Hairline Lowering (Forehead Reduction)

Having a large forehead can be a significant source of concern for many people. A big forehead can often appear out of proportion with the rest of the facial features and lead to a reduction in self-confidence and emotional well-being. Patients may feel very self-conscious about having a large forehead and may choose to wear hats to cover up having a high hairline. The impact on daily activities can be significant with many avoiding going outdoors or carrying out sporting activities for fear of showing their big forehead. In many cases, people may develop anxiety and depression. Fortunately, there are highly effective treatments for forehead reduction to restore facial balance and boost self-confidence.

Hairline lowering surgery or forehead reduction surgery

Hairline lowering surgery also known as forehead reduction surgery or scalp advancement is a surgical procedure designed to lower the height of the hairline and reduce the size of a big forehead. The desired result is a full head of hair due to a lower hairline. The procedure is performed almost exclusively in women where up to 5 cm of shortening can be created. In some cases, to further contour the hairline, a hair transplant procedure can be performed to reshape the hairline which can create a more feminine rounded appearance to the sides of the hairline. In cases where more than 5 cm of lowering is required then a 2-stage procedure with tissue expanders may be necessary to achieve the required level of hairline lowering.

The upper third of the face and hairline is a key aspect of defining one’s gender because it forms the framework for the whole face. Hairlines in men tend to sit further back on the skull compared with a women’s hairline. This gives the impression of a larger and more prominent forehead in men. In women, the hairline sits at a lower position and takes on more a rounded appearance compared with the square-like appearance found in men. For many women with higher hairlines, the hairline can be lowered into a more female type of hairline with smooth curved lines leading to overall facial harmony and balanced aesthetics. An excessively high hairline can lead to a reduction in self-confidence and may lead many women to reduce the number of hairstyles they choose to have as the main priority is always to cover a large forehead.

Causes of an excessively high hairline:

• Genetic factors
• Hair loss from previous surgery such as a coronal browlift

Procedures commonly combined with hairline lowering:

• Brow lift surgery aims to raise the level of the brow to create a more balanced aesthetic appearance
• Eyelid surgery or blepharoplasty
• Facelift
• Forehead contouring also known as a forehead reduction can be used to precisely reshape the forehead bone

What is included in my treatment package?

• As many preoperative consultations with your surgeon as you like to make sure the procedure is right for you
• Treatment at a specialist day surgery facility recently rated ‘Good’ by the CQC
• Enhanced same-day discharge with the added benefits of recovering in your own home
• 24/7 clinical support from your surgeon for the first 48 hours and our expert postoperative support team
• Your very own dedicated patient coordinator
• In-depth preoperative medical assessment to make sure you are fully fit for the rhinoplasty procedure
• Exceptionally high standards of postoperative care described as ‘outstanding’ by the CQC with regular telephone and face-to-face checks by our expert postoperative support team

RealSelf Top Doctors

RealSelf top doctor status is awarded to less than 10% of the RealSelf doctor community.  This status is earned by achieving consistently high patient satisfaction (from RealSelf reviews), getting excellent feedback on expert answers to patient questions, and investing significant time in Q&A and other doctor activities. RealSelf top doctors are rated among the very best surgeons in the UK.

Patients who smoke will be advised to stop for at least 2 weeks before the date of their procedure. Smoking has detrimental effects on your circulation and is well known to slow the healing process. All medications, prescribed and over the counter will be reviewed. Aspirin and aspirin-containing medicines should be stopped both before and after surgery. Aspirin and NSAIDs impair the body’s natural clotting process and may cause bleeding complications after surgery. If you require pain relief after surgery, paracetamol is advised.

Hairline lowering is an outpatient surgical procedure meaning you will be admitted and discharged on the same day which allows you to recover in the comfort of your own home. The hairline lowering procedure can be performed under either a general anaesthetic or a local anaesthetic. Although our surgeons recommend TIVA general anaesthesia for optimal comfort. The surgeon begins by marking the location of the planned new hairline. The incision is performed in a zig-zag configuration to closely resemble the appearance of a natural-looking hairline.

The skin above the marked new hairline is surgically removed. The skin margins are then carefully sutured together in 3 layers to reduce the tension on the superficial aspects of the incision. As the incision is sutured, the new hairline is surgically lowered to the planned marked position. Your surgeon may choose to use non-dissolvable sutures which are then removed at your follow-up appointment as these give much better scar cosmesis compared with dissolvable sutures. During the healing process, hair follicles will regrow through the incision line and this helps to disguise the appearance of the resulting scar.

Where the hairline needs to be advanced more than 5cm, then a 2-stage procedure is necessary. In the first stage, a temporary implantable device called a tissue expander will be inserted to place the forehead skin on stretch. The tissue expander is essentially an inflatable balloon that when inflated beneath the skin will stretch the skin. The balloon is inflated by injecting a sterile saline solution. The tissue expander is left in for approximately 4-6 weeks before being removed and the surgical hairline advancement takes place in the second procedure. In some cases, your surgeon may recommend a third-stage FUE hair transplant procedure to increase the density of the hair follicles. The skin that was placed on stretch by the tissue expander often leads to a reduction in the density of hair follicles as the hair follicles are spaced further apart.

