What Is The Best Method To Correct My Forehead Asymmetry?

Q: Dr. Eppley, Here in my country plastic surgery almost not developed and I hear people dying at hands of inexperienced surgeons. Yes really it happens here. I don’t know how it happens even with plastic surgery but sadly it happens. So I have only choice to go abroad. I have forehead asymmetry as you see in pictures. Asymmetry not only visible but greatly effected how I look. Basically my skull lacks symmetry that caused bumps and holes around my head. Thankfully most of them under my hair area. When wear glasses especially new ones (which I normally because of astigmatism) I literally see difference between my ears location and end of glasses. My ears located approximately 0.7 to 1 cm difference. I think asymmetry caused my astigmatism and my teeth problems. My teeth don’t stand on each other freely. What you see is my teeth’s normal standing position which have ~4mm gap. Anyway, my biggest concern is my forehead which looks awful and pictures could not show how I look in reality. X-ray image just happens to be in my phone which was taken before I went military service. I have several questions: 

– I have allergies and do forehead correction surgery might cause any complications? 

– Which method is best in terms of longevity and price: Traditional pmma, prefabricated or silicon implant? 

– How long it takes to all job done? How long I need to stay in hospital? 

– Will it have complications at later life? 

– Do implant or cement fall off if I engage combat sports like box? 

– Can bone cement or implant removed later if needed? After 20-25 years. 

Thank you for your attention.

A: Thank you for your inquiry, sending your pictures, and detailing your concerns with the focus on the forehead. As best as I can tell from the pictures the forehead asymmetry is on the right side which I have circled in an attachment. Whether this forehead asymmetry is treated by bone cements or a custom forehead implant I can answer your questions as follows:

1) I am not aware of any negative relationship between allergies and any form of skull implant materials.

2) A custom solid silicone forehead implant is the superior method because it offers the most precise correction of the asymmetry with placement through the smallest possible scalp incision. The only reason to choose bone cements is for a somewhat  lower cost although a larger scalp incision is needed.

3) There will be no complications later in life.

4) Neither a custom implant or bone cement will become displaced or ‘fall off’ with trauma.

5) Either forehead augmentation material can be removed at anytime after surgery regardless of the length of time later.

Dr. Barry Eppley

Indianapolis, Indiana