Forehead Reduction (Hairline Lowering)

Forehead reduction (hairline lowering) is a surgical procedure that aims to make the forehead look shorter in people with a high forehead by removing a strip of forehead skin along the hairline and advancing the scalp forward. It is also known as forehead shortening.

The height of the forehead mostly depends on the structure a person is born with. Reshaping a bony prominence of the forehead by burring is a separate procedure; whether it is needed is assessed at the examination. Results vary from person to person.

Who Is Forehead Reduction Suitable For?

Forehead reduction may be considered for people with a naturally high hairline or a tall forehead, whose scalp is sufficiently flexible, whose hair loss is not progressing, and who are in suitable general health with realistic expectations, if they are found suitable at the examination.

Who Is Forehead Reduction Not Suitable For?

The operation is not performed, or is postponed, in the following situations:

• People with progressive hair loss (other methods such as hair transplantation may be more suitable in this case)
• People whose scalp is not flexible enough
• Uncontrolled heart, lung, diabetes or other chronic diseases
• Bleeding or clotting disorders
• People who cannot stop smoking (because of the risk of wound-healing problems)
• Unrealistic expectations

Preparation Before Forehead Reduction

Before the operation, the height of the forehead, the shape of the hairline, hair density and the flexibility of the scalp are assessed at the examination, and the new hairline is planned. The necessary tests are carried out.

Regularly used medicines should be reported to the doctor; the doctor decides whether blood-thinning medicines should be stopped, and no medicine should be stopped without consulting the doctor. A break from smoking and alcohol is recommended before the operation.

How Is Forehead Reduction Performed?

The operation is usually performed under general anaesthesia or under local anaesthesia with sedation. An incision is made along the hairline, usually as an irregular line so that the scar is better hidden by the hair.

The planned amount of forehead skin is removed, the scalp is loosened, advanced forward and secured, and the incision is then stitched. How much the forehead can be shortened depends on the flexibility of the scalp. If the forehead is very high, a staged plan or an approach combined with hair transplantation may be needed.

The length of the operation depends on its extent. The person is usually discharged the same day or the next day.

Recovery After Forehead Reduction

After the operation there may be swelling and bruising on the forehead and around the eyes, and a feeling of tightness and numbness in the scalp; pain is controlled with the painkillers recommended by the doctor. Keeping the head slightly raised in the first days helps reduce swelling.

The doctor decides when the hair can be washed, when the stitches will be removed and when work can be resumed. Swelling decreases markedly within a few weeks; numbness in the scalp may take months to resolve.

Does Forehead Reduction Leave a Scar?

A permanent scar remains along the hairline. The scar is usually hidden by the hair and becomes less noticeable over time; however, it may be visible when the hair is cut short or combed back, and in some people it may be prominent.

Risks of Forehead Reduction

Like any surgical procedure, forehead reduction has risks. The most common are swelling, bruising and temporary numbness of the scalp.

Less commonly, a prominent or wide scar, temporary or permanent hair loss around the scar, bleeding or a collection of blood (haematoma), infection, delayed wound healing, asymmetry, an unnatural-looking hairline and permanent changes in sensation may occur. In some cases a corrective procedure may be needed.

If increasing redness, swelling, discharge from the wound or fever is noticed, the doctor should be contacted immediately.

Frequently Asked Questions About Forehead Reduction

Why is forehead reduction performed?

It is performed to reduce the height of the forehead so that the forehead looks more in proportion with the rest of the face.

Is forehead reduction performed on the bone?

No. Forehead reduction is performed on the forehead skin and the scalp. Reshaping a bony prominence of the forehead is a separate procedure, and whether it is needed is decided at the examination.

What are the disadvantages of forehead reduction?

A permanent scar remains along the hairline, and hair loss may occur around the scar. How much the forehead can be shortened is limited by the flexibility of the scalp; in people whose hair loss is progressing, the result may change over time.