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

I'm exploring options for face and neck lift that will minimize scars that may become exposed when my hairline recedes two inches from ear to ear due to frontal fibrosing alopecia. If I'm going to lose some of my hair I want to make sure my face and neck are looking their best. Just want to make sure I consider both conditions when making my decisions. Has anyone dealt with this double whammy? Based in NY metro area and willing to travel.

Doctor Answers 16

Face Lift

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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.

Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Facelift & Alopecia

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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.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 37 reviews

Planning for the frontal and temporal hair loss is essential

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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.  

Gregory S. Keller, MD, FACS
Santa Barbara Facial Plastic Surgeon
4.9 out of 5 stars 15 reviews

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Face and necklift options with hair loss.

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We have all certainly seen cases of female alopecia but it usually does not preclude facelift surgery under most circumstances.  Nonetheless, preserving your sideburn and hiding the incisions artfully around your ear will permit a facelift and necklift without significant threat to your remaining hair.  Incisions can be made irregularly irregular and a long curving lines so that after 2 to 3 weeks they become barely perceptible if at all visible.

Best wishes and good luck.  Ask your surgeon to show close-up photos of other patients after their facelift for you to see how well camouflaged properly placed incisions can be made.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Facelift with Hairloss

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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.

Paul S. Gill, MD
Houston Plastic Surgeon

Facelift Options for an Aging Face

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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

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

Face lift

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

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Face lift - planning ahead for alopecia

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Thank you for asking about your face and neck lift.

  • Fortunately with a face and neck lift, the scars should not be an issue.
  • These scars usually run around the ears, not up into the hair line.
  • If you incision follows the side burn area a short way, that is all that my eventually be revealed. 
  • Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

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

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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.  

Alopecia and facelift scars

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Thank you for your question.  There are many different variations of scar techniques described for facelifts.  Often, the scars can be limited to the hairline in front of the sideburn anteriorly, and behind the ear posteriorly.  These areas are rarely affected by alopecia in women.  The shorter scar technique can then be combined with a number of techniques to address the laxity of the underlying facial musculature or SMAS.  Frequently, facelifts area combined with fat grafting to achieve a more youthful, fuller midface . I recommend seeing a board certified plastic surgeon for a consultation in person to discuss any concerns you have.  Good luck!

Brian A. Pinsky, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 6 reviews

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.