Forehead/Brow Bone Augmentation

Q: Dr. Eppley, I am interested in forehead/brow bone augmentation. I’m an Asian male, living in Korea. Like many Asian males, the prominence of my forehead and brow bone is very slight. So the appearance of my face is too flat.
Thus, I’m considering the forehead and brow bone augmentation.For years, I have searched for a hospital who does forehead “including brow bone” augmentation surgery However, Even though many Asians are not satisfied with their forehead and brow bone, all hospitals in Korea say it’s dangerous to use any implants on the brow bone, because there are much important nerve on brow bone region.So I had almost given up, and just at that time, I found your website on Google. So I wonder whether this surgery is really dangerous or not. If not, I wonder why Korean doctors do not operate on the brow bone.

A: It is common, in my experience, to perform brow bone augmentation along with forehead augmentation in many patients particularly that of the Asian male. Whether this is done with bone cements, custom forehead/brow implants or performed brow bone implants, the brow bone can be successfully and safely augmented. The only nerves that exit from the brow bones are the sensory supraorbital and supratrochlear nerves. These nerves supply feeling to the forehead and anterior scalp. They are not motor nerves that cause the forehead to move or the brows to animate. These nerves are at risk in any type of brow surgery whether it is a cosmetic brow lift or any type of brow bone reduction or brow bone augmentation procedure. The risk of injury to these nerves at that of numbness or partial loss of feeling. In rare cases, some pinpoint discomfort may occur from compression of an implant. This is why any forehead implant takes into consideration the location of the supraorbital nerve and makes a relief on its design. This is also why the implant should be designed too aggressively to hang too low over the brow bone.

Having said that, I can not give you a reason why brow bone augmentation, based on your research, can not be found in Korea. It is certainly not a dangerous procedure. I have designed and performed numerous forehead/brow bone augmentation procedures without the nerve complications that you have described.

Dr. Barry Eppley
Indianapolis, Indiana