Hairline Lowering Surgery or Forehead Reduction Surgery
What is Hairline Lowering Surgery or Forehead Reduction Surgery?
A high or excessively large forehead can detract from your otherwise proportional
features. An excessively high forehead can be due to genetic factors, hair loss, or
from prior surgery such as a coronal brow lift or rarely an endoscopic brow lift. A high hairline or excessively high forehead can make an individual feel very self
conscious and limit which hairstyles to wear to help camouflage the large forehead.
Forehead reduction surgery or hairline lowering surgery can be used to reduce an
excessively high hairline or large forehead in both men and women.
Dr. Aharonov is the leading plastic surgeon in the world for forehead reduction or hairline lowering surgery. He pioneered and is the ONLY surgeon who performs his trademarked Forehead Reduction One Stage Technique (FROST), which lowers the hairline significantly without having to use a tissue expander. Dr. Aharonov's FROST procedure can lower hairlines large distances that were previously only done with a two stage procedure using a balloon type tissue expander. He is best known for his virtually invisible scarring which is crucial for the most optimal result with hairline lowering surgery. There are many small details such as the angles of the incision, differences in the direction of hair growth, flexibility of the scalp and preservation of the blood supply that make this procedure challenging. Patients from all over the world come to see Dr. Aharonov for hairline lowering surgery and especially his FROST procedure.
Dr. Aharonov's patients benefit in many ways over any other surgical practice. Here are some ways the surgical experience is superior:
1. Dr. Aharonov performs hundreds and hundreds of hairline lowering surgeries. No other surgeon in the world performs even a fraction of his surgical volume. This provides Dr. Aharonov with a virtually flawless and seamless mastery of the FROST surgery.
2. The resulting scar from his hairline lowering surgery is unparalleled due to the absolute lack of tension on the scar and other proprietary surgical techniques. Other surgeons often place too much tension on the scar which leads to an enlarged thickened scar that only gets worse over time. You can see examples of Dr. Aharonov's scar over 10 years after surgery.
3. Even with minimal scalp laxity, about 2-3 cm of reduction can be achieved with Dr. Aharonov's technique. Most other surgeons would recommend a tissue expander or blame the lack of reduction on not having enough scalp laxity. With Dr. Aharonov's FROST surgery, even the tightest patients will achieve a significant amount of lowering.
4. Dr. Aharonov has perfected a way to have substantially less swelling after surgery which means a faster recovery and speedier return to work or school. Before and during surgery, patients receive a specialized IV cocktail infusion with medications and vitamins which reduce nausea, inflammation, and has additional therapeutic benefits. The cocktail will also boost the patient's natural healing abilities and immune system.
Dr. Aharonov is a foremost expert in the one stage forehead reduction surgery. Very few surgeons perform hairline lowering surgery and most of these surgeons are only able to bring the hairline down slightly or less than an inch in a one stage procedure. Dr. Aharonov's FROST procedure is able to bring the hairline down by as much as 2 inches in a one stage procedure without a scalp or tissue expander in some patients. Not having to use a scalp expander makes all the difference. Needing to use a scalp expander means an additional surgery as well as weeks and weeks of gradual scalp expansion which is uncomfortable and inconvenient.
Forehead Reduction or Hairline Lowering Surgery
Forehead reduction or hairline lowering surgery consists of excising a strip of forehead skin right in front of your current high hairline. This results in an incision that is slightly behind your hairline. Hair eventually grows back within the scar, and therefore helps minimize the appearance of the scar. Scar healing varies from patient to patient. While some patient's scars can look virtually imperceptible within a few weeks, on average it might take somewhere around 3-6 months for the scar to get to this point in most people. Dr. Aharonov uses the latest techniques in minimally invasive surgery and scar reduction to help your scars heal imperceptibly. Dr. Aharonov's technique of forehead reduction surgery has proven to be almost immediately effective, well tolerated by patients, and associated with minimal complications and minimal pain. Some patients can return to work as early as 2 days after their hairline lowering surgery.
Good candidates for forehead reduction or hairline lowering surgery include women with a high hairline or large forehead who otherwise have thick hair. Men with a high hairline or large forehead can also be good candidates for hairline lowering surgery if they have a thick hairline and no family history of hair loss. Men that have had a new hairline created with hairgrafting and want their new hairlines to be lower are also good candidates. Individuals with thinner hair can have great results especially if the forehead reduction is used in combination with a small amount of hair grafting. If you have low or heavy brows, this surgery can also help elevate your brows to a more natural and attractive position, but the hairline lowering surgery by itself does NOT affect the position of your eyebrows.
