Can I Get A Combined Frontal Bossing/Hairline Advancement Surgery?

Q: Dr. Eppley, I’m a 30 year old male with a 23.5″ head that looks huge for my 5’8″ body. I’m interested in reducing the frontal bossing, lowering the hairline, and having a hair transplant if it’s feasible.

A: Head circumference aside I think the primary problem is the frontal bossing which is magnified by the high hairline. This is a challenging problem in that both issues must be dealt with for an effective improvement. Unfortinately a ‘scarless’; hair transplant alone to move the frontal hairline forward will likely be be inadequate as the density of hair that can be placed and how far forward it can advanced will simply not be enough….and that leaves frontal bossing unchanged.

Normally I would be very cautious about a frontal hairline advancement in a male with a high hairline because of the obvious scar line and you never know just how much forward movement the scalp will permit. Also the greatest movement needed of the hairline is where it is most recessed (temporal hairline) so a frontal hairline advancement does not solve the hairline shape…it moves it all forward along the similar pattern that it has. But if one needs frontal bossing reduction there is no other good incisional choice to do it so that may tip the balance in favor of it for its dual benefit.

That being said my advice is:

1) I would certainly also consult with a hair transplant specialist to get their thoughts about the frontal hairline since this is not my area of expertise.

2) It is prudent to assess the frontal bossing with a 2D CT scan to measure the bone thickness to determine if adequate bony reduction can be safely done.

3) I have attached an image of what I think can be realistically achieved by a combined frontal hairline and frontal bossing reduction. (if the bone permits) The purpose of the image is not to show you exactly what the result would be. Rather it is done for the purposes of  howing what I would expect the least result to be….as that should be the trigger for surgery. (not what one may ideally want as who knows if that is ever achievable)

Dr. Barry Eppley

World-Renowned Plastic Surgeon