title: Cessation of hairline recession following open forehead rejuvenation.
abstract: BACKGROUND
  The senior author (B.G.) observed that patients who underwent forehead rejuvenation using a pretrichial incision did not experience hairline recession. The aim of this study was to objectively measure the effects of forehead rejuvenation on hairline recession.
  
  
  METHODS
  A 15-year retrospective review was performed in 31 forehead rejuvenation patients [17 endoscopic and 14 open (pretrichial incision) with adequate early (within 1 year) and late (≥ 8 years) postoperative photographs] and 11 age- and follow-up-matched cosmetic surgery patients who did not have forehead rejuvenation. Hair recession was measured using the Mirror program for Windows by averaging two successive perpendicular distances from bilateral medial canthi to the hairline and dividing by the intercanthal distance. In pretrichial incision patients, the distance from the incision to the anterior hairline was recorded.
  
  
  RESULTS
  The difference in short-term postoperative hairline measurements among groups was not significant (p = 0.445). Only the pretrichial group demonstrated significant stability between short-term and long-term hairline positions (p = 0.005). The pretrichial group demonstrated a stable or improved hairline position compared with either the endoscopic (p = 0.017) or control group (p = 0.006), whereas these patients demonstrated significant recession over time. Hairline measurements between early and late postoperative photographs in the endoscopic and control groups were not significant (p = 0.621).
  
  
  CONCLUSIONS
  The pretrichial incision results in a stable hairline position over time compared with the endoscopic technique or matched controls. Pretrichial incision patients did not demonstrate separation between the scar and hairline, indicating no hair loss in this site.
authors.affiliation: Cleveland and Akron, Ohio From the Department of Plastic Surgery, Case Western Reserve University School of Medicine; University Hospitals of Cleveland Case Medical Center; and Northeastern Ohio Universities College of Medicine.
authors.forename: Bahman
authors.initials: B
authors.lastname: Guyuron
authors.forename: James
authors.initials: J
authors.lastname: Gatherwright
authors.forename: Ali
authors.initials: A
authors.lastname: Totonchi
authors.forename: Rouzbeh
authors.initials: R
authors.lastname: Ahmadian
authors.forename: Navid
authors.initials: N
authors.lastname: Farajipour
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000209:etiology*; D002921:Cicatrix / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005546:Forehead / Q000601:surgery*; D006197:Hair / Q000254:growth & development; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012060:Rejuvenation; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000009:adverse effects* / Q000379:methods; D013995:Time; D055815:Young Adult