What face and neck lift options exist for 56-year old post menopausal women with early stage frontal fibrosing alopecia?

Assuming that your frontal fibrosing alopecia is due to a lichenoid process, and that your hair in the temporal areas will also gradually regress, the frontal and temporal incisions should be planned accordingly and kept to a minimum.  Since we also transplant hair, we are aware that the loss here can be somewhat unpredictable.  The area around the ear should not be much of a factor, but in the temporal area, the incision should be directed backward, and little hair removed, if a great deal of skin removal is not necessary.  A good mid-face lift might diminish some of the facelift flap rotation and skin excision. Still, it is impossible to give you much advice without looking at factors such as: how much skin needs to be removed, what your hair mass looks like now, etc.  

Hi there, There are many options available to you. My advice, would be to do what you can to understand the options available so you can understand what options are presented by surgeons. I posted a link below that may help, it is an article discussing why we do different types of facelifts. I hope if will be helpful to you,James P Bonaparte

With you current condition I would recommend a full face and necklift with a sideburn type incision.  This will protect your hairline from changing position and still allow for proper advancement.  A coronal incision, one that extends up towards the top of your head, would likely contribute to a more posterior placement of your hairline and worsen your look.  

Depending on the exact location of your hair loss, facelift scars should not be an issue. Assuming you are not losing hair in your temporal tuft, a trichophytic incision can be used there to hide the scar along the hairline. I would prefer that scar over a temporal scar since a temporal scar ends up pulling the temporal tuft hair line up and back and will cause too much facial show for most patients. That incision essentially makes you lose more hair bearing skin as opposed to a trichophytic temporal incision that will retain that hair. See someone with experience that can examine you and determine the best option for your personal anatomy.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

Hello and thank you for your question. This is more common than you may think.   If good technique is used,
this can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your face.  Careful attention must be paid to your temporal hairline.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect
is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

The main incisions for facelifts are in the crease in front of the ear then going behind the structure called the tragus then on the back of the ear. Rarely does alopecia in women affect the temporal tuft (sideburn area). This hides the top of the incision. Behind the ear the incision can be made so it's barely visible if at all. We do these all the time for men.

The good news is that having alopecia doesn't mean that you can not have a facelift. However, without examine you in person so that I have some idea of the amount of skin that will need to be existed, it's really impossible to give you any kind of accurate advice. Luckily, you live in an area with excellent board certified plastic surgeons. Look on the American Society of Plastic Surgeons website to find the ones near you and then schedule a consultation with the one or two whose work you like best to be assessed in person and discuss your options.Kindly,Kouros Azar

Thank you for your question.  Traditional facelift scars hide well within the ear and occipital hairline.   The amount of visible scar in front of the ear will depend of the amount of skin laxity in this area.   You may be a candidate for a staged hair transplant to help cover these scars and add hair to your areas of concern.   Platelet rich plasma has been shown to help stimulate hair growth with this procedure.  All the best.

Usually facial scars do very well after facelift surgery.  Best of luck with your decision to move forward.

Thank you for posting your questions. It is very smart of you to share and discuss any concern you have before deciding to have a procedure. I believe frontal fibrosing alopecia will not be a very big issue, as sutures can be easily hidden behind the ears. I recommend meeting with a board certified physician who is experienced with such suturing approach. Best of luck.