Hairline lowering surgery can sometimes be combined with hair grafting, especially in men to lower the hairline. In women the one stage forehead reduction is usually performed alone and does not usually need any hair grafting, but hair grafting can be used at the same time to shape the hairline and make it rounder. Dr Aharonov's FROST procedure can lower a hairline in a one stage procedure by up to 4-5 cm, which is about one and a half to two inches.
Hairline Lowering Surgery in Women
Hairline lowering is best suited for women who have always had a high hairline. With the aging process, this is accentuated giving women a balding or masculine appearance. By lowering the hairline and reducing the forehead size, Dr. Aharonov is able bring the proportions of the face and hairline into balance. This procedure can be performed at the same time as a Forehead Lift, or alone. In rare instances when there is not enough elasticity in the scalp to provide adequate hairline lowering, a tissue expander can be placed under the hair bearing part of the scalp. This is usually only needed when more than 2 inches of hairline lowering is needed. The expander is slowly filled over time. This will stretch the hair bearing scalp, which can then be advanced thereby lowering the hairline. After several weeks, the tissue expander is removed and the hairline is lowered into its correct position utilizing a hidden incision at the hairline.
Most patients are suitable for a one stage hairline lowering procedure. With Dr. Aharonov's Forehead Reduction One Stage Technique (FROST), patients can achieve results that were previously only able to be achieved with a two stage surgery with a tissue expander. Optimal outcomes are achieved in patients with an otherwise dense head of hair but with a large forehead that is too big for their face. Patients with lighter skin tend to have a less noticeable scar much earlier than patients with darker skin, who might take slightly longer to heal their scar. In patients with darker skin who occasionally have a hypopigmented scar, micropigmentation of the scar (permanent makeup) can be used to make the color of the scar match the color of the skin. This is only needed if there is still some hypogimentation of the hairline lowering scar after healing is complete. This is something that dark skinned people should keep in mind before proceeding with hairline lowering surgery.
Dr. Aharonov is well known for his virtually invisible scarring. The scar is the most important indicator of optimal outcome for forehead reduction surgery. If a patient has a smaller forehead but an obvious scar, they will be just as self conscious about the scar as they were about the large forehead. It is therefore crucial to have a virtually invisible scar with the hairline lowering surgery. Hairline lowering surgery has been attempted by many surgeons with very poor scar results. Dr. Aharonov routinely has to correct such scars from other surgeons.
Patients with lighter skin usually do not need to worry about how well the scar heals because it heals almost invisibly in a matter of a few months. When the hair grows through the incision it further camouflages the scar and makes it even more difficult to see.
For improved results, Dr. Aharonov sometimes recommends a small amount of hair grafting performed either together with the Forehead Reduction surgery or separately at a later time. Please read more about this option below. Dr. Aharonov will discuss with you if you would have improved results with additional hair grafting.
Hairline Lowering Surgery in Men
Hairline lowering surgery is best suited for men who have always had a high hairline and are NOT actively losing hair. Men with thinning hair or who are actively losing hair are better candidates for hair grafting and NOT the forehead reduction surgery. Forehead reduction surgery does NOT raise the eyebrows at all, which is a concern of many men. A combination of Forehead Reduction surgery and a forehead lift can be performed at the same time, if raising the brows is also desired. With Dr. Aharonov's specialized Forehead Reduction technique, It is usually possible to lower a man's hairline by 1-2 inches (3-5 cm) in one stage WITHOUT a tissue expander. In rare instances when there is not enough elasticity in the scalp to provide adequate hairline lowering, a tissue expander can be placed under the hair bearing part of the scalp. This is usually only needed when more than 2 inches of hairline lowering is needed. The expander is slowly filled over time. This will stretch the hair bearing scalp, which can then be advanced thereby lowering the hairline. After several weeks, the tissue expander is removed and the hairline is lowered into its correct position utilizing a hidden incision at the hairline.
Hairline lowering surgery in men is a good option when more than 1.5 cm (0.75 inch) of lowering is needed. When less than 1 cm of hairline lowering is needed hair grafting alone is probably a better option.
