Your Questions
Your Questions
Q: Dr. Eppley, how can I lengthen my short forehead? I know many people want to shorten a long forehead and bring the scalp forward but I can’t find anywhere about doing the reverse of that. My forehead is so low that I think it makes me look unusual and almost simian like. The distance between my eyebrows and hairline is only 4.5 cms.
A: A traditional coronal browlift will lengthen your forehead to some degree but with that increase will be a resultant elevation of the brows as well. The problem is that simple stretching of the skin will not necessarily make for more than 1/2 to 1 cm of forehead lengthening without changing your brow position. There simply is not enough skin to stretch to make an appreciable difference. The most successful treatment of the short forehead is a two-stage approach with a tissue expander placed first followed by a pretrichial browlift approach. This is the most assured method of lengthening the forehead skin and moving the hairline back without adverse brow alteration. This works because the tissue expander is placed in the forehead and creates more forehead skin. The undesired amount of low scalp hair is then removed and replaced by new forehead skin.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a very short forehead and really want it to be longer. (more skin) But I have been told that a browlift will also make my brows lift up as well as lengthen my forehead which I don’t want. I have read about the use of tissue expanders to make more skin. Do you think the use of tissue expansion is too invasive for someone with a short forehead?
A: The issue with forehead tissue expansion is not whether it is more invasive as it does not involve much more tissue dissection than any form of a browlift. The question is whether it is worth the effort. It is a two stage process with the first procedure being the placement of a tissue expander and a second stage about 6 to 8 weeks later for removal and the retropositioning of the frontal hairline. So it becomes two operations…neither are very complex or extensive nor is recovery difficult or extended. Then there is the intervening interval between the two when the inflation of the tissue expander occurs. Once a week saline injections are done to gradually stretch out the upper forehead. Patients often do this on their own. Through this tissue expansion phase, it will become obvious that there is a bulge in the forehead, so this is a socially awkward period. As you can see from this description, one has to be fairly motivated to be willing to go with this effort. But tissue expansion works really well anywhere on the skull or forehead because it is pushing off of a solid platform underneath. (bone)
Dr. Barry Eppley
Indianapolis, Indiana