Forehead Reduction Phobia

[LongTimeLurker]

Hi All,

 

I'm new here so my apologies if I've broken protocol. I've been reading forums like this on and off for ... wow it's been a long time now at least 4-5 years.

 

My question is regarding Forehead Reduction. I've seen a few people questioning it on here, but the response is usually quite negative. I believe it's a good thing, and I wish more people would take the same approach with FUE or Strip. Although, I feel a lot of the negativity stems from lack of knowledge on the subject.

 

Regarding Forehead Reduction, here's my logic:

If you have a high & receded forehead you could have a HT... Let's say you wanted to lower your hairline 2cm... with a 15 cm hairline, you would theoretically need 3000 graphs to attain 100/cm2.

 

Or you could get a Forehead Reduction, and small number of graphs to conceal the scar.

 

I'm pretty sure a Forehead Reduction would be less expensive, you would be saving your graphs for future loss, the result would be immediate.

 

Now the arguments I hear against Male Forehead Reduction is that when you lose more hair the scar will become visible. But if you have a ht in conjunction with the forehead reduction, you could place hairs in and in front of the scar thus concealing the scar.

 

You would still have to worry about future loss, but that's the case with either option. At least with the forehead reduction, you haven't depleted your donor.

 

Comments?

[mattj]

Can you provide any examples of aesthetically pleasing results of this procedure?

[LongTimeLurker]

http://www.kabaker.com/Hair_Line_Lowering-1_01.html

 

Or google : forehead reduction surgery

 

It is mostly performed on women, because of MPB. There is a scar at the hairline, but perhaps it would be concealable with fue.

[mattj]

I think the end result looks pretty weird for many of those patients, especially the males.

[Sparky]

The guy on that website looked way better before the forehead reduction surgery. All the pics look weird, I'd rather have a massive forhead or be bald than do that.

[aaron1234]

Yeah, I was thinking the same thing. Many of those patients look better in the before photos. That should not be the case with ANY cosmetic procedure.

[Manko]

I have to be honest, the results aren't bad. I'm a little shocked, because I was instantly very leery of this post. I think the guy looks better after the forehead reduction. He kind of became a punk rocker in one session. I'm still leery, but the pictures are intriguing.

[Manko]

Originally posted by Manko:

I have to be honest, the results aren't bad. I'm a little shocked, because I was instantly very leery of this post. I think the guy looks better after the forehead reduction. He kind of became a punk rocker in one session. I'm still leery, but the pictures are intriguing.

 

Quoting my own quote, one serious caveat would be to see how these people look when they're 50. It's definitely along the lines of a facelift, but for some reason instead of pulling the face back, the hair is being pulled forward. There's no way in a million years I'd ever consider it, but some of the pics are hard to judge since they seem to have been taken almost immediately after surgery (or at least, I hope so).

[Manko]

Alright, one more comment before bed. I was just looking at the rest of the website, and not surprisingly the guy is offering scalp reductions. I'd have sworn that was a taboo procedure today (UncJim, if you're out there), so all things considered I would personally stay away from this doctor.

[Manko]

Now I'm off to bed, wifey is calling. Last comment, Kabaker is recommended by this site, but truthfully based on a lot of his available procedures I would think he would not have passed the test. In addition to scalp reductions, he's also offering juri flaps. I'm not sure what to think anymore, but I remember those 2 procedures being considered very old and dangerous approaches, and very much along the lines of big punch grafts. UncJim would definitely have an opinion, but I'm afraid that I'm now walking in dangerous territory by criticizing a site-sponsored doc.

[Bill - Seemiller]

In my opinion, forehead reduction surgery is a viable solution for many women with naturally large foreheads and higher hairlines. Recommended hair transplant surgeon Dr. Kabaker is one of the world's leading experts in performing this procedure with minimal risks and high rates of success. The best part about this procedure is that women can achieve the desired result in a fraction of the time as hairline reconstruction via hair transplant surgery. The major disadvantage of this procedure however, is that it's highly invasive and requires more time to properly heal.

 

In men, the procedure is a lot riskier, especially since unlike hair hairline reconstruction via hair transplantation, no DHT safe hair has been moved to the hairline with forehead reduction surgery. Thus, in the event a patient later experiences male pattern baldness, hairline recession could destroy the cosmetic result of the forehead reduction procedure.

