Forehead lift by shorter pretrichial incision combined with direct lateral brow skin excision. (photos)

I have some forehead wrinkles and moderate brow ptosis. Could I have a shorter than usual pretrichial incision at forehead no longer that the distance between the middle of the eyebrows. I believe this will eliminate most forehead wrinkles by removing forehead skin with frontalis fascia uplift. Then finish it off with a small lateral direct brow elliptical skin excision to eliminate hooding laterally. Is that op as described possible?

Doctor Answers 6

Forehead Lift

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What you are describing is possible the questions are whether it wold be effective and would the scars ben a good tradeoff. It is never wise to make the assumption that a brow lift will get rid of forehead wrinkles as those effects are usually very limited. Also the shorter the scar (like limited to between the eyebrows) will also make for a very limited brow lift effect. The length of a hairline browlift procedure has a bearing on how much brow lifting effect can be achieved.

If you could be certain you will not continue to have a higher hairline

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you could consider what you have mentioned so your scars will never show.  Otherwise you would be better off with an endoscopic browlift and if you didn't want something that complicated, you could choose to have the scar just above your brow in one of your forehead furrows... but it takes a while for the redness to go away.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Forehead Lift with Short Pretrichial Incision and Lateral Direct Brow Lift

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You can demonstrate the effectiveness of a short pretrichial incision by placing your fingers at the hairline and lifting up. I think you'll find that limited elevation can be achieved if that incision is limited. A direct brow lift can be done laterally but there is the possible risk of an unfavorable visible scar. Hair will grow through a trichophytic incision across your entire hairline so the  entire incision will be hidden. I suggest you consult with a surgeon experienced in this work who uses all brow lift techniques to discuss your options.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

Browlift procedure

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When performing a short scar, there is minimal to no skin to be removed due to the excess bunching of residual skin. The a coronal approach allows a variable amount of skin performed to lift the forehead and anchor  it, in addition to softening the frontalis and corrugator muscles and placement of fascia grafts underneath the vertical lines between the eyebrows. The reason for the pre-trichial approach is to lower the hairline, not raise it. For more information and many examples of browlift, placed in the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 155 reviews

Modified brow lift

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Your plan seems feasible. You need to find a doctor who has experience with this exact plan. Most of us would recommend whatever has been working well in the past such as a trichophytic hairline aporoach or the endoscopic one. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon


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You have plenty of hair, so might want to consider an endoscopic lift.  This will give you a more even  browlift, getting the medial and lateral brow.  It will move your hairline back a little, but usually not much at all.  If you try to elevate just the medial brow you may get an odd shape to it, and look surprised. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

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