Q: Dr. Eppley, I am interested in forehead reshaping. I am self conscious about the overall shape of my forehead and the width of my frontal bone. I would like to obtain a symmetrical, square like forehead by widening the brow and frontal/temporal region. I would also like to fill in the central frontal depression. Would you recommend bone cement or a computer generated implant for this procedure?
A: What makes your forehead look like it does in the frontal view is the anterior temporal lines which flare outward as they go back into the frontal hairline at the top sides of the head. Rather than having a straight vertical temporal line which would give the forehead a more square symmetrical shape. The question is whether it is best to increase the width at the bottom of the temporal lines to that of the top or to being in the temporal lines at the top to match that near the bottom of them. Either one will help achieve a more square look. Based on your own description it appears that the former would be how to change the width of your forehead. When you add in the need for central forehead augmentation it then become a clear choice of a computer designed custom forehead implant for your forehead reshaping surgery. These are a lot of precise changes to be made and it is far better to make that precision effort on the computer than leave it up to the surgeon to artistically make it during surgery using bone cements. Also the use of a custom forehead implant allows a smaller scalp incision to be made with less overall tissue trauma.
Dr. Barry Eppley