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Written By: Erin Storm, PA-C
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The Skinny
When it comes to the face, we all know about nose jobs, lip enhancement, and good old Botox®. But what about the forehead? Forehead shape and size is a major component of the facial aesthetic and is heavily influenced by hairline and brow shape. Excessive distance between the hairline and the brow line, an overly prominent brow, or a receding hairline can all lead to a large forehead appearance (learn more in our complete guide to Forehead Shape & Size Concerns). Fortunately, numerous plastic surgery procedures exist including forehead reduction surgery, hair transplantation, hair restoration, and a forehead lift.
The Specifics
Who may consider a forehead reshaping procedure?
A disproportionately large forehead can influence the entire symmetry of the face. Genetics, gender, and age, control the bone structure, the brow line, and the hairline. Depending on your unique anatomy there are three subcategories for forehead concerns overviewed below:- Large Forehead: A large forehead is perceived as too much skin surface between the superior (upper) portion of the forehead, which is the hairline, and the inferior (lower) portion at the brow line.
- Heavy Brow: A heavy brow is one that appears overly prominent or out of proportion to other facial features. This can create the false appearance of a large forehead.
- Receding Hairline: Whether from genetics or age, a receding hairline will cause a perceived widening between the hairline and brow line leading to a large forehead.
What can you expect from a forehead shaping procedure?
There are numerous procedures varying in invasiveness to address forehead shape and size. Invasive surgical procedures can have far reaching impact, while a hair transplant procedure can change forehead appearance while simultaneously improving hair volume, health, and length. The nature of your individual concern or concerns will determine which procedure is most appropriate.- Forehead Reduction (Hair Lowering): This procedure aims to surgically reduce forehead size by removing excess skin and lowering the hairline closer to the brow to shrink the distance from brow to hairline.
- Brow Lift: A brow lift surgical procedure alters the brow line rather than the hairline to change forehead appearance. In this case brows are restored from a sagging/aged position to appear more youthful and toned.
- Hair Transplant: Hair transplants or hair restoration procedures make use of one of many restorative options to promote improvements in hair growth, health, volume, and length. This can correct a receding hairline, enhance a brow appearance, or provide more volume for styling.
Recovery periods vary by procedure with surgical options necessitating more time for healing. The permanence of results is also dependent on the procedure utilized. With some procedures, hair, eye, forehead, and overall facial aesthetic can be greatly enhanced simultaneously.
When should you consider a forehead shaping procedure?
The timing of the procedure is dependent on your underlying concern. Generally, good candidates should have ruled out underlying medical illness, be in good health, and be prepared for needed recovery time.For those pursuing a surgical forehead reduction or brow lift, the time to pursue treatment is a personal decision whether the cause is genetics or aging. Individuals electing for hair transplant procedures will experience the most benefit the earlier in the hair loss process they pursue treatments.
Why should you consider a forehead shaping procedure?
As with any cosmetic procedure, the “why” is entirely unique to the individual. Genetics, the hands of Father Time, and changes to your luscious locks may create an undesirable forehead appearance. All forehead procedures will benefit overall facial aesthetic, and for some will also address changes to their eye and hair appearance. Maybe we should change the 'why' to a 'why not?'Forehead Reduction Procedures
A forehead reduction or scalp advancement will surgically alter the position of the hairline in relation to the brow line, diminishing the vertical distance of the forehead. This is not recommended for patients with significant hair loss.- Forehead Reduction
- Overview: A surgical procedure under general anesthesia for hairline lowering. Excess forehead skin is removed from the forehead and the new hairline is placed closer to the brow.
- Cost: $7,000 - $14,000
- Recovery & Results: Swelling, pain, and bruising for a few weeks. Numbness and hair shedding will continue for months. The results are permanent.
Brow Lift Procedures
A brow lift surgery will change the position of the browline, and simultaneously enhance the appearance of the eye. The overall aesthetic of the forehead will change as skin in the area is restored and tightened.
- Combination Midbrow Incision with Endoscope Brow Lift
- Overview: A surgical procedure in which small incisions are made in the midbrow and an endoscope is inserted to visualize the internal structures for repositioning.
- Cost: $4,000 - $7,000
- Recovery & Results: Swelling, bruising, and tenderness will resolve within two weeks. Full recovery will occur within a few months. This procedure is permanent.
