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The Influence of Age and Gender on Forehead Soft Tissue Thickness: A Magnetic Resonance Imaging-Based Study
Cagri Cakmakoglu, M.D.
Grzegorz Kwiecien, M.D.
Layne N. Raborn, M.D.
James R. Gatherwright, M.D.
Addison Barnett, M.S.
Marjorie C. Kragel, M.D.
Pierce L. Janssen, M.D.
James E. Zins, M.D., F.A.C.S.
Cleveland Clinic
2025-01-10
Presenter: Marjorie C. Kragel, M.D.
Affidavit:
The work is an original project to which all authors made valuable contributions. Dr. Kragel assisted with final manuscript drafting. The senior author Dr. Zins oversaw all stages of the project, assisted with revisions, and provided critical guidance.
Director Name: James E. Zins, M.D., F.A.C.S.
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: Variations in soft tissue thickness related to age and gender are clinically significant for addressing facial aging and planning aesthetic interventions. Previous studies have assessed skin thickness using various methods, including ultrasonography and biopsies, but data specifically examining forehead soft tissue thickness by age and gender are limited.
Objective: This study aimed to investigate the effects of age and gender on forehead soft tissue thickness using MRI, a non-invasive modality that provides excellent contrast resolution and reliable measurements.
Methods: We conducted a retrospective analysis of 160 Caucasian adults (80 females, 80 males) aged 20-99 years, grouped by decade. We measured midline and lateral forehead soft tissue thickness in the sagittal plane on T1-weighted MRI sections, from skin to external cortical lamina, in the lower, middle, and upper thirds. Statistical analyses were performed using factorial ANOVA to assess the impact of age and gender.
Results: Males had significantly greater forehead soft tissue thickness than females at all ages and across most regions. Notable differences were observed in the midline (5.4 mm in males vs. 5.0 mm in females; p = 0.043) and in the lower third of the lateral forehead (9.4 mm in males vs. 8.6 mm in females; p = 0.008). Thickness increased from the third to the fifth decade, peaking between ages 40-49, then declining in later decades, particularly in the lower third.
Conclusion: Forehead soft tissue thickness varies significantly by age and gender, highlighting the importance of considering these differences in planning aesthetic procedures for optimal outcomes.
