What Are The Incision Options in Male Brow Bone Reduction?

Q: Dr. Eppley, I have a prominent supraorbital bone and I want to do supraorbital bone ( eyebrow bone shaving) Is it possible to shave or peel the excessive supraorbital bone by minimal invasive technique (endoscopic technique) because the problem that I have a baldness on the both sides of the head and I don’t want to have a long visible scar on my forehead. And is it possible to remove the excessive eyebrow bone by making an incision on the upper eyelid ( transpalpebral technique) in order to avoid the long visible scar the resulted from the conventional open method for the forehead rasping. Thanks

A: Your question about the access for any form of brow bone reduction is a good one and that is always the challenge in male brow bone reductions. Whether it is burring or bone flap setback the endoscopic and transpalpebral approaches will not work. There is no good instrumentation through the endoscope to make any significant brow bone reduction possible and the upper eyelid incision provides limited access to the brow bones because of the supraorbital nerves which are impossible to work around without permanent injury to them. Thus in many men the choices become a mid-forehead incision, which can work well if a horizontal wrinkle line is present, and a frontal hairline incision if the frontal hairline is not too far back.

I would agree that the typical coronal scalp incision is not an acceptable scar tradeoff for most men.

Dr. Barry Eppley

World-Renowned Plastic Surgeon