Beginning with mastery of the techniques of forehead surgery employed by surgeons of the past, Dr. Spiegel has used new technologies to innovate a method of shaping the hairline, forehead bones, eyebrows, and eye region that is safe and effective and provides remarkable results.

What is the Surgery like?

To access the forehead bone, a fine incision is made along the hairline from temple to temple. The incision is done in front of the hairline so that Dr. Spiegel can preserve all of the hair you have while advancing the scalp and hairline to a more feminine position. Following surgery, some patients will elect to have a few hairs transplanted in front of the new hairline although in most cases, this is unnecessary. Through this incision, Dr. Spiegel is able to reshape the bones around the eye and forehead to a natural feminine shape. Several of different techniques are needed in order to get an optimal result due to varying anatomy. Utilizing his expertise in sinus surgery, Dr. Spiegel is able to reposition the forehead bones while minimizing any disruption of the sinus function.

Some patients have forehead bones that are very thick and using a burr to thin the bone is enough to get the desired result. However, this is quite rare. In most cases, patients have bones that varies in thickness depending on the area. Dr. Spiegel begins most cases by burning down the bone until he gets close to the sinus cavity. Once he determines where the sinus cavity is located he removes a small area of bone above the cavity but he is careful not to cut into the area. Then he reshapes the small fragment just enough, so it fits back into the forehead but sits farther back into the cavity – removing the heavy brow bossing and giving the forehead a flatter, more feminine appearance.

Once the forehead is shaped to its desired position and balanced with the rest of the face the small fragment is held in place snug with the body’s natural tissues, in some cases with a tiny titanium screw, and a special “bone cement”. This “cement” is the patient’s living bone ground down to a smooth paste and laid over the broken bones helping the bones heal rapidly in their new position.

At this point, Dr. Spiegel is able to shape the hairline by advancing the scalp in areas where it is receded. A natural result is obtained which typically eliminates the need for any fat grafting in the temporal area. At the same time, Dr. Spiegel carefully lifts the eyebrows to their natural feminine position on the new forehead. The look is subtle and not overly pulled; rather it gives patients a beautiful result highlighting their eyes and new, smooth forehead.

For those who don’t need scalp repositioning, forehead contouring and brow lifting can be achieved through a nearly invisible incision. Additionally, for some, minimal brow shaping and brow lifting are all that is needed and this can be done with an endoscopic approach. Dr. Spiegel is an expert at the use of surgical endoscopes and has published papers relating to their surgical use.