Can My Bulging Brows Be Just Shaved Down?
Q: Dr. Eppley I heard people with protruding brows just have some of the forehead protrusion above the eyebrow cut or shaved off some. No metal plates and screws! Am I correct?
A: No you are not correct. Brow bone reduction requires that the outer table of the frontal sinus (the bulge or protrusion) be removed (cut off), reshaped, and then put back in place in a flatter shape. Putting it back in place requires small low-profile metal plates and screws to properly hold the reshaped bone in place until it heals.
The reason that the bulging brow bone can not simply be burred or shaved down is that this bone is actually very thin. The bulge is present, not because the bone has gotten thicker, but because the air-filled frontal sinus has expanded pushing out its front wall. For significant brow bone reduction to occur, the bone must be taken back as much as 8 to 10mms. The thickness of the frontal wall of the frontal sinus is only about 2 to 3mms thick. Burring into it would only expose a deep empty sinus cavity, not bone.
Bony protrusions or thickening above the brow bone, however, can be shaved or burred down as there is no underlying sinus cavities above the brow. Bone in most of the forehead can very safely be taken until one nears the diploic cavity or marrow space which could be 5 to 7mms of width reduction.