Brow Bone Implant and Nerves

Q: Dr. Eppley, I am a young Asian male whose brow bones are flat, and is seeking to get them stick out through brow bone implant surgery. Would there be any long and short term side effects through implants, considering the amount of delicate nerves that lies in close proximity?

A:The nerves to which you refer (supraorbital and supratrochlear nerves along the brow  ridge) are neither sensitive nor are they motor nerves. They are sensory nerves from the first division of the trigeminal nerve that exit out the brow bones and head north to supply the feeling to the forehead and the front of the scalp. They are very hardy nerves that are manipulated quite frequently in many forehead/brow bone procedures. In placing any brow bone implant around these nerves the implant design must consider their location so they are not compressed as a result of the implant’s placement. But this is usually an avoidable problem. This becomes a very relevant issue in the implant’s design if one is trying to drop down the brow bone edge inferiorly or desires a lot of horizontal (forward) projection. But fir the typical forehead/brow bone implant, a notch is made in the design of the nerve foramina based on the patient’s 3D CT scan.

Dr. Barry Eppley
Indianapolis, Indiana