Posts Tagged ‘forehead reshaping’
Wednesday, February 1st, 2012
Q: Dr. Eppley, my head is mildly deformed looking from the side. The forehead bulges out at the top and makes my head look too long from the side view. I want my forehead to have a more curved look that angles backward. I have attached a side view which shows me before and after I have done some computer imaging to show the forehead shape I am after. Can this look be surgically achieved?
A: Thank you for your inquiry and sending the photo attachments. What you are talking about is a cranial reduction/forehead reshaping which would be done by a burring removal technique. The important question is whether it can be reduced enough to achieve the result you are looking for. That is best answered by knowing how think the outer table of the cranial bone is. That can be evaluated by simple plain x-rays of the skull (AP and lateral views). From these films the amount of bone that can physically be removed (outer table) can be measured. There is no question some reduction be done, I (and you) would want to know the best we can beforehand if it is enough to justify undergoing surgery for it.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cranial reduction, dr barry eppley, forehead reshaping, indianapolis
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Sunday, January 22nd, 2012
Q: Dr. Eppley, I am interested in forehead contouring surgery. My forehead is kind of rounded and I would like to have it more like square-shaped. When looking at a profile view my forehead sticks out where my brows are and my eyes look deep in the face. I also have attached a picture of a gentleman that his forehead looks more like square and that is exactly what I’m looking for or something close that will reduce my forehead. Thank You
A: Thank you for sending your pictures. Your forehead shape is a combination of brow bone protrusion and an upper forehead that slopes backward. Together this gives your forehead a 50 to 55 degree backward slant in a profile view. The desired forehead shape that you have shown is almost completely vertical. While that is not completely possible from the forehead shape that you have now, you can make significant improvement in your current shape. To change the slant of your forehead, you need to address the two components of the problem, brow bone protrusion and upper forehead retrusion. This is done through a combination of brow bone protrusion and forehead augmentation above the brow bone area. Neither brow bone reduction or forehead augmentation alone will make this improved shape. It takes this combination ‘ying and yang’ approach to create the substabtial forehead shape change that you desire. I have attached an imaged result of what I can think can be achieved by this approach. This would be done through an open coronal incisional approach.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: brow bone reduction, dr barry eppley, forehead augmentation, forehead reshaping, indianapolis
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Sunday, December 11th, 2011
Q: Dear Dr. Eppley, I am a young women and am very insecure about my forehead. It’s very large and I’m tired of bangs. As you can see in the pictures, my forehead sticks out because of the “horns” I have smacked in the middle of my forehead. It feels hard. It may just be the bone but I still want to see if any procedure can be done to make them go away or, if not, make them less noticeable when light is shown on them.
A: I can see by your pictures that you have an upper frontal bone bulges, often what people refer to as ‘horns’. There are two approaches to making your forehead smooth and less prominent. The simplest approach, and I suspect the one of most interest to you, is to do a burring reduction of these bumps to make your forehead smooth and less prominent. This would be done through an incision way back in the scalp. The other approach to forehead smoothness is to build up the forehead below and around it with a cranioplasty material. This would not only make your forehead smooth but would also give it greater convexity which is viewed by many women as a desireable forehead feature. Both of these forehead reshaping/reduction approaches will work to make the forehead smooth adn get rid of the bumps, it is just that the shape of the forehead in profile view will be different depending upon which one you would choose.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, forehead horn removal, forehead reshaping, indianapolis
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Friday, March 18th, 2011
Q: I am wanting to get my forehead fixed. It just never grew in right and I have been made fun of since I was a kid. Photos may not look bad but I have been called horn head, hell boy, and square head all my life and I just want it to look a little better. I have two prominent ‘horns’ for lack of a better word on my forehead. I don’t know if these are just bone growths or my brain sticking out. They feel hard though. I have attached a picture so you can see them. Can these be burred down or something to make them look better?
A: Based on the one picture that I could see, it looks like you have two bulges on the sides of your forehead creating that look. These are very much like larger osteomas. The skull is thicker in these bulging areas. Reducing the bony bulges is actually fairly easy by burring them down to make the forehead less square and more round. The trick to it, however, is getting there to do it. The best approach would be a coronal (scalp) incision across the top of the scalp but that resultant scar (fine as it is) may not be a good choice for a male.The other approach is an endoscopic one where much smaller incisions are used. The access is not quite as good but I should still be able to burr down the prominent areas.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley, forehead reduction, forehead reshaping, indianapolis, plastic surgery of the forehead
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Sunday, November 21st, 2010
Q: Dear Dr. Eppley, I wonder whether you could give me some advice about forehead recontouring. I have a very prominent brow and two bony protusions on my forehead. I look fine straight on but at 45 degrees I look extremely hollow-cheeked and my eyes look abnormally deep-set. I tried cheek implants about 15 years ago (they have since reabsorbed) but of course these only made my eyes look even deeper-set. I also have a very strong chin and nose but can’t reduce these either because they go some way to balancing out my brow line. Would you be able to provide me with some idea as to my suitability for surgery? Thank you very much.
