Can Temporal Reduction Be Done By Just Removing Just Part Of The Muscle?

Q: Dr. Eppley, I have questions regarding skull width reduction. 

1) Can the bone on the side of the head be thinned, or just the muscles? I’m asking because I think the top part of my head above the muscles might need to be thinned also. 

2) Is skull width reduction predictable? Meaning if the muscles on the sides of the head are extracted, is it possible to remove say 4mm and keep some of it  (maybe by thinning the muscles instead of completely removing them) or does the entire muscle have to be removed? 

3) Is the result usually smooth, or are the noticeable bumps after the procedure? 

A: In answer to your head width/temporal reduction questions:

1) The temporal muscles on the side of the head make up the majority of its width. Bone reduction has little width reduction effect. However, if the temporal line at the top of the muscle needs to be reduced that is done by bone burring.

2) Temporal muscle removal is largely an all or none approach as predictable thinning of the muscle can be not done, particularly from the hidden incision behind the ear.

3) Because what lies under the muscle is smooth bone the contour of areas where the muscle is removed will be smooth. The only potential contour issue is the transition of the cut edge of the muscle along the line of cut from the top of the ear up to the bony temporal line. Usually this muscle cut line is not seen, as it typically flattens out over time, but there is always a risk that some area of transition may be seen with movement. (jaw opening) This is really only a potential relevant issue in men who completely shave their head.

Dr. Barry Eppley

Indianapolis, Indiana