Can Forehead Horn Reduction Be Done Under Local Anesthesia?

Q: Dr. Eppley, Hi there, I have two forehead horns/bumps on my upper forhead that I am interested in having burred down. I still want a feminine and more rounded forehead but I just dont like the two asymetrical bumps on the sides (I did have two head injuries as a child that may have caused these). I wanted to know if a) this can be done with two smaller perpendicular incisions rather than along the front of the hair line (I have seen this in some of your photos) and b) is it possible to get this done under local anesthesia with drugs/gas to make me drowsy? I am very hesitant to go under general and have had other surgeries under local + drugs that have worked well. C) do you ever see cases where scar tissue fills in after the bone burring to be just as bad as before or close to? D) do you need x-ray or CT imaging beforehand? Thanks!

A: Forehead horns are congenital frontal eminence developments that have no coorelation to prior forehea trauma. They can be reduced by bone burring  and whether they can be fully reduced is a function oif the bone thickness. This is the value of the CT scan to make that preoperative determination. Access to do the procedure can be done using a limited frontal hairline incision. To keep the incision(s) limited it can not be any further back or perpendicular to the hairline as this prohibits the linear access/visibility to do the procedure.  I have not yet seen bony forehead horn regrowth nore would expect that to occur.

Local anesthesia is not an option for me to perform it. Patients that need that technique will need to seek out other surgeons who may be willing to do so.

Dr. Barry Eppley

World-Renowned Plastic Surgeon