Your Questions
Your Questions
Q: Dr. Eppley,I am interested in some form of forehead reshaping. I have two hard-like horns or lumps on my forehead. They have been there since I was a teenager. Now that I am in my early twenties it bothers me greatly. They feel like really hard like bones. They really affect me and bring my self esteem down. I’ve been to my family doctor and I was told it was really nothing. I am hoping you can help me. I have attached pictures from different angles for your assessment.
A: One of the most minor forms of forehead reshaping is reduction of prominent bulges. Your pictures show a very classic example of them and how protuberant they can be. Thank you for sending your pictures. They are the type of forehead bulges/osteomas/horns that I have seen many times. They are common excess growths of the forehead bone and are almost always on both sides.They are benign and normal but obviously not aesthetically desireable. They can be burred down to make for a more smooth confluent forehead contour. Depending upon the shape of the rest of your forehead and how much they can be burred down, it is sometimes also helpful to build up with bone cement around the area to get a really smooth forehead shape. That shaping consideration aside, the only other issue to consider is one of surgical access. You have to have an incision somewhere to gain access and this would be back in the scalp. Thus one has to accept a very fine line scalp incision to do it. Fortunately even in men with thinner or thinning hair cover, the scalp incision heals well with very minimal scar.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in forehead reshaping. I have two large forehead bumps that can be easily seen, even from a distance. I was wondering if these could be smoothed down and what the cost would be? Also how long it would take to get in for an appointment and if anything else like a CT scan would need to be done?
A: Your forehead reshaping concerns present a common forehead anomaly that I see. Your forehead bumps are classic for what I call ‘forehead horns’. I have seen these many times and why they occur I can not tell you. But they tend to appear exactly where they are in you and are almost always bilateral. (on both sides) They are fairly easy to reduce and do not require a CT scan or x-ray before doing so. They involve the outer cortex of the skull bone and do not go ‘deep’ or past the diploid layer of the skull bone. When taking them down there often is an indentation below the bumps that, when the bumps are taken down, can make the forehead appear sloped backward. In these cases, I often apply a thin layer of bone cement to correct the forehead inclination. Whether this issue applies to you would require assessment of better pictures from different angles.
The forehead inclination issue aside, the far more important issue is how to get in to do the forehead bump reduction. This requires an incision somewhere and it is an issue of whether to use a more wide open scalp incisional approach or more limited incisions directly over the bumps. That is an issue for further discussion.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a question or two. I’m 18 years old and have an really messed up forehead. Its bulgy, has horns and the brow bones sticks out and I also have a high hairline but small forehead. Is 18 to young to be fixing this? What age should I wait till. This is my biggest insecurity. And also how is the pain process? Thank you for taking your time to read this and I hope you respond soon! I have attached pictures so you can see how ugly it is!
A: It looking at your pictures, I see an uneven forehead, small upper prominences (what you can horns) and some brow prominence. You also have a mildly high frontal hairline or long forehead. That all could be treated in a single procedure, going through a hairline or pretrichial incisioon, burring down the forehead from brow bones up to the horns and then bringing the hairline forward to close. (removing so upper forehead skin to make your forehead vertically shorter. Surprisingly, that is not a painful procedure afterwards (patients report more like a headache) as it is really just a reverse form of a cosmetic browlift procedure with some bone reduction. At your age, your forehead bone is fully grown so it is perfectly appropriate to be doing these permanent modifications. The question to consider is not your age for the procedure (physical maturity) but whether this is enough of a concern for you to justify a surgical change. (emotional maturity)
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I’ve found a website that can do plastic surgery to change your appearance by making your ears pointed. And can put implant horns/antlers on your forehead or the top of your head. I was wondering if you can do something like that but if not, do you know any surgeons who can do something like that? The website I saw is made from a surgeon/doctor.
A: The procedures that you have requested are both unusual and dysmorphic in nature. While plastic surgery can create an enormous number of facial changes, the goals of such procedures are to reconstruct one to a more normal appearance or to enhance one’s normal physical features. Altering one’s ears to a ‘spocklike’appearance or putting forehead and skull implants in to create horn-like protrusions are a poor use of plastic surgery techniques and implant materials. While I am certain there are some ‘surgeons’ out there that perform these procedure, I would know of no board-certified plastic surgeons that would perform these disfiguring procedures that, no doubt, one day the patient will ask to reverse and restore a more normal appearance.
Dr. Barry Eppley
Indianapolis, Indiana