Background: Aesthetic analysis of the face is best accomplished by dividing the face into equal thirds. A long forehead may lend the appearance of a less attractive, disproportionate, and senescent face.
Objective: To provide data regarding options for surgical correction of the long forehead.
Methods: Patients complaining of excess forehead length were divided into 3 groups on the basis of forehead length in relation to other facial proportions. Patients with mild elongation underwent an endoscopic forehead lift, those with moderate elongation underwent an open forehead lift, and those with severe forehead elongation underwent open forehead shortening.
Results: A total of 755 patients were evaluated, including 702 women and 53 men undergoing forehead surgery since 1998. Follow-up ranged from 12 months to 8 years. Four hundred thirty-eight patients underwent endoscopic forehead lift for mild forehead elongation, 297 patients underwent pretrichial forehead lift for moderate elongation, and 20 patients underwent major scalp advancement for severe forehead elongation. Successful forehead rejuvenation was achieved in all groups. Complications were minor and included alopecia and delayed wound healing.
Conclusions: An optimally proportioned forehead may be achieved by use of a variety of elective operations on the basis of severity of forehead excess and geared to reducing forehead length.