Can A Hairline Advancement and Upper Forehead Contouring Be Done In A Male Patient At The Same Time?

Q: Dr. Eppley, is hairline lowering + forehead augmentation possible during one procedure and for a male patient? I have a slight asymmetry in my frontal bone where one side bulges out and is more prominent while the other side is flat and has a slight dip. This can be seen in pictures. The result I would like to achieve is seen in pictures 5, 6, and 7. I’d like top of the frontal bone more rounded with the side profiles raised, so that the hairline drops down and wraps around the curve and sits straight relative to my face as seen in picture 5. 

From what I’ve read online, a scalp advancement/hairline lowering is not typically recommended for men due to problems resulting from male pattern baldness/receding hairline and the eventual visibility of the incision scar. If this procedure is done, could minoxidil/Rogaine be an effective measure to prevent the hairline receding and hide the scar? 

If the scalp advancement/hairline lowering is not done, what other ways could we achieve the result in pictures 5, 6, and 7?

A: Thank you for your inquiry and sending all of your pictures to which I can say the following:

1) A frontal hairline advancement and upper forehead augmentation can done during the same surgery.

2) Like any hairline advancement the first question is always whether the patient’s new hairline position is achievable. Based on your own simulation, by pushing your hairline forward, and the natural scalp flexibility that comes with darker skin pigments, I would say the 10 to 15mm advancement you are simulating appears to be possible. (see attached)

3) There are two significant considerations to make in a male hairline advancement, particularly with darker skin pigments….1) how well will the hairline scar do in such a visible area and 2) as you have mentioned what is the permanency in a male of their frontal hairline position? These are two very relevant aesthetic questions of which the answers can never really be completely known…until you do it. I certainly have done darker skin pigmented males for combination hairline advancements and forehead work and have yet to see these potential adverse issues. But not having yet seen them does not mean they can not occur in the next patient.

Dr. Barry Eppley

Indianapolis, Indiana