I am going to undergo a subcutaneous forehead lift as I do not want my hairline to go backwards. Will the scar be noticeable or not?
Will Scar from Subcutaneous Forehead Scar Be Noticeable?
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Doctor Answers 24
Is hairline forehead incision visable?
POSSIBLY IT WILL BE ABLE TO BE DECTED. Then again a well done hairline incision is usually quite good. Skin color can be a factor. Darker skin may have lighter scars and this can show. People with darker hair are more at risk. I like this operation and use it frequently but I alway warn patients that sometimes despite best effort the scars are visible no matter what. Happy Valentines Day
Forehead lift scars
Every browlift has its plus and minus. There are now "hybrid" procedures which do not involve the typical jagged anterior hairline incisions, and actually remove a section of widow's peak. The scars are almost universally excellent.
As in all plastic surgery, there is a huge artistic component beyond the "what procedure do you do"; it is as important as the procedure being chosen who is doing it.
Endoscopic browlifts are fraught with several problems. First and most concerning, they move up the hairline. In fact any browlift originating from above the hairline moves up the hairline. That translates to a high forehead, which can give a prematurely elderly appearance. In many patients it is not an issue, but in many, particularly those above 40 who are noticing their hairlines receding, it is an issue. Also endoscopic incisions typicallly cause some hair loss around the incisions, resulting in 3 small bald spots above the hairline.
Coronal incisions (ear to ear) are still used, but also move up the hairline considerably and often result in numbness due to division of the supraorbital nerve deep branch, which is spared in most other forehead lifts.
Experienced surgeons are familiar with many techniques, and use them to benefit their patients maximally. You may wish to read our book chapter on forehead lifts in the textbook Mathes, referenced below.
There are many ways to perform a brow lift including subcutaneous or subgaleal or subperiosteal. All can cause elevation of the hairline. The position of the hairline is affected by the type of incision used. If the incision is within the hairline, it will move bakwards. To 'lock" the position of the hairline, a hairline incision( border of hair) is used so that the hairline does not go backward. This will leave a permanent scar in front of the hairline.
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Subcutaneous Forehead Lift
For patients who are concerned that the hairline not be moved more superior, a forehead lift with the incision placed in or just slightly behind the hairline is often a great option. Properly constructed, such wounds usually heal up to a point that they are hard to detect. Naturally, individual patient features effect wound healing, so patient and surgeon must discuss this carefully.
Patients need to know that the incision will often be quite noticeable for the first couple months after surgery. During this time, most patients won't want to wear their hair back. The good news is that the incision line typically fades and blends in over time, and most patients do not find the scar objectionable when it has fully healed.
Mark Lucarelli MD, FACS
Subcutaneous forehead lift scars may not be noticeable
Patients today have many good options to alter the shape and position of their forehead and eyebrows. One good option is the subcutaneous forehead lift done in the temporal position. During this procedure, patients received a 2 1/2 to 3 cm car that is behind their hairline. This allows for access and a change in the position of their brows with a well hidden scar. Your best bet is to work with a board-certified plastic surgeon who has a great deal of experience and brow lift surgery and facial rejuvenation. They will be able to assess your brow and face and help determine what combination of procedures will help you meet your aesthetic goals.
Subcutaneous Forehead Lift
The subcutaneous forehead lift is for patients with a high hairline. In this surgery an incision is made just along the hairline, the forehead tissue is lifted off of the muscle to the brows, elevated, the excess cut off and the incision is closed.
Good scars are the direct result of tension. Thus if too much tissue is removed and there is a lot of tension on the skin at the incision it will widen over time. Often surgeons, in an attempt to get the "greatest lift", will cut off too much tissue causing this bad scar. A surgeon who understands leaves good scars.
Forehead lift with hidden scars
There are two components to your question: the first is how to achieve the best looking scar/incision. The second is how to do a browlift without changing the hairline. The subcutaneous browlift is certainly one approach, and in order to prevent pulling the hairline back, the incision is usually placed at the junction between the hair-bearing scalp and the forehead. This should keep your hairline at its current position. In addition, this incision tends to heal very well and become hard to see, but so scar disappears completely. One final point- if your hairline is receding, then when it recedes more, say in a few, years, your incision may become more noticeable, since the hair will no longer be there to hide it, so just be aware that this may occur.
Pre-hairline Incisions Can Heal Very Nicely...
Pre-ahirline incisions can heal very nicely if done properly. You should make sure your surgeon has a lot of experience with the "trichophytic technique" which insures that hair will actually grow in front of the incision. This is the key. Additionally we rarely extend our incisions into the temporal area although others still do. In our opinion little is gained from this extension and there is a possibility that thinning of the hair in front of the incision can occur!
It is the quality if the scar that counts
As Dr. Katz mentioned, the presence of an incision will always lead to a scar. There are no exceptions. The job of a Facial Plastic Surgeon is to place a scar (when possible) in an area where the scar will be minimally visible, and to use techniques which will promote satisfactory wound healing.
I believe that your question pertains to browlift procedures. In the presence of a high hairline, I use a technique known as a Tricophytic Brow Lift, which is carried out in an irregular fashion at the hair line, which follows the curvilinear pattern of the hair line. The incision is beveled in an extreme forward fashion in order to leave several rows of hair follicular units which will later grow back through the scar and make the scar less noticeable.
Minimizing Subcutaneous Forehead lift scars
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.