Frontal Bone Contouring and Forehead Lifting: A Retrospective Study on Aesthetic and Functional Outcomes Publisher



Bayat A ; Owji S H ; Kazemi T ; Nabavizadeh S S ; Bagheri M
Source: Aesthetic Plastic Surgery Published:2026

Abstract

Background: Frontal bone contouring and forehead lifting are widely performed for aesthetic purposes. Emerging evidence suggests that these procedures may also alleviate frontal headache syndromes through mechanisms involving neurovascular decompression and soft tissue repositioning. Objectives: This study aimed to evaluate postoperative changes in headache severity following frontal bone contouring and forehead lifting and to determine the relationship between specific intraoperative maneuvers, including frontal recess widening and supraorbital nerve decompression, and clinical outcomes Methods: A retrospective observational cohort of 39 patients undergoing frontal bone contouring and forehead lifting (April 2022–November 2024) was analyzed. Pre- and postoperative headache severity was assessed using the validated Persian Brief Pain Inventory (BPI-P). Intraoperative details regarding frontal recess status and supraorbital nerve management were collected. Statistical analysis included Wilcoxon signed-rank test, Mann–Whitney U test, and multivariable regression modeling. Results: Patients had a mean age of 36.4 ± 7.5 years (33 males, 3 females, 3 transgender). Significant improvements were observed in worst pain (median 7 → 2), average pain (5 → 0), total pain intensity (4.66 → 0.66), and pain interference (4.28 → 0), all p < 0.001. Subgroup analysis demonstrated a trend toward greater improvement in patients with frontal recess widening (n = 13 vs. 26) and supraorbital nerve decompression (n = 20 vs. 19), although limited by sample size. Conclusions: Frontal bone contouring and forehead lifting, while primarily aesthetic procedures, are associated with clinically meaningful reductions in headache burden. These findings support the hypothesis that aesthetic craniofacial surgery can exert therapeutic effects through neurovascular and musculoskeletal mechanisms. Prospective controlled trials with larger cohorts are needed to confirm efficacy and optimize surgical protocols. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2026.