All About Hairline Lowering Surgery (Forehead Reduction)

Written by Minas Constantinides, MD, FACS, Board Certified Facial Plastic Surgeon on August 22, 2016 12 Comments

hairline lowering

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
Dr. Minas Constantinides
side before Before
side after After

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.

 


Minas Constantinides, MD, FACS

Dr. Minas Constantinides is a board-certified Facial Plastic Surgeon at Westlake Dermatology & Cosmetic Surgery in Austin, Texas. He is on the Executive Committee of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and is a Senior Advisor of the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS).


12 Responses to “All About Hairline Lowering Surgery (Forehead Reduction)”

  1. Aaron says:

    I would like to reduce my hair line lower

  2. Anna says:

    Price range?

    • WD Staff WD Staff says:

      Hi Anna, This hairline lowering is one of those procedures where total procedure cost varies greatly based on the needs of the patient. Real Self is probably one of the best places to get a feel for “average” pricing. In Austin, patients reported a range from $4,850 – $13,00 (https://www.realself.com/Forehead-Reduction/cost/Texas/Austin).

      As always, you will need to get an in-person consultation to be sure of the exact cost of the procedure you will need. Please feel free to contact us if you would like to schedule a free consultation!

      Thanks,
      WD Staff

  3. Dr. Beran says:

    Thanks for sharing this information regarding hairline lowering surgery. My nurses have been showing it to our patients and they have said it has been very helpful. Just wanted to give you some feedback and say good work 🙂

  4. Demetrius says:

    How do I go about finding the right surgeon for this procedure

    • WD Staff WD Staff says:

      Hi Demetrius,

      Thanks for reading our post and submitting your comment. Obviously we think we’re a great fit for this procedure! Specifically Dr. Constantindes specialized in hairline lowering procedures. If you are in the Austin area please give us a call at 512.615.2730 to setup a free consultation!

      Otherwise we recommend doing your research online. Just make sure you choose a board certified surgeon with experience in this specific procedure.

      Thanks again
      WD Staff

  5. Jasmine says:

    Do you offer payment plans for this procedure?

  6. Xaile says:

    How old do you have to be to get this surgery?

    • WD Staff WD Staff says:

      Hi Xaile,

      Thanks for reading our post and submitting your great question! Most surgeons would recommend waiting until our mid-20’s before considering a hairline lowering procedure. This is due to potential facial structure changes that can occur before that age. However, its always good to see a surgeon for an in-person assessment. Every individual is different and patients under that age may be good candidates if certain characteristics are apparent.

      We hope that helps!

      Thanks,
      WD Staff

  7. Lindsey says:

    Hi!

    Do you do virtual consultations or video consultations if I want to consider this procedure with you but states away?

    Thank you!

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