How Successful is Forehead Reduction By Scalp Advancement?

Q: Dr. Eppley, I am really interested in forehead reduction/hairline lowering. I am 21 years old and have not been able to find any local surgeons that can perform forehead reduction surgery. My forehead is incredibly long from the top of my eyebrows back to my hairline. It is like the entire front part of my skull is way in front of my hairline. I am looking for more information as to how this procedure is done and what my options are. I have sent some pictures so you can see for yourself my issue.

A: In looking at your pictures I can see the amount of frontal and temporal recession of your hairlines. You forehead is at least 8cms if not more. While vertical forehead skin reduction and hairline advancement can be done, its success and method depends on how much laxity or looseness your scalp has. Using the natural scalp laxity that can be obtained by surgical release, you will likely get a 1 to 1.5 cms advancement in the midline of the forehead and less so as it tapers into the temporal area. Up to 3cms or more can be obtained with a two-stage approach using a tissue expander first, followed by a second-stage scalp advancement. To find out what you need and which method may be best for you, do the marking test. Trace out the desired hairline with eyeliner pencil and then do a measurement to see how much advancement in centimeters that you need. Also take a feel of your natural scalp tightness by pushing forward on it and see how tight or loose that it is. These are the tests I would do if you were sitting in front of me to answer what method is needed to achieve your forehead reduction goals.

Dr. Barry Eppley

Indianapolis, Indiana