Hairline Lowering
San Francisco

What is Hairline Lowering?

Not everyone is satisfied with the shape of their face. There are several reasons for this, usually related to a perceived lack of balance in their features. Some people associate this with the size of their chin or nose and thus undergo surgery to correct these issues. However, some people feel their forehead is greater in size than it should be. There is a solution.

Also known as Forehead Reduction Surgery, Hairline Lowering is a surgical procedure in which skin is cut out of your forehead so that the surgeon can pull your scalp lower, thereby reducing its size. This operation is usually sought by someone who is uncomfortable with the size of their forehead. It offers natural-looking results without showcasing any drastic changes. In addition, the results are permanent, making this an excellent choice for subtly tweaking the aesthetics of your face.

As many as 20% of all women have what can be described as a high hairline. It usually is a hereditary and natural characteristic. Most modern hairstylists are trained to recognize this and will style the hair combed forward in bangs and thereby disguise it. A high hairline is considered a masculine trait. A hairline that measures its mid-point between 5 cm and 6 cm above a line drawn across the brows is what most classify as a typical and desirable female hairline. A mature male hairline usually is 6-8 cm above the brows.

Hairline Lowering History

The high inherited hairlines that are often seen from those women of Anglo Saxon ancestry can be exemplified by the history and paintings of Queen Elizabeth I, the great Tudor queen, the daughter of Henry VIII, who reigned for 45 years. She had a naturally high hairline, which is revealed in many portraits.

One can find many portraits of women of English nobility of her time who emulated the queen by actually shaving back an inch or so of their hair to more resemble the queen. This was especially true of the women who were in her court. It should be noted that Bette Davis, in portraying Queen Elizabeth, had to shave her hairline back for such a movie role.

She played Queen Elizabeth twice once when she was a younger actress, and as an older actress playing the older queen, the hairline had to be kept proportionate, though Ms. Davis’ hairline had receded naturally with age. Most women who have high hairlines have a compensatory hairstyle or have little concern with it.

Those who have suffered teasing in their formative or teenage years regarding a “big forehead”, or looking more like a boy, carry this burden into early adulthood. The social stigma is similar to people who suffered severe acne in their teen years and become psychologically traumatized. Even small acne scars throughout adult life often can obsess them.

Am I a Good Candidate for Hairline Lowering?

If you feel uncomfortable with the size of your forehead in proportion to the rest of your face, you may want to consider Hairline Lowering. In general, ideal candidates have a naturally high hairline or a long forehead. It’s also important that you have no personal or family history of hair loss, as that can affect the appearance of your new hairline. You will also be examined to make sure you are in general good health before undergoing surgery. This exam will also determine if you have enough skin laxity along your scalp and forehead to ensure a successful operation.

Hairline Lowering San Francisco

Hairline Lowering Procedure in San Francisco

A simple, but sophisticated one-stage hairline lowering in San Francisco can usually bring down the hairline approximately one inch. An appropriate candidate for this operation who desires lowering of a high hairline has to have an appropriate amount of scalp laxity. Alternatively, modern follicular unit hair grafts can be done to achieve a similar effect. The graft operation often has to be repeated to attain the desired density and a 12-18 month period is necessary for growth to be long enough to be incorporated into all but the shortest of female hair styles.

For those who need great advancement of the hairline or who have a very tight scalp, a two-stage procedure wherein balloon-like expander devices are inserted under the scalp in the first stage. The scalp is stretched over a six to eight-week period by gradually inflating the balloon. This allows us to bring the stretched scalp downward as much as we need. In some cases, it has been lowered up to 10 cm. Although the concept of this hairline advancement surgery is not revolutionary, the sophistication of it is really a modern development.

Recovery & Results

After surgery, you will be taken to a recovery room and monitored as you come out of anesthesia to ensure no complications. You will need someone to drive you home. Plan to take at least two weeks off of work so you can give your incisions time to heal. You will need to avoid any heavy lifting or other strenuous activities as you heal during that time. Once you return to your regular activities, you need to make sure to wear sunscreen as your skin will be sensitive after surgery.

You will begin to notice the difference in your hairline the more the swelling fades. Your results should be fully evident after one month. Your scars will also fade, although they will already be carefully placed by your surgeon to minimize their appearance. However, it is still possible your scars will be visible where the incisions were made. Fortunately, various hairstyles can reduce this issue.

