Indianapolis Brow Reshaping Surgery – Forehead Reshaping in Indianapolis
Dr. Barry L. Eppley
As an extremely skilled cosmetic surgeon Indianapolis patients visit to treat their aesthetic concerns, Dr. Eppley performs forehead and brow contouring surgery, which can be used to make modifications to the shape of the forehead and the prominence of the brow ridges. You can view the results of some of Dr. Eppley’s Indianapolis forehead / brow reshaping patients by visiting his forehead / brow reshaping surgery results section.
The forehead is a major part of the face and occupies up to one-third of its total surface area. It is a major contributor to facial aesthetics even though it has only one obvious feature: the eyebrows. However, the forehead actually has three features that create the visual impression of its overall size. The top of the forehead is marked by the variable position of the frontal hairline, which differs greatly between males and females. The bottom of the forehead is outlined by the eyebrows and the supraorbital rims, which are the ridges of skull bone just above the eyes. The sides of the forehead are defined by the temporal ridges, the edges of the bony forehead where it meets with the large temporalis muscles.
The shape of the bony forehead (amount of convexity) and the prominence of the brow ridges help define the masculine or feminine appearance. A long forehead is more acceptable in a male because of the variability of the frontal hairline. The bone ridge running across the forehead above the eyes, known as brow bossing (supraorbital rims), is more pronounced in males. The degree of acceptable brow protrusion is not well-defined and can certainly become excessive, thereby causing an over-masculine or Neanderthal appearance. Male brow protrusion should be enough to create a noticeable break between the brow ridge and the forehead bone above it. It may also extend off to the side, tapering down onto the lateral orbital rims.
Females have almost no discernable brow bossing because their foreheads are more rounded with a fairly flat front. In profile, female foreheads are more vertical instead of backward sloping. This means that some brow bossing may be aesthetically acceptable when there is no break between the brow ridge and vertical forehead bone above it; it should flow smoothly without a noticeable transition. The amount of convexity in profile view, however, is important; it should not stick out further than the lowest edge of the brow ridge. The sides of the brow ridges are also more tapered towards the temples, unlike in males, in which the sides can be more boxy or square-shaped.
Augmentation of the brows and forehead contour can be done using any of the cranioplasty materials, which include PMMA (acrylic), HA (hydroxyapatite cement) and calcium carbonate. Each of these materials has its own advantages and disadvantages. These materials allow wide variability in adding to the brow ridges and increasing the amount of frontal bone convexity, width and smoothness.
Conversely, decreasing the amount of forehead convexity (bossing) can be done by burring (shaving), but the amount is limited by the thickness of the outer cranial table. Reduction of the overly prominent brow bone can be done by burring alone, burring combined with infracture, or complete frontal table removal and remodeling. Which method is used is based on how thick the brow bone is and the location of the underlying frontal sinus. Almost all forehead and brow contouring procedures require a scalp incision for best results. Only reshaping of the tail or sides of the brow bone can be done through an upper eyelid incision.
The length of the forehead can also be reduced both in its bony bulging and in its forehead skin length. Through a frontal hairline (pretrichial) incision, the frontal hairline/scalp can be brought forward and excess vertical length of forehead skin removed. This shortens the long forehead and puts the scalp in a more aesthetic position. In rare cases, a staged approach with a tissue expander may be used when the hairline needs to come forward more than 2.5 to 3 cms. Through a hairline incision, forehead bulging can be shaved down to reduce a small amount of excessive convexity and forehead width.
Temporal augmentation can be done to build out the deficient or concave temporal region (muscle to the side of the bony forehead). These temporal hollows can occur from natural development, certain diseases (such as autoimmune diseases), severe weight loss, or neurosurgical operations. Through a small incision inside the temporal hairline, dermal grafts or synthetic implants can be used for temporal augmentation. In larger temporal defects, bone cements or custom implants may be needed.
Dr. Eppley performs a range of facial plastic and reconstructive procedures, including rhinoplasty and facelift surgery, and has helped many Indianapolis jawline enhancement surgery patients achieve a more attractive lower face. He has also treated numerous Indianapolis migraine surgery and Indianapolis neck contouring patients.