The forehead occupies one-third of the aesthetic facial units and, because of its broad featureless surface, seems like a very straightforward augmentation area. In reality, however, there are numerous shape changes that can be done for differing aesthetic effectsbased on desired changes to its height, width, projection and shape. Thus forehead augmentation is more complex than it seems to many and a wide array of forehead shape changes through custom implant designs.
Custom forehead implants can be designed in many ways depending on what area of the forehead needs augmentation and the aesthetic goal. I typically classify them by anatomic coverage or the bone and surrounding muscle areas in what js known as the implant footprint. Below are the 10 common custom forehead implant design types used in aesthetic craniofacial surgery based on a patient’s 3D CT scans.
Custom Forehead Implant Designs
1. Central GlabellarAugmentation
Adds projection only to the low central forehead between the eyebrows
Purpose
- Correct flat or concavecentral forehead
- Fill in a deep glabellar depression
- Decrease pseudo brow bone prominence
Coverage
- Glabellar valley only
- Does not extend out to surrounding forehead areas.
- Smallest custom forehead implant
2. Total Forehead Implant
Augments the entire forehead from temple to temple but not including the brow bones
Purpose
- Global forehead reshaping
- Smooth overall contour
- Usually for a more convex forehead shape (women)
- Can make the male brow bones appear less prominent due to a backward sloped forehead
Coverage
- Suprabrow bone break up past the forehead onto the skullBrow ridge to upper forehead
- Does not extend beyond the bony temporal line
3. Brow Bone Enhancement Implant
Adds projection primarily to the supraorbital ridge only.
Purpose
- Stronger more prominent brow ridge
- Masculinization of the upper face
Coverage
- Directly over the brow bones
- Usually extends down to the front-zygomatic suture line of the upper lateral orbital rim
4. Forehead -Brow Bone Implant
Enhances both brow prominence and forehead projection.
Purpose
- Complete masculinization of the upper third of the face
- Adds increased projection to entire forehead
Coverage
- Brow ridge
- Total forehead
- Dopes not cross the bony temporal line
- Extends superiorly onto the top of the skull
5. Extended Forehead -Brow Bone Implant
Enhances both brow prominence and forehead projection as well as the anterior temporal area.
Purpose
- Complete masculinization of the upper third of the face with a widening effect as well
Coverage
- Brow ridge
- Total forehead
- Crosses the bony temporal line
- Extends superiorly onto the top of the skull
6. Forehead Widening Implant
Extends forehead augmentation onto the side of the forehead onto the anterior temporal region.
Purpose
- Increase forehead width
- Correct narrow or pinched appearing forehead
Coverage
- Entire forehead
- Lateral overflow onto temples
7. Large Extended Forehead -Temporal Implant
Covers entire forehead and extends significantly onto the temporal areas and onto the top of the skull
Purpose
- Augment the entire front half of the skull
- Provide significant forehead/temporal widening
- Create a round smooth forehead shape
Coverage
- Entire forehead
- Extends significantly onto the temporal areas and top of the skull
8. Vertical Lengthening Forehead Implant
Adds volume higher on the forehead toward the hairline.
Purpose
- Create a more vertical forehead profile (taller straighter forehead)
- Lengthen the forehead with some posterior hairline displacement
Coverage
- May not always extend down to the bottom of the forehead
- Will usually go further back along the top of the skull
9. Asymmetric Forehead Implant
Custom shaped to correct one-sided skull irregularities.
Purpose
- Correct congenital asymmetry often from plagiocephaly
- Fix post-trauma contour deformities
Coverage
- Targeted unilateral regions
- May be part of a skull implant above it
10. High Forehead (Upper Skull) Implant
Extends above the forehead toward the top of the skull.
Purpose
- Smooth transition from forehead to skull
- Improve cranial contour
Coverage
- Upper forehead to frontal skull
- More of a top of the head implant than that of the forehead
10. Suprabrow Brow Bone Implant
Fills in a deep hollow/concavity above the brow bones.
Purpose
- Makes the brow bones appear less prominent when the cause is an abnormal depth above them
- Improves the profile shape of the forehead
Coverage
- Just above the brow bones but below the central forehead.
- It looks somewhat similar to a brow bone implant but sits above it with a underside concave shape to it.
Dr. Barry Eppley
Plastic Surgeon