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Hairline lowering
Hairline lowering (alternately, a scalp advancement or forehead reduction) is a surgical technique that allows an individual to have their frontal hairline advanced certain distances depending on variables such as pre-operative hairline height, scalp laxity, and patient preference.〔Marten TJ. Hairline lowering during foreheadplasty. Plast Reconstr Surg 1999;103(1):224-236〕 It can be used to address a congenitally high hairline or sometimes a hairline that has recessed from hair loss. It is performed mostly on women.〔Kabaker SS, Yu KC. Ancillary surgical procedure and flaps, in Unger W, Shapiro R et al. Hair Tranplantaion 5th edition. London Informa Healthcare; 2010;p 496-503〕 The normal attractive female hairline midpoint is usually 5–6 cm above a point between the eyebrows at the top of the nose.〔Mayer TG, Fleming RW. Hairline aesthetics and styling in hair replacement surgery. Head Neck Surg 1985;7(4):286-302〕 There appears to be a prevalence for high hairlines amongst women of Anglo-Saxon, Chinese and East African origin although it is seen in all ethnic and racial groups.〔Kabaker SS, Champange J. Hairline Lowering Facial Plas Clin North America 2013;21(3):479-486〕 Frontal hair loss is also prevalent in African American women who straighten their hair and style it with traction.
== Scalp laxity ==
Satisfactory hairline lowering is a balance between patient expectations and anatomical limitations. Scalp laxity is a primary determinant of extent of hairline advancement. When scalp laxity is insufficient for the desired amount of advancement, use of tissue expanders can greatly increase the possible advancement.〔
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