What is forehead reduction surgery?
The forehead reduction surgery without a hair transplant, also known as frontoplasty is a less known surgical technique which consists in eliminating a determined portion of the scalp to descend the hair entry line and this way diminish the size of the forehead. When removing the excess skin and without implanting the hair which is missing, it becomes the only technique which allows immediate aesthetic results from the first moment.
Do you have a complex about your wide forehead?
In many patients a wide forehead is evident and the aesthetic improvement that this technique provides is very noticeable. The wide forehead gives women an appearance that is older and not very feminine. Subjectively not very attractive. In men this problem is better tolerated although on many occasions causes complexes. In both cases, a wide forehead can determine the hairstyle and the general “style” of a person.
The causes can be hereditary or non hereditary (acquired by hair loss). It can also be provoked (iatrogenic) in patients who have undergone an eyebrow lift or frontal lifting surgery.
Because of this, the forehead reduction surgery or frontoplasty is the surgical technique which repositions the hair line in a lower position in just one surgical procedure, ensuring to correct the damage in both men and women with immediate aesthetic results.
The face is divided vertically into three thirds from the hair line to the jaw passing through the interpupillary line and the subnasal point. In an ideal situation, the length of these three thirds coincides. A wide forehead gives an aged and masculine appearance.
How can a wide forehead be corrected?
A wide forehead can be corrected in two logical ways: adding the hair which has been lost or removing the excess skin. Hair transplant surgery has been developed and popularised in the last few decades and can be an option although the results are produced in months and can be less natural. The other option consists in a less known surgical technique which is relatively simple and attainable which achieves in just one surgical procedure, the reduction of the forehead by between 1,5 and 3 cm with immediate aesthetic results and minimal time off work.
In other cases, the solution to the problem can only be achieved through the combination of the 2 techniques: removing the skin and also transplanting the hair.
How do I know if my forehead is very high and if I can benefit from the surgical technique without hair transplant?
Although there have been descriptions of many existing classic methods of cephalometry which measure and analyse the more normal and aesthetic proportions of the face, we can say that a forehead is wide if the patient perceives it that way.
Many people perceive their forehead as ample or wide and they do not like it because they cannot see a well proportioned, harmonious or aesthetic face. This view does not match their personality and that is why they perceive it that way.
The maximum we can move or advance the hair line is 3 cm in one surgical procedure with immediate and predictable aesthetic results. When more descent is needed we use expansors or hair transplants.
How do we do the forehead reduction or reduction frontoplasty surgery in Facial Surgery Benidorm?
Few surgeons have learned and published this surgical technique in medical literature. Surprisingly, the term “Hairline Lowering” was not described until 1999 by Dr. Marten, but without doubt one of the current authors with the most experience in this field is Dr. Kabaker1, otorhinolaryngologist and facial plastic surgeon of Oakland, California, who has recently become the only person to have published a detailed description of his surgical technique and the observations of his 30 years of experience performing it.
The surgical technique performed by Dr. Batllés and Dr. Garcia Roig in Facial Surgery Benidorm follows the basic directions of professor Kabaker incorporating new technical details such as the reduction of the tension of the scar through multiple (between 3 and 5) direct anchors in the bone. Together with, the bevel cut of the scalp preserving the hair folicules and the subsequent surgical microsuture with 6-zero monofilament which we perform in our centre, assures the best result possible of the scar.
The forehead reduction surgery or reduction frontoplasty can be performed in approximately 1, 5 hours under local anaesthetic and sedation in our Out Patient Consultation, without the need for general anaesthetic or hospitalisation. After the surgery, in the recovery room of our Centre the patient will be dressed with a compressed bandage and a cryotherapy mask. After 2 to 3 hours the patient can return home. There is no need for drains or bandages afterwards. The patient will attend a revision 7 days later where the stitches will be removed. The use of a turban is recommended during the first week. The results are evident from the initial moment. When with the weeks that pass the scar matures and the hair grows on it, the scar will remain hidden and very unnoticeable. This will happen in the 3-6 months following the surgery.
A correct diagnosis (determine if the technique is indicated for the patient) and a correct surgical planning are essential so that through a refined surgical technique, the results are very satisfactory from the first moment on. It is a very effective and efficient technique and more efficient than a hair transplant.
Design of the incision. In IMCF we make a non-anatomic irregular incision following the hair line. We do it a bevel incision at the level of the 2nd or 3rd line of thick hair, behind the fine hair that draws the insertion line. This allows the selected hair to grow across the scar. In level with the skin on the forehead, we draw the incision at the optimal distance taking precaution to draw other parallel levels if after an adequate planning and surgical technique, the elasticity of the advanced flap does not allow us to arrive, without strain, to the marked target.
The most important aspects to take into account to achieve a good result are the following:
- The ideal candidate for this surgery is a female patient with a high hair line since birth (congenital) and without a family history of hair loss.
- The average advance is around 2, 5 – 3 cm. The greater the laxity of the tissues of the patient the better the advance. This laxity is previously examined in a very simple manner to determine our expectations and those of the patient.
- The bevel incision on the hair and the suture that follows so that the cut hair can grow on the scar is crucial to achieve virtually invisible scars.
- The suture without strain is vital for this purpose and to this way avoids complications such as hair falling into the scar. We perform between 3 and 5 small perforations in the bone which allows us to go through and suture on them leaving the skin without tension.
Suture anchors. Through a specifically designed device, we carry out two opposing perforations with a 1.5 mm bit at a 45° angle which allows us to create a tunnel in the bone through which we can pass the suture and anchor the galea to the cranium. This allows us to accumulate the tension of the wound in the deep stronger structures, leaving the more sensitive areas of skin and dermis tension free.
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