Age and Gender Differences of the Frontal Bone: A Computed Tomographic (CT)-Based Study

Background Age-related changes of the frontal bone in both males and females have received limited attention, although understanding these changes is crucial to developing the best surgical and nonsurgical treatment plans for this area. Objectives To investigate age-related and gender-related changes of the forehead. Methods Cranial computed tomographic images from 157 Caucasian individuals were investigated (10 males and 10 females from each of the following decades: 20-29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, 80-89 years, and of 8 males and 9 females aged 90-98 years). Frontal bone thickness and forehead distance measurements were carried out to analyze age and gender differences. Results With increasing age, the size of a male forehead reduces until no significant differences to a female forehead is present at old age (P = 0.307). The thickness of the frontal bone of the lower forehead (<= 4 cm cranial to the nasal root) increased slightly in both genders with increasing age. In the upper forehead (>= 4 cm cranial to the nasal root), frontal bone thickness decreased significantly (P = 0.002) in males but showed no statistically significant change in thickness in females (P = 0.165). Conclusions The shape of the frontal bone varies in young individuals of different genders and undergoes complex changes with age because of bone remodeling. Understanding these bony changes, in addition to those in the soft tissues, helps physicians choose the best surgical and nonsurgical treatment options for the forehead. Level of Evidence: 4