What Are The Chances Of Blindness in Getting A Brow Bone Implant?

Q: Dr. Eppley, I am interested in the brow ridge implant. From the website I noticed there are two kinds of implant, one goes with the way to the upper forehead the other do not, which is more suitable for my case? Also, I have frontal bossing because of my lack of a protruding brow bone can implant fix this? I know there are a lot of nerve on the forehead and glabella area, so I am worried what is the chance of blindness if the implant gets infected? Or chances of shifting? 

A: In answer to your brow bone augmentation questions:

1) Based on just one side view pictures with your hair obscuring most of your forehead, and no knowing what your aesthetic upper third of the face goals are, I can not tell you what exact style of brow bone implant would be appropriate for you. This will require better pictures, computer imaging and a discussion to provide an informed answer.

2) Contrary to your perception of the neural anatomy of the forehead there are really only one set of sensory nerves that provide the feeling to the forehead which are the supraorbital/supratrochear nerves.  Dissection and implant placement is done around them and it is to be expected that there will be some temporary numbness of the forehead after surgery of which feeling eventually returns. These nerves are not responsible for forehead movement nor have any relationship to the optic nerve. Thus there is zero risk of any optic nerve injury or blindness.

3) Unlike implants placed through the mouth, I have never seen infections in any forehead or brow bone implant.

4) I have also never seen such implants shift or would I expect that to occur even when a traumatic injury occurs to the forehead.

Dr. Barry Eppley

Indianapolis, Indiana