I'm considering hairline lowering. How likely is scarring?

Question

I am considering a hairline lowering procedure to reduce my forehead by at least 1.5 inches. What are the chances of a linear hyper tropic scar developing at the suture site? I obviously don't want an obvious scar. Will occlusive dressings like tegaderm help to prevent this? And at what point can I start this? I am African American if that helps. Also for physicians that specialize in this

Matthew Richardson, MD · Answer

I commonly perform forehead reduction surgery (scalp advancement, hairline advancement) on African-American women and do not see issues with poor wound healing or keloid scarring. While this is certainly possible, it has not been an issue for my patients. Any noticeable scarring that might occur could be treated in a variety of different ways depending on the appearance, including scar revision, steroid injections, and hair transplantation. Again, most patients do not need any of these because they heal so well.Be sure to see an expert. All the best,

Anil R. Shah, MD · Answer

Hello,
It is hard to find doctors for forehead lowering since they need to be experts in 2 areas.  First of all, doctors need to be experts in facial plastic surgery or plastic surgery to lift up the scalp area and advanced along the forehead.  The galea is released during this.  A key component is hiding the scar along the border of the scalp.
The second component is being an expert in hair transplantation.  The hairline is lowered and the scar is camouflaged through hair transplants. 
Look for a surgeon specializing both plastic surgery of the face and who does hair transplants.
Best,
Dr. Anil Shah

Jae Pak, MD · Answer

You always get a scar when you cut your skin.  This applies to forehead reduction where a doctor needs to cut your skin along your hair line.  You will have a scar along your hairline no matter how great the doctor or how innovative the surgery technique may be.  One factor in how your scar may look depends on the individual.  Generally, African American patients do not heal the best and can have hypertrophic scarring.  This is where it would help to see a doctor in person.

Andrew Jimerson, MD · Answer

If scarring is a major concern, you might consider a minimally invasive hair transplant to your forehead.  In my office, I use NeoGraft.  This is a machine that allows us to harvest individual hair follicle units from a donor area in the back of your head and transplant this hair to your forehead.  There is no linear scar and very minimal downtime.

William Rassman, MD (retired) · Answer

Scarring occurs 100% of the time with a hair line lowering procedure; however, the question more properly asked is will the scarring be visible. This is more an individual consideration on how you heal. If scarring becomes a problem, then a hair transplant in front of the hairline works well to hide the scarring. Alternatively, you can do a hair transplant hair line lowering procedure as shown in the web reference below

Sheldon S. Kabaker, MD FACS (retired) · Answer

If you do not have a history of abnormal scarring and have thick hair at your present high hairline, it is unlikely you will get an unfavorable scar. Other conditions have to be taken into consideration such as scalp laxity and ongoing hair loss from heredity or traction. Use of materials such as Tegaderm, starting a week after suture removal,  may be helpful but is no guarantee for lessening visible scarring. Those of us who answer you likely have experience with operations to reduce the size of foreheads.

I'm considering hairline lowering. How likely is scarring?

Answers (6)

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