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Skull Reduction Bone Thickness Color Mapping

Calculating bone thickness in skull reduction (cranial contouring) surgery is a critical step for safety and predictable aesthetic outcomes. Below is a practical, surgeon-focused explanation of how this is done in modern practice. Primary Assessment Tool: 3D CT Skull Scan A 3D skull CT scan allows direct measurement of the three layers of the skull, Read More…

Forehead Augmentation: Comparative Analysis of Bone Cement and Custom Implant Techniques

Abstract Forehead augmentation is an established craniofacial aesthetic procedure used to alter contour, projection, and symmetry of the upper facial skeleton. Two primary structural methods are employed: intraoperatively sculpted bone cements and preoperatively designed custom implants. Although both techniques provide permanent augmentation, they differ significantly in fabrication method, precision of shape control, surgical requirements, and Read More…

Gender-Specific Design Principles in Custom Forehead Implant Augmentation

Abstract Forehead augmentation using custom-designed implants has become an increasingly refined procedure in craniofacial and aesthetic surgery. However, optimal outcomes depend on recognizing the fundamental anatomical and aesthetic differences between male and female foreheads. This article outlines the gender-specific skeletal characteristics, aesthetic objectives, and implant design principles that guide successful custom forehead augmentation. Female forehead Read More…

Rib Removal Surgery – Patient Frequently Asked Questions

Can rib removal surgery give me a waist like Pixie Fox? In almost all cases, the answer is no. Pixie Fox’s result is not typical and should not be considered a realistic expectation for most patients. Her outcome reflects a very specific combination of factors, including the extent of her surgery, her body type, other Read More…

Outcomes for Rib Removal Surgery for Waist Reshaping

Having performed more than one hundred rib-removal surgeries for body contouring over the past decade—encompassing nearly 400 individual rib modifications—I am frequently asked about the waist-narrowing effects of this procedure, particularly as they relate to one of the most well-known patients in the world to undergo it: Pixie Fox. More specifically, patients often ask whether Read More…

Male vs Female Cheek Implant Augmentation – Aesthetic Shape Differences

While a variety of off-the-shelf cheek implants are available, none of them provide any guidance about gender specificity. This is unfortunate, as like all facial augmentations, few are non-gender specific or non-binary in nature. Yet this is how most surgeons approach cheek augmentation… locked into choosing whatever is in the catalog believing or hoping that Read More…

Custom Cheek Implants and Zygmatic Arch Augmentation

The zygomatic arch is a key structural and aesthetic component of the midface. In cheek augmentation, it influences width, contour, and facial balance—distinct from the forward projection created at the malar eminence. 1. Anatomical foundation Formed by the zygomatic bone and temporal bone Defines the lateral cheek contour and contributes to facial width Serves as Read More…

Scalp Roll Excision: Preoperative Marking Guidelines and Surgical Technique

Scalp roll excision is designed to remove a redundant fold (“roll”) of skin along the posterior scalp or upper neck, most commonly in the occipital region. These folds may present as single, double, or—less commonly—triple rolls. Successful elimination of the rolls and restoration of a smooth posterior head contour depends primarily on accurate preoperative markings. Read More…

Female Forehead Implant Augmentation Concepts

Ideal Female Forehead Contour Side-profile: Smooth, slightly convex curvature Soft brow transition Balanced projection (no bulge) Aesthetic Concept: Curvature, softness, and continuity Augmentation Method Comparisons Fat Grafting Shallow soft-tissue fill Achieves surface refinement Bone Cement Rigid onlay over bone Achieves structural contour change Custom Implant Pre-shaped implant fixed to bone Offers precise shape creation Custom Read More…

Female Custom Forehead Implant Augmentation Case Study

Introduction Female forehead augmentation is designed to enhance a forehead that is flat, concave, irregular, or under-projected by creating a smooth, gently convex, feminine contour. Unlike forehead feminization surgery (FFS), which primarily reduces or sets back bone, forehead augmentation adds volume to refine shape and curvature. The goal is not exaggeration, but subtle refinement. In Read More…