Frequently Asked Questions

Frequently Asked Questions 2016-11-18T04:36:19+00:00
The hairline lowering procedure is not new. Dr. Ende authored the original description of this procedure in 2008! More and more physicians are now learning this procedure and performing hairline lowerings based on Dr. Ende’s original writings.
Absolutely not! The procedure technique was published in 2008 by Dr. Ende. Recently the popular TV show “The Doctors” featured Dr. Ende’s procedure and finally introduced it to the world. This introduction has catapulted the procedure to a level much higher than Dr. Ende ever dreamed, making it one of the most popular procedures in Dr. Ende’s practice.
Watch Dr. Aharonov present Dr. Ende’s technique on national television!
http://www.thedoctorstv.com/main/home_page?init_type=Feature&init_id=2179
The cost of a hairline lowering procedure is based on several factors. These include scalp flexibility, expected procedure time, desired amount of lowering as well as several other factors. A general range for the surgical fee is 6000 to 8000 dollars with most patients falling somewhere in the middle. This fee is inclusive of the endotine cost which currently exceeds 500 dollars. My staff can provide a cost estimate after I review your expectations as well as emailed photos. Additional cost is involved if performing a brow lift at the same time, but this saves money over having the brow lift performed on a separate date.
These are the same procedure, just 2 different names.
Dr. Ende also offers this procedure in Philadelphia, Pennsylvania. For those not wishing to come to the East Coast, Dr. Kabaker performs this procedure in California and Dr. Ramirez in Hawaii. Dr. Kabaker and Dr. Ramirez coauthored the original paper on hairline lowering with Dr. Ende.
No. Dr. Ende strictly adheres to privacy laws and would never do this to you or anyone else without full written permission. Some patients who do not want their pictures on the internet are more than happy to have them displayed in a powerpoint presentation in the office. Dr. Ende and his staff are more than happy to show you these pictures during your consultation. With the number of surgeries that Dr. Ende has performed, you are likely to see a hairline lowering before and after picture of someone with a similar hairline to yours.
It is possible to perform this procedure on men, but alternative treatments exist such as follicular unit hair transplantation. Male patients with stable high hairlines are better candidates than those with male pattern baldness. Men who lose hair in the future may be left with a visible scar requiring hair transplantation to camouflage it. Having said this, many male patients choose to undergo a hairline lowering procedure and love the results. These patients have the procedure performed knowing that they might need to followup with Dr. Ende when and if they lose more hair in the future for a small hair transplant session.
Most patients do experience numbness to the central front of the scalp. This is expected and resolves within 6 months in most patients. Shock hair loss is a rare side effect that causes temporary hair loss along the frontal hairline. Dr. Ende saw this several years ago, but has not seen this complication since the use of perioperative Kenalog. If shock hair loss does occur during a hairline lowering procedure, the hair typically regrows at the first hair cycle (about 3 months postoperatively). Hairline lowering is not performed under general anesthesia in most patients, which reduces the anesthetic side effects. Infections may occur as with any operation, but infections in the scalp are exceedingly rare. Infection rates are well below that seen with facial surgery.
Most patients experience very little bruising and swelling with a standard hairline lowering procedure. Hair styling is usually enough to cover the sutured area, but a clean hat is also fine. Most patients feel well enough to go out in the general public within 2 days of the procedure.
As with any surgical incision, the area remains red for the first 4-8 weeks. Hairs grow through the scar to disguise it as early as the first week after a hairline lowering surgery. Most of my postoperative pictures are taken at 8 weeks at which time most of the healing has taken place and the scar is barely perceptible.
Dr. Ende has the staff and facility to perform a hairline lowering procedure any day of the week. Unlike most other surgeons who have 1 operative day per week, Dr. Ende performs several surgeries every day. Check with Dr. Ende’s consultant for surgical availability
Most patients undergoing a hairline lowering procedure do not undergo further additional procedures on their scalp. Some patients require hair transplants to the corners or wish to add density to other areas on the scalp. Hair transplants can be performed during or after your hairline lowering procedure. Most patients who present to Dr. Ende for a hairline lowering consult, elect to undergo the hairline lowering procedure. However, Dr. Ende will present both hairline lowering and hair transplant options to you during your consultation.
Patients who undergo a hairline lowering procedure and lose additional hair along the hairline will most likely elect to undergo a hair transplant procedure in the future to disguise the scar. Alternative treatments to lower the hairline in these patients would be hair transplants. The procedure is best for those with a high stable hairline.
The farthest that I have ever lowered a hairline was 10 cm with the use of an expander. Most patients can have their hairline lowered 2-3 centimeters without the use of an expander.
