Forehead contouring with fillers: early experience with 18 consecutive cases

Introduction: forehead contouring is a surgical procedure usually performed to reduce frontal bossing in males. Nonsurgical procedures, such as filler injections, in selected cases, could be an alternative to surgical forehead recontouring, improving the aesthetic of the forehead and achieving a more convex appearance of the upper third. Moreover, by reducing the perception of supraorbital bossing, it can also be performed as a procedure to camouflage and deal with the process of forehead aging. Authors describe their early experience in frontal contouring with fillers. Material and methods: this is a retrospective study that takes into account all the forehead contouring procedures performed from January 2014 to January 2019. Eighteen patients, ages ranging from 26 to 56 years old, were treated with hyaluronic acid or calcium hydroxyapatite-based filler injections. Results: a VAS and a Pain scale were submitted to all the patients in order to evaluate the result achieved, and the pain felt in performing the procedure. At the end of every procedure for each case, patients experienced redness and surface irregularities which resolved themselves within 48 hours. No Ecchymosis was ecorded. During the follow-up period, in one case, a nodule secondary to the CaHa injections was recognized and surgically excised. Conclusion: although there are several limitations regarding this study, outcomes of the present case series suggest that a non-surgical contouring of the forehead with the use of fillers could be another possible indication for these medical devices, although a filler specifically developed for forehead contouring, has yet to exist. Larger, blinded, and controlled studies are required to support the effectiveness of this technique.