Many men and women have elongated foreheads that can make them self-conscious to the degree that they won’t wear their hair up or get a shorter haircut. Overly high foreheads can give the face an unbalanced appearance, and it can make you look older than your true age. To correct this condition, we perform forehead reduction surgery at Utah Facial Plastics.
Frequently Asked Questions
Also referred to as hairline lowering surgery, forehead reduction surgery reduces the height of the patient’s forehead by removing excess skin and bringing the forehead down to a more natural level. This surgery can lower the hairline up to 2 inches. The exact amount of modification possible is determined by the laxity of the patient’s scalp, the hairline height, and personal preference.
This procedure is more common with women because they don’t suffer from pattern balding in the same way that men do. Typically, the female hairline should begin between 4 to 6 cm above the eyebrows, at the transition point between the vertical forehead and where the forehead slopes backwards towards the scalp. Forehead reduction surgery can bring the hairline down to a more pleasing position.
Men can also have this surgery, but it’s important to assess the degree to which the hairline is receding before proceeding. That’s because if the hair continues to recede, the patient may also need hair transplantation even after this surgery.
The best candidates for forehead reduction surgery have some of these criteria:
- A high hairline
- A large forehead
- Some laxity in the forehead skin and scalp
- Men with thick hair density and no family history of male pattern balding
- Heavy brows (these can be lifted by this surgery)
This is usually an outpatient procedure performed using a combination of twilight anesthesia and local anesthetic. The first step is for Dr. Thompson or Dr. Henstrom to mark the location of the post-surgery hairline. Next, the excess skin between the current and future hairlines is surgically excised and the hair-bearing scalp is brought forward. The wound is sutured using two layers of stitches or surgical clips. This ensures clean healing with minimal scarring. Hair will eventually grow through these incisions, hiding the scar.
In some cases, hair transplant surgery may be a better option to lower the hairline. This can be done as a stand alone procedure or in combination with forehead reduction surgery depending on the patient. This method harvests individual hair follicles from the back of the scalp (where balding is rare) and transplants them to the hairline. Hair transplants can also help to fill in the side regions to create a natural, round appearance.
During the procedure, you will feel nothing. There will be some pain during recovery, but it is not extreme.
Forehead reduction surgery doesn’t involve a significant recovery period. There will be some swelling and bruising, and this can linger for a few weeks around the forehead and can descend to the eye area. Ice compresses will help with pain and swelling. During your first few days after surgery, you’ll need to keep your head in an elevated position, even when sleeping.
Over the longer term, you will likely have numbness in the front of the scalp behind the incision. This can last from a few days to up to several months while the nerves grow back. This numbness will often transition to itching around the incision line as the nerves return to function. This is a sign that the scalp is healing. You may also have periods of swelling, usually at night, and this can linger or come and go for weeks, even a few months.
You may have some hair loss at the front of the scalp during the first 2-4 weeks after surgery. This is simply due to trauma. But the hair will settle down and begin to grow back i
Most patients can return to work in a week or so, but you’ll want to cover the area with a scarf or loose fitting hat.
Your results are immediate, but you will have to deal with swelling and some bruising. Most bruising clears within 7-10 days. You will have some hair in the area fall out. This is called “shock alopecia,” and it can worry you. But in 3-6 months the hair begins to grow again. The new hair will grow through and in front of the incision, masking the scarring.