Forehead reshaping consists of a variety of augmentative and reductive procedures to affect on overall appearance change. In some cases they were done together but, more times than not, they are done as isolated forehead augmentation or forehead reduction procedures.
Bony reduction can be done on the brow bones and the frontal bone of the forehead. Brow bone reduction is a well known procedure that involves the techniques of shaving/burring reduction and bone flap removal and setback. Frontal bone reduction is less well known but equally effective and consists of burring removal of the outer table of the skull to reduce its protrusion or bossing.
But an often overlooked part of the forehead that plays an important role in its shape is reduction of the anterior temporal line. The temporal line is the transition between the outer edge of the bony forehead and the attachment of the temporalis fascia/muscle. This is a raised bony line that is easily seen on any skull model and goes from the lateral brow the whole way to the back of the head.
Beyond the tissue differences that the temporal line represents, it is equally important that a near 90 degree contour change occurs between the front and side of the forehead. This is important in some cases of forehead reshaping where a less wide or less square forehead is desired. The anterior temporal line is reduced by burring to round off the corner of the forehead. This usually requires some release of the upper fascial attachment.
Reduction of the temporal line is an important surgical technique to narrow forehead width as well as make a rounder and less rectangular shape.
Dr. Barry Eppley