A: Occupying the upper one third of one’s face, the shape and size of the forehead can impact significantly one’s facial balance and appearance. Your description illustrates that quite clearly. The brow bone area, known medically as the supraorbital rims, is a bony prominence like the cheeks and chin in the lower two-thirds of the face that has cosmetic significance. When it is normal (not protruding) one does not give it a second thought. When the brow bones are excessive, however, it can change the look of one’s entire face…and changing other parts of the face will not really ‘hide’ the brow protrusion or its impact on how one’s eye area looks.
While the shape of the forehead and brows is significant, it is not commonly surgically changed. This is not because the possible forehead recontouring procedures are difficult, have high risks, or involve a long recovery, as they do not. It is because it requires an open approach with a scalp incision and a resultant scar in the scalp. For women this is not usually a major stumbling block, but for most men it is. Since many more men have forehead concerns than women, this makes the number of cosmetic forehead contouring procedures that are done fairly small.
Dr. Barry Eppley
Indianapolis Indiana
Tags: brow bone reduction, dr barry eppley, forehead contouring, forehead reshaping, indianapolis, plastic surgery
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Monday, November 15th, 2010
Q: Is it possible to reduce the size of my forehead? I do not mean lowering the hairline, because my hairline is already low. My forehead is vertical and almost seems as if I do not even have a forehead to begin with. The shape of my head is very strange. As most people’s head is round or square. My head is like the roof of a house, being pointed at the top making a sort of 60 degree angle. I can feel and hear my head always cracking as if its not stable or solid. I am also not sure it bone can be molded or change shape but I have been able to compress my head through pressure. Very very painful but I was desperate. With a 30 minute span however, it would return back to its original shape. I most know if there is some way to mold my cranium to a rounded shape?
A: First of all, you should now that it is not possible to reshape your skull bone by any form of external pressure, except in newborns where the skull plates are not yet fused. All you are doing by external compression is squeezing the fluid out of your soft tissues overlying the bone. Once released, the fluid returns and your ‘skull’ reverts back to its original shape. I can assure you that your skull is solid and is not ‘cracking’.
It is possible to do some forehead reshaping through an open scalp approach. The bone can be reduced and shaped by about 5 to 6mms, maybe more, in some patients depending upon the thickness of their outer cortical table. This may be enough of a change for some patients to notice a visible difference.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley, forehead reshaping, indianapolis, plastic surgery, skull reshaping
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Saturday, October 23rd, 2010
Q: I am a male and would be interested in receiving a surgery in order to correct my bulging forehead. Do you perform that kind on procedure on men?
A: Forehead surgery or forehead reshaping can mean different things to various patient, both male and female. The two most common procedures performed on the forehead are brow bone reduction in the male and brow bone reduction/tapering in the transgender patient. (male to female) There are also a variety of other forehead reshaping procedures from defects and asymmetry caused by craniofacial birth defects and trauma and prior neurosurgical/craniotomy operations. Bu, by far, regardless of the diagnosis the vast majority of forehead surgeries are done in men.
The typical cosmetic reason for male forehead surgery is brow bone reduction. Large brow bones, caused by overgrowth of the underlying frontal sinus, can create very prominent bulges in the forehead bone above the eye. (supraorbital rims) While most patients think it is a thickening of the bone and a simple burring down will suffice, this is not so. Rather the frontal table of the frontal sinus (visible brow bone) must be removed, reshaped, and then put back in a more flatter or recessed position. While tremendously effective, the access to perform that procedure requires a long scalp incision. This cosmetic trade-off is a serious one to consider and is usually an issue which prevents most men from having the procedure. Until a more minimally invasive approach to brow bone reduction is developed, most men with prominent brow bones will have to live with them.
