Hair Transplant | Forehead Lift Caused Hair Loss - What Are My Options?

Forehead Lift Caused Hair Loss - What Are My Options?

I am a 52 year old female. A little over 1 month ago I had a forehead lift which left me with a bald spot around the front forehead incision line. The area is approx. the size of a quarter which is mostly in front of the incision line but extends slightly behind as well. The surgeon states she is unsure why this area lost hair. She says she has not had this happen with any other patients. I also have lost hair volume throughout my head. Is this a normal hair loss issue after a forehead lift and do I have any options that might help regrow the hair.
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Hair loss is a potential complication of surgical brow lifting and forehead lifting. Fortunately, this problem is uncommon for most patients who undergo surgical rejuvenation of the brow and forehead regions. There are several factors that can influence ones predisposition to losing hair following surgery and two primary patterns in which hair can be lost.

Technical issues related to the performance of the surgery can contribute to postoperative hair loss. Factors which compromise blood flow to the hair-bearing scalp set the stage for unexpected hair loss. Inadvertent disruption of the scalp’s blood supply, aggressive surgical cautery at the wound edge and excessive tension along the incision line are three of the most common causes of post-surgical hair loss.

Diffuse hair loss following brow and forehead surgery can occur throughout the entire lifted region and in the adjacent non-lifted scalp. This pattern of hair loss can range from a minor density reduction to a profound loss of density. Small, isolated patches of complete hair loss can also occur following surgery. Localized areas of complete hair loss often occur in the region of the incision line and are commonly related to direct follicular damage from cautery or to excessive tension in the region of the hair loss. Patients with “weak” hair, such as those with a predisposing nutritional deficiency, thyroid imbalance or preexisting anemia may be at higher risk for hair loss since their follicular health is compromised to begin with.

The key to successfully treating diffuse and isolated hair loss relies on early diagnosis and appropriate intervention. Most cases of hair loss following forehead and brow lifting resolve with time. Unfortunately, stressed follicles enter a three to four month resting phase prior to beginning a new growth phase. The patient has to be patient during this frustrating phase of follicular recuperation. Topical Rogaine applied twice a day over the affected area is encouraged to stimulate follicular regrowth. A healthy, well-balanced diet with adequate protein intake and vitamin supplementation is also important for follicular health.

Patients with isolated patches of complete hair loss are more likely to suffer an irreversible loss than those with a diffuse hair loss. Surgical restoration of the bald area is possible when the area has fully recovered. However, it is vital that surgical intervention be delayed for an absolute minimum of four to six months to allow for the possibility of spontaneous regrowth within the stressed or shocked follicles. Topical Rogaine should be applied throughout this recovery phase.

Raymond J. Konior, MD
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

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