Vertical indentation in forehead. Is there a surgery to flatten out this line? (Photo)

Question

I've had the vertical indent in my forehead (see pictures) for the last two years, relatively unchanged. I saw a dermatologist who said it was not coup de sabre, and that it was probably just my underlying bone structure showing up more as I aged. However, I was diagnosed with systemic scleroderma last year. The doctors still aren't sure if my forehead is related to that. I'm doing amazingly well though, and I was wondering if a surgery exists to flatten out this line?

Nelson Lee Novick, MD · Answer

Frankly, at least from the photo, it does appear to be en coup de sabre, and I would treat it exactly as I treated this same condition for my wife by elevating and smoothing the indentation using a low viscosity, malleable, HA filler--of course only following approval first by a board certified rheumatologist. Since the forehead is not an area to be treated by a novice, inexperienced injector accustomed to treating ordinary smile lines with plain Restylane or simple Juvederm, you would be well advised to consult an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

Anil R. Shah, MD · Answer

Hello Rosie314! My name is Jessica, I am a physician assistant, and one of the providers at Shah Facial Plastics. It is difficult to assess based on the images. However, I do recommend to schedule an appointment for an in-person consultation to better examine the area of concern and develop an effective treatment plan. I hope this helps and best of luck!

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Leonard Grossman, MD · Answer

In my opinion, any indents on the face and body can and should be corrected with the use of patients own fat. When fat grafting is performed by an expert plastic surgeon, the results are extremely natural and permanent. I hope this helps and good luck from New York City Plastic Surgery.

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