For improved results, Dr. Aharonov sometimes recommends a small amount of hair grafting performed as a separate procedure performed a few months after the hairline lowering surgery. Please read more about this option below. Dr. Aharonov will discuss with you if you would have improved results with additional hair grafting.
Men should be aware that if they do lose their hair after having forehead reduction surgery the scar might become more noticeable. It is important to establish that there is low probability of male pattern balding based on family history and other factors. If there is some future hair loss, hair grafting is an option at that time as well to maintain the position and density of the hairline. All of your options will be thoroughly discussed during your office consultation with Dr. Aharonov.
Chin Augmentation Along with Hairline Lowering Surgery
For reasons not fully understood, about 60% of patients who have a larger than ideal forehead also tend to have a smaller chin than is ideal for their face. Maybe the two might be related developmentally. If that is something that is bothersome, there are a few ways to augment the chin. The first is to use a chin implant. Chin implants can be easily placed at the same time as the forehead reduction surgery through a mini incision under the chin. Another way to augment the chin is with fillers. This is an office based non surgical solution which could quickly and easily make the chin larger with minimal risk. In fact, the filler is reversible and can easily be dissolved for any reason at all. If your chin is an issue to you, discuss this with Dr. Aharonov during your consultation.
Forehead Reduction One Stage Technique (FROST) with Simultaneous Hair Grafting
Dr. Aharonov currently prefers to wait at least 3-6 months in most patients before performing hair grafting after the forehead reduction. Hair grafting is more consistent and predictable when performed at a later time than when done at the same time. For this reason most people should hold off on doing hair grafting until the forehead has a chance to heal for a few months.
Due to the nature of Forehead Reduction surgery it is not possible to bring the hairline at the temples forward. In patients with significant temporal recessions the Forehead Reduction surgery alone can lead to a slightly squarish hairline. For patients desiring a more rounded hairline, or for those who might benefits from advancing some of the temporal hairline, hair grafting done a few months after hairline lowering surgery will achieve these results.
When patients have thinning hair or a hairline that is not very dense, hair grafting can help thicken the hairline which will provide an optimal outcome when the new transplanted hair grow in. Usually patients with dense thick hair do not need additional hair grafting. Dr. Aharonov will discuss the benefits of hair grafting with you during your consultation.
Hair grafting can also add to scar camouflage in people with either thinning hair or with people with dark skin who have a history of hypopigmented scars.
Brow Bone Contouring Along with Forehead Reduction Surgery
Some people might have an overly prominent brow bone which they might find aesthetically undesirable. The brow bone can be contoured and reduced during the Hairline Lowering Surgery. Another way to make brow bones less noticeable is with blending of the brow bone with fillers or fat injections which can create a softer contour.
Tissue Expansion for Lowering the Hairline (Two Stage Forehead Reduction Surgery)
In instances where the hairline needs to be lowered by significantly more than 2 inches, the Forehead Reduction One Stage Technique (FROST) might not be enough to lower the hairline adequately. In these instances the two stage technique with a tissue or scalp expander might be needed to lower the hairline by such a large amount. This is considered a two stage procedure. In the first stage, a tissue expander is placed under the scalp. The tissue expander is then slowly filled with water 2-3 times a week over the course of 6-8 weeks to help stretch the scalp and provide further slack for adequate hairline lowering. When there is sufficient scalp expansion for the forehead reduction surgery, the next stage is performed. The second stage is similar to the one stage hairline lowering surgery. This is done in the operating room under IV sedation. The tissue expansion makes it much easier to lower the hairline by a dramatic extent, but it is important to know that the scalp is stretched out over a greater area leaving the hair much thinner. The FROST technique does not stretch the scalp significantly and instead advances the entire scalp as is leaving the hair density unchanged. Tissue expansion on the other hand stretches the scalp instead of just advancing it leaving the scalp and hair thinner. The two stage forehead reduction surgery is reserved for patients who need a significantly greater hairline lowering than can be achieved in the one stage hairline lowering surgery. The one stage FROST procedure can typically lower the hairline by as much as 2 inches. Which procedure is right for you depends on many factors, and Dr. Aharonov will discuss all of these during your consultation.
