One of the most frequent requests we get for facial feminization surgery (FFS) and gender affirming facial surgery (GAFS) more generally is to reverse a receding hairline–a common effect of testosterone. The hairline advancement is a technique that involves creating an incision on the hairline and bringing down the receding corners to create a rounder hairline and decrease the size of the forehead. Patients who have not yet experienced a receding can still go through a variation of this technique called hairline reshaping if they are still interested in the aforementioned effects. More information on recovery and scar care can be found below.
Many of our patients who seek GAFS report experiencing dysphoria related to their hairline. One of the most seen effects of testosterone on the body is the recession of the hairline, giving it an “M”-shape. The purpose of the hairline advancement technique is to round out the corners of the “M,” which can help create a smaller, more rounded out forehead or conventionally feminine face. Our surgeons use the same coronal incision as the frontal sinus setback to lower and/or reshape the hairline.
Using the same incision technique, hairline reshaping is another variation of this procedure that is more commonly performed on younger patients who have not started to experience hair loss. Older patients typically request both hairline lowering and reshaping, which can be difficult to achieve. Given the limitations of a patient’s scalp, and when given the choice, the vast majority of patients focus on reshaping their hairline rather than lowering. Once healed, this technique can be combined with hair transplants to help create a fuller hairline.
In order to achieve the maximum amount of hairline advancement, your surgeon will make an incision around the hairline. The pretrichial coronal incision also allows our team to perform a frontal sinus setback, brow bone contouring, and a brow lift. Read more about coronal hairline incisions on our Frontal Sinus Setback page.
Healing for scalp advancement/hairline lowering is similar to the process described in the frontal sinus setback, although there would be significantly less swelling for patients who want to have their hairline lowered without any brow bone setback and/or contouring.
The GCC recommends that patients shower and gently wash their hair two days after surgery is completed. For the first 2-3 weeks patients should apply Bacitracin ointment to the incision area twice daily. Any scabs that appear will usually resolve in 2-3 weeks, at which point patients can switch to silicone scar gel. Patients can resume light activity at three weeks, and at six weeks patients can resume full activity; that said, patients who get this procedure performed without a frontal sinus setback will likely feel better in less time. Any swelling that appears as a result of hairline advancement will be mostly resolved within the first week, although some swelling will persist for a few months following surgery.