Scalp Advancement Surgery (Hairline Lowering Surgery)

Overview of Scalp Advancement Surgery

Scalp advancement, also known as hairline lowering, is a surgical treatment for hairline recession that provides significant results in lowering the anterior hairline by up to 2-3 cm. This procedure also benefits the temporal area, though not as significantly as the anterior part.

Benefits for Facial Feminization

Scalp advancement surgery is commonly undertaken for facial feminization. It changes the level and shape of the hairline, making the entire face appear more balanced, youthful, and feminine.

Determining the Degree of Hairline Advancement

The degree of hairline advancement is determined by the existing hairline height, the laxity of the scalp (how easily the scalp tissues can be stretched), and the patient’s desire.

If you have good scalp and hair qualities, scalp advancement surgery will provide the quickest results for hairline restoration in one session, compared to hair transplantation which requires multiple sessions.

Combination with Hair Transplantation

The combination of scalp advancement and hair transplantation can be considered if you have hair recession greater than 3 cm and/or a very deep or receded temple hairline. These two procedures should be done separately, ideally with at least a 6-month gap for the best possible result.

Common Combination with Other Procedures

For those undergoing facial feminization, scalp advancement is often done together with forehead/brow ridge contouring and/or brow lift. These procedures can share the same incision, yielding better outcomes for both feminization and rejuvenation.

Surgical Procedure

The incision for scalp advancement surgery is made along the existing anterior hairline and curves upward, hidden inside the hair-bearing temple scalp. The partial or entire scalp is lifted, and its underlying fascia is loosened by surgical intervention. This makes the scalp more elastic, allowing it to be stretched and advanced anteriorly to lower the hairline.

Absorbable stitches, and sometimes surgical plates and screws, are used to secure the new position of the anterior hairline. The incisions are stitched finely to heal properly with minimal visible scarring. Hair growth through the incision line eventually covers the scars.

Conclusion

Scalp advancement surgery is a useful procedure for rejuvenation and/or facial feminization. It is particularly beneficial for patients with a high hairline and good hair quality. This surgical procedure is commonly done with forehead bone contouring and/or brow lift to provide the best possible outcome for facial feminization.