Wrinkle reduction in forehead and glabella regions after subcutaneous forehead lift: a retrospective analysis using the wrinkle assessment scale

Introduction Horizontal forehead and glabellar wrinkles are key indicators of upper facial aging. Various non-surgical and surgical treatments exist; however, quantitative evidence regarding their effectiveness remains lacking. Therefore, this study aimed to assess the effectiveness and safety of SFL in improving forehead and glabellar wrinkles using the validated Wrinkle Assessment Scale (WAS). Methods This retrospective study examined the medical records of patients who underwent SFL with a pretrichial incision at a single institution between January 2015 and September 2024. Wrinkle scores of forehead and glabella were assessed using the WAS preoperatively and at the last postoperative follow-up. Comparison of the degree of score improvement between the forehead and the glabella was carried out. Inter-rater reliability was examined in a random subset of 100 patients using the intraclass correlation coefficient (ICC). Postoperative complications were also collected. Results A total of 697 patients were included in this study. Significant reductions in forehead and glabellar wrinkle scores were observed postoperatively. The forehead and glabellar wrinkle scores improved from 2.47 ± 1.29 and 2.14 ± 0.92 preoperatively to 1.52 ± 0.96 and 1.47 ± 0.83 postoperatively, respectively. When comparing the degree of pre-to-postoperative improvement between the two regions, the mean improvement was greater in the forehead (0.95 ± 0.85) than in the glabella (0.67 ± 0.65). Inter-rater reliability demonstrated excellent agreement (ICC = 0.954 for forehead; 0.941 for glabella). Minor complications were present in a few patients; however, no significant long-term complications were observed. Conclusion The SFL is a safe and effective procedure for wrinkle reduction in the forehead and glabellar regions. This technique demonstrated significant anti-aging benefits, with a low complication rate, presenting an effective option for managing forehead and glabellar wrinkles.