Am I a Suitable Candidate for Forehead Reduction Surgery? Should I Do Something To My Hairline as Well? (photo)

I am 21 years old and have been losing hair ever since I was 13. I don't have much hair fall anymore, but my forehead has become high & I cannot even part my hair because it looks bad so I just keep it messy. I really want to do something about it. And my hairline isn't VERY thick as you can see in the photos so I think maybe hair grafting (I have moderately thick hair on the sides and back) in combination with forehead reduction is what I need? It is depressing. Please help me out. Thanks.

Doctor Answers 8

Forehead Reduction Surgery

There are a few considerations here.  Hairline advancement, or forehead advancement surgery, is a technical procedure and very few actually perform the procedure.  If you have been losing hair, you would want it to be stable, meaning no hair loss, for at least 2 years before considering the procedure.  The scar is wide but if done in experienced hands, it heals extremely well (the surgeon can actually angle the scar so hair will go through it hiding the scar even more.  

In darker skin types, one of two things can happen when an incision is made anywhere on the body.  The first is hyperpigmentation and the second is hypertrophic scarring (like keloids).  This is very uncommon but, in my practice, because we do so many brown skin individuals, we see this from time to time.  If you proceed with this, make sure your surgeon discussed pretreating your skin prior to surgery to reduce those risks.  

Lastly, you want to plan for the very unlikely scenario of thinning of the hairline in the future.  This will require some hair grafting but you may not have to do this right away.  Hairline advancement does present a cost effective option for younger patients who want an improvement and postpone the cost of the hair transplant to later in life. 


Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 41 reviews

You need to find out why you are losing hair before considering surgery.

You need to find out why you are losing hair before considering surgery.
A doctor usually needs to examine a patient, diagnose a problem (of why you are losing your hair or much more hair loss that you may have in the future), then needs to understand your goals and expectations before giving you options or a treatment plan. A lower hair line may be possible but what happens when you lose more hair?

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
4.9 out of 5 stars 79 reviews

Forehead Reduction Surgery to alter hairline

It would be first important to know the nature of how and why you are losing your hair (there are different reasons, hormonal, genetic, certain medical conditions, etc) and that your hair loss is stable. With that information one could best recommend whether hair bearing scalp flaps with or without micro-grafting would be your best option

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 124 reviews

Options

Yours is a difficult problem.  The easiest plan is to wear bangs to camouflage the high hair line.

You can have an operation to reduct your forehead.  The incision is made at your hairline,

lifting the scalp so that it can be advanced forward allowing the surgeon to excise or cut out

about a half to a full inch of your forehead.  There will be a scar at the hairline, so you may still

have to wear your hair down on your forehead.  Usually the scar is not bad if it is done properly. 

Another consequence of this surgery is that there will be some numbness to your scalp.  You may

get some feeling back, but it could be permanent. A better solution would be to see a surgeon who

does hair grafting.  This is a relatively easy procedure to do if you find someone who does this

all the time.  You don't want to be someones first case.

Good luck

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon
4.2 out of 5 stars 12 reviews

Forehead Reductionh Surgery

Before recommending a technique to lower your hairline I want to know if the progression of your hair loss from a very young age has been evaluated. I am cautious about recommending treatment for . hair loss in a patient in whom I don't know the ultimate extent of their alopecia. If you are a candidate for hair replacement surgery I would recommend a flap or hairline lowering using the Irregular Trichophytic Incision which we described many years ago.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 35 reviews

You are 21, these surgeons are proposing creating is less natural than your current hairline.

It is important to understand that with a hair flap procedure the hair line, which is actually a zone and not a line, can look unnaturally compressed even in the best of hands.  This can also be true for a micro grafted hair line as well.  The message is that you need to be careful regarding what you are looking for.  I would recommend that you start with several opinions after in depth personal consultations before embarking on any hair surgery.  You will be even more depressed if you are unhappy after surgery because of some unanticipated result or effect.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 22 reviews

Forehead reductoin versus hair transplants

I f you are no longer losing hair, and are female with  average scalp laxity and do not employ hair styling that weakens the hair or puts traction on it,  I would suggest you first consider forehead reduction. Transplants could always be done later. Transplants will not give you thicker hair in the front  than what we see on the pictures.With the forehed reduction, these finer hairs could be excised making the leading hairs of your new hairline come from the thicker hairs that are a few millimeter behind. However, thick hairs at the very front of the  hairiline can look unnatural. If you are male, this becomes an entirely different discussion. 

Sheldon S. Kabaker, MD FACS
Oakland Facial Plastic Surgeon
4.8 out of 5 stars 22 reviews

Hair Grafting For Forehead Reduction.

Given your long forehead, skin color and sparse density at the frontal hairline, I would consider hair tranplantation as opposed to an excisional  forehead reduction. This would be aesthetically safer as opposed to a potentially visible scar along the hairline.

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.