Hairline & Forehead Surgery

Hairline advancement, frontal bone setback, forehead and orbital contouring, and brow lift can all be important aspects of facial feminization surgery. Here is what to expect before and after this procedure with Dr. James Lee.

Before Surgery

You do not need to shave your hair in preparation for surgery as we are able to make incisions while carefully preserving as much hair as possible. However, before surgery you should:

  • Remove any and all piercings
  • Remove any hair or eyelash extensions
  • Stop electrolysis 2 weeks before surgery
  • Stop topical retinoids 2 weeks before surgery (6 months for oral retinoids like Accutane)
  • Stop nicotine and marijuana products 3 months before surgery
  • Eat a well-rounded diet including vitamins and protein

After Surgery

Expect that there will be significant bruising and swelling after surgery. Recovery will look something like this:

  • Day 1 after surgery: You will be swollen and uncomfortable. The head wrap may feel tight – that is normal. Most patients find that the pain is tolerable because many areas on the face are numb. Your throat may be hoarse due to the breathing tube from anesthesia.
  • Day 1 you should: take tylenol and ibuprofen alternating every 3 hours and take breakthrough narcotic pain medication if those medications are not enough. Take a stool softener to help with constipation if you take the narcotic pain medication. Keep your head elevated as much as possible, even when you are sleeping (this will help with the swelling). Walk around normally to prevent blood clots but avoid strenuous activity that elevates your heart rate or blood pressure. Apply ice wrapped in a towel to the surgical site, 20 minutes at a time and make sure not to make it too cold over numb areas.
  • Days 2-3 after surgery: The swelling will peak around day 2 or 3 after surgery. Your eyelids may swell shut around this time and they may swell asymmetrically. This will only last for a day or two. Your head wrap may start to feel a bit tighter as the swelling gets worse.
  • Days 2-3 you should: Continue with the pain medication regimen as needed and continue elevating your head at all times. Ask a caregiver to help if you are having trouble seeing with the swelling of the eyelids. Continue ice on and off until day 3.
  • Days 4-7 after surgery: The swelling starts to improve little by little every day. Pain starts to improve day by day and many patients stop taking narcotic pain medication by day 5. Sensation may start to return on parts of the forehead.
  • Days 4-7 you should: Continue the pain medication regimen but start decreasing the amount of narcotics to avoid too much constipation. You may remove the head wrap dressing after day 3 and shower but you should put the jaw bra (if you have one) back on when dry and wear it at all times otherwise. Alternatively, you may leave the entire head wrap dressing on until your postoperative visit at 1 week. At this appointment, we will remove the dressings and remove stitches on the hairline if there are any. Continue keeping the head elevated at all times.
  • Week 2 after surgery: The swelling continues to improve and patients typically do not need narcotic pain medication at this point. Sensation on the forehead continues to improve.
  • Week 2 you should: Take tylenol or ibuprofen as needed for pain but decrease pain medication use as tolerable. Continue to keep your head elevated up to 1 month after surgery. Come to your 2 week postoperative appointment for staple removal.
  • Months 1-3 after surgery: Most of the swelling is resolved but may be worse in the morning if you are sleeping without elevating your head. You may feel “electric shock”, tingling, burning, or itching sensations on the top of your head and forehead as the nerves recover. This is normal and the frequency will decrease as the nerves recover over several months. Your hairline scar will be very pink during this part of the healing process. Hair will start growing back near the incision lines around this time.
  • Months 1-3 you should: Apply diligent sun protection on the hairline scar. Use at least SPF 30 sunscreen on the scar when there is UV exposure and reapply every 2 hours you are in the sun. Starting 1 month after surgery you may exercise normally but avoid putting your head down on gravity and avoid trauma to the face.
  • Months 3-12 after surgery: The scar will continue to fade little by little until 12 months after surgery. Sensation will slowly return to the top of the scalp for up to 18 months after surgery. Hair will continue to grow longer over this time period.
  • Months 3-12 you should: Continue applying diligent sun protection to the scar for up to 12 months after surgery. You may exercise and do all your normal activity starting 3 months after surgery. Continue to avoid trauma to the face.

Why Choose Dr. James Lee for Facial Feminization Surgery?

Choosing the right surgeon for facial feminization surgery is critical. FFS requires advanced knowledge of craniofacial structure, aesthetic judgment, and technical precision.

Contact our office today to begin your journey.