Q: Dr. Eppley, I’m not sure if you remember me…I originally enquired about coming to see you for a forehead implant a few years ago. After a lot of consideration, I decided to just do forehead shaving in my own country (mainly due to cost factors and work schedules), and to see how I felt about that result. I am relatively happy with the result however the the bone has been shaved unevenly and I feel one side is more protruding than the other more flatter (preferred) orbital rim area. Also there is some bumpiness in the middle part of the forehead.
I would like to do a slight refinement of this area and make the orbital rim smoother and less deep set. And at the same time to do a lateral brow lift to raise the outer corners of my brows.
I mainly wanted to know if it would be possible to do the slight forehead shaving revision using the same incision used for the lateral brow lift? I like the technique where the lateral brow lift incision is just in the hairline at the temples, thus it being skin which is removed in the brow lift, rather than hair bearing scalp, and then possibly getting a few grafts to cover the incision after it has healed. Is it possible to use some sort of long shaving device (ie an endoscopic shaving tool) from the lateral brow lift temple incision and shave down the slightly protruding orbital areas?
I don’t want to risk potentially making my current coronal incision scar wider by going in again and know I want to get a lateral brow lift for an exaggerated cat like/ eyebrow extending up and out type appearance, so I thought this would be a good potential method. What do you think?
Below would be the position I was thinking about the scar to be. Allowing the skin and outer portion of eye to be pulled upwards without any raising of the hairline, while at the same time being relatively close to the eye for easy access to the orbital bone area.
A: Good to hear from you again and I do remember you. It is not possible to effectively shave any portion of the forehead or orbital region through a temporal/lateral brow lift incision. It is simply too far away and the access is too limited to effecttively work through. Any attempt to use the temporal approach for forehead contouring is likely to cause as many irregularities as it is intended to solve.
Dr. Barry Eppley