Forehead, temporal augmentation and lateral browlift with Ellanse M

Abstract

Background: Ellanse M, a polycaprolactone-based filler, is a versatile collagen stimulator used in aesthetic treatments, particularly for forehead, temporal rejuvenation and lateral brow lifting. We propose a modified forehead classification system (Type I to V+T) to guide practitioners in determining the volume of Ellanse required and predicting patient satisfaction. Objective: A retrospective analysis of 86 patients who received Ellanse M filler for upper face rejuvenation from 2016 to 2018 was conducted. Methods: A modified classification system is used to categorise forehead patterns (Types I to V) along with temporal hollowing (T). Type I+T is for forehead with central depression, Type II+T is with bilateral triangular depression, Type III is for Type I and II combined, Type IV+T is for sloping forehead pattern and Type V+T is for more severe sloping forehead pattern. Forehead enhancement and temporal rejuvenation with Ellanse M were performed for forehead rejuvenation and to address temporal hollowing respectively. Patient satisfaction was measured at 3 months post-treatment at optimal collagenesis and 2 years after treatment. A linear regression analysis was performed to correlate forehead classifications with patient satisfaction. Results: The overall patient satisfaction rate was 78% (67/86) at 2-year follow-up. Patients with Type I+T, Type II+T, and Type III+T forehead groups had the highest satisfaction rates. Conversely, the Type V+T group experienced the highest dissatisfaction rate (2/8 patients dissatisfied). This was corroborated with linear regression analysis. Eight patients were lost to follow-up and the results were interpreted using an intention-to-treat analysis. An average of 5.9 vials (1 ml/vial) (range 3 to 7 vials) of Ellanse M was used per patient. Conclusion: Our modified forehead classification identified Type I+T, Type II+T and Type III+T forehead patterns were associated with higher postprocedural satisfaction rates. There was no vascular complications or nodule formation in this series.

Keywords

• botox; ellanse; forehead and temporal augmentation; lateral browlift; point of care ultrasound; polycaprolactone filler