Where Do You Hide Brow Lift Incisions If You Don't Have Hair?

Fantastic question, and genuinely one of the trickier planning problems in facial surgery: where do you hide your brow lift incisions if you don't have hair to hide them in?

Most brow lift techniques assume you've got a hairline to tuck the scars into. So what happens when you don't? The good news: you have real options, and one of them turns something people usually complain about, forehead wrinkles, into an advantage.

There are a whole lot of different places we can put an incision for a brow lift:

• Directly above the eyebrows themselves
• In the creases of the forehead (hiding the scar inside an existing wrinkle)
• At or behind the hairline
• For an endoscopic brow lift, small incisions off to the sides, plus one right at the hairline

In plastic surgery we're always trying to be creative about hiding incisions based on your particular anatomy and what you have to work with. Hairline incisions are lovely when you have hair to conceal them. When you don't, we simply choose a different hiding place, the same way we choose an incision location for any procedure based on the individual.

If you don't have hair to hide the incision, one of the forehead creases is often your best option.

The logic is simple: a scar placed inside an existing crease blends into a line your face already makes. Instead of introducing a new line on a smooth surface, we're tucking it into an established one. For patients with a well-defined central forehead wrinkle, this can be an excellent choice.

Here's the option a lot of people don't know exists. Normally an endoscopic brow lift places its small incisions back in the hairline. But we can instead put those incisions in the forehead creases, a little lower down, avoiding the hairline entirely.

This isn't experimental improvisation, there are a couple of papers describing this approach over the last seven or eight years, and the results are great. So if you like the idea of an endoscopic (more minimally invasive) approach but have no hairline to hide behind, this is a legitimate, published option worth asking about.

So which one is right for you? It really comes down to how your forehead wrinkles are placed:

• A really defined wrinkle in the central forehead → that central crease may be the best place to hide your incision.
• Wrinkles higher up and off to the sides → the endoscopic brow lift (with incisions in those upper/lateral creases) may be the better fit.

It's an individualized decision based on your actual anatomy, which is exactly the kind of thing to map out together at a consultation.

I love this part, because it flips the usual script:

Patients often come in frustrated by their forehead lines. But in brow lift planning for someone without hair, those lines are an asset. They're pre-made camouflage. The deeper and better-defined they are, the better they conceal a well-placed scar.

Not having hair doesn't rule out a brow lift, it just changes where the incision goes. Instead of the hairline, we look to:

• Directly above the brows
• Inside a forehead crease (often the best option when there's no hair)
• An endoscopic brow lift with the incisions placed lower, in the forehead creases rather than the hairline, a published approach with great results

Which one is right depends on where your forehead wrinkles actually sit. And in a nice bit of irony, those wrinkles work in your favor here, giving us natural lines to hide the scar in. Talk it through with your surgeon, and remember that thoughtful incision placement is a big part of how any scar ultimately looks.