Can My Coronal Scalp Incision Be Used For Temporal Implants and Radix Reduction?

Q: Dr. Eppley, I am a 28 year old ciswoman and have had temple augmentation with bone cement (hydroxyapatite) around 8 years ago. At the same time, I also had some of my brow bone burred down through a coronal incision (to get rid of that neanderthal look) and a brow lift to reattach the muscles and skin in a natural position.

I was initially very happy with the results, but over time the hydroxyapatite has somehow disintegrated and I am now back to having hollow temples (and a narrow head shape in general).

I am now looking for a more temporary solution and am thinking of temporal implants. Specifically, I am looking into custom-made temple implants starting at my temples and extending to the side of my head (I attach pictures of similar augmentations I found on your website).

Further, I am thinking about further burring down my brow bone bossing and – while the coronary incision is already open – potentially also reducing the radix of my nose (not sure if this is possible through a coronary incision though, but I thought this may be possible and would be really interesting to know). More precisely, I asked the surgeon back then to undercorrect the bossing and not lift my brows more than necessary as I wanted the most subtle of results. After eight years during which my brows have had time to drop again, I am now looking to redo this (but this time properly without undercorrection).

Before scheduling a consultation with you, I wanted to reach out and make a quick inquiry about feasibility and cost (I understand that this is very individual but a ballpark price would be really helpful to know whether I can afford surgery with you) to make sure that I don’t waste your time with an unnecessary consult. If possible, I would be really grateful if you could give me some initial answers on following questions:

1) Very roughly, how much would an augmentation with custom-made implants (similar to the ones attached to this email) cost including the implants?

2) Can the radix of the nose be shortened through a coronary incision?

3) Very roughly, how much would burring down the brow bone and (if possible) radix – using a coronary incision and closing with a brow lift – cost?

A: Using your existing coronal scalp incision the placement of custom temporal implants, radix nasal reduction and a bro9w lift can be performed. The radix reduction will need to be supplemented by an intranasal approach as well as the verst high radix reduction needs bidirectional osteotome bone cuts to be successful. The browlift is the tricky one as using a coronal incision to do it sacrifices scalp which I don’t like to do if it can be avoided.

These are all good cost questions and I will have my assistant pass along some cost estimates to you.

Dr. Barry Eppley

World-Renowned Plastic Surgeon