Forehead biconvexity enhancement with fat grafting

Abstract

Background: Frontal biconvexity is a key criterion for an attractive forehead. Fat injection as an effective, safe and reliable method for soft tissue augmentation could be used to enhance forehead contour. We report our experience with combined platelet-rich plasma (PRP) and fat grafting to create or restore frontal biconvexity and to reduce wrinkles. Methods: Fifty-seven females and 4 males (mean age, 40.2 years) underwent the combined PRP and fat injection. Fat mixed with PRP on the ratio of 5:1 was injected in small aliquots in the space between the dermis and underlying frontalis muscle. Patient satisfaction with the cosmetic result was evaluated by a questionnaire using pre- and postoperative photos and a four-point grading scale. Results: All patients who underwent three injection sessions (n = 5) evaluated the esthetic result as excellent. In patients who had two injection sessions (n = 36), 36 evaluated the result as excellent, 50 as good, and the remaining 5 as moderate. In patients who had a single injection session (n = 15), 27 evaluated the result as excellent, 40 as good, and the remaining 5 as moderate. Concerning frontal wrinkles, 25 of 34 (73.5) patients reported good improvement and the remaining 9 (26.5) reported moderate improvement. Conclusion: Fat injection combined with PRP should be considered as an effective tool to improve forehead biconvexity. Level of evidence: Level IV, therapeutic study. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature