Reshaping Your Forehead With Plastic surgery

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Reshaping the forehead is an uncommon outpatient request. While the plastic surgical operation techniques to do so are well known and not new, the need to do forehead contouring is not. Most commonly, forehead reshaping is done on patients who had a congenital skull deformity (e.g., craniosynostosis) or a frontal skull deformity secondary to trauma or after a neurosurgery craniotomy procedure. The cosmetic reasons would be to soften leading brow ridges or to flat out some forehead irregularities.

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The rehabilitation of forehead irregularities can theoretically be done by whether burring down bone or adding a synthetic material to it. In reality, burring down bone on the skull is a minute course and can never make as big a disagreement as one would think. The brow ridges can be burred down but the limiting factor is the underlying frontal sinus. If the overlying frontal sinus bone is thin, then very minute bone can nothing else but be taken. Above the brow ridges, burring down forehead bone is very efficient for small raised areas that are nothing else but identifiable but is less efficient at reducing large covering areas of bone.

Filling in or adding to the forehead bone is a much easier and efficient procedure. The real examine in forehead augmentation is what material to use. Primary Pmma (polymethylmethacrylate) has been around for a long time and has the advantages of a very low cost, high resistance to impact forces, and ease of intraoperative contouring. Its main disadvantage is that some patients over time can manufacture some low-grade reactions to it and it may get loose, come to be infected or the overlying forehead skin may thin, although these issues are fairly low risk. Newer 'more natural' materials such as hydroxyapatite cements (Ha) have been available over the past 10 years. Ha offers the advantage of being a more natural, less synthetic material as its buildings more closely resembles that of bone. Its disadvantages are that it is considerably more expensive, has a low resistance to impact (easily shatters), and is a bit tricker for the plastic surgeon to use. The advantages and disadvantages for Ha vs. Pmma must be carefully and weighed on an individual case basis.

Regardless of the material used, synthetic forehead augmentation commonly requires an open scalp incision which, because of its length, is a significant notice in a cosmetic procedure. (particularly for men) Endoscopic or minute scalp incisions may be able to be used in small areas of augmentation in carefully selected cases.

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