Scalp advancement surgery (Hairline lowering surgery)

Scalp advancement, also known as hairline lowering is a surgical treatment for hairline recession to provide a significant result in lowering the anterior hairline for up to 2-3 cm.
It is also beneficial in improving the temporal area but not as much as it does on the anterior part.
The scalp advancement surgery is commonly undertaken for facial feminization in order to change the level and shape of the hairline making the entire face appear more balanced, youthful and feminine.
The degree of hairline advancement is normally determined by the existing hairline height, the laxity of the scalp (how easy the scalp tissues can be stretched) and the patient’s desire.
If you have the good scalp and hair qualities, the scalp advancement surgery will give you the quickest result for hairline restoration done in one time compared with the hair transplantation which requires multiple session treatment.
The combination of scalp advancement and hair transplantation can be taken into consideration if you have hair recession greater than 3 cm and/ or very deep or receded temple hairline, however these 2 surgical procedures should be done on separate times, ideally with at least 6 months gap to obtain the best possible result.
Oftentimes, for those who come for facial feminization, the scalp advancement is commonly done together with the forehead/brow ridge contouring and /or brow lift because these 3 procedures can share the same incision and it yields a better outcome for both feminization and rejuvenation.
The incision of scalp advancement surgery is made along the existing anterior hairline and curve upwards that will be hidden inside the hair bearing temple scalp. The partial or entire scalp will be lifted and its underlying fascia can be loosen by surgical intervention.
Then the scalp becomes more elastic that it can be stretched and advanced anteriorly to lower the hairline. The absorbable stitches and sometimes, the surgical plate and screws are used to secure the new position of the anterior hairline.
The incision are stitched finely that it heals properly with less to hardly visible scarring. The hair also grows through the incision line so it will eventually cover the scars.
In conclusion, the scalp advancement surgery is a useful procedure for rejuvenation and / or facial feminization which should be considered by patients who have high hairline with good hair quality. This surgical procedure is commonly done with forehead bone contouring and/or brow lift to provide the best possible outcome of facial feminization.