Hairline Lowering (Forehead Reduction)

Do you feel like your forehead is too large, or your hairline too high? A prominent forehead can look out of proportion and change the balance of the facial features. Thankfully, this can be corrected through a form of plastic surgery known as hairline lowering or forehead reduction, a surgical procedure to bring the scalp and hair lower onto the forehead.

Are You a Candidate?

Good candidates are individuals who feel like their forehead is too long or hairline is too high. People with very thin hair density may not be good candidates for this procedure, though most other adults in good overall health are medically able to undergo forehead reduction. This procedure is often chosen as an alternative to hair transplants, which require multiple sessions over a longer period of time before achieving comparable results. Patients with both a high hairline and drooping eyebrows often undergo forehead reduction along with a brow lift.

The Procedure

Hairline lowering surgery is performed with either local or general anesthesia and requires about two to three hours. The incision is placed along the hairline. As the hair grows over the incision line after surgery, any resulting scar becomes inconspicuous. During surgery, the excess forehead skin is removed and the scalp advanced forward. The incision is then closed with sutures. If the scalp is tight and the hairline is substantially higher than the optimum level, the surgeon may perform a two-stage procedure. Known as ‘expansion assisted hairline advancement,’ the first step is the insertion of an expander underneath the scalp behind the hairline. The expander is then inflated through injections of water stretching the scalp. Over a period of four to eight weeks, the device increases the amount of scalp with hair. Then, during a second surgery the expander is removed and the excess scalp tissue is moved forward to make the hairline lower. With this approach, the hairline can be moved by up to two inches.

Safety Information

Although forehead reduction surgery is relatively safe, no surgical procedure is without some degree of risk. The potential complications of hairline lowering include bleeding, infection, and fluid accumulation. Possible aesthetic risks include unfavorable scarring, asymmetry, or hair loss around the incisions. These may be corrected through further procedures such as hair grafting. Temporary or permanent numbness to the front of the scalp is also common, though in most patients it lasts only a few weeks.

Recovery Time

After surgery, the incisions will be covered with a dressing. The stitches may dissolve, or they may be removed by the doctor in about a week. Most patients take about a week away from work and other activities, although some are able to return to their normal activity level within just 2 to 3 days. After surgery, some swelling and bruising can be expected. This may extend downwards to give patients ‘black eyes.’ During this time, ice compresses can ease discomfort and swelling. Keep the head and neck elevated and follow the surgeon’s instructions regarding recovery.

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 $7,000 for one-stage surgery, or $10,000 to $14,000 for the two-stage surgery. 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.