Dr. Barry Eppley
Tags: brow bone reduction, dr barry eppley, forehead reshaping, indianapolis, plastic surgery
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Monday, September 27th, 2010
Q: I have two forehead bumps that are very distressing to me. They have been there since I was very young. They stick out like horns and I am very self-conscious of them. Can they be taken down and made smooth with the rest of my forehead? What is involved in this type of surgery and what are the risks?
A: Thank you for sending your pictures. I can clearly see the two upper forehead bumps. While they are not true osteomas, they are protrusions of the frontal bone. They can easily and simply be reduced through burring reduction. You can take down the outer table of the frontal bone in these areas up to 5mms to 7mms which should make them smooth and even with the rest of your forehead contour. This can be done through an incision either back in your hairline or just along your hairline. This would result in a very fine line scar. The hairline incision, commonly used in pretrichial or hairline browlifts, offers an advantage in that one could advance the frontal hairline forward if one desired. In your pictures, it appears that your forehead is fairly long between the hairline and the eyebrows. That distance could be easily reduced at the same time by bringing the hairline forward. I have found that to be very helpful with burring down upper forehead prominences as the combination of bone reduction and a shorter forehead length makes for a very smooth and more pleasing forehead shape.
This is an outpatient procedure done under general anesthesia that takes less than two hours to do. There is very minimal pain and swelling afterwards. A wrap around dressing is used just overnite. One can shower and wash their hair the very next day. There are are not real risks to the procedure other than the fine line scar which blends in quite nicely and is rarely detectable. Usually one’s hair grows through the very edges of the scar so it is not visible.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, forehead bump reduction, forehead reshaping, hairline advancement, indianapolis, plastic surgery
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Sunday, July 18th, 2010
Q: I have a hairline which is so far back I can’t stand it. In addition, I have a buck forehead which bulges out. I would like my hairline to be lowered and my bulgy forehead to be reduced. I know that this involves a scar along the hairline in the end. I am African-American. Would this be a good procedure for me? I have attached some pictures for your review.
A: Thank you for sending me your series of photographs. They do show quite well your concerns, the far back location of your frontal hairline and the prominent bulge of your forehead. There is no question that you can bring your hairline further forward. It would be fair to say that it could be brought forward at least an inch (25mms) and maybe up to an inch and a half (35mms). That advancement is greatest in the middle and tapers off as one goes into the sides. (temple) About 5mms of forehead bone protrusion can be brought down in the very center of the forehead. You can never get it as reduced as one would like, due to the thickness of the skull bone, but some lessening of the protrusion can be obtained.
One could argue that there is little to lose by the procedures because it will be better than where you are now. Any forward movement of the hairline and forehead bone reduction will be viewed by you as a plus. However, the one trade-off is a fine line scar along the new hairline. While in most patients this is never a significant issue, in darker pigmented individuals this is something to consider. There is also the type of hair you have, meaning I suspect you don’t wear bangs because of the kinky texture of your hair. (although the purpose of doing a scalp advancement is so I can feel comfortable wearing their hair back) I have never done a hairline lowering in someone of your ethnicity so I can’t speak for how that scar will look. At it worst, it is a fine line white scar. While that would be an almost irrelevant issue in skin of lighter complexion, there is always the possibililty that a scar revision may be needed if it is too noticeable.
The key to any elective cosmetic plastic surgery procedure is that we are always trading off one problem for another. You just want to be sure that the scar ‘problem’ is a more tolerable one than the hairline that is too far back. Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, forehead reduction, forehead reshaping, hairline advancement, indianapolis, plastic surgery
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Saturday, June 12th, 2010
Q: Hello, I am a 28-year old male with very prominent brow bones and I would like to have them reduced to a normal size and shape. What is involved in doing this kind of plastic surgery? Are there any significant risks and do you think the results will be worth it? Thank you very much and I look forward to your reply.
A: Brow bone reduction is more than just burring down thick brow bone ridges. It actually involves removes the outer plate of the frontal sinus, reshaping it, and putting it back on. A prominent brow bone is really not bone, it is an overgrowth of the frontal sinus. Brow bone reduction is really about reducing the size of the air space of the frontal sinus, in essence making a room smaller by lower ing the height of the roof.
Brow bone reduction must be done through a scalp incision. While the operation is not complex or dangerous for those trained in craniofacial plastic surgery, it requires that expertise and training to be very comfortable doing it. The key aspect in the decision to have the operation, in my opinion, is the acceptance of a scalp scar. One should have a good density of scalp hair and some confidence that all hair on the top of the scalp may not be eventually lost.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: brow bone reduction, dr barry eppley, forehead reshaping, indianapolis, plastic surgery
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