When should I start to worry about no hair growth in the VERY LARGE coronal brow lift scar? (Photo)

One of the known complications following a coronal brow lift is loss of hair in the suture closure line. This can be a temporary or permanent situation and the defining timeline is usually 6 months. If the hair doesn't grow back in that time, then it probably won't. The reason for this occurring is usually that the scalp flap is closed under too much tension. A course of treatment with topical Latisse can be attempted for the next 6 to 8 weeks but if the alopecia persists then ultimately the scar will have to be resected in one stage or it may require multiple stages with hair transplant.

Coronal forehead/brow lift is obselete nowadays and I am afraid you have been a victim of an outdated procedure. The consequences you have are not a result of a bad execution of the techqnique, they are features of the technique itself. The coronal forehead lift without internal anchors is based on the principle of skin resection and pull backwards, being the closure the support element for the uplifted forehead. The downsides are:-baldness around the incision, sometimes irreversible-numbess of the scalp, irreversible-widening of the scar with great visibilityModern options are:-endoscopic forehead lift: I don't recommend this one, due to the limited suspension anchor options, thus normally the result is short lasting and the brow elevation insufficient-short scar forehead lift: minimal scarring, no skin removal, 2 rows of firm anchor, long lasting effects, no visibility of scars, no baldness, quick procedure, safe neurologically (no frontal branch damage if the surgeon knows the anatomical particularities)WIth that said, I still keep a hope of hair re-growth in your case, sometimes the baldness is temporary (telogenous stage) due to overtension and ischemia over the scar, thought irreversible alopecia is a likely possibility. For the wide scars a revision can be highly successful, but you'll have to wait long time

I am sorry about the hair loss that you are experiencing. Hair loss after scalp incisions is usually due to damage to hair follicles. Sometimes, a widened scar will give the appearance of hair loss. It appears to me that you have the latter. Although I would suggest waiting for at least 3 more months, I think you will need revisional surgery to correct the problem. The scar (hairless area) needs to be removed in such a fashion that the hair follicles are not injured. This is accomplished by bevelling the incision parallel to the direction of hair follicles on either side of the widened scar and bringing the edges back together.  Never hesitate to get a second opinion from a board certified plastic/facial plastic surgeon.

Hi and thank you for your question.  After 3 months, it is unlikely that you will see much hair regrowth back within the scarred area.  It is usual to wait 8-12 months to see what your final result will be and then to schedule some sort of revision.  It looks like you may need a scar revision under minimal tension and possibly hair grafting in the future for any problem areas.  You should definitely follow-up with your board certified Plastic Surgeon to discuss these options.  Good luck with everything!

Widening of the scars or just hair loss will need to be addressed. First step is to attempt medical treatments to revive areas of alopecia. These treatments can include Rogaine, Biotin, Latisse and aldactone - see your doctor for more advice.The second step if step one fails is to have either hair transplants or a scar revision. If a scar revision is chosen then be sure that the revision leads to a zig-zag scar - this scar is much harder to see and the hair will not part in a way to show the scar as you have now.For more information, read my book "A More Beautiful You - Reverse Aging Through Skincare, Plastic Surgery and Lifestyle Solutions".

Is the area of alopecia(no hair growth) limited to the scar or is the scalp also devoid of hair?You indicated the scar is getting bigger....If the scar is widening, once it has stabilized(stops progressing) then a scar revision will remove the bald scar area. Closure with a tension-free technique is essential.If the scalp itself has lost hair then I would wait, but while waiting there are modalities to help aid hair regrowth. If they do not help over time, a "scalp reduction" and or hair grafts may be necessary.You are not here yet.Hope this helps

Sorry to say this is a the major complication of coronal surgery - scar with no hair. Consider scar revision with hair transplants...