Background: The shape of the forehead is well known to be gender specific. Besides the prominent brow bones, the male forehead has a slight backward slope to it and is broader than that of a females. This slight backward slope contributes to the prominence of the brow bones with increasing slopes making the brow bones look bigger. (pseudo brow bone projection)
While there can be an acceptable retroinclination to the male forehead there comes a point when it slopes back too far and becomes aesthetically undesireable. What the exact angle is as to how much backward slope is aesthetically excessive defies a specific number but it is in the range of greater than 15 to 20 degrees.
Case Study: This 45 year-old male was bothered by the backward slope to his forehead. While much of his forehead was covered by hair, he knew that beneath the hair the forehead sloped backward with two specific grooves heading back into the hairline along the temporal lines. A 3D CT scan of his forehead revealed its slope and lateral deficiency.
A custom forehead implant was designed to decrease his forehead slope and make the whole forehead wider. At its thickest point the central thickness of the design was 5mm while the lateral thickness was 7mm before it tapered into the temporal muscle.
Under general anesthesia, a 9cm long scalp incision behind his hairline was made. Subperiosteal dissection was done down to the brow bones and out onto the temporalis muscle fascia to accommodate the width of the implant. Multiple perfusion holes were placed into the implant prior to its insertion. After central positioning and making sure the edges were unfolded and laying properly, the scalp incision was closed in multiple layers with resorbable sutures.
A custom male forehead implant is the best way to create an overall contour change of the upper third of the face. It ensures the smoothest result from side to side as well as the smoothest transition possible into the temporal regions. Equally importantly it also allows for the smallest insertion scalp incision possible which is of critical importance in a male.
Highlights:
1) The male forehead has less of an inclination and is wider than that of a females.
2) A custom forehead implant in a male offers the smallest incision for its placement.
3) Thicknesses of only a few millimeters that cover a broad surface area like the forehead can make a visible difference.
Dr. Barry Eppley
Indianapolis, Indiana