Morphology of the Aging Forehead: A Three-Dimensional Computed Tomographic Study

Background: Age-related changes have been studied for lower and middle facial bones. Although the forehead comprises one-third of the facial area, no studies have investigated age-related changes in the upper part of the face or forehead. The purpose of this study was to use three-dimensional computed tomography (3D CT) to investigate age-related changes in the frontal bone. Methods: A retrospective review was performed for patients who underwent 3D CT scan of facial bones. Patients were divided by gender and age (20 to 40 years, 41 to 60 years, and above 60 years). The frontal bone curvature was evaluated by the length of frontal bone and by two frontal bone angles in relation to the Frankfurt horizon. Results: In both genders, aging was associated with increasing lower slope length. In elderly men (>60 years), the upper slope angle was significantly higher when compared to younger male subjects. Women demonstrated similar age-related changes, but the differences were only statistically significant for the middle and older age groups. Conclusion: This study demonstrates quantifiable age-related changes in the frontal bone. These findings contribute to the understanding of age-related changes of the facial soft tissues. The mean measurements in each age group can be used as a reference when planning forehead reconstruction.