Fillers correct volume loss to forehead

Injectable fillers, once mainly reserved for the nasolabial fold and the lips, have tremendous potential for the forehead, according to an expert who spoke last weekend at the 2014 Annual Meeting of the American Society for Dermatologic Surgery.

In women, the ideal forehead has a gentle reverse slope of 12-14 degrees going upward, says Vince Bertucci, M.D., F.R.C.P.C., president elect of the Canadian Dermatology Association, co-director of the Cosmetic Dermatology & Laser Fellowship at the University of Toronto, consultant dermatologist with Women’s College Hospital, Toronto and medical director of Bertucci MedSpa in Woodbridge, Ont.

READ: More coverage of the 2014 ASDS Annual Meeting

That means that if you look at a woman’s face in profile, the brows will project more than the hairline, he says. But as people age, he says, “you lose volume in the forehead which often shows up as horizontal concavity in the middle third of the forehead.”

Injectable fillers can correct the volume loss, allowing the forehead to develop “a more aesthetically pleasing contour,” Bertucci says. “Additionally, it sometimes helps to lift and reposition the brows to their more youthful position.”

Fillers also help provide support for the underlying tissues, meaning that fewer horizontal forehead wrinkles develop when someone raises her eyebrows, he says. As a result, fillers can be a helpful addition to botulinum toxins such as Botox, he says.

Bertucci cautions that it’s important to be careful to limit injections to safer vascular areas. It’s best to avoid the area around the glabella and brows. If using a needle, aspirating before injecting helps to reduce the risk of intravascular injection; using a blunt-tipped cannula is also be helpful, he says.

Why are fillers only now being seen as a valuable tool for the forehead? Bertucci says it’s a matter of deeper understanding of beauty and aging with the passage of time. “Our knowledge of what makes an aesthetically pleasing face has evolved over the years,” he says. “We’re becoming more aware of what makes the face look harmonious, balanced and beautifully contoured.”