24 year old male, significant changes to forehead in past few years - advice? (photos)

Thank you for your photos. It is a bit difficult to tell what is going on from the photos. I do see some atrophy or volume deficiency above the eyebrow. If you have lost weight this alone can contribute to this deformity that you are referring to. And aging alone can cause similar changes. The forehead is a wonderful place to fat graft. It is generally blended into the temples along the cheek and the premasseteric area. Upper third volume enhancement does a wonderful job and reshaping the face into a more youthful one.

David formation are the two edges of the front talus muscles. In the center of the V there is no muscle and that is what that three-dimensional contour represents.

Carefully placed fillers can probably restore the central forehead contour but it’s important that the fillers be placed in a way that doesn’t leave streaks or bumps. Botox of the front talus will eventually cause some muscle atrophy and this can soften the appearance but will have a pretty profound impact on brow movement with a further drop of the brow.

I’m not sure if you’re contracting the muscles in the pictures. We really need proper full face pictures without facial expression to make a good assessment.

Botox and fillers are probably your best option if you feel like you need to address these concerns.

Surgical permanent interventions may be a little extreme for someone who is just showing the outline of their facial muscles.

Fat transfer as possible but a fairly high risk procedure in regards to having an uneven contour with palpable lumps of fat necrosis. Fillers are far more predictable, accurate and forgiving for this type of work. For more severe forehead contour irregularities implants or methyl methacrylate(Bon-do type material) Can be an option.

Expect to get different opinions from different providers.

This may not be the easiest thing to treat but there’s definitely room for some improvement.

Finding talented and experienced providers is the key.

Best,

Mats Hagstrom MD