Follicular Unit Grafting for Lowering the Hairline
Follicular unit hair grafting is an option for people who either have a thinning hairline
or just want to lower their hairline or reduce their forehead by less than 1 cm. Hair
grafts are harvested from the back of the head and grafted one by one to the front
of the scalp to achieve a natural result to lower the hairline. Dr. Aharonov works
closely with a hair transplant surgeon who only performs hair grafting, so you get
the best possible result if you choose to have hair grafting.
Good candidates for hair grafting include men with a thinning hairline, or women with either a thinning hairline, or who only need about 1 cm or less of forehead reduction or hairline lowering, or for people with only temporal recessions who would like them filled in. Attempting to lower a hairline significantly with hair grafting alone is not only extremely expensive, but can often lead to very unnatural results. It is virtually impossible to achieve normal hair density with hair grafting alone, even with multiple procedures. Patients often end up spending thousands of dollars, as well as several years, just to end up with suboptimal results that in most cases need to then be excised. One round of hair grafting will NEVER achieve adequate hair density and can take over a year to see the final results. Dr. Aharonov has had dozens of patients who had spend sometimes tens of thousands of dollars on hair grafting, just to then have a one stage forehead reduction to lower the original hairline and cut away all the grafts. Dr. Aharonov will discuss your options and goals with you to see if you are a good candidate for this type of forehead reduction.
What to expect from a Forehead Reduction or Hairline Lowering Surgery
When you see Dr. Aharonov in his Beverly Hills office, he will go into detail during your consultation on what to expect from your hairline lowering or forehead reduction surgery. All of your questions and concerns will be addressed. There is no need to shave your hair for your forehead reduction surgery, so there won't be a long recovery period where you aren't able to go out in public. You can expect to lower your hairline by up to 4-5 cm in a single procedure. Under rare circumstances, if extensive hairline lowering is needed, Dr. Aharonov can use a skin expander in the scalp to help stretch the scalp and allow him to reduce the forehead by an even greater amount. However, this is rarely needed. Men having hairline lowering surgery need to understand that hair loss may be progressive in males and further procedures in the future may be required to maintain results. Women with low brows can have a brow lift as part of the hairline lowering surgery, if desired. Forehead reduction surgery or hairline lowering surgery does not raise the eyebrows unless otherwise planned.
For patients who are from out of the state or country, we can arrange to have a phone or video chat consultation with Dr. Aharonov regarding hairline lowering surgery. Before having a phone consultation it will be very helpful to have a few pictures of your face and hairline via email for Dr. Aharonov to review during your phone consultation. It is possible for us to take care of all the preoperative details after your phone or video chat conversation with Dr. Aharonov.
Who is NOT a Good Candidate for Forehead Reduction Surgery
Several factors play a role in deciding who is and who is not a good candidate for forehead reduction surgery. These factors include hair density, future hair loss risks, skin color, and history of previous surgery. The only absolute contraindication for forehead reduction surgery is a previous history of a coronal brow lift. A coronal brow lift is performed through a long incision about a couple of centimeters behind the hairline and spanning the entire head almost from ear to ear. This a a type of browlift that unfortunately is still done by some surgeons. The brows are raised by cutting away hair bearing scalp and raising the brows and forehead higher. This could cause a person with a normal sized forehead to all of a sudden have a large and high forehead. A coronal brow lift is an absolute contraindication for forehead reduction surgery because it endangers the front of the hair bearing scalp.
If a patient has a history of hairgrafting using strip excision, and the resultant scar is considerably long, this might be a relative contraindication to hairline lowering surgery due to blood supply compromise. This can be assessed on a case by case basis to determine the extent of the risk.
Other relative contraindications to surgery include people with very thin hair density, or people who are actively losing hair. Skin color is something that needs to be taken into account because darker skinned individuals will take longer for the scar to heal and become less visible after hairline lowering surgery.
