Forehead Contouring as an Adjunct to Rhinoplasty: Evaluation of the Effect on Facial Appearance, Personal Traits and Patient Satisfaction

Demirel O.

PubMed 33811290 Publisher (DOI)Free full text (PMC)

What this paper says

In 15 patients who had forehead fat grafting alongside rhinoplasty, a custom satisfaction score rose from 9.13 to 24.86 and forehead inclination angle changed from 19.04 to 16.74 degrees.

Overview

The nose has a large effect on facial appearance, but the author argues a whole face approach produces better results, and the forehead is relevant because of its gender related features and its relationship to the nose. This retrospective study assessed the effect of adding forehead contouring with fat grafting to rhinoplasty on personal traits, facial appearance and satisfaction.

Sections of note

Retrospective study of 15 patients; the journal assigns level of evidence IV.
Facial appearance and personal traits were rated on the subject Global Aesthetic Improvement Scale.
Satisfaction was measured with a custom designed Forehead Rhinoplasty Outcome Evaluation Questionnaire.
Forehead inclination angle was calculated as an objective indicator of fat graft survival and contour improvement.
Mean questionnaire score was 9.13 before surgery and 24.86 after, P less than 0.01.
Significant improvement was observed in attractiveness, femininity, youthfulness, facial harmony, forehead contour and facial profile.
Mean forehead inclination angle was 19.04 degrees before surgery and 16.74 degrees after.

What it means for a patient

Fat taken from the patient's own body was used to reshape the forehead in the same operation as the nose.
The forehead angle change is the only objective measure reported and it indicates the grafted fat persisted.
Fifteen patients with no control group and a non validated custom questionnaire is weak evidence.
The abstract does not state how long after surgery the assessments were made.

Why this paper matters

Facial proportions are judged as a whole, and the profile line from forehead to nose is a standard element of that judgment. This small study tests treating them together. Whether the added forehead grafting rather than the rhinoplasty produced the satisfaction gain cannot be separated here.

Terms

Forehead contouring: reshaping the forehead surface, here by adding fat.
Fat grafting: transferring fat from elsewhere on the body to add volume.
Global Aesthetic Improvement Scale: a rating of how much appearance changed after a procedure.
Forehead inclination: the angle at which the forehead slopes backward.
Adjunct: a procedure added alongside a main one.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

Abstract

Background: The nose has a great impact on facial beauty and appearance. Therefore rhinoplasty is one of the most performed procedures worldwide. However, considering the varying degrees of cosmetic operations holistic approach to face is essential to achieve more successful results. In order to this, the forehead is noteworthy with its gender-related features and important relation to the nose. The purpose of this study is to assess the effect of forehead contouring with fat grafting adjunct to rhinoplasty on personal traits, facial appearance and patient satisfaction.

Methods: A total of 15 patients who underwent rhinoplasty and forehead contouring with fat grafting were enrolled in this retrospective study. Facial appearance and personal traits were evaluated via subject Global Aesthetic Improvement Scale (S-GAIS), and patient satisfaction was assessed with custom design Forehead Rhinoplasty Outcome Evaluation Questionnaire (F/ROE-Q). Forehead inclination was calculated as an objective indicator of fat graft survival and contour improvement. Pre- and postoperative photographs were taken and used for evaluation.

Results: According to the F/ROE-Q score, mean total preoperative score was 9,13 and the mean total postoperative score was 24,86 (p < 0,01). High postoperative satisfaction scores were observed in all patients. Statistically significant improvement was observed in attractiveness, femininity, youthfulness, facial harmony, forehead contour, facial profile view parameters based on S-GAIS assessment. The mean forehead inclination angle was 19,04o preoperatively and 16,74° postoperatively.

Conclusion: With the important benefits such as higher patient satisfaction and improvement on facial appearance and personal traits, forehead contouring with fat grafting was an efficient and applicable procedure adjunct to rhinoplasty.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).