Scalp Advancement and the Pretrichial Brow Lift

    April 2018 in “ Facial Plastic Surgery ”
    Jeffrey H. Spiegel
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    TLDR The surgical technique of scalp advancement and pretrichial brow lift shortens the forehead and lifts brows, is good for women and transgender women with high foreheads, but not recommended for men and has some risks.
    The document from 2018 by Jeffrey H. Spiegel, MD, FACS, details a surgical technique known as scalp advancement and the pretrichial brow lift, aimed at shortening the forehead and lifting the brows, which is particularly beneficial for women and transgender women with high hairlines or large foreheads. The technique involves a pretrichial incision at the hairline, potentially combined with a trichophytic incision to allow hair growth through the scar, camouflaging it. The procedure is not recommended for men due to the risk of male pattern baldness and carries potential risks like scarring, shock effluvium, numbness, and other surgical complications. The author has performed several hundred procedures and reports positive results with stable hairline and incision healing, and suggests that additional devices are not necessary. The procedure also includes galeotomies and rapid intraoperative tissue expansion, with the possibility of adding follicular unit grafts if complete rounding of the temporal recession is not achieved. Preoperative counseling is advised to address risks, and the document does not provide specific numbers of people involved in the study or clinical trials.
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