Q: Dr. Eppley, I am interested in temporal reduction surgery. I have too much width of my head. So I wanna reduce width and do your surgery that removes temporal muscle and/or reduces the underlying skull bone .I think the back of my skull needs more volume as well but I want to take surgery that reduce skull width first. I am sure I need surgery seriously as soon as possible.I think I need upper side bone reduction and lower side bone or bite muscle reduction. I am 30year old male living in Japan. I also wonder whether Botox injections that reduce bite muscle is safe and effective or not. Thanks for taking your time to read this.
A: Posterior temporal reduction (mainly muscle with some bone) can be an effective head width reduction procedure. (it is also the only one that can be done) While Botox injections may have some mild effect on muscle reduction, the amount of Botox that would be needed would eventually be greater than the cost of the surgery, would need to be repeated and at best would only create about 1/3 to 1/2 the effect of surgical reduction. But Botox injections are certainly safe and effective, it is just a question of their cost over time in such large muscle masses.
Dr. Barry Eppley