The hairline lowering procedure was the “brain child” of Dr. Richard Fleming and Dr. Toby Mayer more than 30 years ago. They even described it in their medical textbook “Aesthetic and Reconstructive Surgery of the Scalp”. This book is considered the bible for aesthetic and reconstructive surgery of the scalp including hairline lowering. At the same time, the doctors developed an innovative technique that allows the hair to grow through and in front of the incision, so no scar is visible. This technique, called the “Irregular Trichophytic Incision” has been performed by the doctors on numerous actors, actresses and models all over the world. You see the doctors’ results daily on camera and on the big screen.
When the scalp is tight, tissue expansion gives the doctors the opportunity to advance the hairline without tension to avoid a visible hairline scar. Some doctors who do not perform tissue expansion make more extensive scalp incisions within the scalp which limits the choice of hairstyles.
Many women have a large forehead secondary to a congenitally high hairline or a hairline that has been elevated after previous cosmetic surgery. Our hairline advancement procedure has been developed to lower that hairline and bring the proportions of the face into balance. With the aging process, the high hairline is accentuated giving women a balding/masculine appearance. The hairline advancement can be performed as an isolated procedure or at the same time as a hairline forehead/brow lift.
With this technique an incision is made within the hairline and the scalp advanced after mobilization of the hair bearing tissue. Hair follicles are buried under the skin closure at the completion of the operation so hair will grow through and in front of that line, giving patients total freedom of hair styling. In some instances where there is not enough elasticity in the scalp to provide adequate advancement, a Tissue Expander can be placed under the hair-bearing scalp. The Expander is slowly filled, and, over time, will stretch the scalp to provide the needed advancement of the hair-bearing scalp and lower the hairline. After several weeks, the Tissue Expander is removed and the hairline is advanced to its correct position, utilizing the camouflage incision at the hairline.
In male patients with a high hairline, hair replacement surgery is frequently necessary. If a male patient has good thick hair at the hairline, we can use the same techniques we described for women. However, if male pattern baldness progresses later in life, hair replacement surgery would be necessary.
Our patient Myeisha talks about her hairline lowering experience: Myeisha