Hairline Lowering

A high hairline or elongated forehead can result in an unbalanced appearance, often prematurely aging those affected. An oversized forehead can detract from a woman’s facial harmony, and is particularly disliked by younger women. Due to hairline recession with age, men are not as good candidates for this procedure as women. However men may also be a candidate for hairline lowering, but need a thorough assessment first to determine their suitability. Today, a hairline lowering surgical procedure can help restore balance to the face, bringing the hairline to a more aesthetically pleasing position.

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The Surgery

Traditionally the female hairline starts between 4 and 6 cm above the eyebrows. Typically, the hairline should start at around the transition point between the vertical forehead and the point where the forehead starts to slope backwards towards the scalp. It can look relatively unattractive if the hairline starts well above this transition point.

The most important factor in a successful hairline lowering surgery is scalp flexibility. If a patient has a relatively flexible scalp – in other words if they can wriggle it backwards and forwards quite freely – a good anterior scalp advancement or lowering of the hairline can be achieved. If the scalp is not flexible, however it can be more difficult to advance the scalp to reduce the forehead and sometimes two stage surgery is needed.

Other factors that need to be taken into consideration are density of the hair, the presence of any hair whorls or cowlicks, and whether there is any active or hereditary hair loss in the family.

Hairline lowering surgery can be performed at the same time as brow lifting surgery but the two procedures don’t necessarily need to be performed together and it’s important for patients to understand that hairline lowering does not necessarily elevate the brows.

The Procedure

During the procedure, an irregular incision is made between the existing anterior hairline and the forehead.

The hair-bearing scalp can then be lifted and moved forwards. It’s important for the surgeon to have experience with the trichophytic incision. This technique means hair can grow through the incision during the recovery phase to help camouflage the incision. It’s also important for the surgeon to understand the direction of hair growth and preservation of scalp blood supply. These are all technical details which help ensure optimal results. The surgery is performed under general anaesthesia.

The Recovery

A light dressing is applied that is typically removed one day after surgery. Any sutures are then usually removed three and seven days post-operation. The procedure is typically very well tolerated. The vast majority of patients are able to return to work within three to seven days of the surgery. Patients need to be prepared to wear a fringe to cover the incision line for the first year. However it is very unusual for anyone to need to keep their hairline covered beyond three months. Many patients are able to wear their hair pulled back within weeks of the surgery.

The Results


The hairline lowering procedure can be performed at any age, although the most common age is from the early 20’s onwards. There is no age limit for the procedure.

All hairline lowering procedures are performed in a private, accredited hospital under general anaesthetic with a qualified anaesthetist and usually take approximately 2.5 hours. You can go home the same day but will require someone to pick you up who can care for you at least the first night.

The hairline lowering procedure gives permanent improvement and does not need to be repeated.

An irregular incision is made between the existing anterior hairline and the forehead. This technique means hair can grow through the incision to help camouflage the scar.

There are no Medicare rebates for hairline lowering as it is a cosmetic procedure.

This is determined by your scalp and forehead laxity – in other words how easily you can move it backwards and forwards. Usually 2-3cm can easily be achieved, often more.

A more complex, two-staged procedure is available for those with little scalp movement or who require advancement of the hairline by more than 4cm – this will be fully discussed at your consultation if applicable to you.

Avoid strenuous activity including aerobics and heavy housework for a week to 10 days.

Walking and mild stretching are fine. Yoga and Pilates postures involving inversion or extensive stretching should be avoided for 1-2 months.

You will be seen by Dr Nettle within 1 – 2 days of your surgery.

Regular appointments are made to remove sutures and to check on your healing following surgery.

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Hairline Lowering