Q: Dr. Eppley, I am interested in correcting my coup de sabre involving my forehead and eye. What would be an approximate cost of correcting my linear scleroderma.
A: There are three approaches to treating your left forehead/orbital scleroderma (linear scleroderma en coup de sabre); forehead bone augmentation with bone cements, fat injections and the insertion of a dermal-fat graft. Which one would be appropriate for you would depend on how the tissues feel (skin stuck to bone with complete loss of fat) and whether there is an underlying bone defect on the orbital rim and in the frontal bone. (which almost always there is) Since there is usually both fat and bone defects along the line of scleroderma the most common surgical approach would be bone augmentation by bone cements combined with fat injections, either done together or in two separate stages.
To determine the ideal treatment needed for your linear scleroderma, a combined physical examination and a 3D CT scan is the best way to know exactly what to do. In many cases, these procedures are covered by insurance. But, at the least, fat injections can be done on a cosmetic fee basis and this is the most economical approach and would be part of any ideal surgical approach anyway.
Dr. Barry Eppley