Forehead lift surgery can elevate the sagging brows, eliminate the vertical creases between the eyes and the horizontal lines across the forehead, and change the hairline height if the patient requests for it.
(Forehead lift surgery and brow lift are basically the same procedure—the incision patterns and “cosmetic effects” are similar—although there are techniques that can elevate or reshape the brows without lifting the entire forehead.)
As with any facial plastic surgery, the ideal forehead lift technique depends on the patients’ underlying anatomy and the “cosmetic effects” they are after. For instance, some like to shorten their forehead, while others want to maintain its height after elevating the brows.
If one of the goals is to reduce or maintain the forehead height, leading Los Angeles plastic surgeon Dr. Tarick Smiley says the ideal technique involves an irregular (serrated) incision made precisely at the hairline. This is different from the standard or coronal lift in which the incision goes from ear to ear, across the top of the head.
The coronal lift does not suit patients with high forehead because it inadvertently elevates the forehead by up to 1 inch, an “effect” some people humorously call “five-head.”
(“Four-head” is when the person can fit four fingers between her eyebrows and hairline. “Five-head” when it is too wide that five fingers can all fit on it.)
Fortunately, the hairline incision technique, or medically referred to as trichophytic, does not cause the dreaded five-head effect and in fact may even shorten the appearance of wide forehead by moving the hairline slightly more forward. Nonetheless, it should not be overdone otherwise the “primitive appearance” may ensue.
This is not to say that the hairline incision technique is superior to the coronal lift because it all boils down to the patients’ anatomy. For instance, women with a notably short forehead may consider getting the coronal approach to slightly increase its height.
Some surveys have suggested that women with a slightly large forehead, along with other “cute” or babyish features such as fuller lips, large eyes, and prominent cheeks, are generally regarded as attractive and youthful by other people.
Nonetheless, should there is a need to alter the hairline height during surgery, it must not be lifted excessively because a high hairline is masculinizing for women. And even in men, overzealous elevation is avoided to prevent unnatural results.