The Mind-Blowing Details of Forehead Lifts vs. Forehead Reductions (Forehead Reduction Lift Design) ​

This time, I've prepared a topic on facial proportions regarding forehead lifts and forehead reduction lifts! ​ Hello, this is Dr. Returning from Returning Plastic Surgery. Last time, we learned about the successful method for an endoscopic forehead lift.

[Blog Link Card] Title: If You're Getting an Endoscopic Forehead Lift and Don't Want to Regret It, Read This!! Snippet: Hello, this is Dr. Returning, plastic surgery specialist Kim Yongwoo. This time, we will deeply... blog.naver.com ​ When performing a forehead lift, the hairline can recede, making the forehead appear wider. To prevent this, a forehead reduction (hairline lowering) via a hairline incision must be performed concurrently. Let's take an anatomical approach to determine in which cases a combined forehead reduction is necessary.

The Face's Golden Ratio

[Source] Neligan 4th edition

The vertical "golden ratio" of the face is known to be 1:1:1 for the upper, middle, and lower facial thirds. Therefore, during consultations, we might plan the following surgeries to improve areas that don't match this ratio in photos:

• If the lower face is long:
• Genioplasty (Chin reduction)
• Witch's chin correction
• Lip lift (Philtrum reduction)
• If the mid-face is long:
• Double-jaw surgery
• Facelift
• Lower blepharoplasty with mid-face lift
• If the upper face is long:
• Forehead reduction
• Forehead reduction lift

Is 1:1:1 Really the Golden Ratio??

[Source] https://www.instagram.com/katarinabluu/

While 1:1:1 has historically been called the golden ratio, these days, a shorter mid-face and lower face are considered key elements of a "baby face" or youthful appearance. Karina, who is synonymous with a small face, shows this youthful ratio, with a shorter lower face compared to her upper and mid-face. ​ #FacialProportions #WideForehead #BrowLift #ForeheadWrinkles #EndoscopicForeheadLift #ForeheadReductionSideEffects #ForeheadReductionCost #ForeheadLiftCost #ForeheadLiftSideEffects #ForeheadLiftAndReduction #BestForeheadLiftSurgeon #GangnamForeheadLift #ReturningPlasticSurgery #DrReturning #DrKimYongWoo

Forehead Lift vs. Forehead Reduction: Which One Do You Need? (After photos in the case are 6-month follow-ups)

We must have clear criteria for whether to perform a forehead lift, a forehead reduction, or a combined forehead reduction lift to perform the correct surgery.

When a Forehead Lift is needed

[Image: Forehead lift indications / Before & After]

• Sagging brows
• Forehead wrinkles
• Narrow forehead

 

 

[Image: Forehead lift case]

When Forehead Reduction is needed [Image: Forehead reduction indications / Before & After]

• Wide forehead

When a Forehead Reduction Lift is needed [Image: Forehead reduction lift indications / Before & After]

• Sagging brows
• Forehead wrinkles
• Wide forehead

 

[Image: Forehead reduction lift case]

#FacialProportions #WideForehead #BrowLift #ForeheadWrinkles #EndoscopicForeheadLift #ForeheadReductionSideEffects #ForeheadReductionCost #ForeheadLiftCost #ForeheadLiftSideEffects #ForeheadLiftAndReduction #BestForeheadLiftSurgeon #GangnamForeheadLift #ReturningPlasticSurgery #DrReturning #DrKimYongWoo

Forehead Reduction Design

If the focus is solely on "reducing" the forehead, you might end up with a forehead that is shorter but looks wider. Anatomically, the central part of the scalp descends more than the temporal (side) areas. If this isn't considered during the design, you might be unhappy with the shape even though the forehead is shorter. This must be considered during the design consultation.

[Image: Forehead reduction design diagram] In the design, you must follow the green line, not the blue line, to avoid a wide-looking forehead.

The design in the photo above should follow the green line, not the blue one, for the reduction.

• Green line: Focuses on temporal (side) reduction, creating a harmonious, rounded forehead line.
• Blue line: Focuses on central reduction, resulting in a forehead that is shorter but looks wide.

A surgery following the blue line can result in a shape where the center is reduced, but the sides look wide. A surgery following the green line will create a more ideal forehead shape.

