The New, Risky Cosmetic Treatment Experts Want You To Pass On

In 2021 cosmetic procedures and plastic surgery are no longer spoken about in hushed tones. From nonsurgical rhinoplasty (which alters the shape of the nose without having to go under the knife) to lip flips (the new, quick way to make lips appear fuller), treatments are more popular than ever — and this is partly facilitated by the so-called 'Zoom boom'.

Viewing themselves through an unflattering, front-facing camera has magnified many people's insecurities. With the appeal of downtime and recovery at home, rather than in a workplace of prying eyes, it's no wonder plenty are booking in for procedures or 'tweakments'. Then there's TikTok. Countless doctors and happy patients are flocking to the app to share their expertise and unique experiences, boosting hype around buzzy new cosmetic trends — and propelling them into mainstream beauty. One TikTok trend making waves at the moment is forehead filler. Judging by the combined number of views, likes and comments attached to the hashtag, it's slowly but surely becoming a highly sought-after procedure.

Dr Magdalena Bejma, founder of Dr Bejma Medical Clinic, says: "Forehead filler involves injections of hyaluronic acid [HA], which is a substance found naturally in our bodies. HA adds volume and hydrates skin cells, leaving the forehead looking refreshed and smooth." This reduces the appearance of lines and wrinkles, as Dr Kaywaan Khan, medical doctor and aesthetician at Hannah London, explains: "As we age, the collagen and elastin in our skin begins to break down, resulting in sagging, loss of volume, and wrinkling — particularly in the forehead where the muscles of facial expression are highly active and the tissue below the skin is thinner." He says that forehead filler can be used to subtly improve the skin and reduce the lines caused by natural ageing.

So what is the difference between forehead filler and Botox injections? Dr Khan explains that botulinum toxin injections (most commonly referred to by the brand name, Botox) relax the muscle under the skin, improving wrinkling; filler does this by hydrating the skin, making it appear more plump. "As well as using filler to improve appearance of wrinkling, using forehead filler to improve the profile is another common request and a growing trend," adds Dr Khan. He says that a slight concave shape (due to protruding eyebrows or a prominent forehead in many cases) can be smoothened to give a gently curved shape and that some would argue this is more 'feminine' and aesthetically pleasing, as well as potentially anti-ageing. 

On TikTok, one of the most clicked forehead filler videos — with 1.6 million views and counting — shows a patient's journey after having the procedure done in Korea, where they say it's increasingly popular. Forehead filler is slowly making its way to UK shores, with Dr Vy Nguyen, aesthetic doctor at Skin & Sanctuary, explaining that it's a hugely desirable treatment among Asian clients in particular. "It is believed to promote attractiveness and youthfulness," she says. "Though still a relatively new concept in Western treatments, the influence of social media — particularly TikTok — means more people in the UK are coming across it and are now asking clinics about its benefits."

The almost instant results – plump, glowing skin; erased fine lines and wrinkles – might look impressive but cosmetic experts aren't sold. Recently, plastic surgeon and TikToker @therealtiktokdoc stitched a popular forehead filler video with a response which shocked his followers. "Be very careful," the surgeon warned through gritted teeth. "Forehead filler can be very, very dangerous." He then went on to tell his 6.7 million followers why they might want to give this emerging cosmetic trend a miss.

Dr Bejma explains that forehead filler injections (especially to the lower-middle of the forehead, where you might see frown lines) are considered high risk injections. "We have many arteries running invisibly under the skin in this area," says Dr Bejma. "If filler is accidentally injected into one of these arteries, it can lead to necrosis," otherwise known as skin tissue death caused by a blockage to the blood supply. This causes irreversible damage, but it isn't the only major risk.

Blindness can also occur if forehead filler goes wrong — and it could even happen in the hands of a qualified professional. Dr Mahsa Saleki of sas Aesthetics says: "Many experts advise caution with these procedures as there’s a very real danger of embolising [blocking] the supraorbital artery, or its branches, which supply the eye." When these blood vessels are cut off, Dr Saleki says it can cause loss of vision. Due to the incredibly worrying risks of forehead filler procedures, Dr Bejma says that many injectors consider this area too risky to inject. "To them, the risks outweigh the potential benefits," she adds.

According to Dr Nguyen, other common side effects of forehead filler include bruising, infection, swelling, unevenness and lumps and bumps — the latter of which Dr Khan expands on. "When forehead fillers are used for contouring with the aim of obtaining a more rounded shape, this can often produce asymmetries and irregularities." This, he says, is because filler can migrate or move around under the skin. This may be down to forehead skin being thinner than the lips, for instance, which tend to be plumper and appear to 'hold' filler better.

Lastly, Dr Saleki advises that forehead filler should only be a temporary fix as it can potentially cause permanent changes. "Injecting dermal filler stretches the skin of the forehead, which is otherwise quite taut," she says. "This may lead to loose skin around the brows and upper eyelids if over-filled, or done in cases where filler is not warranted."

Dr Khan says that despite some horror stories about forehead filler, it is growing in popularity and isn't going to disappear any time soon. "There is definitely a place for forehead fillers alongside other treatments, and they can provide real benefits to some people," he explains, but there are a handful of things you need to know before going ahead.

"First and foremost," says Dr Bejma, "forehead filler should be only administered by an experienced medical practitioner. Never get this treatment at a beauty salon, ever." She says that accidental injection into the arteries is rare in expert hands but still possible. To be as safe as possible, be sure to check the credentials of your injector via the General Medical Council register. Aesthetic platforms such as Glowday and Save Face are also very helpful in pinpointing a trusted professional.

It also pays to head to a consultation before any procedure — especially something like forehead filler — to determine whether filler might be the most appropriate treatment for you. "At Skin & Sanctuary, we always request that a client has a full consultation before any injectable procedure," says Dr Nguyen. "When this involves fillers, we advise them to take some time to consider the advice, including discussion on the risk and cost involved." The effects of filler aren't permanent, either, and will need topping up. "Filler can last between six and 18 months depending on the volume, thickness and injection location, as well as personal lifestyle factors," says Dr Nguyen. "This would be the same for forehead filler."

Establishing aftercare is also paramount, particularly if something doesn't look or feel right after your treatment. "Early recognition is the key and swift treatment is essential for full recovery," says Dr Bejma, who suggests monitoring your skin for any bruising or pain. Always get a phone number and other contact details from your injector (Dr Bejma advises an out-of-hours telephone number, too) should you need to get in touch with them about any worries or queries. "Ask your injector how many forehead treatments they have performed, too, and ensure that they have emergency medication in clinic should complications occur. Hyaluronidase is used to dissolve filler, for example," she continues.

If it's fine lines and wrinkles you're looking to minimise and you want to go down the cosmetic procedure route, experts champion Botox. "This is a superior option for the forehead as it is generally cheaper, quick, less invasive and more predictable in eliminating dynamic wrinkles," says Dr Nguyen. However unlike filler, botulinum toxin cannot be dissolved. You'll have to wait for your body to break it down in its own time before it wears off. "Although it does not have volumising properties," adds Dr Bejma, "repeated Botox treatments over time will soften deep, static wrinkles."

If you're not keen on going under the needle? Dermatologists rate skincare with retinoids (derived from vitamin A) for reducing the appearance of fine lines and wrinkles over time. There are plenty of adored retinol serums and creams out there, such as SkinCeuticals Retinol 0.5 Refining Night Cream, £70, and Medik8 Crystal Retinal, £59, which is available in varying strengths depending on what your skin can tolerate. Retinoids are also available on prescription from a dermatologist.