Hairline Lowering Surgery With Bone Tunneling Suture Fixation: Effectiveness and Safety in 91 Patients

Aesthet Surg J. 2019 Apr 8;39(5):NP97-NP105. doi: 10.1093/asj/sjy304.


Background: People with a wide forehead often look older. Hairline lowering surgery is a good treatment option, which is generally performed utilizing Endotine.

Objectives: We describe our hairline lowering surgical technique involving bone tunneling without Endotine, a method designed to produce comparable outcomes with fewer side effects. We evaluated the effectiveness and safety of our technique.

Methods: Charts of 91 patients who underwent hairline lowering surgery without Endotine were reviewed retrospectively. We utilized standardized preoperative and postoperative photographs to measure the proportions of 3 face parts and the length of the forehead. We also determined changes in forehead length at various times after surgery, occurrence of postoperative complications, and overall patient satisfaction with their surgical results.

Results: Of the 91 patients, 80 were female and the mean age was 28.67 ± 7.15 years. Preoperatively, the mean forehead length was 8.09 ± 0.69 cm and ratio of facial part lengths was 1.08:1:0.99 (cranial to caudal). The hairline was advanced 18.37 ± 2.90 mm. One month postoperatively, the mean forehead length was 6.57 ± 0.52 cm and facial parts ratio was 1:1:0.99. Compared with preoperatively, forehead length was significantly reduced at 1, 3, 6, and 12 months postoperatively. Forehead length was not significantly different at 1 and 12 months postoperatively. All patients were satisfied or very satisfied with their overall surgical results.

Conclusions: Hairline lowering surgery with bone tunneling was effective and safe, and patients were satisfied with the results. The effects appeared immediately following surgery and were sustained over time.

MeSH terms

  • Adult
  • Cosmetic Techniques
  • Female
  • Forehead / anatomy & histology*
  • Forehead / surgery*
  • Humans
  • Male
  • Patient Satisfaction
  • Photography
  • Postoperative Complications
  • Retrospective Studies
  • Scalp / anatomy & histology*
  • Scalp / surgery*
  • Suture Techniques*