Forehead reduction is commonly referred to as a hairline lowering procedure, doesn’t reduce the forehead, but rather brings the down frontal hair line.
It is also known as scalp advancement and is, often performed during facial feminization surgery.
A high hairline or elongated forehead in women can result in a more masculine appearance, often prematurely aging those affected. An oversized forehead can detract from a woman’s facial harmony and balance, and is particularly disliked by younger women.
Medical hair Restoration Clinic, headed by the experienced top South African Hair surgeon, Dr Larry Gershowitz is now offering this hairline lowering procedure can help restore balance to the face, bringing the hairline to a more aesthetically pleasing position.
Traditionally the female hairline starts between 5.5cm to 6 cm above the eyebrows. ‘Typically, the hairline should start at around the transition point between the vertical forehead and the point where the forehead starts to slope backwards towards the scalp,’ explains Dr Gershowitz. ‘It can look relatively unattractive if the hairline starts well above this transition point.’
Dr Gershowitz explained that, the most important factor in a successful hairline lowering procedure is scalp flexibility. ‘If a patient has a relatively flexible scalp – in other words if they can wriggle it backwards and forwards quite freely – we can achieve good anterior scalp advancement or lowering of the hairline and forehead reduction,’ he says. ‘If the scalp is not flexible, however it can be more difficult to advance the scalp to reduce the forehead and sometimes two stage surgery is needed.’
During the procedure, an irregular incision is made between the existing anterior hairline and the forehead. The hair-bearing scalp can then be lifted and moved forwards. Dr Larry says it’s important for the surgeon to have experience with the trichophytic incision. ‘This technique means hair can grow through the incision during the recovery phase to help camouflage the incision,’ he says. ‘It’s also important for the surgeon to understand the direction of hair growth and preservation of scalp blood supply. These are all technical details which help ensure optimal results.’ The procedure is usually performed under conscious sedation as a day surgery procedure.
A light dressing is applied that is typically removed one- three days after surgery. Any sutures are then usually removed seven and twelve days post-operation. ‘In my experience the procedure is typically very well tolerated,’ says Dr Larry. ‘The vast majority of my patients are able to return to work within three to seven days of the surgery. I always tell patients they need to be prepared to wear their hair ‘forwards” in a fringe to cover the incision line for the first few months. However my personal experience is that it is very unusual for anyone to need to keep their hairline covered beyond three months’. Many patients are able to wear their hair pulled back within weeks of the surgery.
Frequently Asked Questions
How much hair lowering can I expect?
This is determined by your scalp and forehead laxity in other words how easily you can move it backwards and forwards. Usually 2-3cm can easily be achieved, sometimes more. Depending on the results a second procedure can be preformed to further lower the hairline.
How long does the improvement last?
The hairline lowering procedure gives permanent improvement and does not need to be repeated, but a second procedure may be performed at a later stage to further lower the hairline.
How long does the procedure take?
The procedure takes approximately 1 1/2 to two hours and is normally performed either under intravenous conscious sedation.
What age is best for hairline lowering?
The hairline lowering procedure can be performed at any age, although the commonest age is from early 20’s on. There is no older age limit for the procedure.
How long should I take off work?
You should be up and about the afternoon after surgery but plan on taking it easy for the first week after surgery. Most people are back at work within 7-10 days, but it is possible to return to work earlier.
How Long before I get back to normal activities?
Avoid strenuous activity including aerobics and heavy housework for a week to 10 days.
Walking and mild stretching are fine. Yoga and Pilates postures involving inversion or extensive stretching should probably be avoided for 1-2 months.
What Does it Cost?
The cost for hairline lowering varies greatly. The costs depends on a couple factors such as whether the surgery is performed in one stage or two, the amount the hairline must be lowered and the surgeon performing the procedure.
The cost is approximately R22,500 including the conscious sedation.
Forehead surgery is not usually covered by health insurance because it is considered to be a cosmetic procedure. However, many surgeons offer flexible payment plans and other financing options to make forehead reduction surgery affordable.