The forehead makes up a large part of the upper face. A smoothly rounded, well-proportioned forehead gives the face a soft, balanced look, while a flat, sloping or uneven forehead can make the face look out of proportion. The shape of the forehead is also one of the features people subconsciously use to read gender: typically female foreheads are rounder and smoother, while typically male foreheads are broader, with more prominent brow bones.
Forehead augmentation adds volume and shape to the forehead using a fat graft or an implant. It’s suitable for people with a flat or sloping forehead, an uneven forehead, or as part of facial feminization surgery.
In the past, liquid silicone or other fillers were often injected into the forehead. Over time, injected silicone can migrate down to the eyes, cheeks and temples, distorting the face and disrupting blood and lymph flow. Because it spreads into the tissue, it’s very difficult to remove. Surgical augmentation with a solid implant or your own fat avoids these long-term problems.
Related procedures include forehead contouring to reduce a prominent brow ridge, and a brow lift to raise low brows.
Figure 1: Positioning of Material for Forehead Implant
Who Is a Good Candidate?
- You have a flat, concave or sloping forehead that looks out of proportion with your face
- Your forehead is uneven
- You want a softer, rounder forehead, including as part of facial feminization
- You’re healthy, have realistic expectations and understand the risks
Forehead Augmentation Materials
1. Fat Transfer
Fat is taken by liposuction from another area such as the abdomen, thighs or upper arms, processed, then injected into the forehead and shaped to create a fuller, rounder contour. This can be done under local anesthesia.
- Advantages: no incision, minimal scarring, and uses your own tissue
- Limitations: part of the injected fat is gradually reabsorbed over 1–2 years, so a top-up may be needed
2. Bone Cement (PMMA)
Polymethylmethacrylate (PMMA) has been used in surgery for many years. It’s well tolerated by the body, stable, long-lasting and easy to shape during surgery. The operation takes about 2–3 hours.
3. ePTFE (Gore-Tex)
ePTFE was first used for artificial blood vessels and later adapted as an implant material. It causes very little immune reaction. Its porous structure allows your tissue to grow into it, which holds the implant firmly in place. It’s soft, strong and flexible, and can be shaped to follow the curve of the forehead.
4. Silicone Sheet
Thin silicone sheets are less commonly used, because they aren’t flexible and are difficult to shape to the curve of the forehead.
5. Customized PMMA Implant
A PMMA implant made specifically for you, designed from a 3D scan of your skull so it fits your forehead precisely. It can also correct areas where bone is missing.
- Advantages: an exact anatomical fit, less time spent shaping during surgery, and a lower risk of asymmetry
- Limitations: requires a 3D scan and time to manufacture before surgery
Preparation for Forehead Augmentation
- Consult an experienced plastic surgeon about your goals, medical conditions, risks and potential complications.
- Have a health check, including blood tests (CBC, electrolytes, HIV, hepatitis B and C) and a chest X-ray.
- Stop aspirin, anti-inflammatory drugs and herbal supplements for at least 2 weeks, as they can increase bleeding and bruising.
- Stop smoking for at least 2 weeks.
- Don’t eat or drink for at least 6 hours before surgery.
The Procedure
- Surgery is usually performed under general anesthesia.
- An incision is made 1–2 cm behind the hairline, without needing to shave your hair. The incision length depends on the material and the size of the implant
[CONFIRM: the current pages also describe an ear-to-ear incision for some materials]. - The scalp is lifted down to the brow bone, and the implant is placed to cover the forehead.
- The incision is closed and a compression bandage is applied. The procedure typically takes about 1 hour, or 2–3 hours when bone cement is shaped during surgery.
Post-operative Care
- Keep your head raised on pillows for 1–2 weeks to help swelling go down.
- Apply cold compresses to the forehead for 20 minutes at a time during the first few days to reduce swelling and discomfort.
- Wear the compression garment provided as much as possible for at least 2 weeks.
- Take pain medication as needed.
- Keep the incision clean daily, applying povidone-iodine as instructed.
- From day 2, wash your hair gently with mild baby shampoo. Don’t scratch your scalp, and dry your hair thoroughly.