Lowering the Hairline after Browlift Surgery
Browlift surgery can sometimes cause a high forehead and can raise the hairline, depending on the method used to raise the brows. Browlift surgery can also cause the brows to be too high and give the patient an artificial "surprised" look. It could be possible to lower the brows down to a more natural position, and also lower the hairline depending on the type of browlift surgery the patient has had. After an Endoscopic Brow Lift it is possible to lower the brows back down and lower the hairline slightly by performing what is called an Endoscopic Brow Lowering Surgery. Endoscopic Brow Lowering Surgery is performed through the previous endoscopic brow lift scars. The previous surgery is simply done in reverse to lower the brows back down and hopefully lower the hairline as well. Patients with a history of an endoscopic brow lift are also good candidates for the Forehead Reduction Surgery to lower the hairline even more than is possible via the endoscopic approach. Forehead Reduction surgery is well suited for patients that are happy with the position of their brows after an endoscopic brow lift, but desire a lower hairline.
After having a Coronal Brow Lift the options are more limited. These patients are NOT candidates for the Forehead Reduction Surgery, but are good candidates for the endoscopic brow lowering surgery. Their eyebrows can be lowered and the hairline will lower slightly.
Preparing for a Hairline Lowering or Forehead Reduction Surgery:
During your consultation, Dr. Aharonov will discuss your goals for the surgery and
ask about your medical history and any medication that you take. You should stop taking aspirin or anti-inflammatory medicines such
as Aleve, Motrin or Advil at least one week prior to surgery to minimize bleeding and bruising during
your hairline lowering surgery . A list of over the counter
medications and supplements to avoid will be given to you during your
preoperative consultation. You should avoid alcohol or salty foods for three days
prior to surgery to decrease fluid retention and swelling. You should discuss all
of the medicines that you are on with Dr. Aharonov. If necessary, you may take
your essential medications with a tiny sip of water in the early morning on the
day of your hairline lowering surgery.
It is also essential that you disclose any medical conditions that involve the eye such as glaucoma, dry eye, detached retina, and thyroid disorders such as Graves’ disease, under active or overactive thyroid, cardiovascular disease, high blood pressure, circulatory disorders, diabetes, blood clotting disorders, or a history of forming large scars also known as keloid scars. It is important to tell Dr. Aharonov if you smoke, or have had previous facial surgery.
You should be in the most optimal nutritional state prior to your hairline lowering surgery. An adequate diet with certain vitamin supplements such as Vitamin C is recommended. Dr. Aharonov can discuss nutritional supplements with you during your preoperative consult that will help you heal better after your forehead reduction surgery.
Dr. Aharonov will also answer your questions at that time regarding your hairline lowering surgery. Remember that by carefully following Dr. Aharonov's advice and instructions, both before and after hairline lowering or forehead reduction surgery, you can do your part to ensure the best possible outcome.
Anesthesia for Forehead Reduction or Hairline Lowering
Dr. Aharonov performs all of his hairline lowering surgeries in an AAAHC accredited outpatient surgery center in Beverly Hills. Board certified anesthesiologists, which are medical doctors, perform all of his forehead reduction surgery cases. Dr. Aharonov prefers to have a physician caring for your anesthetic needs during your hairline lowering surgery, as their experience minimizes the potential of unpleasant postoperative side effects. For his forehead reduction surgical cases, Dr. Aharonov uses an extremely safe combination of IV sedation and local anesthetic, not general anesthesia. This technique provides superior operating conditions combined with maximal patient safety and comfort. You will be completely asleep with no chance at all of waking up during your hairline lowering surgery. In all likelihood, you will awaken with very little discomfort, nausea, or anesthetic side effects. In his Los Angeles area surgery center, all of the appropriate monitoring, medication and emergency equipment are available at all times. On the day of your Hairline Lowering surgery, you will meet your anesthesiologist and can discuss any questions that you may have.
What to Expect After Forehead Reduction or Hairline Lowering
After a forehead reduction procedure in our Beverly Hills surgery center, there
will be some swelling and bruising in the forehead, head, or even the eye or
cheek area. This can take up to a couple of weeks to resolve, but individuals
vary on their recovery time. Many patients are healed enough to go back to
work after a couple of days. Immediately post-op, you should use ice compresses to
relieve the pain and swelling. Your forehead and head will be tightly wrapped
overnight, which further helps to minimize swelling after your hairline lowering surgery. You will be
given a prescription for pain medicine and antibiotics, although most patients
do not require much pain medicine after the first day or two. After one week,
Dr. Aharonov will remove your sutures in his Beverly Hills office.
