Q: Dr. Eppley, I want to have forehead and skull reshaping surgery. I will fly to US at the end of February.
I have fat injection in my forehead 3 times. Each time interval is 1 year. The last time is 4 months ago. Now I have problem with the fat lump as you can see in the picture. The fat lump creates the ugly on my forehead.
1. I want to reshape my forehead and skull as the green line in the picture. I want to have a high and big forehead as in the picture. Which method is suitable to me?
2. I think I should have the brow shaving to achieve the result I want. I attach the desired result.
3. Is it possible to remove the fat which has been injected in my forehead to smooth my forehead?
4. How long I need to stay in Indiana for the surgery?
5. What is the cost for the surgery?
I hope to hear from you soon.
A:Thank you for sending all of your pictures and describing your forehead augmentation with fat injections outcome. Your forehead augmentation result speaks to why I don’t like this method of forehead augmentation. It can create a lump/bump appearance and the fat often drifts down lower closer to the brows rather than higher up in the forehead which most Asian women want. While it does not always create the result you have, I have seen it enough times that it is always a potential outcome. When fat injections in the forehead go awry, they can be very difficult to remove and runs the risk of forehead irregularities just like what can occur with liposuction anywhere on the body. But the use of liposuction on the forehead has a higher risk potential for these irregularities due to the higher skin tightness of the forehead and being able to see cannula lines.
In answer to your questions:
1) As you have discovered in your case, achieving your forehead shape result will; require bone augmentation. This can be done by bone cements or a custom forehead implant. The latter is always preferred when possible as it can can cover a broad surface area with the smoothest result possible.
2) I would agree that brow shaving would be a useful adjunct to your forehead shape goals.
3) As stated above the only fat in the forehead can be removed is with liposuction. And I think that has to be done as part of your forehead reshaping goals. BUT it should be not done at the same time as the aforementioned forehead procedures due to blood supply and healing concerns from the scalp incision and elevated forehead tissues. Any efforts at fat removal should be done first and allowed to heal. I can do that or the doctor who injected the fat should be able to perform it as well.
4) You would only be here for a day or two after surgery and then you could go home.
5) My assistant will pass along the cost of the surgery to you later today.
Dr. Barry Eppley