Hair Loss from Brow Lift

Dr. Rassman,

On Nov. 30th I had a contour thread lift of the brows. (contour threads: barbed sutures now used to pull eyebrows up – they don’t dissolve – made of polypropelene)

The incision on the left side of my scalp (just behind the hairline) had a touch of keloid or hypertrophic scarring but the right side is awful. I have a dime sized circular bald spot – very smooth. It’s so terrible. I’m in tears almost daily. It was infected and antibiotic ointment helped flatten it out but the hair is completely gone. There are no pores or anything.

I’m writing to you to see if you know (without benefit of seeing it) whether the hypertrophic process just creates skin that is fibrous and the hair follicles are still “alive” underneath, but can’t grow through or whether it kills the follicles. My plastic surgeon said he didn’t know what it was and that he could just cut it out, but from what I’ve read, a straight line incision is not the answer —- and aside from that, I was hoping to get my hair back.

Any feedback would be appreciated

Photographs would help. I will give you some general comments about brow lifts, scars and hair loss. Scars and hair loss in brow lifts are not uncommon. My practice is skewed because I see many of these, probably a disproportionate number of them relative to what a normal plastic surgeon does. I get the complicated patients, which hopefully are only a small percentage of those that the plastic surgeon gets. Most of the time when hair is lost, the hair will return in 5-9 months. When it does not, then hair transplants can solve the problem nicely. Scars take on a series of categories, including: Hypertrophic scars (unusual in the first few weeks after surgery, keloids (very rare), widened scars (more common). Hypertrophic scars may require steroid shots and widened scars may require hair transplants if they are detectable months after the surgery. Cutting out the scar from a previous surgery often does not work, but without seeing it, if would be impossible for me to make that judgment.