All About Hairline Lowering Surgery (Forehead Reduction)
Thousands of men and women across America have over prominent foreheads or receding hairlines. The typical hairline begins anywhere between 5 and 6.5 cm above the eyebrows. Hairlines that start above that point often cause the face to appear aesthetically disproportionate, potentially resulting in difficulty wearing the hair up or off the forehead.
What is hairline lowering surgery?
Hairline lowering surgery, also referred to as forehead reduction, is a highly effective way to move the hairline to a natural level. This surgical technique can effectively lower the hairline by up to 2 inches. The exact amount of modification possible will be determined by how loose a patient’s scalp is during a consultation with a board-certified facial plastic surgeon or plastic surgeon.
Before and After Hairline Lowering
How is hairline lowering surgery performed?
Hairline lowering is a surgical outpatient procedure typically performed using the combination of twilight anesthesia and a local anesthetic. The procedure begins with the surgeon marking the anticipated post-procedure hairline. Next the excess skin between the current and future hairlines is surgically excised and the hair-bearing scalp is advanced to the new hairline. The scalp is then secured into its new location using dissolvable bone anchors or bone tunnels into the skull. The procedure is completed with the incisions being closed using 2 layers of sutures. Additionally, a hair grafting procedure like FUE hair transplant surgery can be used alongside hairline lowering surgery to change the shape of the hairline. For example, the hairline can be moved forward and additional hair can be transplanted to the side regions to create a more round appearance.
Is there permanent scarring?
While scarring should be expected from the procedure, a skilled surgeon can minimize its visibility. Many of the incisions made during the procedure can be placed slightly behind the future hairline, allowing them to cover with the hair. The incisions are not made in straight lines, but usually involve S- or V-shaped curves that break them up and help to hide them. Additionally, incisions can be made in a way that allow hair to regrow through and in front of the scar further reducing its visibility.
How long does the procedure take?
While each individual procedure is different, hairline lowering treatments typically take between 2 and3 hours to complete.
Who is a good candidate for hairline lowering surgery?
Men and women who have a naturally high hairline or large forehead and otherwise thick hair, as well as no personal or familial history of hair loss, are great candidates for hairline lowering surgery. All potential patients should be in good overall health and refrain from smoking for one month before and after the procedure.
Scalp laxity is extremely important to the success of any forehead reduction procedure. During your pre-operative consultation, a detailed pitch test will be performed to help decide whether you will be a good candidate for surgery.
What are other risks of hairline lowering surgery?
Hematoma, or a collection of blood underneath the scalp, is the most common complication with an incidence of about 5%. Infection is rare. Antibiotics are given intraoperatively and may be prescribed for one week after the surgery.
Numbness of the scalp from the incision to the vertex is expected and often resolves, but may take as long as one year in some patients. A rare patient will experience permanent numbness.
Sometimes, the scar is still slightly visible and may be further camouflaged by micro-follicular hair transplants into it.
What should I expect after hairline lowering surgery?
Post-procedure, many patients will experience some pain which can be controlled using prescribed pain medication. Moderate swelling along the forehead, scalp, eye, and cheek areas is common. Much of this swelling diminishes after the first few days, with all swelling fully resolving in a couple of weeks. Bruising is expected but will resolve without intervention within 10 days. By following our diet and perioperative instructions, swelling and bruising will resolve more quickly. Patients can return to work and light activity after 7 days from the procedure, using a scarf or loose fitting hat to cover the area. The sutures placed in the hairline are removed after one week. Patients may do a full workout and fly 2 weeks after the surgery. Often there is global hair thinning of the whole scalp after the surgery (called “shock alopecia”) that can last 3 months. Then 3 to 6 months after the procedure hair regrows through and in front of the incision site, camouflaging the area and making it imperceptible.