What are the cons of a hairline lowering? (Not the graft procedure)

Question

My mother feels as if the surgery will not give me the results I want along said with a surgeon I contacted (didn't do hairline lowering's but his opinion) Why so much negativity around this surgery? I have seen before and afters and it seems to be efficient, and something that will benefit me. But everyone I have contacted so far is opposed to this. I don't know what else to do, I hate my hairline. Are there big cons to the surgery? Is it worth it? (Non graft, literal lowering of the hairline)

Jae Pak, MD · Answer

You should first make an appointment with a doctor for an exam to make sure a forehead reduction is possible in your particular case.In general, forehead reduction surgery involves an incision along your hair line and pulling your scalp forward and cutting out any overlapping skin then sewing back the skin.    This obviously requires an exam to make sure your scalp is loose enough and you do not have other un-diagnosed cause of hair loss.Limitation of a foreahead reduction is that sometimes you will see a scar on the hair line (no matter which technique or doctor you choose).  Another limitation is that you will not get the rounding on the side corners (oval shaped hair line which many women have).

William Rassman, MD (retired) · Answer

There are two types of procedures for lowering a hairline. One, is a surgical excision of the upper forehead followed by the downward advancement of the hairline up to an inch from where it was prior to the surgery. To accomplish this, the entire scalp from the frontal hairline to the very back of the crown, is lifted up and pulled forward. When this is done by an experienced surgeon, the hairline can often be advanced about 2/3rd – 1 inch if there is enough looseness when this lifting process is done. This procedure is often complete in one surgical session; however, it may not address receded corners of the hairline if the corner recession is significant. A great advantage of this surgical approach is the immediate impact of the procedure on hairline location with healing usually complete in a week or so. Sometimes this procedure produces a scar in front of the hairline, and if this is this is the case, a hair transplant in front of the hairline can address the scar. If there is corner rounding or if you are a male, a hair transplant lowering surgery is better because of the risk of recession in men with genetic balding. Recession will reveal the scar from a hair line advancement surgery. The only disadvantage to this is that it takes 6-8 months to fully grow out. For men, a hair transplant is a better procedure because of the risk of hair loss is high and hairline recession will show the scar from a hairline advancement surgery. Although this does happen in women, it is less frequent

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

This operation is not done my many surgeons and is not taught in residency programs. If you have not had any prior scalp surgery and have adequate looseness of the scalp and forehead, the incidence of complications is very liw. Certainly the complication rate is less then what can occur with hair transplantation which is the alternative treatment. Physicians who have not seen the operation being performed, certainly could not give positive or negative information that is meaningful.

Richard W. Fleming, MD (retired) · Answer

Before I say a word, full disclosure is necessary. We developed and first described the Irregular Trichophytic Hairline Incision Technique for hairline lowering many years ago. I was not aware that so many people were opposed to this surgery. I do transplants and we have written a medical  textbook on hair replacement surgery. I continue to do a large number of these procedures because it will provide normal uniform density with total freedom of hair styling which cannot be achieved with transplants. I'm not aware of a better technique.

What are the cons of a hairline lowering? (Not the graft procedure)

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