How Safe Is Forehead Horn Reduction Surgery?

Q: Dr. Eppley, I recently came across your work regarding frontal bossing reduction and found your approach very informative. I would like to inquire about the procedure, particularly in my case as a 27-year-old male considering this surgery.

Could you please advise on the following points:

1. How safe is frontal bossing reduction surgery for someone my age?

2. What are the potential risks or complications associated with this procedure?

3. What side effects should I expect during both the short-term recovery period and long-term?

4. Are there any specific considerations or increased risks for male patients?

I would greatly appreciate your professional insight to help me better understand the procedure and make an informed decision.

Thank you for your time and expertise.

A:Thank you for your inquiry and sending your pictures. You have classic forehead horns which is a more limited of frontal bossing. This is treated by one of two methods: 1) by far the most common is burning or shave reduction of the forehead horned prominences, and 2) less common but a viable approach if indicated is to build up the forehead around the horns to create a smooth contour. Based on an assessment of your pictures the most common approach, burning reduction, would be indicated in your case.

In answer to your specific questions:

1) forehead horn reduction is not about safety but effectiveness. This is a very safe surgery since it is performed on the outside of the skull. The more critical question is whether the bone is thick enough to allow for an adequate reduction. This is determined preoperatively by getting a 3-D skull CT scan and using color thickness mapping of the bone thicknesses the thickness of the forehead horns can be measured,

2) The only risks of the surgery are aesthetic in nature. 1) how effectively can the forehead horn prominences be reduced and 2) how well does the very fine line anterior scalp incision heal.

3) There are no side effects of the surgery other than some short-term swelling which is largely gone in 7 to 10 days after the surgery.

4) The only consideration differences between male and female patients for forehead horn reduction is the location of the frontal hairline. Some men are going to have a frontal hairline that is way posterior to the fore head horns or they may not have a frontal hairline at all, both of which poses challenges in terms of incision location. This does not appear to be an issue in your case.

Dr. Barry Eppley

Plastic Surgeon