Can Brow Bone Reduction In A Man Be Done So There Is Not A Scalp Scar?
Q: I have very prominent brow bones and want to get them reduced. What would cause the frontal sinus space to become so prominent? I have an older brother who has a nice flat brow bone and forehead. Conversely, my father has somewhat of a prominent brow but not quite as large as mine So could it be just genetics? Or could it be from falling on my forehead when I was younger? As far as brow bone reduction surgery goes, I have read that it involves a scar across the top of my head. Given my hairline this is not very appealing. Is there a way of going between the very top bridge area of the nose and bottom of the brow to contour it that way and bypass the hairline all together?
A: There is no known reason that the frontal sinus expands to such a large degree, short of the presence of a sinus tumor. It has nothing to do with trauma and is just purely a genetic blueprint issue.
There is an alternative to a scalp or coronal incision which is done directly as you have indicated. It is an incision done directly across the brow bone area, being just at the brow hairline margin and then coming across the middle by stepping done into a horizontal skin crease between the top of the nose and the forehead area. This is known as the ‘open sky’ approach and has an historic use for the treatment of fronal sinus fractures and tumors. For most men, it is a better option for brow bone reduction than a scalp incision and would be less noticeable. It would also make the surgery less traumatic and involve a quicker recovery. It does heal as a very fine line scar. If one’s brow is big enough and disconcerting enough, this is a reasonable approach.
Dr. Barry Eppley