Will My Hairline Advancement Need A Tissue Expander First?

Q: Dr. Eppley, I am interested in forehead reduction/hairline advancement surgery. I am a 20 year old female, and I wanted to ask about forehead recontouring. I would like to know more information. I am self-conscious about my forehead as it curves/bulges outwardly. I’m not sure if this is applicable to this, but I have included a picture to get a better opinion.  I also want my hairline lowered. Will a tissue expander be needed?

A: The success of frontal hairline advancement depends on the tightness of one’s scalp and how much forward movement of the hairline one desires. If the scalp has some looseness and the amount of hairline advancement in not greater than 10 to 15mms, then a scalp expander will not usually be needed. Although I have seen some patients whose scalp is so tight that is barely moves even with full release.

A hairline lowering will help but will not get rid of the bulge appearance completely. The two procedures are often done together for maximal effect.

Based on this profile picture you have sent, I think your rounder forehead can be made flatter. The relevant question is how much? Generally up to 4 or 5mms can be taken from the most central prominent area. But I alway check a simple skull x-ray first to see how thick the bone is in that area.

Dr. Barry Eppley

Indianapolis, Indiana