A high or receding hairline is one of the most noticeable features that can undermine facial feminization, even when other procedures have produced excellent results. Hairline lowering surgically advances the scalp forward, reducing forehead height and creating a rounder, more feminine frame for the upper face. The result is immediate — a visible difference you can see from the moment the bandages come off.
What Is Hairline Lowering?
Hairline lowering, also known as scalp advancement or forehead reduction, repositions the frontal hairline by advancing the hair-bearing scalp forward and removing a strip of forehead skin. The typical reduction is 1.5 to 3 centimetres, depending on scalp laxity. The incision is placed along the existing hairline so that the resulting scar is concealed by hair growth once healed.
For trans women and transfeminine individuals, a high hairline — whether caused by a naturally tall forehead, temple recession, or early male-pattern hair loss — can significantly detract from an otherwise feminized face. Hairline lowering is frequently combined with forehead contouring during the same surgical session, allowing the surgeon to address both the bony contour and the hairline position through a single incision.
Common Concerns Hairline Lowering Can Address
- High or receding hairline that creates an excessively tall forehead
- Temporal recession that gives the hairline an M-shaped or squared appearance
- A forehead that appears disproportionately large compared to the rest of the face
- Inability to wear hair pulled back without feeling self-conscious
Are You a Good Candidate?
- Trans women or transfeminine individuals who want a lower, rounder hairline
- Adequate scalp laxity to allow the scalp to be advanced forward
- No active scalp conditions such as severe alopecia or scalp psoriasis
- Non-smoker or willing to quit before surgery
Techniques & Options
The amount of hairline advancement achievable depends primarily on your scalp laxity, meaning how much the scalp can be stretched forward without excessive tension. This is assessed during consultation by gently pushing the scalp forward and measuring the available movement. For patients with limited laxity, tissue expanders placed under the scalp in a preliminary procedure can increase the distance of advancement. The incision is designed to follow the natural irregularity of the hairline so that the scar is maximally concealed.
The two primary approaches are:
Single-Stage Scalp Advancement
The most common approach. An incision is made along the frontal hairline and the scalp is undermined, lifted, and advanced forward. A strip of forehead skin is excised and the scalp is secured in its new position with deep galeal sutures and fine skin closure. The hairline typically advances 1.5 to 3 centimetres.
- Achieves immediate, visible hairline lowering in a single procedure
- Incision follows the natural hairline for optimal scar concealment
- Can be combined with forehead contouring through the same incision
- Recovery is straightforward with most patients returning to activities within two weeks
Two-Stage Advancement with Tissue Expander
For patients who need more than 3 cm of advancement or have limited scalp laxity, a tissue expander is placed beneath the scalp in a preliminary procedure. Over four to six weeks, the expander is gradually filled with saline, stretching the scalp to allow a greater degree of advancement in the second surgery.
- Allows greater advancement (up to 5+ centimetres) in patients with tight scalps
- Produces additional hair-bearing skin rather than just stretching existing tissue
- The two-stage approach reduces tension on the final scar
- Ideal for patients with significant hairline recession or a very high forehead
Recovery Timeline
Days 1–3
Tightness across the forehead and scalp is the predominant sensation. Some swelling may extend down to the eyebrows and upper eyelids. A light compressive dressing or headband is worn. Pain is typically mild and responds well to prescribed medication. Rest with your head elevated.
Days 4–7
Swelling subsides and the tightness begins to ease. You can gently wash your hair following your surgeon's instructions. Numbness behind the incision line is common after scalp advancement and resolves gradually. Most patients feel comfortable going out by the end of the first week. Avoid strenuous activity that raises blood pressure to the scalp.
Weeks 2–3
Sutures or staples are removed at your follow-up appointment. The incision line may appear pink or slightly raised but is largely concealed by surrounding hair. You can resume most normal activities. New hair growth through and around the scar typically begins within a few months.
Months 3–12
The scar continues to fade and becomes increasingly difficult to detect as hair grows through it. Scalp sensation returns progressively over this period. The advanced hairline is fully stable and permanent. Many patients report being able to wear their hair pulled back confidently by six months.
What to Expect
Safety & Risks
Hairline lowering is a well-established procedure with a strong safety record. As with any scalp surgery, there are specific risks related to blood supply, nerve function, and scarring that should be understood before proceeding.
- Visible or widened scar along the hairline
- Temporary or prolonged numbness behind the incision
- Hair thinning or shock loss near the incision (usually temporary)
- Asymmetry of the hairline
- Infection at the incision site (rare)
- Insufficient advancement if scalp laxity is limited
A thorough assessment of your scalp laxity, hair density, and hairline shape is carried out before recommending a plan. If there is concern about achieving sufficient advancement, a two-stage approach with tissue expansion will be discussed. Scarring potential and every relevant risk will be reviewed in detail during your consultation.
How Much Does Hairline Lowering Cost in Thailand?
Our pricing is transparent and all-inclusive — your quote covers everything from surgeon fees to hospital stay.
Hairline Lowering
All-inclusive surgical package- Board-certified surgeon fee
- Anaesthesia & operating theatre
- Hospital stay & nursing care
- Post-operative medications
- Follow-up appointments
- Dedicated care coordinator
Common Questions About Hairline Lowering
Everything you need to know before your procedure
Dr. Kanokwan Pattanaporn
MEDICALLY REVIEWEDDr. Kanokwan Pattanaporn
MEDICALLY REVIEWEDGender Affirmation Surgeon · Bangkok
Last reviewed: February 25, 2026
Medical References
- Ramirez AL et al. Hairline Lowering: Large Scalp Advancement — Facial Plastic Surgery (2001)
- Guyuron B, Rowe DJ. How to Make a Long Forehead Smaller — Clinics in Plastic Surgery (2013)
- WPATH Standards of Care Version 8 (2022)
- Capitán L et al. Hairline Restoration in Facial Feminization Surgery — Facial Plastic Surgery (2019)
Medical disclaimer: Content on this site is provided for informational purposes and should not be treated as medical advice. Outcomes, timelines, and eligibility differ from person to person. Speak with an experienced gender-affirming surgeon before proceeding with any procedure.
What's Included
- Board-certified surgeon fee
- Anaesthesia & operating theatre
- Hospital stay & nursing care
- Post-operative medications
- Follow-up appointments
- Dedicated care coordinator
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