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American Association of Plastic Surgeons

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Gender And Age Variances Of The Forehead Soft Tissues: A Magnetic Resonance Imaging (MRI) And Computed Tomography (CT) Based Study
Cagri Cakmakoglu, M.D, Grzegorz Kwiecien, M.D, James Zins, M.D.
Cleveland Clinic Foundation, Cleveland, OH, USA.

Background: Age-related forehead soft tissue changes of have received scarce attention, even though appreciation of these is vital when performing forehead rejuvenation. The aim of this study is to examine the forehead soft tissue to guide age and gender related forehead soft tissue changes.
Methods: Cranial CT and MRI from 90 Caucasian individuals were investigated. (5 males and 5 females from each of the following decades: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90-98 years). Forehead skin, subcutaneous and muscle thickness were measured to in an effort to analyze changes.
Results: The overall soft tissue thickness of the forehead ranged from 4.1-9 mm, with an average of 4.70.3 mm. With increasing age, the soft tissue thickness of the male forehead decreases significantly. By age 70-79, gender soft tissue differences were no longer apparent. In the lower forehead, (≤3 cm cranial to the nasion), soft tissue thickness decreased both in males and females. The skin thickness of the upper forehead (≥3 cm cranial to the nasion) and mid forehead, increased slightly with aging while subcutaneous tissue thickness decreased in both genders with increasing age.
Conclusions: The shape of the forehead soft tissue thickness varies in young individuals of different genders and undergoes complex changes with age due to aging process. Because soft tissue cover is thin, changes in the skin and subcutaneous tissue may take on greater importance than in other parts of the face. Documenting such changes may allow us to more accurately reverse such changes in the future.


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