Can A Brow Bone Implant Lower The Position Of The Eyebrows?

Q: Dr. Eppley, Can you give a few details about lowering the eyebrow position through brow bone augmentation and tissue expansion? 

You have claimed that there is no other way to achieve such change because of the tightness of the forehead’s soft tissues, which is apparently the limiting factor in driving the eyebrows downwards.

1) How would one get started doing this? I suppose the implant placement would follow the initial tissue expansion, correct me if I’m misinformed though.

2) Is the duration of the tissue expansion stage similar to how long it takes to expand e.g. the skull? Is the amount of tissue expansion similar too?

3) Is this a reliable procedure to permanently lower the eyebrows or is there a chance they go up again to the initial position pre-operatively?

Thank you in advance,

A: In answer to your brow bone implant and eyebrow change questions:

1) All brow bone implants will create some eyebrow lowering. But I would not consider it extreme or to the level that you may desire.

2) Due to the tightness and fixed length of the forehead tissue to which the eyebrows are attached at the lower end, there are tissue stretch limits as to how much eyebrow lowering can be achieved regardless of how a brow bone implant is designed.

3) To gain tissue laxity to drop the eyebrows down a significant amount, extra forehead tissue needs to be created. (the concept of tissue expansion.

4) Forehead tissue expansion can be done two different ways, the use of a traditional 1st stage tissue expander or the placement of an initial brow bone implant followed secondarily by a larger one later. Either approach has their advantages and disadvantages.

Dr. Barry Eppley

Indianapolis, Indiana