Q: Dr. Eppley, Would the custom forehead implant also augment the temporal regions that require augmentation or would I need separate temporal implants?
I have seen surgeries performed where the implant is rolled up and inserted via a small (4 cm) incision that runs from front to back of the scalp versus side to side. Is this possible regarding the implants you use? Thank you.
A: A custom forehead implant can be made to any dimensions and size including incorporating the temporal region. Whether it should extend past the anterior temporal line at the sides of the forehead into the temporal region depends on where you are looking to achieve temporal augmentation.
The concept of using only a 4 cm long scalp incision to place a forehead implant only applies to small round central forehead implants usually used in women. Men that get a larger custom forehead implant that includes the brow and temporal regions need a longer scalp incision despite the fact that they may be rolled for insertion. A custom forehead implant covers a large surface area and, as as result, need a longer scalp incision for insertion that does a smaller more central forehead implant.
Dr. Barry Eppley
Q: Dr. Eppley, I was just curious on the cost of the filler for forehead horns. My brow bone sticks out too far and I would like to have it filled like I see in the photos on the website. Do you know the cost roughly? Also, would you ever have to get this procedure done again in the future or will it be permanent once it’s done? Thanks in advance!!
A: For filling in the central depression of the forehead, I really don’t use an injectable filler technique for it in most cases. Synthetic injectable fillers are only very temporary (a few months) while the fate of fat injections is uncertain as well as its permanency. I have used injectable bone cement as a form of injectable filler but it is difficult to get it perfectly smooth and, if it does not become smooth, a secondary revision of it is going to a larger incision to access it to even it out. The most successful strategy in my experience has been the use of a wall custom implant made from a 3D CT scan. This fills in the depression nicely and is permanent. I would need to see some pictures of your forehead to provide a more specific answer as to what work best for you. But central forehead augmentation to fill in a depression between the brow bones and the upper forehead prominences is usually best done with a custom forehead implant approach.
Dr. Barry Eppley
Q: Dr. Eppley, I am seeking a custom brow bone implant. My problem is that my brow bones are very low, typical Asian. My eyelids are protruding.I believe this makes me look too soft, messy in the eye area, sad etc. not manly. I have thought of this for at least five years. My brow bone is less protruding or equal to eyelid protrusion.
For men the brow bone should be substantially more protruding than the eyelids, almost close to protrusion of upper lip.
What I wish for is a permanent brow bone implant. I want an attractive manly forehead and supraorbital rim area. I want the brow bone to protrude more than eyelids and close to protrusion of upper lip based on analysis of male faces I want to look like.
A: What you are seeking is a custom brow bone implant. Most likely this would have to be a combined forehead brow bone implant to create the best overall effect. This type of custom made implant is made off of the patient’s 3D CT scan. Its final shape requires some artistic design but how much brow bone augmentation is needed can be determined by looking at the difference in the brow-eyelid position in the profile view. Thus type of facial implant would need to be placed through a scalp incision.
Dr. Barry Eppley