Plastic surgery and topical treatments are options for forehead wrinkle removal. Some treatments produce permanent results, and others produce temporary results. Each procedure carries some risks of adverse reactions. To minimize risks, the American Society of Plastic Surgeons recommends using a surgeon who has completed at least 5 years of surgical training with a minimum of 2 years in plastic surgery.
Surgical Brow Lift
A brow lift is a surgery that pulls saggy forehead skin tighter, putting the forehead skin in a more youthful position. The tightened skin smooths forehead wrinkles and reduces eyelid sagging. A brow lift surgery is performed through a large incision made just above the hairline at the center of the forehead or through several small incisions made just above the hairline. Through the incision, the plastic surgeon pulls the skin up and removes excess skin. Possible complications from a brow lift may include visible scarring and loss of sensation at the suture site (which is usually temporary). Sometimes results from the brow lift are not as successful as anticipated.
Botox
Botox (botulinum toxin) injections temporarily remove forehead wrinkles. The plastic surgeon administers a local anesthetic to numb the forehead before injecting the Botox into the forehead muscles. The Botox relaxes the forehead muscles so that wrinkles become less visible or go away. The procedure must be repeated every 3 months. Complications include temporary redness, temporary drooping of the eyelids and temporary paralyzation of forehead muscles.
Dysport
Dysport is another botulinum toxin that was approved for the use in wrinkles by the FDA in 2009. A 2006 study published in Journal Watch Dermatology reported that in clinical trials, Dysport was less effective than Botox in removing wrinkles, although earlier studies performed by the same researchers found that Botox and Dysport produced equal results. In the study, trial participants who received Dysport reported more adverse reactions than the patients who received Botox.
Skin Resurfacing
Plastic surgeons can remove the top layers of the skin to reduce or remove wrinkles. Chemical peels, dermabrasion and laser resurfacing are common methods used to resurface the skin. Chemical peels use harsh acids to remove the top layers of the skin. During dermabrasion, the plastic surgeon scrapes the top layers off the skin. Laser resurfacing uses heat from a laser to remove the upper layers of skin. A local anesthetic is applied to the skin before skin resurfacing procedures to reduce pain. Resurfacing procedures leave the skin red, raw and sometimes with sores and scabs for up to 3 months. Once the skin heals, it is smoother and contains fewer wrinkles. Possible complications of skin resurfacing include skin infection, pain and scarring.
Tretinoin
Tretinoin is a topical retinoid made from vitamin A that increases the speed in which skin cells shed, which reduces the appearance of wrinkles. Tretinoin increases sun sensitivity and therefore must be used with a sunscreen. Skin redness and skin irritation are also common at the beginning of tretinoin treatment. Not every person experiences results from tretinoin, and those who do experience minimum to moderate wrinkle reduction results. The cream must be applied daily, on a continual basis. Once use of the cream is discontinued, the wrinkles come back.
References
- American Society of Plastic Surgeons: Choose a Surgeon You Can Trust
- Journal Watch Dermatology 55(6):975-80; Botox vs. Dysport for Glabellar Lines; George J. Hruza, MD; Dec. 15, 2006
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