Patients who have the hairline lowering or forehead reduction surgery will experience numbness in the front of the scalp behind the incision. This numbness can last anywhere from a couple of weeks to months, as the nerves slowly grow back The incision site pain is usually minimal, but can be controlled with medication, if necessary. Forehead reduction or hairline lowering patients can experience an itching sensation that corresponds to the nerve endings slowly growing back to innervate the scalp. This is a good sign that your scalp is recovering. These symptoms can also occur after dense graft packing or any incision made in the scalp. There may be some temporary shedding of the hair in the front of the scalp within 2-4 weeks after surgery. The hair will come back after several months. Remember, with hair grafting, the hair almost always falls out and goes through a three month "resting phase" before growing in. You will be able to shower and shampoo your hair the next day after your hairline lowering surgery.
Activity Level and Exercise After a Forehead Reduction or Hairline
You should plan on relaxing at home for at least a couple of days after your forehead
reduction surgery. You should avoid strenuous activities for two weeks after forehead reduction surgery to
decrease any swelling or bruising. This includes yard work, bending, jogging or
weight training. Walking at a normal pace during this time is recommended.
Most patients return to work in 7-10 days after their hairline lowering surgery, but some patients return to work even sooner. Most of the visible signs of surgery should fade completely within about three weeks.
Our Los Angeles California patients have been extremely satisfied with the results of their forehead reduction or hairline lowering surgery. They have a more youthful and balanced appearance and can feel free to style their hair as they desire or discard their collection of hats and scarves.
Risks of a Forehead Reduction or Hairline Lowering Surgery
As with any surgical procedure, there are risks involved. You and your surgeon
will work together to minimize these risks and maximize your results. Follow
your surgeon's instructions both before and after your forehead reduction
surgery. Always be completely honest about your medical history and habits
including smoking, alcohol or drug use. Be realistic as to your expected
outcome. You will look like a refreshed rejuvenated version of yourself, not like
a young version of someone else.
Minor risks of the procedure include bleeding, infection, numbness or hair loss at the incision site, poor wound healing or unfavorable scarring, fluid accumulation or asymmetry. These risks are very rare, and when they do occur, are usually temporary. Any brow asymmetry may correct itself as the healing process progresses, and rarely is it noticeable enough to require surgical intervention. Both you and Dr. Aharonov can take steps to minimize scarring, and in the vast majority of patients, forehead reduction or hairline lowering scars are invisible. In the rare event that you are left with an unsightly scar, hair grafting can always be placed within the scar, thereby making it disappear.
Forehead Reduction Surgery or Hairline Lowering Surgery Combined
with a Browlift
Depending on the patient, a Brow Lift can sometimes be desirable along with a forehead reduction or hairline lowering. This decision will be discussed during the consultation process. The brows can be lifted during the forehead reduction process if desired, but having hairline lowering surgery alone does not raise the brows.
Frequently Asked Questions About Forehead Reduction Surgery and Hairline Lowering Surgery
1. Why is your way different?
We like to treat our patients the way we would want to be treated. I would personally not want to walk around with a tissue expander in my head unless I absolutely needed it. I would not want to get hair grafting to lower my hairline more than 1 cm because it NEVER looks as natural in real life and up close as does a hairline lowering surgery. I would want my surgery to be done in a fully accredited surgery center NOT in a regular office. I would want IV sedation to be performed by a board certified anesthesiologist NOT a nurse. These are the ways some places cut corners and cost. I would want the best for myself and would only do the same for my patients.
2. Is it possible to get a more rounded hairline with the forehead reduction surgery?
It is possible to make the hairline more rounded by using a few hair grafts either at the same time as the hairline lowering surgery or at anytime afterwards if needed. Hair grafting is usually not needed for most patients if they have a dense hairline. A few hair grafts can be done at the same time as the forehead reduction surgery to either help thicken the hairline or round out the hairline. However, hair grafting is more accurate and predictable when done separately and therefore Dr. Aharonov prefers to not combine the two procedures unless absolutely needed.
3. How bad will I look right after surgery? Will I be able to hide it fairly well?
There is actually a pretty quick recovery time after the hairline lowering surgery. There could be a small amount of bruising and some swelling which resolves quickly. Most patients can hide the fact that they had surgery within several days after their hairline lowering procedure. During your consultation you will see many patients during all stages of healing to give you a good idea of what you will look like after your forehead reduction surgery.