- Wear button-up shirts during recovery, so you don’t irritate your scalp when dressing.
- Stitches are removed after 10 days.
- Attend every follow-up appointment.
Recovery
- About 1–2 weeks: most people return to work.
- 3–4 weeks: avoid strenuous activity and exercise.
- About 1 month: the result is clearly visible, and you can return to heavy exercise.
- About 3 months: residual swelling has settled and you’ll see the final result.
Risks and Complications
When a highly-skilled and experienced cosmetic surgeon performs the forehead augmentation, forehead augmentation is associated with very few complications however, possible risks include:
- Infection from fat graft or implant or incision area.
- Hematoma (internal bleeding)
- A shift in implant position (which can be fixed by screws)
- Poor scarring.
- Poor healing.
- Bleeding.
- Numbness within the forehead and scalp near the incision site. In most cases, it will recover within a few weeks.
- Side effects from anesthesia
Before & After Forehead Augmentation
Reviews for Forehead Augmentation
Video: Forehead Augmentation
Why Choose Kamol Hospital in Bangkok for Forehead Augmentation
- Five material options: Fat transfer, ePTFE, bone cement, silicone and custom-made PMMA implants, so the material can be matched to your anatomy and goals.
- Custom implants from 3D scans: Personalized PMMA implants for a precise fit and better symmetry.
- Hidden incision: Placed behind the hairline, without shaving your hair.
- Whole upper-face planning: Forehead augmentation can be combined with forehead contouring, a brow lift or hairline lowering, including as part of FFS.
- Hospital-level safety: Surgery under general anesthesia in a JCI-accredited hospital.
- Support for international patients: Multilingual coordinators and Kamol Trip help you plan your stay in Bangkok.
Frequently Asked Questions (FAQs)
Which forehead augmentation material is best?
It depends on your anatomy, how much volume you need and your priorities. Fat transfer avoids an incision but may need top-ups. ePTFE is soft and flexible, and becomes held in place by your own tissue. Bone cement is stable and easy to shape during surgery, while a custom PMMA implant is designed from a 3D scan for the most precise fit. Your surgeon will recommend the best option after examining you.
Why not just use fillers or silicone injections?
Fillers can add volume, but results are temporary. Injected liquid silicone is not recommended: over time, it can migrate to the eyes, cheeks and temples, distorting the face, and it’s very difficult to remove. A solid implant or your own fat gives a more predictable, long-lasting result.
Will the implant look or feel unnatural?
When placed correctly beneath the scalp and forehead tissue, an implant blends smoothly into the shape of the forehead, so it shouldn’t be visible. You may be able to feel the implant edges if you press firmly, especially if your skin is thin. Your surgeon will shape and position the implant to give a natural contour.
Can forehead augmentation be combined with forehead contouring?
Yes. If you have a prominent brow ridge, it can be reduced with forehead contouring, and the area above it augmented to create a smooth, rounded curve. This combination is common in facial feminization surgery.
Will I have a visible scar, or need to shave my hair?
The incision is made behind the hairline, so the scar is hidden by your hair once healed. You usually don’t need to shave your hair. Fat transfer requires only small entry points for the injections.
Are the results permanent?
Implants such as ePTFE, bone cement and custom PMMA give long-lasting results, and can be removed or adjusted if needed. With fat transfer, part of the fat is reabsorbed over 1–2 years, so a top-up may be needed to maintain the result.
Why choose Bangkok, Thailand for forehead augmentation surgery?
Bangkok, Thailand is a popular destination for patients seeking cosmetic and facial contouring procedures. Forehead augmentation requires careful attention to the patient’s existing facial structure and the shape, size, and position of the implant. At Kamol Hospital, surgeons tailor forehead augmentation to the individual’s anatomy and aesthetic goals, with structured care before and after surgery.
How long should I stay in Bangkok after forehead augmentation?
Plan to stay in Bangkok for about 10–12 days. This allows for stitch removal at 10 days and a follow-up check before you fly home. Thailand is a popular destination for facial surgery, and Kamol Trip can arrange accommodation close to the hospital.
