How Can I Treat My Coup De Sabre Forehead Deformity?

Q: Dr. Eppley, I have had coup de Sabre since I have been in 5th grade (10 years old ) mainly affecting my forehead and part of my scalp. I have been looking for doctors that are willing to do cosmetic surgery on my forehead to bring it back to its normal state but none have been willing. I have had consultations about this disease but never had answers. I came across this article of your procedure on a patient with my same condition and would love to have this procedure done to make me feel better and more confident with my look. Coup de Sabre has affected me in many ways. I hope to speak soon. Thank you for your time. 

A: Thank you for your inquiry and sending your picture. I have treated numerous cases of linear craniofacial scleroderma, most of which have affected the forehead and scalp along the distribution of the supraorbital  nerve. In treating the forehead contour deformity the brow and forehead bone is deficient as well as the overlying skin is thin. I have treated it with both bone cements and fat grafting and each has their own advantages and disadvantages. In the end the problem is both a combination of bone and soft tissues so ideally both are eventually needed for optimal results.

Dr. Barry Eppley

Indianapolis, Indiana