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

Area of Science:

• Plastic Surgery
• Cosmetic Surgery
• Otolaryngology

Background:

• Forehead reduction, also known as hairline lowering surgery, is increasingly sought after for cosmetic enhancement.
• Disproportionately large foreheads can negatively impact a patient's appearance, potentially causing them to look older, more masculine, or less attractive.

Purpose of the Study:

• To systematically review and quantify the reported outcomes of forehead reduction procedures.
• To analyze data from existing studies to determine the efficacy and safety of hairline lowering surgery.

Main Methods:

• A systematic review and meta-analysis was conducted on adult patients undergoing forehead reduction.
• Search strategies were implemented across multiple databases, with abstracts and full texts reviewed in duplicate.
• Study quality and risk of bias were assessed using established tools, and random effects meta-analyses were performed.

Main Results:

• Eight retrospective cohort studies comprising 882 patients were included in the review.
• Meta-analysis of four studies (801 patients) reported a mean forehead reduction of 1.6 cm (95% CI: 1.4-1.8 cm).
• The pooled complication rate was low, at 1% or less, including temporary/permanent alopecia, scarring, paresthesia, and hematoma.

Conclusions:

• Forehead reduction surgery is associated with a low complication rate (<1%).
• A mean hairline lowering of 1.6 cm is achievable.
• Future research should standardize reporting of reduction amounts and ensure a minimum follow-up of 12 months.