Should A Forehead Augmentation Go Further Back Onto The Top Of The Skull?

Q: Dr. Eppley, I’m currently considering forehead augmentation surgery to make my forehead less sloped, more symmetrical on each side and more prominent at the front. I wanted to ask whether adding additional PEEK material or bone cement will automatically change the top of my head shape slightly, as this is connected to my forehead. I also ask this because I had previous surgery where the forehead bone was shaved down very thinly and in the process my frontal skull/head connected to this forehead area also became very flat at the top and front. Please note that the top of my head was not touched in the previous surgery, only the forehead bone was shaved down. I noticed that in the picture below, the top of the patients head also changed shape slightly and appears higher and less flat (like the forehead) after forehead augmentation surgery. Could you please advise me on the cost of the same procedure or by using peek implants instead?

A: Like all forehead augmentations, it can not just stop at the top of the forehead unless the forehead augmentation is but a millimeter or two. As the slope of the forehead becomes less the implant design must extend further back onto the top of the skull and over the sides of the bony temporal line onto the temporal fascia to blend into the rest of the skull. (see attached)

Because of the need for these extensions and that they be smooth and very feathered, the use of bone cements has largely been abandoned. This requires a computer designed implant. Unless one wants a full coronal scalp incision to place the implant this is also why PEEK and any other completely inflexible materials are also not desired by most patients today. Solid silicone skull implants offer the far superior method for any form of aesthetic skull augmentation.

Dr. Barry Eppley

Indianapolis, Indiana