The Truth About the "2cm Forehead Reduction" The Pythagorean Theorem

We estimate the amount of reduction based on facial proportions and scalp laxity, but honestly, it's difficult to predict the exact amount due to many variables during surgery. When going for consultations, you will most often hear "2cm" as the planned amount of reduction. However, patients may become dissatisfied when they see their post-op photos and feel it wasn't reduced by the full 2cm. Why doesn't 2cm of excision equal a 2cm reduction? ​ This is where the Pythagorean theorem comes in.

[Image: Diagram of forehead angle]

When 2cm of the scalp is excised, it results in approximately a 1.4cm vertical reduction from the front. (Assuming a 45° forehead inclination angle)

If the forehead inclination angle is 45° and the excised amount is 2cm, the vertical length that comes down in a frontal photo is 1/√2 cm, which is approximately 1.4cm. In short, for a 45° sloped forehead, 2cm of excision still only looks like a 1.4cm reduction in photos. The more sloped (slanted) the forehead, the less the vertical reduction effect will be from the front. ​ Key Points for a Long-Lasting Forehead Lift The Importance of Periosteal Dissection / Corrugator Muscle Release

 

[Image: Dr. Returning's actual surgery] The importance of periosteal dissection and corrugator muscle resection during an endoscopic forehead lift.

While watching the endoscope, it is crucial to clearly identify and separate (skeletonize) the nerve bundles and thoroughly release the surrounding resistant tissues (periosteum / corrugator muscles). This process requires a high level of skill from the surgeon. If done recklessly, it can lead to nerve damage. If the surgeon is hesitant and dissection is incomplete, the lifting effect will not be sustainable.

Forehead Lift/Reduction Recovery

• Drains (Hemovac): We do not use drains except in special cases.
• Swelling: Major swelling subsides in 2-3 days. By day 7, only some yellow bruising may be observed. By week 2, major swelling is gone, enough to wear makeup. Residual micro-swelling will gradually subside over 2 months.
• Stitch Removal: For a standalone forehead lift, there are only small incisions in the scalp, and stitches are removed around day 7. If combined with a forehead reduction, there is a long incision along the hairline, and stitches are removed around day 10.
• Sensation Recovery: The time for sensation to return depends on aggravating factors. Recovery is slower for elderly patients, diabetics, or smokers. Age is the most important factor. Patients in their 20-30s may recover fully within 2-3 months, while those in their 60-70s will recover slowly, taking 6 months or even up to 2 years.

#FacialProportions #WideForehead #BrowLift #ForeheadWrinkles #EndoscopicForeheadLift #ForeheadReductionSideEffects #ForeheadReductionCost #ForeheadLiftCost #ForeheadLiftSideEffects #ForeheadLiftAndReduction #BestForeheadLiftSurgeon #GangnamForeheadLift #ReturningPlasticSurgery #DrReturning #DrKimYongWoo

Forehead Reduction Lift Results (Case photos are 6-month follow-ups)

At Returning Plastic Surgery, we provide natural and satisfying results with a customized design that considers the patient's facial proportions and condition, using endoscopic forehead lift/reduction.

Case 1

• Upper:Middle:Lower Ratio: 1.2 : 0.9 : 1.0
• Forehead Angle: 35°
• Reduction Amount: 2cm

This patient had a 1.2:0.9:1.0 ratio with a 35° forehead angle. A 2cm reduction restored a 1:1:1 ratio from the front.

[Image: Forehead Reduction Lift 6-months]

Case 2

• Upper:Middle:Lower Ratio: 1.1 : 0.9 : 1.0
• Forehead Angle: 45°
• Reduction Amount: 2cm

This patient had a 1.1:0.9:1.0 ratio with a 45° forehead angle. A 2cm reduction restored a 1:1:1 ratio from the front.

[Image: Forehead Reduction Lift 6-months]

As seen in Cases 1 and 2, even though both had a 2cm reduction, the change in the frontal ratio is different. This shows that when deciding the reduction amount, we must consider the facial ratio and forehead inclination angle to create an ideal proportion. ​ In summary, Considerations for Forehead Reduction Lift Design:

1. Focus on temporal (side) reduction for a rounded shape.
2. Facial proportions.
3. Forehead inclination angle.

This concludes my explanation of the design considerations for a forehead reduction lift. I hope this was a great help to those who are considering a forehead lift/reduction based on their facial proportions. This has been Dr. Kim Yongwoo from Returning Plastic Surgery. Thank you.