While wrinkles and sunspots offer the most obvious signs of forehead ageing, other features contribute to the impression in more subtle, yet equally profound ways.

As a broad expanse on facial skin, the forehead acts like a billboard for the face. An uneven complexion contributed to by freckles and sunspots sets the scene. Transverse forehead and vertical glabellar (between the eyebrows) wrinkles build upon the appearance of ageing. Yet there are other, more subtle changes that further signify the ageing process.

Thinning of the skin and loss of subcutaneous fat are two such changes. An increase in the height of the hairline is another, the management for which differs between men and women. Finally the descent of the eyebrows, particularly laterally, contributes to the overall picture of ageing.

Both non-surgical and surgical techniques assist in rejuvenating the forehead. The best results are usually achieved with a multi-modality approach. Fraxel laser softens wrinkles and removes sunspots, while increasing the collagen content of the skin. Botox eliminates reversible wrinkles while further softening permanent ones. Structural fat grafting is well employed to fill in hollows and has a beneficial flow-on effect in improving the quality of the skin. The latter is caused by adipose-derived stem cells in the fat graft.

A descended brow can be elevated through minimal access, key-hole surgery with scars hidden within the hairline. A moderately lengthened forehead can be shortened with a scar confined to the frontal hairline, where it is incredibly well camouflaged, while a very long forehead dictates advancing the scalp forwards to reduce its height. Glabellar muscles responsible for frown lines between the eyebrows can be permanently weakened during the forehead surgery procedures or even through an upper blepharoplasty incision.

Taking all of the stigmata of forehead ageing into account and addressing each of them in equal measure will deliver the most natural, long-lasting results.