Step 1, lower the hairline via reverse browlift, Dr. Lindsey McLean VA

[Dr. William Lindsey]

This attractive mid-40s female complained of an abnormally high hairline and large forehead. She'd consulted with 2 hair docs who recommended lots of hair, and one general plastic surgeon who recommended excising forehead skin in front of the hairline and skipping hair work.

 

When she came to me, first off I told her that she was not un-attractive and didn't need to do anything. Her husband agreed.

 

However, she's in the health care field, and has considered her condition for 20 years or more.

 

I felt that indeed she has a high hairline, which is quite common in white females--accounting for the fact that while I've done 3400 facelifts...I've only done a hundred or so browlifts--I think most browlift options can exacerbate an already high hairline and make an un-natural result.

 

I also felt that she has brow ptosis, or abnormally low hanging eyebrows.

 

So a combination treatment option was offered and this is step one. First, we did a trichophytic incision (this is what trichophytic was made for as I've posted elsewhere on this site), and a browlift. But rather than simply raise the brows, I undermined way back under her scalp and pulled that foreward too. I was able to excise an inch and a quarter of hairless forehead skin, and then a nice trichophytic closure was done. She wore a wrap one night, and then a tennis sweatband for 2 weeks. Sutures were removed on day 5, see pictures, and hopefully she'll return in a month for a scar check...but she lives a fair distance away.

 

I expect her forehead skin to stretch back a little, and she will probably want a hairline hair transplant this fall. OR perhaps this will take care of it to suit her.

 

She was a great patient and went back to work on day 6, with minimal discomfort. She'll have a bit of a surprised look for a few weeks, and hopefully in a few months she'll have hair growing out in front of that hairline scar.

 

Dr. Lindsey McLean VA

[Dr. William Lindsey]

She stopped in Friday for a 6 week check. The scar looks perfect for 6 weeks. I hope that by the 6 month check its faded and has hair in front of the scarline.

Dr. Lindsey McLean VA

[Ellie]

When i first saw this patient I was amazed the hairline could be lowered this much, that it would actually stretch forward to such a degree. I think this type of browlift is better than the coronal which elevates the hairline and the endoscopic which has limitations and can fall . The patient also avoided having lots of grafts, she must be pleased. The scar looks very good, thats obviously very important in that area and a skilled surgeon is essential. Good work.

[aaron1234]

Scar looks very good! Probably won't absolutely need a transplant to hide it in 6 months. Anxious to see it again.

[MusoInOz]

Great work Dr L!

 

I always enjoy your write ups very much to the point with all the required info.

 

Mike.

[Dr. William Lindsey]

Thanks for the comments.

 

1. Specifically, I quit doing endoscopic browlifts as most people, me included, were "afraid" to really free up the arcus marginalis (tendon that connects the forehead to the brow bones) with limited visualization. Once I made the decision to abandon them and just do open brows...my patients got better results.

 

2. I agree, and I am not sure that she will need additional hair this fall. BUT, in talking with her and her husband recently, she wants more. If we do something, I"ll push for a conservative approach at best.

 

 

Thanks

 

Dr. Lindsey McLean VA