For A Male Forehead Augmentation Should I have A Custom Forehead Implants Or Use Bone Cement Instead?

Q: Dr. Eppley, I’ve always found my forehead to be very irregular, and last month I visited a maxillofacial surgeon in Brazil. He diagnosed me with non-treated Trigonocephaly (although a very soft one).

My forehead is indeed a bit triangular, and I have a ridge on the very top of the forehead, in the hairline, although I never experienced any neurological disorder. I’ve attached some pictures.

He suggested two different treatments:

1) Customized facial implant, made with a 3D CT Scan

2) Non customized implant (made of bone cement by the surgeon)

He advised the Customized facial implant (made of soft material), as the incision is smaller and results are more predictable. I found you on the internet as a reference for customized implants.

What type of material do you use? I saw many possibilities, such as PTFE, POREX, PEEK, Titanium, Silicone. I worry about the size of the incision, as my father and grandfathers are bald, but the doctor said he would need to cut across the entire head to open and cut (reduce) the ridge on the top anyway.

A: Thank you for your inquiry and sending your pictures. I don’t think there is any question that the superior method for your forehead augmentation is with a custom implant for two compelling reasons: 1) the incision needed to place it would be very small (unlike bone cements which would require a full coronal scalp incision) and 2) the shape precision need for any forehead augmentation shape is very high and unforgiving. Trying to get the proper shape by hand (even if one could accept the coronal incision) is very difficult to do. It is far superior to spend the needed preoperative time in a computer design where the effects of the changes can be better appreciated. This results in a far lower risk of revisional surgery due to shape/contour issues.