Tomography of the Forehead Arteries and Tailored Filler Injection for Forehead Volumizing and Contouring

BACKGROUND The forehead is a challenging area for filler injection because of the risk of serious complications. Anatomy-based filler injection techniques help to avoid severe vascular complications. MATERIALS AND METHODS Sixty-six cadaver heads were infused with adequate lead oxide contrast through the external carotid arteries, internal carotid arteries, facial artery, and superficial temporal artery. Three-dimensional computed tomography scans were reconstructed using validated algorithms. We measured the length and arc length of "beautiful" foreheads evaluated by 3 skilled surgeons. RESULTS The frontal branch of the superficial temporal artery (FBSTA) was classified based on the main trunk as follows: Type I FBSTA (89.72%) took a sudden turn (89.56 degrees +/- 11.76 degrees) once passing through the temporal crest, whereas Type II FBSTA (10.28%) barely turned (52.26 degrees +/- 6.81 degrees) at the temporal crest. A total of 319 arteries passed through the midline in 48 cadaver heads. There were more superficial arteries (292 of 319) than deep arteries (27 of 319). The difference in the length and arc length of the forehead was 19.66 +/- 4.35 mm. CONCLUSION This study introduces an effective technique for forehead filler injection that minimizes the risk of filler injection and improves patient satisfaction.