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Dr. Barry Eppley

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Case Study – Female Forehead Augmentation


Forehead feminization Surgery Dr Barry Eppley IndianapolisBackground: Like the rest of the face, the appearance of the forehead is very gender specific. A female forehead usually has three specific components to it. First there is no perceptible brow bone ridge or brow bone break into the forehead. It is smooth as it ascends from the supraorbital rims into the upper forehead. Secondly, this ascension upward has more of a vertical orientation and not a backwards sloping or anterior protrusion profile to it. Lastly, there is an overall convex shape that is more full centrally and tapers into the temporal regions.

Female forehead augmentation can be done using a variety of different materials from bone cements to preformed and custom silicone implants. The choice of which material method to use depends on a variety of factors not the least of which is the amount of augmentation needed and the type of incisional approach to be used. With a completely open approach to forehead augmentation a viable option is that of bone cements. Such visual access allows for good cement application and shaping which is a critical part of intraoperatively applied onlay materials.

Before custom forehead implants became a treatment option, the gold standard for female forehead augmentation was the use of PMMA bone cements. This is still a useful material choice but does require a scalp incision of some length. A hairline or pretrichial incision can be used if one is also moving the hairline or one can tolerate the location of the scar. The further back in the hairline one goes the longer the scalp incision must be to provide adequate access for cement application and shaping.

Case Study: This 25 year old female wanted to create a better forehead shape. She felt her forehead sloped back too far and wanted more projection, particularly in the central part of the forehead. She already had a coronal scalp incision/scar from a prior procedure.

Female Forehead Augmentation with PMMA Bone Cement intraop Dr Barry Eppley IndianapolisUnder general anesthesia, her coronal incision was reopened and a complete forehead flap developed down to the brows. Sixty (60) grams of PMMA bone cement was prepared with antibiotic powder to create a putty. The PMMA putty was applied to the forehead and shaped by using the forehead flap to spread it out evenly over the forehead until it set. Once set final shaping and smoothing of the edges was done by a handpiece and burr.

Female Forehead Augmentation result side view Dr Barry Eppley IndianapolisFemale Forehead Augmentation result oblique view Dr Barry Eppley IndianapolisFemale forehead augmentation can be successfully done using PMMS bone cement. The material offers a permanent and smooth solution to reshaping the contours of the forehead. A longer scalp incision is usually needed to assure smooth edges. Most females do not need large volumes of material and usually 60 grams of PMMS material are adequate.


1) The ideal shape of the female forehead is that of a more convex shape without brow bone prominences and a near vertical orientation.

2) Female forehead augmentation can be done using bone cements but require a more open scalp incisional approach to do so.

3) A coronal scalp approach to a female forehead augmentation is best reserved for those women havingĀ  other skull procedures or who already have a full coronal scalp scar.

Dr. Barry Eppley

Indianapolis, Indiana

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Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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