What Are The Different Techniques For Brow Bone Augmentation?
Q: Dear Dr. Eppley, what are the different techniques used in brow bone augmentation? What are the pre-operative and postoperative things to consider? Thank you so much.
A: When it comes to brow bone augmentation, the first consideration is what part of the brow does one want augmented? Most patients want the whole brow done and it must be approached through a scalpor coronal incision. There are some patients who just want the tail of the brow augmented and that can then be done through an upper eyelid incision. The next consideration is what material to use. There are four options including preformed implants and three mixtures which are applied and then harden which include acrylic (PMMA), hydroxyapatite (HA) and Kryptonite. (calcium carbonate) Because of moldability to the brow bones and that more volume can be obtained, I prefer the mixture materials. There are arguments to be made for any of them and they all will work. Considerations must be given to cost, long-term tissue acceptance and fracture resistance. From a cost standpoint, acrylic is best and is the most fracture resistant but there may be some tissue thinning over many decades of implantation. (emphasis on the word…maybe) HA and Kryptonite are very similar to bone so there will never be any problems with tissue acceptance but they are more easily fractured (theoretical concern, not one I have ever seen) and cost more. The choice of any of these materials for brow bone augmentation must be done on an individual patient basis.
Dr. Barry Eppley