Eyebrow Reconstruction with Free Skin and Hair-Bearing Composite Graft

In 1999, a study described the successful surgical reconstruction of a 46 × 26 mm defect in the middle third of a 74-year-old female patient's left eyebrow following Mohs micrographic surgery for a recurrent basal cell carcinoma. The reconstruction involved using a combined nude and hair-bearing full-thickness skin graft harvested from the contralateral postauricular temporoparietal region. The graft was carefully placed to ensure the hair growth direction matched that of the recipient bed. This method allowed for a cosmetically satisfactory repair of larger eyebrow defects, with the transplanted hair growing in the correct orientation. The patient experienced complete hair loss of the graft at four weeks due to telogen effluvium, but hair regrowth occurred after 12 weeks. The patient required hair trimming every two weeks, and skin resurfacing with a CO₂ laser was performed one year later to improve the cosmetic result. The study concluded that this technique provides an optimal functional and aesthetic outcome for large eyebrow defects, can be performed under local anesthesia, and offers less discomfort for the patient.