Q: Dr. Eppley, I am interested in brow bone reduction surgery. In the past few months my brows have started to be protrude. Is there anything that I can do to stop it or how much would it cost to have it remove or is their payment options? Its really affecting my way of life.
A: Brow bone reduction surgery is always an option for brow ridges that have excessively overgrown. Your brow protrusion, as long as it is symmetric (and it appears so in your pictures) is the result of a pneumatization process. (development and expansion of an underlying air cavity) While not present at birth, the frontal sinuses have a fair degree of development by 7 or 8 years of age but continue to grow (expand) until well after puberty. Why some people develop bigger frontal sinuses than others is not clear other than due to hormonal influences. (men develop bigger frontal sinuses than women hence the development of the stronger male brow ridge) Spontaneous frontal sinus growth after puberty could be the result of a late pubertal spurt, medications such as steroids or a more conscious awareness of its size.
While brow bone reduction surgery can be done (usually an osteoplastic flap setback is the most effective technique), this requires a scalp or coronal incision way back in the hairline. While this can certainly be done, men always have to think very carefully about this scar trade-off. Given that you shave your head this consideration is of high significance. Initially this is a far more important hurdle to cross than that of the cost of surgery.
Dr. Barry Eppley
Q: Dr. Eppley, I have noticed that my son who has just turned 21 years old has quite a prominent protruding brow. In fact, I noticed it a few years ago and I am quite positive that it has become larger in the past 12 months. He is 6ft 5in (195cm) tall – a very slim built person; a sports man. Other body features, such as face and head, are all normal in size and do not have the ‘giant syndrome’ disease – which I recall most people with a large protruding brows have. I am wondering – will the brow bone stop growing or could it become larger? Should we be concerned? Should he see a physician? Is this a particular condition or syndrome which needs investigation? Look forward to your early response. With sincere thanks.
A: In theory, frontal sinus development is almost always complete by the later teen or early 20s. Your son is a large man so his frontal sinus development may be normal for his size…or it could represent an underlying endocrinologic disorder of the pituitary gland or excessive growth hormone. I would recommend that he be initially seen by an endocrinologist to rule out this potential medical condition even though it may be unlikely. X-rays of his frontal sinus would also be helpful to determine its size. If there is not an endocrinologic basis for his frontal sinus development and it is an aesthetic concern, brow bone reduction/reshaping is a surgical option
Dr. Barry Eppley