How would you treat indents on forehead caused by thickening and furrowing? (Photo)

Question

I posted on here before thinking what I had was fat loss, but I finally found out the changes I'm seeing are from something called pachydermoperiostosis. Since it's furrowing and skin thickening that is going on, how could this be treated by a plastic surgeon? Would it still be fat grafting even though it's skin thickening? I wrote a whole blog about getting diagnosed for anyone who is curious: https://youmemindbody.com/disease-illness/it-began-with-a-forehead-indentation

Dallas Buchanan, MD · Answer

Thanks for your pictures and questions. Sounds like this has been a long process in finding out what is going on. Treating the joint/arthritis issues you may be dealing with is probably best treated with NSAIDs or steroids and would be best treated/managed by a Rheumatologist. However, the skin thickening of the forehead and the glabellar region has been shown to improve with Botox injections in some small studies (link provided to one such study, may others out there as well). I would see a local plastic surgeon or experienced injector to discuss starting a treatment regimen. This would likely require ongoing treatment 3-4 times a year. Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Darryl J. Blinski, MD · Answer

Based on your posted photos, this Denty can first be examined in person only and possible in office ultrasound with the new colored coated ultrasound device to see the thickness of the fat layer versus the thickness of the fat layer in the in the in the hill versus the dent. Micro and crafting by syringe liposuction from donor areas of the body with injection which might take more than one session. Expect fees to range from $2500-$5000 per session. Best to initially virtual consult with then follow with an in person consultation and ultrasound  of the forehead

How would you treat indents on forehead caused by thickening and furrowing? (Photo)

Answers (2)