Brow Bone Reduction
Q: Dr. Eppley, What type of implant is movable, shave-able, and low risk of infection? I am planning in getting a custom forehead implant, 12mms thick on top of my forehead. And also can a brow bone be shaved once the implant is placed?
A: Custom made silicone forehead and other skull implants have proven to be the most adaptable with the lowest risk of infection in my experience. I have yet to see an infection with silicone skull implants. (unlike PMMA and other bone cements) They are made from the patient’s 3D skull CT scan. Whether a forehead augmentation could be as much as 12mm depends on whether the overlying forehead tissue and scalp can safely stretch to accommodate it.
If the brow bone is reduced at the same time or even later by an osteoblastic bone flap technique, it would be important to seal all the opening along the osteotomy lines with hydroxyapatite cements to ensure there is no risk of an air leak up into the implant space. This is not important in brow bone reduction by shaving as there is no exposure to the underlying frontal sinus. (at least there should not be)
Dr. Barry Eppley