Brow Bone Augmentation after Hairline Advancement

Q: Dr. Eppley, I am interested in brow bone augmentation. Last year I had a hairline lowering procedure. Apart from some minor shock loss, the surgery went well. I had planned to have additional hair transplants to round out my hairline in the next six months. But I have been researching brow bone augmentation and it appears that the incision is usually near the hairline. I would like to consult with you about the feasibility of a 5mm brow bone augmentation. My ideal augmentation would add 5mm projection at the outer corners of my eyebrows and gradually slope towards 0mm projection as it approaches the center of the brow bone. Complicating all this is some asymmetry–my right eyebrow is higher than the left, and the eyelid on that side is more prominent, although I cannot tell if this asymmetry is due to the underlying bone. 

If I am a candidate for augmentation, it appears to me that it would be optimal to have the augmentation first, and the transplants second, in order to conceal the scar. Would love to hear your thoughts on this.

A: Thank you for your inquiry and sending your pictures. You are precisely correct in that if your were to do brow augmentation it should be done before the hair transplants as the hairline incision would be used for access to the brows. For the sake of shape precision and with the underlying brow asymmetry, the best approach would be a custom brow bone implant made from a 3D CT scan. That is the best method to ensure the desired implant dimensions.

Dr. Barry Eppley

Indianapolis, Indiana