Often, feminine spectrum trans patients who have dysphoria related to their hairline have “M-shaped” hairlines, and this technique is used to round out the corners of the “M,” which can help create more of an oval-shaped feminine face. Dr. Facque uses the same coronal incision as the frontal sinus setback to lower and/or reshape the hairline.
Hairline reshaping is more common in 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, Dr. Facque will make an incision around the hairline. The pretrichial coronal incision also allows Dr. Facque 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 contouring.
Dr. Facque recommends that patients can 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 6 weeks patients can resume full activity. 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.