 

Your idea of combining a forehead reduction with a minimal hair transplant sounds potentially viable. However, in the long run as pattern baldness progresses, you'd still end up requiring the same number of follicular units to be transplanted as if you never had the forehead reduction procedure. Thus, you'd be putting yourself through and spending money on invasive surgery that will only give you a temporary result.

 

For more information on how the forehead reduction procedure works, its advantages, and disadvantages, visit "Hairline Lowering Procedures in Women with High Foreheads".

 

Best wishes,

 

Bill

[Sparky]

He may be one of the best at doing this procedure, but it certainly doesnt make it right. All the people in those pictures look a bit freaky, especially the guy. Juri flaps and scalp reductions and forhead reductions are really nasty things to have ever been developed.

[LongTimeLurker]

Thanks everyone... I'm not sure I agree with some of you, it think that the end results are very impressive... Keep in mind some of these photos are 1 day post op. I guess it's "eye of the beholder"...

 

My main concern is what Bill brought up, being further loss after the procedure(MPB), could be detrimental. However, i believe that's the case with an HT. The implanted hairs will be ok, but the original hairs will continue to be loss... Depending on the level of loss, you could end up looking like a monk from ye old england.

 

Sorry, I'm just playing devils advocate. I'm very apprehensive about any surgery, INCLUDING FUE. Yes, it is surgery. It is performed by a surgeon. My personal preference would be FUE as it's the least invasive, in my opinion.

[LongTimeLurker]

@Bill,

 

Thank you for everything you do! You have been a voice of reason in a sea of ignorance. Although, I have not always agreed with you, I have found that you're fair, which is the most important quality of a mod.

 

RE: However, in the long run as pattern baldness progresses, you'd still end up requiring the same number of follicular units to be transplanted as if you never had the forehead reduction procedure.

 

I have to disagree. Purely on mathematics, unless there is shock-loss or something similar with the forehead reduction(or I am missing something). Right off the top you have whatever you saved with the reduction, in my case around 3,000 graphs. You will have to continue to have HT's either way.

 

I was always against strip because of the scar, which is the reason I wouldn't consider this surgery. But I wanted to see what the response would be. I hoped some docs might chime in...

[Manko]

Longtimelurker - I didn't think the pics looked that bad, but Bill's point is extremely valid, you wouldn't want that scar front and center. The one guy on Kabaker's site looks like a guy who just had a naturally high hairline, but he didn't seem to have any male-pattern-baldness. I thought he looked alright. I would stay away from doing this surgery if you were going to need an additional HT. A lot of guys are paranoid (largely unnecessarily) about having a scar in the back of their heads, I can only imagine the anxiety of having one right across your forehead.

 

Good luck.

 

Manko

[Sparky]

Most of the worst butcherings in the HT industry have usually included some sort of reduction surgery.

[Bill - Seemiller]

LongTimeLurker,

 

Thanks for your support and recognition that we aim to provide encouragement, information, and support in a fair and safe environment for all.

 

Regarding the above statement, I'm not sure how you can disagree, unless you're thinking strictly short term rather than the long term effects of male pattern baldness.

 

For example...

 

Let's hypothetically take two identifcal twin men in their early 20s who are both destined to become classes 5A on the Norwood scale of hair loss by the time their 40.

 

In their early 20s, one has a successful hairline lowering procedure with no permanent shock loss and the other doesn't. Neither of them have hair transplant surgery. For some time, the patient who had the hairline lowering procedure will have a lower cosmetically pleasing hairline, even as hair loss progresses for a short time.

 

But by the time they're both 40 years old, both patients will have no hairline to speak of nor will they have any hair left on the top of their head. The fact that the one patient had his hairline lowered becomes irrelevant because he no longer has a hairline. Additionally, the one who had his hairline lowered will show visibile scarring. Thus, if the twins at 40 years old both decided to start undergoing hair transplant surgery, both would need approximately the same number of grafts. Make sense?

 

Now, given the same two patients, assuming the one who had a hairline loweirng procedure also had 1000 grafts to camouflage the scar, by the time both men are 40, he'd be 1000 grafts ahead of the game (even though he'd look ridiculous with a rather insigificant number of transplanted hair making up a hairline with no natural hair behind to support it). However, the final number of grafts for each patient would still be the same. And, the twin who had the hairline lowering procedure would have paid for a procedure that only provided temporary improvement.

