Which Should Be Done First – Brow Augmentation or Rhinoplasty?

Q: Dr. Eppley, if I was to have a rhinoplasty to augment the bridge of my nose and a forehead/eyebrow augmentation, which should be done first? Will having the raising of the nose bridge first and then the forehead/ brow augmentation mess up the profile of the nose together with the brow ? Which procedures should I do first for best results ? Does it make a difference ?

A: I think the best aesthetic sequence is to do the forehead before the rhinoplasty. That way the position of the nasal implant can be optimized to that of the frontonasal level of the brow augmentation. That is a lot easier to do than the other way around. Getting a significant augmentation of the brow, particularly in the glabellar area, is more difficult that just forehead augmentation where you leave the brow area alone. Once a forehead/brow augmentation is done it is very difficult to change particularly if you are trying to add more to the brow or glabellar area. Therefore, create whatever brow/forehead augmentation that can be done and then set the level of the nasal bridge to that. In essence, work your way down from the top based on the difficulty of doing the procedure. When brow augmentation and rhinoplasty is done at the same time, it is easier to make both meet in the ‘middle’ so to speak.

Dr. Barry Eppley

Indianapolis, Indiana