Forehead augmentation is sought after by both men and women almost equally. Men typically seek the procedure to either correct a retroclined forehead slope or develop an overall stronger with more prominent brow bones. Women usually seek to have a rounder and more convex forehead with increased verticality. (i.e., the forehead is too flat or not high enough) A custom forehead implant offers the most effective approach for augmenting this large upper facial area to get the proper gender-related changes with as smooth an external contour as possible.
When considering forehead augmentation which adds horizontal projection, it is important to factor in the width of the implant and whether such a design should extend beyond the lateral bony temporal lines. In small forehead augmentations, the implant can stay within the temporal lines. But this is uncommon and most of the time it is usually necessary to carry the implant design over the ‘side’ and onto the upper temporal region to have a natural looking forehead augmentation that does not create a forehead bossing or protrusive forehead appearance. Similarly it is also important that the implant design goes far enough behind the front hairline to have a natural transition from the upper forehead into the top of the skull. Like any other skull augmentation the surface area coverage must be much bigger than many appreciate for a natural looking augmentation effect.
While custom forehead implants cover a large facial surface area that does not mean that it requires a large scalp incision to surgically place them. The elastic deformation property of the implant material allows it to be temporarily reshaped to fit through a remarkably small scalp incision. Once inside the pocket the implant returns to its original shape for proper positioning and orientation onto the bone as seen through the incision.
In men a complete custom forehead implant that includes the brows bones is more commonly done than an isolated forehead implant. Having a brow bone component to the forehead implant adds a layer of complexity to both the design and its placement. The scalp incisions is but longer but not excessively so. An endoscopic technique is used to release the tissues from the brow bones and down along the lateral orbital rim. Just like smaller brow bone implants there may be a need for small upper eyelid incisions for proper positioning and fixation of the thinnest part of the implant…the lateral orbital ‘wings’.
Dr. Barry Eppley