Patients recovering after hairline lowering tends to have very little in the way of postoperative pain. Bruising of the forehead and eye region may develop and this often resolves within 5-7 days. The swelling of the region may take a little longer to settle. Most patients are able to return to work after one week although it is possible to commence light activities after about 2-3 days. Numbness of the area near the front part of the scalp is quite common and is mostly temporary in nature but may take up to three months to fully resolve.

The cost of hairline lowering and forehead reduction will vary on the extent of surgical correction required but you should expect to pay in the region of £5000-£6000.

RELATED: Face Cosmetic Surgery Prices

At Centre for Surgery, we partnered with the most experienced consultant plastic surgeons with expertise in forehead reduction surgery and hairline lowering. Prices for hairline lowering reflect the reputation of the clinic and the expertise of your surgeon. If you are interested in hairline lowering, get in touch with us today to book a consultation. Once you have had a consultation, you’ll be given a detailed quotation by your dedicated patient coordinator. The price of forehead reduction surgery includes:

• Free consultation with an expert surgeon.
• Treatment at our state-of-the-art Baker Street clinic in Marylebone.
• Advanced anaesthesia techniques to allow you to recover in the comfort of your own home later the same day.
• Dedicated assistance from our post-operative nursing team to make sure your healing is smooth.
• Your own patient coordinator to act as a point of contact throughout your patient journey with us at Centre for Surgery.

Forehead reduction surgery and hairline lowering are not available on the NHS as the procedure is designed to improve cosmetic appearance and not to address a medical condition.

Hairline lowering surgery is a commonly performed procedure at Centre for Surgery. At your consultation, your surgeon will discuss the potential risks and complications associated with the scalp advancement procedure.

Risks of forehead reduction surgery

• Anaesthetic complications
• Postoperative bleeding
• Excessive scarring
• Delayed wound healing
• Hair loss around the incisions
• Nerve injury leading to numbness
• Facial nerve injury
• Surgical site infection
• Brow asymmetry
• Requirement for a revision procedure

Hair transplant surgery is an effective alternative to hairline lowering and forehead reduction surgery. This procedure involves the removal of donor hair from thicker areas of the scalp most commonly located at the back of the head. The two most commonly performed types of hair transplant include follicular unit transplantation (FUT) and the newer follicular unit extraction (FUE). FUE involves the removal of individual follicular units from the back of the neck before placing them into the desired area using a specialist hair implantation device. FUT involves the surgical removal of a horizontal strip off her bearing scalp from the back of the head. Individual follicular units are then extracted from this strip before being implanted into the desired areas. Hair transplant surgery is able to produce natural-looking hairlines which can be customised to the shape of the individual patient’s forehead. Hairlines can be created so that they appear straight or curved. Forehead reduction surgery cannot match hair transplant surgery for creating highly customised hairlines, particularly those with a V-shape.

Hair transplant surgery can result in thick hair in the hairline for those who have been affected by thinning or thinner hair. This can help to reduce the appearance of a big forehead. Forehead reduction surgery requires mobilisation of the scalp to bring it lower. A certain degree of scalp laxity is required to facilitate adequate stretching of the skin. Hair transplant surgery does not have the same requirement. The main requirement for a successful hair transplant is to have adequate donor sites for hair to be removed from which can then be used at the hairline. Although hair transplant surgery is popular in men who may be experiencing a hairline recession or a receding forehead, it has also become increasingly popular in women. Forehead reduction surgery involves making an incision in the hairline. FUE hair transplants do not result in visible scarring at both the donor and recipient sites. FUT hair transplants are particularly known for producing visible scores at the back of the head and this type of hair transplant technique is performed less commonly nowadays.

Hair transplant surgery can take a minimum of eight weeks before results become evident. The benefit of forehead reduction surgery is that the procedure can produce results which are visible straight away. It can take many months for people who have had hair transplant surgery to notice results.

However, the lack of scarring is enough for many people to prefer hair transplants particularly if they are experiencing thinning of the hair at the hairline area. Choosing between forehead reduction surgery and FUE hair transplant depends on your tolerance for scarring. Well-performed hairline lowering surgery produces scars that can be well hidden within the hairline.

Hair transplants are very safe and effective with tens of thousands of procedures carried out in the UK each year. Hair transplant surgery is a viable alternative method of forehead reduction. Other alternatives to reduce the size of a big forehead include a surgical brow lift. Brow lift surgery is designed to lift a sagging brow by tightening of the forehead skin to leave a smoother appearance. The level of the eyebrows particularly at the outer part can also be raised to reduce the appearance of a large forehead and also rejuvenate the upper one-third of the face.

RELATED: What is a Brow Lift?

We would recommend having a detailed consultation with an expert consultant plastic surgeon at the Centre for Surgery for discussion of the most appropriate treatment options.