Minimally invasive forehead augmentation is becoming increasingly popular in Asia. However, treatment of the glabella is associated with injection-related complications. The safety of injections can be increased through a thorough understanding of the anatomy and precise injection planes. The authors propose a 3-point injection technique for forehead augmentation in Asian patients that uses CHAP-hyaluronic acid (CHAP-HA) filler. The longevity of the filler was assessed using high-resolution ultrasound (HRU) imaging. Fifteen patients were examined using HRU before and immediately after treatment and at 1 month, 3 months, 6 months, and 12 months. As evident in HRU imaging, CHAP-HA remained visible within surrounding tissue for 6.4 ± 3.7 months. The mean Global Aesthetic Improvement Scale rating was 2.4 ± 0.5 immediately after treatment, 2.8 ± 0.3 at 1 month, 2.7 ± 0.5 at 3 months, 2.1 ± 0.6 at 6 months, and 1.5 ± 0.6 at 12 months. Minimal side effects were reported. The authors demonstrated that CHAP-HA filler may be an optimal candidate for forehead filler augmentation using a 3-point injection technique.
References
[1]
American Society of Plastic Surgeons (2019) 2019 and 2018 Plastic Surgery Statistics Report. https://www.plasticsurgery.org/news/plastic-surgery-statistics
[2]
Phumyoo, T., Jiirasutat, N., Jitaree, B., Rungsawang, C., Uruwan, S. and Tansatit, T. (2020) Anatomical and Ultrasonography-Based Investigation to Localize the Arteries on the Central Forehead Region During the Glabellar Augmentation Procedure. Clinical Anatomy, 33, 370-382. https://doi.org/10.1002/ca.23516
[3]
Liu, H., Chen, D. and Zhang, J. (2020) Ophthalmic Artery Occlusion after Forehead Autologous Fat Injection. Retinal Cases and Brief Reports, 14, 271-274. https://doi.org/10.1097/ICB.0000000000000694
[4]
Hong, W.J., Liao, Z.F., Zeng, L., Luo, C.E. and Luo, S.K. (2020) Tomography of the Forehead Arteries and Tailored Filler Injection for Forehead Volumizing and Contouring. Dermatologic Surgery, 46, 1615-1620. https://doi.org/10.1097/DSS.0000000000002561
[5]
Kim, J. (2018) Novel Forehead Augmentation Strategy: Forehead Depression Categorization and Calcium-Hydroxyapatite Filler Delivery after Tumescent Injection. Plastic and Reconstructive Surgery—Global Open, 6, e1858. https://doi.org/10.1097/GOX.0000000000001858
[6]
Chao, Y. (2018) Saline Hydrodissection: A Novel Technique for the Injection of Calcium Hydroxylapatite Fillers in the Forehead. Dermatologic Surgery, 44, 133-136. https://doi.org/10.1097/DSS.0000000000001136
[7]
Dubina, M., Tung, R., Bolotin, D., Mahoney, A.M., Tayebi, B., Sato, M., Mulinari-Brenner, F., Jones, T., West, D.P., Poon, E., Nodzenski, M. and Alam, M. (2013) Treatment of Forehead/Glabellar Rhytide Complex with Combination Botulinum Toxin A and Hyaluronic Acid Versus Botulinum Toxin A Injection Alone: A Split-Face, Rater-Blinded, Randomized Control Trial. Journal of Cosmetic Dermatology, 12, 261-266. https://doi.org/10.1111/jocd.12059
[8]
Lee, H.T. and Thong, H.Y. (2018) Use of High-Resolution Ultrasound (HRU) in the Assessment of Deep Injections of CHAP-Hyaluronic Acid (CHAP-HA) Fillers for Midface Lift. Journal of Cosmetics, Dermatological Sciences and Applications, 08, 126-132. https://doi.org/10.4236/jcdsa.2018.83014
[9]
Liang, C.P. and Thong, H.Y. (2016) A Guide to Cheek Augmentation: Single-Point Deep Injection of Hyaluronic Acid Filler at Midface in Close Proximity to Medial Suborbicularis Oculi Fat (SOOF) Area. Journal of Cosmetics, Dermatological Sciences and Applications, 6, 1-8. https://doi.org/10.4236/jcdsa.2016.61001
[10]
Cho, K.H., Dalla Pozza, E., Toth, G., Bassiri Gharb, B. and Zins, J.E. (2019) Pathophysiology Study of Filler Induced Blindness. Aesthetic Surgery Journal, 39, 96-106. https://doi.org/10.1093/asj/sjy141
[11]
Wu, S., Pan, L., Wu, H., Shi, H., Zhao, Y., Ji, Y. and Zeng, H. (2017) Anatomic Study of Ophthalmic Artery Embolism Following Cosmetic Injection. Journal of Craniofacial Surgery, 28, 1578-1581. https://doi.org/10.1097/SCS.0000000000003674
[12]
Scheuer, J.F., Sieber, D.A., Pezeshk, R.A., Gassman, A.A., Campbell, C.F. and Rohrich, R.J. (2017) Facial Danger Zones: Techniques to Maximize Safety During Soft-Tissue Filler Injections. Plastic and Reconstructive Surgery, 139, 1103-1108. https://doi.org/10.1097/PRS.0000000000003309
[13]
Beleznay, K., Carruthers, J.D., Humphrey, S. and Jones, D. (2015) Avoiding and Treating Blindness from Fillers: A Review of the World Literature. Dermatologic Surgery, 41, 1097-1117. https://doi.org/10.1097/DSS.0000000000000486
