I am a 21 years old female with a high, square forehead and moderate scarring from past cystic acne. I want smoother skin and a lower, more rounded hairline. I am sick of hiding behind thick bangs and want to know what options are out there for me. Also, should I fix the hairline first, or the scarring? Will any of these procedures affect my ability to get Botox in the future?
Forehead Reduction + Cystic Acne Scar Treatment
Doctor Answers 5
Forehead reduction & acne scar treatment
There is no forehead reduction that can be accomplished without performing a brow lift. The coronal brow lift operation performed in a pretrichial location will lower the hairline but will also raise the eyebrows. Hair transplantation would be another option if a brow lift is not required. Cystic acne scars are best addressed with dermabrasion to the affected area. This is usually done under a local anesthesia; the skin is sanded down to the upper dermis and allowed to reepithelialize resulting in smoother skin once healed.
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Best Treatment for Acne Scars and Large Forehead
Your hairline can be lowered surgically, and Fraxel repair laser of your forehead would greatly improve your old acne scarring. I would advise you to have the problem that gives you the most grief first, and then have the other treatment. Unfortunately they should not be performed at the same time as the bandages from the surgical scalp reduction will get in the way of your post Fraxel repair skin care. Do choose your treating physician most carefully. Good luck and be well.
Lowering the forehead
Your forehead can be lowered, but it will require incision. Depending on the laxity of your scalp and the tightness of your forehead, several options exist. However, the basic principal is making an incision in your hairline at the top your your forehead and pulling the scalp forward. The brows can also be lifted slightly which makes the total height of your forehead shorter.
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Hairline lowering procedure
You can start with either the hariline lowering procedure or the acne treatment scarring. The hairline treatment is basically a reverse brow lift with advancement of the hairline anteriorly. The acne scarring treatment usually requires some form of ablative laser.
We developed the Irregular Trichophytic Hairline lowering procedure more than 30 years ago. If your scalp is flexible we can lower it and make the hair grow thru the scar. However, if the scalp is tight or the patient wishes the hairline lowered 1 1/2 inches or more, then we use a tissue expander to stretch the scalp first before we lower the hairline. Raising the eyebrows or cutting the muscles that make wrinkles can be done at the same time. Make sure you see an experienced surgeon who does a large number of these to get the best result. Many patients don't require Botox after the muscles that make wrinkles are cut.