Does a trichophytic brow lift/TBL make the forehead smaller?

Question

Where is the incision for the TBL? Is it only on the temples or does it go across the forehead? Does it leave a visible scar? Does it reduce the appearance of forehead vertical (including frown lines) and horizontal wrinkles? How often does permanent hair loss occur after TBL? Is there a RISK OF BLINDNESS or other eye problems? Can it cause permanent nerve damage and lead to chronic pain? Can I have a forehead reduction surgery in the future after a TBL?

Michael P. Morrissette, DDS, FACS · Answer

The trichophytic browlift incision is in first 5 mm of the hairline and goes from one temple to the other. Initially there is a hidden scar that diminishes with time as the hair follicles grow through the incision. It does not lengthen the forehead and reduces horizontal wrinkles and the need for Botox in the procerus and corrugator muscles. I have never heard of chronic pain or blindness from this procedure. It is an extremely safe procedure.

Toby Mayer, MD · Answer

Irregular Trichophytic Forehead Lift and Hairline Lowering. I invented and named this procedure almost 50 years ago and have done more than 5000 and have never had any complication. This can be done as just a Browlift or with a forehead reduction. Make sure you see the actual hairline with the hair pulled back!

Patrick Flaharty, MD FAACS · Answer

A trichophytic brow lift is designed to shorten the forehead. The incision is just inside the anterior hairline of the central forehead and usually curves backward behind the hairline in the temples where the anterior incision would be more visible. Every incision creates a scar so the key with all incisions is placing them in discrete areas and meticulous closure to minimize the visible scar. Hairloss is minimal with a TBL as the incision is just inside the anterior hairline but can occur around the temporal incisions. There is really almost no risk of blindness as you are not operating inside the orbit, but you can have swelling around the eyes for a few weeks. With a TBL you will cut branches of the supraorbital and supratrochlear nerves which will cause prolonged numbness of the scalp which can be permanent. By definition a TBL will reduce the vertical distance of the central forehead. An endoscopic brow lift is in many ways a superior operation as it entails only small, hidden incisions, no skin removal, and much less risk of visible scars, hair loss and permanent numbness, but it does not shorten the hairline. For this reason some surgeons are combining the TBL with the endoscopic approach to realize the benefits of both procedures.

Does a trichophytic brow lift/TBL make the forehead smaller?

Answers (3)

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