairs.
Why Hair Looks Unnatural After an Eyebrow Transplant
The eyebrows are an area of the face where hair direction and angle are arranged with great precision. The inner part of the eyebrow points relatively upward, and as it moves from the center toward the outer end, it gradually flows sideways as if lying down.
Therefore, in eyebrow transplantation, how naturally the hairs are placed to connect with the existing eyebrows is more important than simply filling in empty spaces. The typical causes of an awkward-looking result can largely be 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 area hair is trimmed short and then the follicles are extracted one by one. In this case, with only the short remaining hair, it can be difficult to directly confirm in which direction the hair actually bends when long, or what curve it grows with.
On the scalp, a small difference in direction may not be very noticeable, but on the eyebrows, even a difference of a few degrees in angle or a slight difference in curl can make hairs appear to stick up or look separate from 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, there may be follicular units that are relatively thick or contain multiple hairs. If such hairs are excessively thick compared with the existing eyebrows, they may stand out on their own among the eyebrow hairs 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 areas for eyebrow transplantation.
However, this does not mean that hair from a particular 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 well is important.
In eyebrow transplantation, “selecting hairs that match the existing eyebrows well and how they are arranged” is more important than “how many hairs are transplanted.”
The Published Case: Why the Result Was Still Unnatural After Three Eyebrow Transplants
The paper presents the case of a 30-year-old male patient who developed cicatricial hair loss in one eyebrow following an accident.
The patient underwent eyebrow transplantation three times at other medical institutions in 2015, 2017, and 2020, but the shape of the eyebrow still did not look natural afterward, so he wanted further correction.
In this case, the following problems 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 follicles in which several strands grow from one follicular unit
- Some hairs growing beyond the original eyebrow border
This is a case reported in the literature, not a photograph of a patient at our clinic. 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 oriented in the wrong direction have taken hold, it may be necessary to first remove some of the transplanted hairs and redesign the direction.
In the published case, a substantial portion of the follicular units that had been growing unnaturally were removed individually, and then a new eyebrow direction was redesigned.
This is a case reported in the literature, not a photograph of a patient at our clinic. 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 could also be considered, but this patient did not want a period with empty eyebrows, so the approach of performing the removal of the previously transplanted hairs and the new hair transplant on the same day was chosen.
As such, eyebrow revision surgery requires considering the position and angle of the previously transplanted hairs, the condition of scarring, the skin condition, and the available donor area together, so the design can be more complex than in the first surgery.
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 extracted while the hair is kept long rather than cut short, the thickness of the hair, its actual curve, and the direction in which it grows can be checked even before extraction.
The hairs are then placed in the inner, central, and tail portions of the eyebrow, taking into account the curl and direction that 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 check when the transplanted hair is cut short, can be confirmed in advance during the procedure.
However, being able to see how the long hairs are positioned immediately after surgery does not mean that long-term results are guaranteed in advance. The final result 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 presented in the paper, after selectively removing the follicles that had been growing incorrectly, fine single hairs suitable for the eyebrows were selected from around the ears and extracted while kept long.
- Selective removal of a substantial portion of the unnatural transplanted hairs
- Redesign of the new eyebrow direction and angle
- Extraction 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 along the flow of the existing eyebrows
The paper reported that one year after surgery, the shape and symmetry of the patient's eyebrows 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 will occur in all patients.
This is a case reported in the literature, not a photograph of a patient at our clinic. Source: Mir-Bonafé et al., Actas Dermo-Sifiliográficas, 2026
Differences Between Conventional FUE, Strip Excision, 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 | Long hair maintained |
| 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 when applied to eyebrows | Donor hair selection and directional design are important | Linear scarring and the harvesting site must be considered | Requires meticulous selection and a high level of technical proficiency |
It is difficult to say that any one method is absolutely superior for every patient. It is important to determine the surgical method after assessing the shape of the eyebrows, the condition of previous transplants, the presence of scarring, and the characteristics of the donor area hair together.
How Does Modi Hair Plant Clinic Approach Eyebrow Transplantation?
At Modi Hair Plant Clinic, there are largely two things we consider important in eyebrow transplantation.
- 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 particular 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 previously transplanted hairs look unnatural rather than unconditionally adding more hairs.
The revision method may differ depending on whether the problem lies in the thickness of the hair, its direction, its angle, or existing scarring.
Eyebrow revision surgery is not a “procedure to transplant a lot of hair again”; what matters is the process of first identifying the cause of the previous mismatch and redesigning accordingly.
Frequently Asked Questions
I have had several eyebrow transplants but they still look unnatural. Is revision surgery possible?
It is possible depending on the condition. After first checking the thickness and direction of the previously 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 additionally supplement deficient areas.
Why is hair from behind the ear or the nape used for eyebrow transplantation?
Relatively fine hairs can sometimes be found around the ears or at the nape, so these areas may be considered as donor areas for eyebrow transplantation. However, rather than the location itself, it is more important to actually select 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 previously transplanted hairs themselves are excessively thick or their hair quality does not match 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 to 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 common feature of not shaving a wide area of the donor site, 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.
Does the transplanted hair keep growing long after an eyebrow transplant?
Hair harvested from the scalp may retain the growth characteristics of the original hair to some extent even after transplantation, so it may grow longer than the existing eyebrow hairs. Therefore, after transplantation, regular trimming of the length may be necessary.
Is transplantation 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 with cicatricial hair loss may have conditions different from normal skin, so it is advisable to determine the feasibility of transplantation and the surgical scope after a consultation.
In Summary
To achieve a natural result in eyebrow transplantation, the process of selecting hairs that suit the existing eyebrows well and precisely matching direction, angle, and curl is more important than simply transplanting a large number of hairs.
In particular, if you have already had an eyebrow transplant but thick hairs stand out, the direction is off, or you are considering revision surgery because of left-right asymmetry, the priority is to accurately check the condition of the hairs currently in place rather than unconditionally transplanting again.
A revision plan should be established after comprehensively evaluating how much of the previously transplanted hair needs to be removed, which donor hairs can be used, and whether 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.