Forehead plasty or forehead reduction surgery is done to reduce the size of excessively large forehead which may be offsetting the other proportionate features. A very pulled back hairline or an excessively large forehead can make a person self conscious. Generally, people are restricted to having to use only a few hairstyles to camouflage the big forehead. The forehead plasty can be done on men as well as women.
There are two ways to achieve a small forehead. The first method involves surgical removal of a part of the forehead skin which effectively lowers the hairline. The second method involves hair grafting in front of the hairline. Generally a combination of these two procedures is used.
How is the surgery performed:-
The forehead reduction is done by taking a strip of forehead skin from in front of the current hairline. The incision resulting from this is behind the hair line. With time the hair grows on the scar therefore the visibility of the scar is reduced. The time taken for the scars to heal varies from patient to patient. The scars become nearly invisible in most people within 3-6 months. The surgery now is advanced and is minimally invasive and causes minimal pain.
Who are ideal candidates for the surgery:-
Women who have thick hair but have large foreheads are good candidates for this surgery. Men, who have no male pattern baldness as well as no history of it, can opt for this procedure. People who have thin hair can opt for this procedure in combination with hair grafting. The surgery does not affect the position of eyebrows. The forehead reduction surgery can be performed in combination with hair grafting in men, to lower the hairline.
Surgical outcomes in women:-
Women with wide foreheads or high hairlines, ageing worsens the situation by giving a balding appearance to the forehead. By performing the procedure the balance of the forehead can be achieved. In certain rare cases, if there is not enough elasticity present in the skin, a tissue expander is placed under the scalp where there is hairline to perform hairline lowering. This is done in cases where the hair line needs to be lowered for more than two inches. The tissue expander stretches the scalp, which can alter be used for lowering the hairline. After few weeks, using a hidden incision, the hair line is lowered in to the right position and the expander is removed.
The best outcome is achieved in patients with thick hair but broad forehead. The residual scar is more visible in patients with darker skin as compared to patients with lighter skin. The surgical outcome of the procedure is also measured by the type of scar that is left behind. A patient may continue to feel conscious about his/her appearance if the forehead is treated but the residual scar is too big.
Forehead plasty in men:-
Men who have thick hair and are not losing hair are ideal candidate for this procedure. Men who are rapidly losing hair and have a wide hairline because of that should go for hair grafting and not forehead plasty. If a patient desires raised eyebrows, a combination of forehead lift and forehead reduction surgery can be performed. In men, it is possible to lower the hairline by 3-5 cms without using the tissue expander. In men, if more than 1.5 cm of hairline lowering is desired, forehead plasty is the better option. If less than a cm of lowering is desired, it is preferable to go for hair grafting. Male patients have to keep in mind that if they lose hair post the procedure the scar might become visible. To maintain the hairline and density of hair in the future, hair grafting can be a good option.
To achieve optimal results, a small amount of hair grafting may be done along with the forehead plasty. In the forehead plasty, it is not possible to bring the hairline forward from the temples. Therefore, the hairline may end up looking squarish. To achieve a more natural looking result, hair grafting may be done around the temples. Hair grafting can also help to camouflage the scars and help people who have a history of hypopigmented scars.
The forehead plasty can also be done along with recontouring of the brow bone in the patients who have a prominent brow bone.
The forehead plasty is a relatively simple procedure but the outcome can greatly affect a person’s life and self-confidence. Therefore it should be performed by a qualified and reputed doctor only. The preoperative as well as the post-operative instructions of the surgeon should be closely followed to achieve the best results from the surgery.
Dr. Debraj Shome is one of the leading plastic surgeons in India. He has years of experience and many accolades in the field of medicine.