Forehead reduction, commonly referred to as hairline lowering, doesn’t reduce the forehead, but rather moves down the location of where hair grows in. Also known as scalp advancement, this procedure may be performed during facial feminization surgery.
- avg. recovery
About the Procedure
A forehead reduction is performed for patients desiring a smaller forehead either due to a genetically high hairline or from hair loss causing a receding hairline. A forehead reduction typically isn’t recommended for patients who have advanced or active hair loss as this procedure will surgically move the hairline forward, but likely will not be a long term solution for a receding hairline. Similar to a brow lift, during a forehead reduction the incisions will be hidden within the hair to create a more proportional face for the patient. Before the procedure the patient will be anesthetized with either a local or general anesthesia. The surgeon will then mark the forehead indicating the patient’s new hairline. Typically the incision will be in a zigzag pattern to better mimic a natural hairline postoperatively. The skin between the incision and the patient’s hairline will then be excised and the hairline and forehead are advanced forward. The incision will then be sutured. The skin removal method is most effective when the hairline is being advanced 5cm or less from its original position. For patients that need more than 6cm of advancement, a temporary tissue expander will be placed beneath the scalp for 4-8 weeks, and then the surgery will be performed once the skin has grown and stretched. In some cases, your surgeon will recommend that a small amount of hair grafting be performed at a later time to thicken the hairline and optimize results.
The goal of forehead reduction is to decrease the size of the forehead to create a better balance to the face. Forehead reduction can also be used to create a more feminine shape to the face.
What to Expect
Forehead reduction, commonly referred to as hairline lowering, moves down the location of where the hairline begins. Here is a quick guide for what to expect before, during, and after a forehead reduction.
- Stop taking blood thinning medications for 2 weeks
- Stop smoking 4 weeks before and after surgery
- No alcohol 2 days prior
- Do not eat or drink for at least 6 hours before
- Local anesthesia with sedation or general anesthesia
- Incision will be in a zigzag pattern to mimic a natural hairline
- Skin is excised
- Hairline advanced forward
- Sutures to close
During the first week there may be swelling and bruising. Staples will be removed after 1 week. After 2-3 weeks absorbable sutures will fall out. The scar will remain red and elevated for 2-6 months. All patients experience numbness of the front of the scalp, lasting 3-12 months. Sometimes there is an itching sensation during recovery. There may be shedding of fine hairs within 2-4 weeks after surgery. The hair normally comes back after 3 months. Full recovery is expected after 12-18 months.
The ideal candidate for forehead reduction surgery include women with a high hairline or large forehead who otherwise have thick hair or men with more than 1.5 cm (0.75 inch) of lowering needed. When less than 1 cm of hairline lowering is needed hair grafting alone is probably a better option.
Not Recommended For
Forehead reduction surgery is not recommended for patients who have had a coronal brow lift, hair transplant using strip excision, have thin hair density, or are actively losing hair. Patients with darker skin may have more noticeable scarring.
Side effects from forehead reduction may include numbness, fluid accumulation, facial asymmetry, visible scarring, bruising which may extend down to the eyes, hair loss around the scar, loss of mobility and expression in the forehead area and revision or secondary surgery.