Can I Just Remove Bone And Not Muscle In Temporal Reduction Surgery?
Dr. Eppley, I wanted to follow up on my previous question regarding skull width reduction. You said that the bone above the temporal muscles can’t be narrowed very much. I’m curious to know how much it can be thinned. I assume it varies depending on the width of the bone, but is there a percentage rule of thumb?
Also, you seemed to say that the removal of the muscle is an all or nothing procedure, meaning the muscles have to be entirely removed and can’t be partially removed for only minimal thinning. Here’s the dilemma I have: because the bone on top of my temporal muscles is just as wide if not wider than the area below with the muscles, I’m concerned that removing all the muscles (say it’s 7-9mm) but thinning the bone by say 3mm (if that can be done) will cause it to have a curved appearance. Meaning it would curve in right above my ears and then curve out on the top by the bone. Obviously that would not be an ideal outcome.
So I’m worried if my concerns are justified, and if so, if there’s anything I can do to make the thinning of bone and muscles proportionate.
Here are my thoughts:
1) to get Botox to thin the muscles, and if it produces a noticeable effect, to just thin the bone equal to the reduction Botox caused to the muscles. Essentially this way no muscles would be removed.
2) to thin the bone everywhere by an equal amount and not remove any muscles. Essentially to thin the bone behind the muscles and on top of the muscles.
The purpose is to make the thinning equal everywhere.
Thanks for the help,
A: In answer to your skull width reduction questions:
1) The temporal bone can only be thinned 1 to 2mms. But regardless of what can be reduced the only way to do so is an incision along the side of the head. It can’t be done from an incision behind the ear.
2) While you can do Botox to the temporal muscles, it is such a large surface area of muscle and the dose injected is likely to be very inadequate that this will not replicate a surgical effect for either bone or muscle reduction.
3) If you want to thin the bone you have to lift the muscle off the bone. To do so which will cause it to undergo some atrophy even if no muscle is removed.
4) While I can understand what you are trying to achieve the concept of ‘even reduction everywhere’ is not as simple or straightforward as it may seem.
Dr. Barry Eppley