- Coronal Brow Lift
- Overview: A horizontal incision is made along the hairline from ear to ear. The underlying structures are then excised or repositioned as needed.
- Cost: $10,500 - $14,000
- Recovery & Results: Swelling and pain will resolve within two weeks. The sutures and drain are removed within the first week. Full recovery will take several months and the results are permanent.
- Direct Brow Lift
- Overview: Surgical incisions are made above the eyebrow for access to deeper structures. This procedure is ideal for candidates requiring more extensive corrections.
- Cost: $3,700 - $4,000
- Recovery & Results: Pain, swelling, and discoloration will resolve within two weeks. Full recovery will occur over a few months and the results are permanent.
- Endoscopic Brow Lift
- Overview: Several incisions are made along the hairline and an endoscope is inserted to visualize underlying tissues for alterations.
- Cost: $3,700 - $3,800
- Recovery & Results: Due to the use of an endoscope, recovery is typically shorter than an open procedure. The results are permanent.
- Pretrichial Brow Lift
- Overview: In this procedure the incision is made just in front of the hairline (rather than within) allowing access to underlying muscle and tissue.
- Cost: $2,000 - $3,000
- Recovery & Results: Bruising, swelling, and pain will resolve within about two weeks. Full recovery will take a few months. The results are permanent.
- Traditional Midbrow Lift
- Overview: This procedure utilizes an incision made between the eyes in the natural skin indentation formed there. Tissue is then altered or excised as needed.
- Cost: $4,000 - $7,000
- Recovery & Results: Bruising, pain, and swelling will resolve within two weeks. Again full recovery takes months. The results are permanent.
- Chemical Brow Lift
- Overview: A non-invasive procedure in which Botox® injections are used to alter facial musculature bringing the brow into a more desirable position.
- Cost: $800 - $4,000
- Recovery & Results: Some mild swelling, redness, and tenderness will last for about one day. Results will be noticeable within one week. Maintenance treatments will most likely be needed every eight months.
Hair Transplant Procedures
Hair transplant procedures can improve hair density, length, health, and appearance. By restoring the hairline, the forehead appears more proportioned and your mane gets an upgrade too. Note: enhancements to the eyebrow hair can also impact the appearance of the forehead and hair transplants can be utilized similarly in this area.- Follicular Unit Transplantation (FUT)
- Overview: A donor portion of scalp tissue is dissected and hair follicles are removed and re-implanted in the desired area.
- Cost: $4,000 - $15,000
- Recovery & Results: Pain, swelling, and bruising will resolve within 10 days. The results are permanent and hair growth will begin after three months.
- Follicular Unit Extraction (FUE)
- Overview: This hair transplant does not require a donor area. Individual follicles are removed directly from the scalp and relocated.
- Cost: $4,000 - $15,000
- Recovery & Results: Discoloration, tenderness, and swelling will resolve within ten days. Here begins to grow after three months and the results are permanent.
- Neograft
- Overview: This hair grafting procedure is similar to the above, however, a robot is used to assist in follicle extraction and reimplantation for hair restoration.
- Cost: $3,500 - $15,000
- Recovery & Results: Swelling and pain will resolve the same day. The results are permanent and hair growth will begin after five months
- ARTAS Robotic Hair Transplantation
- Overview: This is in an entirely automated hair transplant procedure. Computers and robot technology are used in the hair grafting process to extract and re-implant.
- Cost: $7,000 - $18,000
- Recovery & Results: Most side effects will resolve within two weeks. Hair growth will begin after three months and optimize within one year. The results are permanent.
The Takeaway
Forehead size and shape has significant influence on facial aesthetic (look no further than Mary Shelley’s Frankenstein for proof). Luckily, with the help of a plastic surgeon, it is possible to create your ideal appearance through effective procedures like a hair transplant, hair restoration, forehead reduction surgery, or brow lift.
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Source List
- American Academy of Dermatology Association Hair Loss: Tips for Managing aad.org
- Jeffrey Epstein Hairline-Lowering Surgery PubMed.gov; 2020-05-01
- Paul T Rose Advances in Hair Restoration PubMed.gov; 2018-01-01
- Barry L Eppley Forehead/Brow Reduction or Augmentation with Custom Implants for Enhanced Facial Profileplasty PubMed.gov; 2019-10-01
- Sarit Cohen Forehead Lift Using Botulinum Toxin PubMed.gov; 2018-02-15
