Brow Bone and Lateral Orbital Rim Augmentation by Bone Grafting

Q: Dr. Eppley, I am interested in forehead contouring and brow bone augmentation. I have a negative orbital vector and was wondering how much a procedure would cost for bone grafting around my eyes, mostly upper eyelids and sides of eyes. My eyes look protruding and lack support around the area making me look tired and unhappy all the time. I am not interested in implants.

A: While bone grafting can be done for the brow bone and lateral orbital areas, let me point out the many differences, and what would be presumed to be its disadvantages, from not using custom implants:

  1. A full coronal scalp incision would be needed to do the procedure.
  2. A large area of split-thickness cranial bone grafts would need to be harvested with its contour reconstruction with hydroxyapatite cement.
  3. All bone grafts would need to applied with compression screws.
  4. here would be some resultant contour irregularities around the brow bone and lateral orbital trims due to the combination of the fitting of their edges and the subsequent healing which will undoubtably involve some areas of partial bone resorption.

In short this is a procedure which sounds good in theory because it uses autologous bone, but has its own aesthetic liabilities.

I will have my assistant Camille pass along the cost of the surgery to you on Monday.

Dr. Barry Eppley

Indianapolis, Indiana