4. How much does Forehead Reduction Surgery cost?
We understand that many of our patients live far away form our office and would like to know ahead of time what the cost of hairline lowering surgery might be. There are a few variable that will contribute to the eventual cost including difficulty of your particular case, whether or not hair grafting will be needed, and whether or not a tissue expander might be needed. We can usually give you a pretty accurate estimate after seeing your photos and for sure after having a phone consultation. If you just need a ball park figure please contact our office either by phone or via email and we will be more than happy to give you a range. The reason there is a range in cost for different patients is because each case is unique and might take significantly different times to perform. For example, a simple case might take about 45 minutes, while a difficult case might take close to 3 hours. The anesthesia, nurses, and operating room fees are based on an hourly rate. Hence a longer case will be more expensive. Scalp laxity, distance needed to be lowered, and the shape of the head all play a role in how difficult a case might be.
5. How long after Forehead Reduction Surgery can I fly back home?
Most patients who fly in from out of state usually stay for a week. All the sutures are taken out either 5 or 6 days after surgery. You are free to fly back home after that. Occasionally if a patient cannot stay that long, special arrangements can be made to have a physician or nurse closer to their home take remove the sutures. If so, you would be able to fly home 1-2 days after surgery.
6. I had a consultation with another surgeon who said I would need a tissue expander even though I only need one inch of reduction. Why is your technique different?
When comparing results from different surgeons, please make sure you are comparing apples to apples. Many other surgeons can only lower a hairline by only about 1 cm, or about a third of an inch, in a one stage procedure. Their before and after photos might be only after a tissue expander was used. Dr. Aharonov's Forehead Reduction One Stage Technique (FROST) is very different than other surgeons' techniques. If you only need about an inch of lowering you probably do NOT need a tissue expander and your hairline lowering surgery can be performed in one stage with Dr Aharonov's technique, even if fairly tight scalps.
7. What type of anesthesia do you use for Forehead Reduction Surgery?
For the Forehead Reduction surgery IV sedation is used NOT general anesthesia. This is done by a board certified anesthesiologist in a fully accredited surgery center. IV sedation is much safer and more comfortable than general anesthesia. You are not paralyzed or intubated. You are fully asleep and comfortable.
8. Does Forehead Reduction Surgery raise the eyebrows at all?
Forehead Reduction surgery does NOT raise the eyebrows at all. Some patients request to have brow elevation or a brow lift at the same time which can be done as well. But as is, the Forehead Reduction surgery does NOT raise the eyebrows with Dr. Aharonov's technique. Other surgeon's techniques might lead to some brow elevation, but NOT Dr. Aharonov's technique.
9. Is there a chance that my scalp will stretch backwards and my hairline go back at all after surgery?
With Dr. Aharonov's technique for forehead reduction, there is NO chance that the scalp will retract and recede again. The scalp position is fixed in place to the skull at the new position and will not move back at all.
10. Does the Forehead Reduction surgery raise the hairline at the back of my neck?
While we have not actually measured whether or not this happens, there might be a small elevation of the hairline at the back of the neck when the scalp is advanced forward. This elevation is most likely far less than half the amount of the actual scalp advancement. If the hairline is advanced by 4 cm the hairline at the back of the neck might raise by less than 1-2 cm. This has not been an issue for any previous patients.
11. My scalp feels very tight and does not move much. Does that mean I am not a good candidate for a one stage procedure and will need a tissue expander?
I have dealt with scalps that were extremely tight. While there is never a guarantee as to how much a hairline can be lowered, even it very tight scalps it is usually possible to lower the hairline by 2-3 cm. Each patient is unique and results will vary.
12. The center part of my forehead is fine, but I have significant recessions in my temples. Is hairline lowering surgery right for me?
If there is enough scalp laxity, it is possible to lower temporal recessions significantly with a modified hairline lowering surgery that Dr. Aharonov has pioneered. Even if the front of your hairline does not need significant lowering, this modified hairline lowering surgery might be right for you.
13. Can I see more before and after photos of your work?
Due to patient confidentiality concerns the photos on the website represent only a small fraction of the before and after photos available for viewing in the office during a face to face consultation. During your consultation you will see many photos of all stages of healing in many different patients. This will give you a better idea of what to expect after your surgery and during the healing time. I am always very thankful when a patient gives me permission to show their before and after photos as it helps others see what to expect from forehead reduction surgery.