Is there a technique used for men with receding hairlines so that scaring is minimal? How visible are the scars?
Brow Lift Surgery and receding hairlines?
Doctor Answers (11)
Browlift for a male
As opposed to the female brow, a man's brow is aesthetically acceptable at, or even slightly below, the orbital rim. The male brow may or may not be arched laterally, and most commonly it is relatively horizontal in orientation. In cases where the male brow has descended well below the orbital rim, and the upper lid tissues appear heavy and redundant, a browlift can be an effective means of rejuvenating the upper third of the face. A great deal of care must be exercised, however, to avoid overdoing and thereby feminizing a male brow.
Although men are much less often good candidates for browlifts than women, endoscopic or trans-blepharoplasty removal of the corrugator (or vertical frown line) muscles is as applicable to males as it is to females, to permanently soften or completely eliminate vertical frown lines between the eyebrows.
Browlift and a Receding Hairline
I have utilized small incisions with endoscopic browlift for men with receding hair line or balding scalp. Success rate has been very high.
You have several options.
When considering browlifting in male patients an evaluation of the anterior hairline is very appropriate. The type of browlift chosen will depend on how much hair is present and how deep are the horizontal lines on the forehead.
For a younger male with a smoother forehead and a good hairline, endoscopic browlifting works very nicely and uses minimal incisions that tend to heal well. Risk of complications is generally low. For an older male with more horizontal wrinkles and and a good hairline, endoscopic browlifting is still a good choice.
The difficulty comes when the hairline starts to recede. In those patients you can't always find a way to hide scars from the endoscope. In these patients, I will use one of few carefully performed operations: direct brow lift vs. tranverse brow lift. A direct brow lift used carefully created incisions just at the top hair-bearing edge of each eyebrow to remove skin and directly lift each eyebrow. Depending on various skin issues the scars are generally quite minimal. A transverse browlift using direct excision of the deep horizontal creases in the forehead to lift the brow. I reserve this procedure for the elderly patient with very deep creases. It tends to heal very nicely replacing a deeply shadowed crease with a fine line incisional scar.
One operation that you must be careful with in the patient with a receding hairline is a coronal browlift because it will tend to worsen the receding hairline. Endoscopic browlifts can also have this problem in patients with tall foreheads.
I hope this helps.
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Brow lift and receding hairlines in males
This is a commonly asked question. By reading some of the responses from other physicians who answered, it seems like, as is often the case, opinions vary. I have had wonderful success with my small incision brow lift technique. I believe that this procedure is OFTEN indicated in men and the results can be outstanding. In my hands, the incisions usually heal very nicely and may beome indiscernible with healing. I have no hesitation in recommending this surgery is "follicularly challenged" (like myself) males. Please see my website to see how well these incisions heal in men with receding hairlines.
Brow Lift and scars in men with receeding hair lines?
It's rare, IMHO, that men aesthetically would require a Brow Lift, so I'd be interested in seeing photos of your eye and eyebrow area. In those rare instances where a man's eyebrows need to be lifted, the obstacle to that, as you mentioned, is the receeding hairline which would expose the incision scars for the Brow Lift. Even the endoscopic Brow Lift has 3 vertical 1 to 1 1/2 inch scars along with two 3 to 4 inch curved scars within the temporal hairline that may become visible with hair loss.
For those reasons, it's often best to remove the appropriate amount of excess skin from the uppwr eyelids without performing a Brow Lift. In cases when the brow is very low, a brow suspension can be done through an upper eyelid incision.
Brow lifts for balding men
If we had pictures of your upper face and hairline and had knowledge of your age, balding pattern and family history, I could be more specific of what could work for you. . Brow lifts can be done directly with a scar at the top of the brow or in a crease in the forehead. A coronal approach would hide a scar completely if you have the right balding pattern . The small scars that occur with an endoscopic brow lift could be covered by hair transplants, again depending on your balding pattern. Also there are some surgeons who do the operation through an upper eyelid crease incision. The hairline approach ,even a trichophytic one, should be considered cautiously for those with a balding pattern who are not interested in hairline reconstruction.
Browlift and hairline advancement.
We described several ways of dealing with this 25 years ago. The Irregular Trichophytic Hairline advancement with or withoutt a tissue expander can be done. If the hair loss is going to progress then you would need a Fleming Mayer flap or grafts to take care of any further loss.
Hairline incisions for browlift
Browlifting in males requires an artistic eye as well an ability to yield fine scars. Male brows should not be raised or arched to the degree of the female brow. Men do not have the luxury of camouflage makeup or variety of hairstyles woman enjoy and male pattern baldness can reveal a scar over time.
There are a number of excellent techniques which can address the male brow with minimal scarring such as a browpexy through and upper eyelid incision, an endoscopic browlift in a male with a reasonable hairline and moderate brow descent. The hairline browlift remains an excellent technique in a male with a high forehead as the nonhair baring skin can be removed and in some cases actually lowering the hairline.
Hair transplants can always be placed in front of the scar to hide the incision.
Seek out a board certified plastic surgeon with signifcant facial experience to help you with your decision.
Good luck and I hope this was helpful.
Receding hairline must be carefully considered in planning the male browlift
Your question touches on a very important point which is that the receding hairline can make a previously "invisible" or well camouflaged scar become visible. The pretrichial incision is placed right at the hairline and hides well. It has the added benefit of lowering rather than raising the hairline (a consequence of many other browlift approaches). During consultation, a careful consideration of your pattern of hair loss and that of your relatives will help decide on the ideal approach. Possible approaches include incisions placed within or at the border of the hair-bearing scalp, incisions placed on the forehead or in the upper eyelid. The endoscopic approach where multiple small incisions are used rather than one longer continuous incision is used is very popular today. However, in my experience this approach tends to be less effective in the long term for males for severe drooping of the brows.
Stephen Weber MD, FACS