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Updated: Jan 11, 2026

Innovative Adipose Tissue Fractionation for Transforming Fat into Specialized Components
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Forehead Volumization and Rejuvenation with Hybrid Fillers.

Nabil Fakih-Gomez1, Jonathan Kadouch2, Pia Maria Obeid3

  • 1Department of Facial Plastic and Cranio-Maxillo-Facial Surgery, Fakih Hospital, Main Street, Khaizaran, 00000, Lebanon. info@drnabilfakih.com.

Aesthetic Plastic Surgery
|November 12, 2025
PubMed
Summary
This summary is machine-generated.

Forehead rejuvenation using a hybrid filler of hyaluronic acid (HA) and calcium hydroxylapatite (CaHA) is safe and effective. This approach improved facial volume and patient satisfaction with minimal adverse events over 12 months.

Keywords:
Forehead fillingForehead volume restorationForehead volumizationHyaluronic acid fillerHybrid fillerPremixing

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Area of Science:

  • Aesthetic Medicine
  • Dermatology
  • Plastic Surgery

Background:

  • Aging causes facial volume loss, leading to forehead flatness and wrinkles.
  • Hyaluronic acid (HA) and calcium hydroxylapatite (CaHA) fillers are used for rejuvenation.
  • Hybrid filler techniques combining HA and CaHA are gaining interest for optimized outcomes.

Purpose of the Study:

  • To evaluate the safety and efficacy of a premixed hybrid filler for forehead rejuvenation.
  • To assess patient satisfaction and adverse events associated with the hybrid filler treatment.

Main Methods:

  • A retrospective cohort study of 111 patients (aged 18-43) receiving hybrid CaHA/HA injections.
  • Customized injection volumes and ratios were used, with follow-ups at 2 weeks, 3, 6, and 12 months.
  • Primary outcomes: adverse events (AEs); Secondary outcomes: patient satisfaction.

Main Results:

  • The study included 108 females and 3 males, with an average injected volume of 3.11 mL.
  • Two transient minor AEs (1.8%) occurred: hematoma and edema, both resolved conservatively.
  • No serious complications like vascular compromise or nodules were observed; high patient satisfaction was reported.

Conclusions:

  • A premixed hybrid filler of CaHA and HA, administered via retrograde fanning in the deep forehead fat plane, is safe and effective.
  • This technique successfully improved frontal depressions and volume.
  • No adverse events were reported during the 12-month follow-up period.