Q: Dr. Eppley, I am interested in forehead augmentation to create a wider, more masculine forehead with a custom implant. My forehead is very narrow and convex for a male. From my research I’ve come to realise that my limiting factor is the positioning of my anterior temporal lines. They are too close to the centre of my forehead. I know that designing an implant that extends beyond these lines may be aesthetically problematic. Is it possible to design an implant that covers both the temporal and forehead areas to sidestep this issue? How important is the ‘crossing the anterior temporal lines’ issue? Is it a completely preclusive one, or may the patient insist on going through with widening the forehead regardless?
A:When it comes to forehead augmentation, crossing the temporal lines with the traditional use of bone cements was always problematic because it was impossible to get a smooth transition into the the temporalis muscle area. (which is what lies on the outside of the temporal lines) But with the use of today’s custom forehead implants made from a 3D CT scan, where the edges can be made very smooth, such transition concerns are now minimized. This creating a wider or more lateral anterior temporal line demarcation can now be reliable done in an aesthetic manner.
Dr. Barry Eppley