See Before and After Forehead Reduction Photos in our Photo Gallery
436 N. Bedford Drive, Suite 300
Beverly Hills, California 90210
See Before and After Forehead Reduction Photos in our Photo Gallery
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.
How do you know if you have an excessively high forehead or high hairline? Most people know if they are affected. Unfortunately, most people don't know that they have an option to help reduce their forehead or lower their hairline. There are two ways Dr. Aharonov can use to achieve a lower hairline or a smaller forehead: The first is a surgical approach to remove a portion of the forehead skin and effectively lower the hairline. The second is to make the forehead appear smaller by grafting hair to the front of the hairline. Occasionally, these two procedures can be combined.
Dr. Aharonov is one of the leading plastic surgeons in the world who is an expert in forehead reduction or hairline lowering surgery. He is best known for his virtually invisible scarring which is crucial for the most optimal result with hairline lowering surgery. He is also the pioneer and expert in the 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. 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 country and from abroad come to see Dr. Aharonov for hairline lowering surgery and especially his FROST procedure.
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. 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. In most of Dr. Aharonov's patients, this scar is virtually invisible after only a few weeks. 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. Most 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.
Forehead reduction 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 couple of 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 together with the Forehead Reduction surgery. 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 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 good option. Dr. Aharonov works very closely with The New Hair Institute who are hair grafting experts.
For improved results, Dr. Aharonov sometimes recommends a small amount of hair grafting performed together with the Forehead Reduction surgery or 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.
Forehead Reduction One Stage Technique (FROST) with Simultaneous Hair Grafting
Performing a small amount of hair grafting at the same time as the Forehead Reduction surgery can help optimize results of the hairline lowering surgery. All patients would benefit from this additional small step but some patients would benefit significantly more than others. This section will go over the benefits of hair grafting at the same time of Forehead Reduction surgery.
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 at the same time as the 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.
Tissue Expansion for Lowering the Hairline (Two Stage Forehead Reduction Surgery)
In instances where the hairline needs to be lowered by 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 expand 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. 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 about 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 of forehead reduction or hairline lowering, or for people with only temporal recessions who would like them filled in. 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.
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 within two days 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. 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.
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 at the same time as the hairline lowering surgery. 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.
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. If you are from out of town and would like a phone consultation with Dr. Aharonov, please email us several photos of your face with your hair up. During your phone consultation you will be given an exact cost of surgery.
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 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.
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.