What Are The Risks Of Brow Bone Reduction By Burring/Shaving?

Q: Dr. Eppley,I am female, 35, interested in brow bone shaving. My brow bone is a bit too thick, and I feel it looks a bit masculine. Is there any risks to shaving the bone in the glabella area? Would this make the bone there too thin and easier to fracture in the event of an injury? I don’t need too much shaved, but wondering if even a bit of shaving is risky. Thank you.

A: The issue with brow bone shaving is not one of real medical risk. The only issues with brow bone reduction are two-fold. First, you need a scalp incision and turn down flap to do it. So there will be a resultant fine line scar in the scalp. Secondly, and more relevant to your question, shaving the brow bone has the risk of burring right into the frontal sinus cavity. Most of the brow prominence is not composed by bone at all, but by air from the sinus cavity undermeath. How significantly one can burr down the brow bone depends on how thick the outer cortical table of the frontal sinus is. Often times it is no thicker than 2 to 3mms. The glabellar area, the part of the brow bone between the eyebrows, often will have no frontal sinus cavity underneath so it may be able to be reduced much more.

For these reasons, it is necessary to determine a patient’s eligibility for brow bone reduction knowing in advance the location of the frontal sinuses and measuring the thickness of the bone. This can be done with simple plain x-rays taken from the front and side views. For some patients, brow bone reduction by burring is adequate (minority of patients), but other patients need to have done an osteoplastic bone flap technique due to their thin outer bone covering of the sinus.

Dr. Barry Eppley

Indianapolis, Indiana