Oculoplastic surgeons at the Emory Eye Center are concerned about recent attention in the media regardiing positive aspects of eyelash transplants. The outcome is not always good, Emory experts report.
In fact, surgical augmentation of eyelashes can lead to trichiasis (inward-growing lashes) and vision-threatening complications, say Emory Eye Center oculoplastics specialists.
A paper addressing these concerns, "Trichiasis after Eyelash Augmentation with Hair Follicle Transplantation," co-authored by Anna Murchison and Ted Wojno will appear in the journal Ophthalmic Plastic and Reconstructive Surgery in the spring (www.op-rs.com), published by Lippincott Williams & Wilkins.
Recent national media reports have touted the next wave in cosmetic surgery - hair transplants to give fuller eyelashes. The procedure involves harvesting hair from the scalp and individual implantation of the hair follicles into the eyelid margin. Although this procedure is not new - with scientific publications documenting it as early as the 1970s - it is not risk free.
"Unlike normal hair, which grows without true direction, eyelashes grow with an outward curvature and to a controlled length so as not to cause ocular irritation or damage," says Dr. Murchison, oculoplastics specialist at Emory Eye Center. "Implanted hair does not grow in a controlled fashion, and therefore must be regularly trimmed. The lashes can become misdirected causing ocular irritation, infection and corneal scarring."
Eyelashes can be absent for a variety of reasons. Congenital absence of eyelashes is extremely rare. Acquired loss of lashes is more common and may be due to trauma, burns, infections, surgery, medical conditions, trichotillomania (compulsive hair pulling), eyelid malignancies and reactions to medications or radiation.
Historically, several techniques have been used to improve looks from loss of eyelashes. Grafts from another eyelid, transplantation of follicular units and strips of hair-bearing skin from the scalp or other hair-bearing areas have been performed. Additionally, medical tattooing may be used to create the illusion of eyelashes.
While these techniques have been available for years, there has been a recent surge in interest for surgical augmentation of existing lashes for cosmetic reasons. The augmentation can lead to longer and fuller lashes, but the risk of irritation and even permanent corneal damage makes it a poor choice for patients with normal eyelids and eyelashes, say Emory physicians.
With ocular irritation and infections secondary to transplanted eyelashes cases, the only definitive treatment would be removal of the transplanted eyelashes, which can cause scarring of the eyelids. If this procedure becomes a popular cosmetic procedure, as suggested by some reports, Emory physicians anticipate seeing more patients with avoidable complications.
The Emory Eye Center includes the Department of Ophthalmology, part of the Emory School of Medicine, its clinical sector and all aspects of research. Ranked in the top 20 of the U.S. News & World Report's annual survey of the nation's best eye centers, Emory Eye Center remains in the top ten of the peer-evaluated Ophthalmology Times survey. The South's first corneal transplant was performed in Georgia in 1947; its refractive surgery trials were conducted in the 1980s, and it remains at the forefront of many national clinical trials, including those on macular degeneration and glaucoma.