Everything You Need to Know About Forehead Reduction Surgery

Beauty standards ebb and flow throughout the years, with features like big lips, ample rear ends, and pronounced jawlines all seeing their moments in the proverbial sun. But lately, it’s the forehead that’s receiving the most attention from aesthetics buffs and plastic surgeons alike, or more specifically, forehead reductions.

If you’ve ever been called “five-head” by some inconsiderate individual, you understand how it might make you feel self-conscious to have so much real estate above your brows. And while the facial features we collectively deem attractive vary, having a forehead that is proportional to the rest of your face is pretty universally ideal — although for reference, in Elizabethean times, wealthy women used to pluck the hair from their hairline to make their forehead appear, which symbolized nobility (the more you know!).

Sure, symmetry is great and all — it’s even a measurable sign of attractiveness in humans — but all that matters is whether or not the procedure can achieve the results that will help you feel more comfortable in your skin.

Luckily, there have been multiple advancements and refinements in technique over the last few decades, which has allowed for increased consistency and natural-looking results with forehead reductions, according to board-certified plastic surgeon Adam Kolker, MD, FACS. And now that more transparency in our beauty choices is becoming the norm, it’s easier than ever to seek out answers and make an informed decision about whether or not the surgery is the best next step. No wonder forehead reductions are surging in popularity at the moment.

Curious to know whether the treatment might be right for you? Keep reading to learn everything there is to know about forehead reduction.

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What is forehead reduction?

Make no mistake, this is a more serious in-office treatment than, say, getting your Botox refreshed. Forehead reductions are a surgical procedure that involves anesthesia, wherein, “an incision [is made] in front of the hairline, elevating the soft tissue of the forehead and pulling it backwards,” says Konstantin Vasyukevich, MD, a double-board certified plastic surgeon in New York City.

Essentially, you’re removing a small strip of skin just below your hairline and pulling the skin of your forehead upward to meet your hair. While effectively reducing the surface area of your forehead, the procedure also raises the eyebrows slightly while pulling the hairline downward. The degree to which you can make your forehead smaller varies, but according to a study in The Journal of Facial Plastic Surgery & Aesthetic Medicine, the average amount of reduction is 1.6 cm (although this can vary from patient to patient).

Since your surgeon will be pulling back on the skin of your forehead and lifting your brows ever so slightly, double board-certified plastic surgeon Jennifer Levine, MD, adds that, “raising the brows will improve the appearance of the upper lid.” This isn’t the main goal of the procedure of course, but rather an added benefit of going under the knife.

How to know if you're a candidate for forehead reduction:

It might seem like anyone who has a larger forehead would be appropriate to undergo this treatment, but plastic surgeons will tell you that this is not the case. “If the patient has history of, or a family history of hair loss, the procedure should be used with caution as the hair loss over time may make the incision more visible,” says Dr. Levine. Having a strong hairline and plenty of hair will ensure that your results remain consistent, and imperceptible, throughout your life.

This also means that since many men will eventually experience extensive hair loss (studies show that 53% of men from 40-49 will see significant balding, increasing with age) they are often not good candidates for a forehead reduction.

How to prep for forehead reduction:

As with all cosmetic procedures, you’ll meet with your surgeon (always check that they are board-certified) for a consultation to go over your medical history and confirm that you are able to safely undergo a forehead reduction. You’ll also discuss the procedure’s risks and your desired results. It’s a good idea to bring in photos for a visual reference of what you hope to achieve and how you’d like your forehead to look once you’re healed. You can also ask your doctor to see before-and-after photos of other patients who have undergone the surgery.

Additionally, your doctor will check your skin laxity, or how loose your skin is, to make sure that your forehead will have enough “give” to pull up during the surgery. This entails moving your scalp up and down and side to side for tension, and is crucial to ensure that you are a candidate for the procedure.

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What forehead reduction surgery involves:

Once you are placed under anesthesia, your surgeon will begin your forehead reduction by making an incision at your hairline. “The scalp tissues are then released and advanced forward and downward, taking advantage of existing scalp laxity,” says Dr. Kolker, adding that he can often advance the hairline up approximately 2.5 cm. Once your doctor has established the new hairline position, she or he will cut away a strip of non hair-bearing forehead skin.

Next, Dr. Kolker explains that “the advanced scalp is then anchored to alleviate any tension on the closure line, and multiple layers of sutures are placed to align the incision.” Barring any complications, the incision line will be fairly imperceptible.

He does explain that sometimes a patient doesn’t have enough skin laxity, or the forehead is excessively high, which will require a two-stage procedure, wherein a tissue expander (a balloon-like device that can stretch the scalp) is inserted under your skin, followed by the hairline lowering procedure six-12 weeks later.

What forehead reduction after-care looks like:

Post-surgery, Dr. Levine explains that you’ll most likely experience swelling and bruising (a small price to pay for a treatment that is otherwise permanent). You’ll want to limit your physical activity during the healing process, take over-the-counter pain medication as needed, and follow your doctor’s recommendations on incision care.

“[Maintain] a gentle compressive head wrap for 24-48 hours, after which the hair can be washed with gentle shampoo," adds Dr. Kolker. "Many activities are resumed within 48 hours, and [you can] return to work between four-seven days.” You’ll also need to return to your medical provider five-seven days after surgery to have your hairline sutures removed.

What are the risks involved with forehead reduction?

As with any surgical procedure, there are some risks involved with forehead reductions. Dr. Kolker explains that decreased scalp sensation above the new hairline is the most common, but often resolves over six-nine months. Dr. Vasyukevich cites noticeable scarring and asymmetry as two of the most troublesome side effects of the procedure, but these are still quite rare. There is also a risk of alopecia or telogen effluvium (“shock loss”) of hair follicles along the incision line, but the experts state that these are most often temporary.

How much does forehead reduction cost?

How much any cosmetic surgery costs is determined by many factors, such as choice of surgeon and where you live. For forehead reduction, it can range from $8,000 to $20,000 in major cities like New York or Los Angeles. However, it’s never a good idea to skimp on quality of care when it comes to permanently altering your face. Do your research, budget, ask for before-and-after photos, and find a surgeon who makes you feel confident and comfortable before deciding to undergo the treatment.

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