 

Obviously, the amount of baldness each patient will experience can't be fully predicted and can often be slowed down or stopped with medical therapy. I'm only pointing out the additional risks men have by undergoing this procedure.

 

I also understand that usually patients don't wait until their hair loss is at their worst before undergoing hair transplant surgery. But in the above scenerio of the two twins, both will end up needing the same amount of grafts in the end to achieve the same benefit since the hairline lowering procedure could have no long term effect in the above scenerio (other than a skinnier wallet and a new scar to camouflage).

 

I hope this helps,

 

Bill

[Bill - Seemiller]

Sparky,

 

You really can't compare this procedure to flaps and scalp reduction surgery. Such invasive surgery does come with risks. However, this procedure has been proven to be a viable option for some patients, mostly women with naturally high foreheads.

 

Personally, I think you're letting your bias against old and outdated procedures influence your eyes and opinion on Dr. Kabaker's hairline lowering results.

 

By the way, I'm still waiting for you to reply to my private message on an entirely unrelated topic.

 

Bill

[kaounis]

LTL, you say that you don't want to have a strip surgery because of the scar...right...If you have a forehead reduction surgery, won't that give you a scar right in front of your face! It doesn't make sense....A scar on the back of your head, which can easly be covered, is a lot safer than a scar in the middle of your head which can be very unpredticable and a lot harder to hide!

 

 

Just a thought from the peanut gallery...

[Sparky]

I wasnt really comparing apart from the fact that the clinic in question seems to offer these procedures aswell. The guy who had this done in the picture looked way better before his hairline was lowered, it just looks wrong now, really wrong.

[LongTimeLurker]

@Kaounis:

Did you read what I wrote? I would NOT consider having Forehead Reduction FOR THE SAME REASON as I would not have a strip surgery. BECAUSE OF the scar.

 

@Bill:

You're right.

 

 

I'm waiting out the cloning, or dema-sheath implantation...

[Sparky]

Good idea to avoid scars m8

[rpachigo]

Forehead reduction is nothing new or novel. It is a version of the pretrichial browlift in reverse. This would be the version of the browlift where the incision is placed at the level of the anterior hairline and the forehead is elevated and muscles released underneath. There is a scar usually because of placement along the hairline but anterior facial scars rarely become hypertrophic or keloid compared to posterior scalp scars. Also easier to dermabrade these scars to level out so not an issue usually. In this surgery the elevation has to occur so the muscles are released otherwise there will be some stretchback. But Dr. Kabaker is not doing anything revolutionary here - it is quite commonly performed by most plastic surgeons and may be an adjunct to women with naturally high foreheads. It's essentially a reverse browlift.

[Dr. William Lindsey]

rpachigo is exactly on the mark. good summary.

 

As a facial plastic surgeon trained in the mid 90's, I can tell you that our fellowship training manual mandated learning about scalp reductions, plugs, flaps and that new modern technique of minigrafts... I know Dr. Kabaker, just a bit from meetings, and he had a pretty good fellowship when I was applying back in '94. Pretty good meaning he did some of everything including hair, which almost no other facial fellowship (other than the one I did) offered. He was also referenced in our journals and gave talks on all of those techniques; but that was in the flap hay-day. Recall that I have posted that I did a number of scalp reductions in the 90s, and I still do major scalp reconstructions....if done properly, the scars can be very good. I am NOT suggesting that we go back to the old techniques, but done properly by a skilled doctor like Dr. Kabaker, I suspect his results were very good at that time.

 

Currently, I still offer forehead lowering to females and I prefer it to hair transplantation (in females) because it gives an immediate result, takes about an hour, and when done properly, the scar is close to invisible. I do not offer it to men however.

 

Dr. Lindsey McLean VA

[scar5]

I have had this procedure myself.

The Good

Scar is not a concern - alittle whiter than scalp but firn

Instant result

the not so good

the curve of the scalp changes

the eyebrows raise up, and despite my exceptionally good looks, even i have to say it looks a bit facelifty if that makes sense

shock loss!!!!!!!!!!!!!

Overall, a BAD mistake for me personally, but I was surprised by the healing characteristics considering the back of my head was so butchered