Does Your Hair Thin Following Hairline Lowering Operation?

There is a lot of discussion as to what changes occur in the hair after the scalp is stretched and the hairline is lowered. Lowering the hairline, as is done in forehead reduction, stretches the scalp and the hairs actually have to thin out to an imperceptible degree.

The same thinning occurs in hair transplantation. The hairline lowering procedure does not give anybody more hair. Hair is taken from one place and put into another. With the hairline lowering operation, however, the change is very subtle and is distributed throughout the scalp rather than having the thinning just in the back.

And, the resulting hair density in the front of the scalp is much greater than with hair transplants. There appears to be many concerns about this especially when the discussion of “shock loss” enters the picture. As an aside, shock loss occurs with almost any scalp surgery, especially with follicular unit hair transplantation. By standard definition, however, “shock loss” means that there will be recovery of hair growth starting in three months and being completed by 9 to 12 months to where hair is again long enough to be incorporated into hair styling.

Significant shock loss occurs in less than 2% of patients having hair transplants or hairline lowering. To lessen this effect of thinning, a number of maneuvers can be done. Dr. Miranda has for the last 12 years inserted a small dissolvable device, called an Endotine, which anchors the scalp onto the skull within 3 cm of the hairline.

This has the effect of taking tension off the closure and, as his recent study has shown, it compresses the hair in the front rather than stretches it. This probably accounts for an infinitesimal more stretching of the scalp behind, but it is spread over the scalp behind for about 25 cm to 30 more centimeters. It has been scientifically proven that the use of the Endotine compresses the hair in the front and eliminates frontal thinning that would occur from the scalp being stretched in the front 3 cm of the hairline.

All hair restoration surgeries will microscopically thin the scalp hair, hairline lowering in San Francisco is no exception; however, the thinning is distributed throughout the top and back of the scalp, so it is imperceptible. Initial impressions have been that the whole scalp is stretched about 10- 20% and therefore, the density goes down between 10% and 20% on the top and back.


Therefore, if someone has 100 follicular units/cm2 (as many women do), the hair density would become about 85 follicular units/cm2 after a 3cm hairline advancement. This difference would be imperceptible to the naked eye. Other hair restoration procedures such as follicular unit grafting by FUT, strip harvesting or FUE thin the hair similarly, but the recipient area rarely cannot get that degree of density unless multiple procedures are used.

Hairline Lowering San Francisco

Does Hairline Lowering cause hair loss?

Less than 5% of patients who undergo hairline lowering surgery will experience any sudden hair loss at all, making it a rare side effect. And of those who do experience it, 99% see their regular hair growth restored after a few months, making this a minor worry for few people. So, by and large, your hair growth will not be affected by Hairline Lowering surgery, but if you do, the hair loss will be temporary.

Why Choose Hairline Lowering at PPSG in San Francisco?

Hairline Lowering is one approach to regaining confidence and joy in your appearance. The professionals at PPSG strive to deliver the best Hairline Lowering San Francisco has to offer and are ready to help you create a more symmetrical face so that your features are more naturally balanced. In addition, results are faster than simply undergoing hair restoration surgery. Our board-certified surgeon have decades of experience that will guarantee success, making PPSG in San Francisco the best choice for your Hairline Lowering procedure.

Meet your surgeons

Dr Sheldon S. Kabaker Is Considered By Many To The World’s Most Experienced And Senior Hairline Lowering Surgeon. Since He Retired, Where Can I Find Someone Like Him?

Dr. Kabaker has been a co-director of a Facial Plastic Surgery fellowship since 1986. A number of his past fellows have considerable knowledge and experience with his personal approach and technique to this surgery.

How Is It Dr. Miranda Is Determined To Be The Expert In This Operation?

Dr. Miranda is a board-certified plastic surgeon in San Francisco and has many years of experience in hairline lowering techniques. Many patients travel to meet with Dr. Miranda for his innovative strategies and demonstrated skills and knowledge in the field. Dr. Miranda is highly qualified and gets excellent results for his patients every time.

If you would like to schedule a private, one-on-one hairline lowering consultation with Dr. Miranda, contact Pacific Plastic Surgery Group today at 415-649-2229 or fill out our simple contact form

Hairline Lowering FAQS

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