The hairline lowering is performed the same no matter how far the hairline is to be lowered with the one stage procedure. Dr. Ende has never reported a major complication with this procedure and does not believe the lowering a hairline more will make complications more likely.
There is a consent form that must be signed prior to a hairline lowering that reviews just about every conceivable thing that could go wrong. With that said, Dr. Ende has never seen most of the items on the consent form ever happen in his patients. The problems that Dr. Ende has seen have all been temporary such as shock hair loss. But Dr. Ende has not seen shock hair loss in the last 5 years since using Kenalog during the operation.
Dr. Ende has more experience with this procedure than anyone on the East Coast. There is certainly a learning curve involved with this operation in terms of obtaining adequate amount of lowering as well as achieving a natural looking result. That learning curve occurred a long time ago for Dr. Ende with this operation. In addition, Dr. Ende has a true passion for hairline lowering surgery, which is clearly apparent to every prospective hairline lowering patient upon meeting or speaking with him.
The answer is quite simple. They can’t perform a hairline lowering procedure so they can’t offer it to you. Many hair transplant surgeons do not have the training in other forms of hair restoration or the insurance coverage. Many surgeons performing hair transplants don’t even have a surgical background. The only form of hair restoration that they can offer you is hair transplant. I feel that it is unethical to not discuss all of the possible options in hair restoration with a patient. When we meet in consultation, we will discuss the benefits and logistics of a hairline lowering as well as hair transplantation, to help you make the best choice.
If you are considering a brow lift, doing it at the same time makes the most sense. It doesn’t add much time to the procedure and avoids having to do a browlift at a different time.
Many patients, who have undergone brow lifts, have had their hairlines raised to a higher and undesirable position. A hairline lowering procedure is perfect for many patients who wish to lower their hairline back where it belongs. A previous brow lift does not make the procedure any more difficult or change the healing time.
Not only can the hairline lowering be performed, but the bony bumps can be shaved down. This is actually quite common. In addition, Dr. Ende can change the contour of your forehead at the same time if necessary.
Dr. Ende performs both of these procedures and is passionate about both. A lot depends on the patient’s expectations, goals, time frame, etc. Dr. Ende will have a full discussion about the benefits of each type of hairline lowering to help you decide which procedure is best for you.
Many transgender patients wish to feminize their forehead and hairline by having a hairline lowering procedure along with forehead recontouring. Having a hairline lowered to a lower position can feminize a patient’s features, more so than most other procedures that one can have on their face.
Most patients with a high hairline have proportional features on the rest of their face. Lowering a hairline creates facial harmony with even facial thirds, and stops the high hairline from detracting from an otherwise beautiful face. It really doesn’t matter whether one considers themselves to be pretty, ugly or somewhere in between. There is something to be said about proportionality, and most patients are amazed with what lowering a hairline can do for the rest of the face. It’s best to look at before and after pictures to see what a hairline lowering can do for a face.
A hairline lowering can be combined with a browlift to elevate the brows. However, a hairline lowering by itself does not change the position of the brows.
The hairline and aesthetic facial thirds tremendously influence overall facial shape and attractiveness. Many patients who have a high forehead will wear bangs their entire life to disguise the high hairline. This is certainly an option, but does limit hair styling options.
About 20 percent of women are thought to have a high hairline. One way of characterizing an ideal hairline is through a measurement of equal facial thirds. Facial thirds are measured from the chin to under the nose, under the nose to between the brows, and from the eyebrows to the hairline. Most women will ideally have a 6.5 cm forehead, but this varies by the overall size of the face and head. There are many different shapes to the hairline. Dr. Ende has many before and after photos to share with you in the office. You’ll be able to see someone with a similar hairline to yours, and how a hairline lowering procedure transforms the face.
Hairline lowering is performed by making an irregularly irregular trichophytic incision that mimics the hairline within the fine hairs of the hairline (typically just behind the third row of hair). A trichophytic incision refers to cutting at an extreme angle unlike most surgical incisions that surgeons are familiar with. The incision transects the hair shafts leaving the hair bulbs intact under the skin. Within a few days to weeks, these bulbs will sprout a new hair through the scar to camouflaging it quite nicely. A microfollicular transition zone concept is applicable here, the same is it would be performed in a hair transplant procedure, leaving the patient with a natural and undetectable result.

Click Here for Dr. Ende’s Original Article on Hairline Lowering
 
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