Does My Brow Bone Need Burring Or A Sinus Setback?
Q: Dr. Eppley, I feel my brow is too prominent/large. I had one surgeon tell me only a full “sinus setback/type III” will be the only way to fix it. However, can the bones be modified/burred enough to make a difference? I want the side/profile to be more flat and less prominent. I feel my forehead profile is the only element that makes people look at me strangely sometimes and it makes me very uncomfortable. I read that the supraorbital rims can easily be reduced even with just brow remodeling. Is this true? I appreciate any feedback you can give me, even if it is that I am likely to only benefit from the aggressive sinus setback type of surgery. I just need to know if there is an adequate amount of change that can be achieved with some mild bone shaping and with soft tissue modification to effect a real improvement (not perfection, but more feminine appearance, in profile as well) or if I’ll have to do the full reconstruction. I know an x-ray is the only way to know for certain.
A: In looking at your photos, the brow bulge does appear to be from the frontal sinus. But whether that needs to be burred or setback by osteotomies will require a lateral skull film to best answer that question. In some cases in women, I have done a little burring of the brow bone prominence and building up of the forehead above it to create a smoother more convex forehead. That can be a very good alternative to setback osteotomies for mild amounts of brow bone bulging like yours.
Dr. Barry Eppley