Q: Dr. Eppley, I spoke to you this last summer on Skype regarding forehead augmentation. I favor using bone cement as opposed to a silicone implant. Do you think burring of my supraorbital ridge will be necessary? If so, would the charge me extra? and is there a risk of damage to my sinus cavity?
A: When you have the severely sloped forehead that you have, it would be good to to do some modest burring of the supraorbital ridge. It would be complementary to the forehead augmentation in creating a better overall result. With burring the key is to stay out of the frontal sinus which requires experience in doing so. How much reduction can be obtained is a function of the thickness of your frontal sinus wall. If you need a frontal sinus setback that would be important to know up front because it will take some more surgical time to do and there will be some extra costs in doing so.
The choice of forehead augmentation material is a personal one. I have used both bone cements and custom implants successfully and each has their own advantages and disadvantages. I do not necessarily favor one over the other, I just try and educate the patient on the merits of each material.
Dr. Barry Eppley