Q: Dr. Eppley, I am interested in temporal and brow bone augmentation. I was wondering what you would suggest for a 26 year old patient with weak temple and brown bones that make me look tired. I want the brow and temple area to be smoother and flatter and my eyes to look less protruding. I was reading about fat injections and was wondering if those can give me the results or would I need something more extreme like implants.
A: Thank you for sending your pictures. For the temporal region I can see where our extended anterior temporal implants will fill out the temporal areas nicely up to the temporal lines of the forehead. Building out the brow bones (supraorbital ridges across the top of the eyes would make the actual eyes look less protruding. The best way to achieve that look would be to make a custom brow bone implant for you off a 3D CT scan. Both procedures could be done concurrently. The temporal implants are placed through small (3.5 cm) vertical incisions back in the temporal hairline. The brow bone implants could be placed endoscopically through small scalp incisions.
The problem with fat injections, particularly for the brows, is that they are unpredictabe in terms of survival. In addition they produce very ‘soft’ push on the outside tissues which may be acceptable for the temples but not for the brows. But as an alternative and potentially more appealing treatment strategy this can certainly be done. And there is little to lose but doing so.
In reality, the placement of implants is not much traumatic than doing fat injections in these areas.
Dr. Barry Eppley