Forehead height has a tremendous influence on facial shape and overall attractiveness. It’s estimated that 20% of women have a high hairline. Some men also have high hairlines, but it is considered a more acceptable masculine facial characteristic. What is an “ideal” forehead height? For women, a hairline that measures its mid-point between 5cm-6cm (2-2.4”) above a line drawn across the brows is desirable. For men, 6cm-8cm (2.4-3.1”) is typical. Age will necessarily impact the hairline, but a long, thin face will accentuate the condition even in younger patients.
While not widely discussed, hairline lowering is a surgical procedure that can dramatically enhance your appearance. The operation can usually bring down the hairline approximately one inch. Incisions are hidden within the hairline and results are immediate. Downtime is about one week, but sutures are cosmetically disguisable after 3 days. Hair grafts can achieve a similar effect, but several sessions are required, the cost is double and results are only evident after 12-18 months.
Hairline lowering is often combined with a browlift. As your brows fall or get lower, it makes your forehead look even longer because the space between the hair and browline has increased. This combination procedure brings the upper third of the face into greater aesthetic balance.
Procedure Snapshot:
What part(s) of body treated by this method: forehead, hairline and brow
Time for procedure: 2-3 hours
Adjunct procedures that may be considered: Browlift
Anesthetic: General
Number of sessions required: One
Downtime: One week
Complications/Risks: Temporary numbness of scalp up to one year
Candidates: Smokers, diabetics or those with vascular conditions are not good candidates because a good post operative blood supply is critical. Those with delicate hair may not have as good results.
How long results last: Forever
Cost of hairline lowering ($/$$/$$$): $$
One on one with Dr. Kornstein:
It is very important to critically analyze the face in its entirety because most everyone has an aspect of their face prone to accelerated aging (their so called Achilles heel.) If that “Achilles heel” happens to be a high forehead then forehead height will only become exaggerated as the hairline recedes with age. What was tolerable aesthetically when you were younger may become unacceptable in later years.
Should you decide to address this feature we can first start with forehead fat injections to mitigate the backwards slope of the forehead resulting from loss of bone. This will give the illusion of a more vertical forehead. Another option is hair grafts which are more costly, prone to complications and take months to present any improvement in appearance. Hairline lowering offers immediate gratification requires one procedure and is 50% less cost than any other alternative if you want tangible results. After years of “dressing around the issue” with hairstyles meant to camouflage a high forehead, patients are pleasantly surprised this procedure exists and welcome a solution.
Although the concept of this surgery is not new, the technical nuances, sophisticated skill level and judgment factors involved translate into a limited number of surgeons being comfortable in performing the procedure with consistently favorable results. I am comfortable with the details and subtleties of this surgery should you decide it is the right procedure for you. It should be noted that hairline lowering will not affect the brow. Therefore, if your brows are beginning to fall, a browlift may be recommended for a more holistic solution.
The first generation browlift was in part responsible for the upper third of the face being a less popular topic of discussion. Known as the coronal browlift, the procedure earned a bad reputation because the idea of an incision in the hairline from ear to ear seemed daunting to most patients. The operation could easily be overdone, almost impossible to correct and result in a permanent expression of surprise.
Ten to fifteen years ago the advent of the endoscopic browlift allowed the upper third of the face to become a reasonable part of the consultation. This browlift, accomplished with tiny incisions hidden in the hairline, offers a kinder, gentler, more acceptable approach to correct a sagging brow. A browlift done in conjunction with a hairline lowering procedure is a powerful combination in facial enhancement.
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