Forehead Reduction: A Systematic Review and Meta-Analysis of Outcomes

Peter M. Vila*, Shaan N. Somani, Q. Eileen Wafford, Douglas M. Sidle

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Importance: Forehead reduction, or hairline lowering surgery, is becoming more popular as a cosmetic procedure for patients with disproportionately large foreheads. A large forehead can make a patient appear older, be masculinizing, and less attractive. Objective: To quantify reported outcomes in patients undergoing forehead reduction. Methods: We performed a systematic review and meta-analysis of adults undergoing forehead reduction. A review protocol was published in PROSPERO (CRD42020183366). A research librarian created search strategies in multiple databases. Abstracts and full texts were reviewed in duplicate. The Newcastle-Ottawa scale and Cochrane Collaboration Risk of Bias tool were used. Random effects meta-analyses were performed. The primary outcome was amount of reduction. Other extracted data included study type, location, sample size, scalp fixation method, incision, complications, follow-up time, percentage female, and age. Results: Our search strategy found 376 unique citations, and 8 studies were included. All eight were retrospective cohort studies, comprising 882 patients (range 5-525). Study quality was high, and risk of bias ranged from unclear to high. Four studies were included for meta-analysis, totaling 801 patients. Mean amount of reduction was 1.6 cm (95% confidence interval: 1.4-1.8). Complications included temporary and permanent alopecia, unacceptable scarring, persistent paresthesia, and hematoma. The pooled complication rate was 1% or less. Conclusion: Forehead reduction is associated with a low complication rate (<1%), and a mean lowering of 1.6 cm is reported. Future studies should report mean and standard deviation of reduction, and should follow patients for at least 12 months.

Original languageEnglish (US)
Pages (from-to)34-40
Number of pages7
JournalFacial Plastic Surgery and Aesthetic Medicine
Issue number1
StatePublished - Jan 1 2022

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)


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