Extract

Dr. Kaye: The first case is a patient shown with hair loss—or, perhaps more accurately, repositioning of the hair—after undergoing a face lift (Figure 1). Dr. Connell, how does one avoid this type of problem?

Dr. Connell: In the preoperative evaluation, I carefully examine the patient, pinching the skin to determine how the hair will shift as a result of surgery. If the amount of skin that will be moved toward the temple area would shift the hair to an objectionable degree, I discuss this with the patient. The choices are either having a scar that follows along the hairline, which is not ideal but rarely causes a problem, or having the hairline shift. Most of my patients opt for the incision along the hairline, but there may be some who would not object to the hair shifting.

Dr. McKinney: I would have avoided this patient's problem by not trying to lift the midface so much by means of the temporal incisions. I find that an endoscopie brow lift offers a better option for achieving similar improvement to the mid or upper face, and it avoids shifting the hairline.

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