Can An Eyebrow Incision Be Used For Brow Bone Reduction?
Q: Dr. Eppley, I am 24 years old and my brow bone gets getting bigger. Is there something I can do to stop it expanding? Why is it doing it? Can an incision be made on both eyebrows to perform procedure? What would be your best idea without doing a coronal incision? Can a cut be made in my eyebrow so you can burr it down. ( wouldn’t be much) Then somehow either inject a filler into the top part of my forehead to smooth out… what about some kind of implant for the top part of the forehead? Does that need a coronal incision to be placed in?
A: At your age, your frontal sinus development is complete and should no longer be expanding. That is a function of skull growth which is long over now.
An incision can be made along the eyebrows known as the ‘Open Sky’ approach. It runs along the upper eyebrows and crosses over the nose. While it can be done, it is an historic approach that has largely been replaced by the coronal incision. I am not so sure that wouldn’t be more obvious than the coronal incision quite frankly but I wouldn’t yet rule it completely out
The key question about incisional approaches is what exactly needs to be done to the brow ridge to reduce it. In the vast majority of cases it requires infracturing or an osteotomy of the outer plate of the frontal sinus bone. This can only be done through a coronal approach. Usually simple burring is inadequate BUT if one has just a few millimeters of bone that need to be taken down and the area above it is built up with cement, the eyebrow approach may be reasonable. That could be determined beforehand by one simple x-ray known as a lateral skull or frontal sinus film. That would tell us precisely how thick the frontal sinus bone is and how much can be reduced by simple burring.
Dr. Barry Eppley