Hair loss can occur after various facial rejuvenation surgical techniques. This article aims to provide a comprehensive framework regarding the patterns, causes, and treatment options for hair loss that may appear following facial rejuvenation surgeries.
As expected, hair loss is observed after surgeries in which incisions are made within the scalp. In facial aesthetic surgeries, incisions within the scalp are commonly used. The main reason for this is that these incisions remain hidden among the hair and are not noticeable in the long term. From this perspective, the scalp is one of the anatomical areas where surgical scars can be best concealed in plastic surgery.
During these incisions, hair is never cut. Hair is separated similarly to a hairdresser’s parting technique, allowing the incision to be made between the follicles without damaging the hair shafts. Throughout the surgery, utmost care is taken to protect the hair roots. Despite this, some patients may experience hair loss around the incision site postoperatively.
Although hair loss after facial rejuvenation surgeries can be concerning for patients, it is often based on predictable mechanisms. The way hair loss appears largely depends on the type of surgery performed, the length of the incision within the scalp, and the surgical techniques used. Below, I address the most common surgery types in terms of hair loss and the specific mechanisms associated with each.
Hair Loss After Coronal Forehead Lift Surgery
The coronal forehead lift is one of the facial rejuvenation surgeries with the highest risk of hair loss. In this technique, the incision extends from one ear to the other, spanning the entire scalp and forming a crown-like line.
The main causes of hair loss after this surgery include:
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Making a very long incision within the scalp
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Reduced blood circulation in the scalp in front of the incision line
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Impaired blood supply to hair follicles during large flap elevation
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Tension along the incision line and pressure from sutures
In rare cases, almost all hair in front of the incision line may be permanently lost. For this reason, coronal forehead lift surgery is currently used more selectively.
Hair Loss After Classic Temple Lift Surgery
In classic temple lift surgeries, relatively smaller but still moderately long incisions are made within the scalp. Since this area is critical for shaping the hairline, even small mistakes can lead to visible aesthetic problems.
Factors contributing to hair loss after this surgery include:
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Surgical trauma to hair follicles around the incision
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Repeated pressure during retraction
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Use of heat-generating devices such as electrocautery near the incision
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Excessive tension on the scalp in the temple area
After these surgeries, hair loss is usually not complete but manifests as thinning or reduced density around the incision line.
Hair Loss After Endoscopic Forehead Lift Surgery
Endoscopic forehead lift has the lowest risk of hair loss among forehead lift techniques. In this method, usually three or four small incisions of approximately 1.5–2 cm are made in the scalp, and the surgery is performed using very fine instruments.
Despite this, limited hair loss may still occur postoperatively. The causes may include:
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Local surgical trauma around the incision
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Local inflammation due to sutures or fixation materials
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Foreign body reaction to devices such as Endotins
Hair loss in this context is usually patchy, localized, and most often temporary.
Hair Loss After Facelift Surgery
After facelift surgeries, hair loss is most commonly observed in the temple and occipital regions. Much of this is related to incision planning rather than direct follicle damage.
Main causes of hair loss after facelift surgeries include:
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Improperly planned incision lines
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Repositioning of the hairline
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Excessive tension in the temple or occipital skin
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Impaired circulation around the incision
In some cases, even when there is no actual hair loss, the repositioning of the hairline can create the appearance of thinning, giving the patient a sense of baldness or hairless areas.
When hair loss occurs, patients are first educated about the natural life cycle of hair. Hair growth has three main phases: growth, resting, and shedding. Surgical trauma, stress, and local inflammation can push some follicles into the resting phase. In this case, hair falls out but the follicle remains alive, essentially “asleep” within the scalp. Over time, these follicles reactivate and begin producing hair again.
If the surgery has been performed carefully and there are no factors causing permanent follicle damage, such hair loss is usually temporary. Most hair regrows naturally within six to nine months. To support this process, some patients may benefit from adjunctive treatments such as PRP (platelet-rich plasma) or topical minoxidil.
If significant improvement is not observed after 9–12 months, it is unrealistic to expect spontaneous regrowth. At this point, the next step can be considered. If the bald area is small, it can be surgically excised in an elliptical fashion, and the scalp edges can be approximated and sutured. This is a simple procedure, typically lasting five to ten minutes under local anesthesia in a clinical setting. In minor hair loss after endoscopic forehead lift, this approach is often preferred.
If the hairless area is larger, hair transplantation becomes an option. This type of hair transplantation differs from large-scale male pattern baldness procedures. Usually, a small area of about 3x3 cm is shaved in the occipital donor site under local anesthesia. In long-haired female patients, this is often inconspicuous. Follicles are harvested using the FUE technique and implanted into the bald area considering direction and angle. The goal is not to restore full original density but to achieve enough coverage to camouflage the area. Achieving 20–30% of the original density is often sufficient.
Patients experiencing hair loss after facial rejuvenation surgeries should always discuss this with their doctor. While the waiting period can extend up to a year, in most cases this is a natural process that resolves on its own. For more detailed information about facial rejuvenation surgeries and their potential effects, you can contact us anytime.
