ORIGINAL RESEARCH article
Front. Surg.
Sec. Reconstructive and Plastic Surgery
Wrinkle Reduction in Forehead and Glabella Regions After Subcutaneous Forehead Lift: A Retrospective Analysis Using the Wrinkle Assessment Scale
Provisionally accepted
- 1Konyang university hospital, Department of Plastic and reconstructive surgery, Daejeon, Republic of Korea
- 2Weill Cornell Medicine - Qatar, Doha, Qatar
- 3Boston University, Boston, United States
- 4Jenith Hospital, Ulsan, Republic of Korea
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Introduction: Horizontal forehead and glabellar wrinkles are key indicators of upper facial aging. Various non-surgical and surgical treatments exist; however, quantitative evidence regarding their effectiveness remains lacking. Therefore, this study aimed to assess the effectiveness and safety of SFL in improving forehead and glabellar wrinkles using the validated Wrinkle Assessment Scale (WAS). Methods: This retrospective study examined the medical records of patients who underwent SFL with a pretrichial incision at a single institution between January 2015 and September 2024. Wrinkle scores of forehead and glabella were assessed using the WAS preoperatively and at the last postoperative follow-up. Comparison of the degree of score improvement between the forehead and the glabella was carried out. Inter-rater reliability was examined in a random subset of 100 patients using the intraclass correlation coefficient (ICC). Postoperative complications were also collected. Results: A total of 697 patients were included in this study. Significant reductions in forehead and glabellar wrinkle scores were observed postoperatively. The forehead and glabellar wrinkle scores improved from 2.47 ± 1.29 and 2.14 ± 0.92 preoperatively to 1.52 ± 0.96 and 1.47 ± 0.83 postoperatively, respectively. When comparing the degree of pre-to-postoperative improvement between the two regions, the mean improvement was greater in the forehead (0.95 ± 0.85) than in the glabella (0.67 ± 0.65). Inter-rater reliability demonstrated excellent agreement (ICC = 0.954 for forehead; 0.941 for glabella). Minor complications were present in a few patients; however, no significant long-term complications were observed. Conclusion: The SFL is a safe and effective procedure for wrinkle reduction in the forehead and glabellar regions. This technique demonstrated significant anti-aging benefits, with a low complication rate, presenting an effective option for managing forehead and glabellar wrinkles.
Keywords: Facial aesthetics, forehead and glabellar wrinkles, Retrospective study, subcutaneous forehead, Wrinkle Assessment Scale, Wrinkles
Received: 27 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Lim, Jung, Jung, Koh, Lim and Ryu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: In Chang Koh
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