Can A Brow Bone Reduction Be Done Through The Upper Eyelid?
Q: Dr. Eppley, I am interested in brow bone reduction. I have a prominent brow ridge and orbital region. The orbital region is particularly prominent. I am not a candidate for coronal incision as I have a receding hairline. I have been told by a couple of surgeons that it is possible to do an eyelid incision to shave down the orbital bone region. Would this be something that is possible at your clinic? Thanks for any help.
A: The transpalpebral (through the eyelid) approach be used if the outer half of the brow bone needs reduced. (tail of the brow bone) But it can not be used for the inner half of the brow and glabellar region due to the location of the supraorbital and supratrochlear nerves, They directly exit the lower end of the brow bone in this area and block access to any type of brow bone reduction. If one was willing to sever these nerves and live with permanent numbness of the forehead and frontal scalp then this approach could be used. But I know few patients who would consider this a good tradeoff. The other option would be to do the procedure through a horizontal forehead wrinkle if you have a prominent one.
Dr. Barry Eppley