Will Brow Bone Reduction Make My Large Skull Look Better?
Q: Hello, I wonder if you can help my son (19 year of age) who suffers from low self esteem due to the appearance of his head size since he started school. He has seen four psychologists and therapists to help him deal with his concerns. The problem is his head size which is too big. I know that nothing can be done to reduce the overall size of his skull but he also has very prominent brow bones which draws attention to his face making him more self conscious. Can anything be done about this?
A: Skull shape and size is one of the features of our appearance that we take for granted…unless it is too big or small and out proportion to the rest of the face. When the skull is bigger, a form of cosmetic macrocephaly, the sheer thickness and surface area of the bone make any reduction not practical to surgically consider.
It is not surprising that another part of the skull (brow bones) is big given the overall size of the skull. Changing something on the face that is likewise bigger and out of proportion as an alternative is a form of ‘camouflage’ and can be psychologically empowering. When faced with a physical problem that is unchangeable, being able to positively modify something else can be a good diversion that can provide some self-image enhancement.
Prominent brow bones are the result of overgrowth or pneumatization of the frontal sinus. Reducing them involves takes off the front table of bone, which is quite thin, and putting it back in a reshaped and flatter form. That can soften the forehead and orbital appearance which is where most eye contact in conversation is directed.
Dr. Barry Eppley