Scalp Advancement for Shortening of a Long Forehead

Q : Hi Dr Eppley, I am inquiring about how to reduce a long forehead. My forehead is so long it is ridiculous. I have good hair but my hairline is so far back I can’t wear my hair pulled back. My forehead also has a bulge in it near the hairline which makes it look like it is even back further. I have heard that a plastic surgery procedure exists that can pull my hairline forward. Is this possible?

A: The typical distance for most people between their eyebrows and their hairline (forehead length) is up to 7 cms. When that distance is greater than that, most people would consider it to be a long forehead. In actuality, however, if one thinks that they have too much forehead skin then they do.

One’s forehead can be shortened through a skin excision procedure. The skin is removed in front of the hairline and the scalp hair brought forward in its place. In essence, this is a reverse browlift. The amount of scalp advancement can be up to 2 cms to 2.5 cms without any problem. More can sometimes be obtained by a very posterior scalp elevation at the subgaleal level the whole back to the occiput. Even more than that can be obtained by a two-stage procedure using a tissue expander although this is reserved only for the most severe cases.

The trade-off for a forehead reduction is a fine line scar along the hairline. As long as one has reasonable hair density and hair quality this is not a concern. With the forehead bone exposed, any bony contouring or reduction can be done at the same time.

Dr. Barry Eppley