Can I Get Back A Bigger Brow Ridge After A Brow Bone Setback?

Q: Dr. Eppley, I had facial feminization surgery 2 years ago and a type 3 forehead contouring which I regret doing and I’d like to have a bigger brow ridge so I am looking into forehead contouring using bone cement.

A: With a brow bone flap setback technique there is very likely some non-healed areas (bone gaps) along the margins of the flap. While these are not a problem now raising the forehead flap for access will expose them so a bone cement approach is the way to go for any form of brow bone augmentation. But the type of bone cement is critically important which is why HA (hydroxyapatite) is preferred over PMMA (acrylic) HA can tolerate exposure to the frontal sinus since it was originally developed for frontal sinus obliteration. Conversely PMMA does very poorly when exposed to any sinus bacteria and often ends up infected as a a a result.

Since most type III forehead contouring procedures often overlook the tail or outer aspect of the brow bone I will assume that the augmentation needed is mainly over the more central bone flap region

Dr. Barry Eppley

World-Renowned Plastic SurgeonCan I