How Can My Forehead Dent Be Fixed?

Q: Dr. Eppley, Hello, I’m interested in scheduling a consultation for a permanent correction of a localized indentation in the center of my forehead. The depression is mainly due to a previous frontal-bone fracture rather than a soft-tissue issue, and I am specifically interested in learning whether I may be a candidate for PMMA bone-cement frontal skull reshaping or another form of reconstructive forehead contouring. I can provide photos and obtain a thin-cut CT scan with 3D reconstruction if needed. Could you please let me know whether your surgeons have experience treating post-traumatic depressed frontal-bone fractures similar to mine, what procedure they would generally consider, and whether you can provide a rough price range—including surgeon, facility, anesthesia, and material fees—before I schedule a consultation? I understand an exact quote would require an examination, I am working with a limited budget and am trying to determine whether the procedure is financially doable for me. Thank you!

A: Thank you for your inquiry and sending all of your pictures. The key question is whether your left forehead indentation is due to a bone defect or a reflection of soft tissue atrophy from the obvious trauma that has occurred in that area as evidenced by the vertical scar. This is where the 3-D CT scan of your forehead would be invaluable to answer that question.

For the sake of this discussion, let us assume that it is a bony indentation. The ideal approach would be hydroxyapatite cement contouring going through the scar that already exists.

From a cost standpoint, we will start with this being the ideal approach. There are other more economic alternatives in terms of materials, but we won’t pursue that until we know where you stand with the hydroxyapatite cement approach.

Dr. Barry Eppley

Plastic Surgeon