Have You Ever Seen Shock Hair Loss In Temporal Reduction Surgery?

Q: Dr. Eppley, At the moment I am undecided as to whether I want bone burring to be done due to the bi-coronal incision (incision that travels over the scalp) so I just want you to assist me in weighing up the risk to benefits by answering some enquiries. I also say this based off a recent Instagram post of yours demonstrating this surgery which is shown in the image attached image. It is to my satisfaction that these incisions in the image look quite simple and much less invasive compared to the approach we have planned for myself hence why I have these enquiries: 

-Based off my CT scan, if you were to bone bur the temporal line, what is the most in millimetres that you could reduce and would this reduction be noticeable? 

-Would I still achieve forehead narrowing if I just had anterior & posterior temporalis muscle reduction without any bone burring? 

-Have you ever had patients encounter shock loss with hair from this large incision ? 

-If the large scalp incision was done, how long would it take for stitches to close up and heal? 

-Is there an alternative incision in achieving bone burring? 

Your answers to these enquiries would influence me in deciding if an incision that large is worthwhile doing as I’m starting to feel that I’ll be the most comfortable with the approach shown in the image below. 

A: You can’t do the type of bony temporal line and anterior temporal muscle reduction that you seek through the anterior temporal incision shown in that picture. That does not apply to your case.

Bony temporal line reduction is always at least 5mms, which when done bilaterally (or even unilaterally) makes a visible external difference. Your case is no different in that regard.

Temporal muscle reduction of any type will not change forehead width. Foreheasd width reduction is controlled by the bony temporal line.

The only hair shock loss I have ever seen in larger scalp incisions is when it is used for large skull implants or tissue expanders (which is very uncommon)….not with any form of skull reduction which is what I would expect with a total lack of tension on the incisional closure.

Dr. Barry Eppley

Indianapolis, Indiana