Hairline Lowering: A Cosmetic Procedure for Women with High Hairlines

In 2013, a cosmetic procedure known as hairline lowering or advancement was described for women with high hairlines but no hair loss history. The procedure could advance the hairline by up to 2.5 cm in a single stage, or up to 3.5 cm in scalps with greater laxity. For those with minimal laxity or needing more than 2.5 cm of advancement, a two-stage process involving scalp expansion could achieve up to 10 cm of advancement. The single-stage procedure typically moved about 3000 follicular units in 1.5 hours, while the two-stage could move up to 12,000 units. Both procedures had high patient satisfaction despite the two-stage process being more inconvenient and costly. Preoperative assessment, careful incision and closure techniques, and preservation of the occipital arteries were emphasized for optimal results and minimizing scarring. Postoperative sensation loss for 6 to 12 months was expected, and risks such as bleeding, infection, shock loss, and scarring were considered rare.