A youthful and attractive forehead appears smooth, continuous, and gently curved in the front view, with a prominence that curves naturally into the nose and eyebrows when viewed from the side, with no prominent hollows or ridges, no fine lines when in neutral expression, and no excessive expression lines or wrinkles when looking up.
Age-related soft tissue volume loss in the forehead can lead to the appearance of a forehead that is flat on both the front and especially the side view, with hollows and ridges that appears uneven and bony, as the shape of the underlying bone becomes more prominently visible. Years of sun and environmental damage also leads to the loss of collagen in the skin, which leads to the appearance of dry and tired skin with many static lines and wrinkles. This can lead to an old, haggard, or harsh looking appearance.
Unlike the cheeks where aging changes often involves loss of support, aging changes in the forehead is predominantly due to loss of volume, in the form of fat in the subcutaneous layer, and collagen in the skin. Therefore, the most direct and effective way to rejuvenate a forehead is to replace volume in the forehead, and for that reason we most commonly choose collagen stimulators such as Ellanse for our forehead treatments. HA fillers are effective as well in younger patients or patients with less deficiency or hollows in their foreheads, but may not be cost effective or may even look unnatural in older patients where larger volumes are required.
In the case of Ellanse treatments, a blunt cannula is used to avoid trauma to the structures within the forehead, and especially to reduce the risks of the product entering the blood vessels in the forehead, which could lead to the extremely rare but potentially catastrophic complication of skin death or even blindness. Nerve blocks can be used in this area so most of our patients report the entire procedure to be painless or very minimally uncomfortable. However, one must prepare for the downtime of swelling (which can be painful) that will gradually resolve over the next 3-5 days. The initial “result” seen is impermanent and comes from a soft filler that is mixed in the product to help the doctor distribute the product evenly. This filler is fully resorbed by the body over the next 2-4 weeks, and very perceptive patients may notice the “results” diminishing in this period as a result. Over the next 3 months, the biostimulatory properties of the Ellanse encourages the body to produce new collagen in the treated area, which in turn replaces soft tissue volume in the forehead, as well as improve skin quality and skin hydration.
The final result is a forehead that is smooth, continuous, and gently curved, without obvious hollows, concavities and convexities, with less obvious lines and wrinkles in both static and expression, that frames the eyebrows, eyes and nose better. Importantly, a gentle forehead curve shapes the upper face and provides a youthful contour to the whole face, especially in the side / profile view. This gives rise to an appearance that is younger, more energetic, more feminine and more attractive. As the results are from the stimulation of natural collagen, it only diminishes with natural loss of collagen due to aging, and will last a minimum of 2 up to 4 years depending on the type of Ellanse used, as well as individual patient characteristics.