How Can My Frontal Bossing Be Treated?

Q: Dr. Eppley, I am writing to inquire about a consultation regarding potential facial reconstructive surgery. I have several concerns about my facial structure that I would like to address, and I am hoping to explore options for surgical correction.Specifically, my primary concerns include:

Forehead: I have a pronounced or prominent forehead, which I believe may be related to frontal bossing. I am interested in discussing potential procedures to reduce the prominence of the forehead and achieve a more balanced facial profile.

Brow Ridge: I have minimal to no definition of the supraorbital ridges (brow ridges) above my eyes, which gives my face a flatter appearance in the upper facial area. I would like to discuss whether brow augmentation or other procedures could help enhance this region and create a more defined appearance.

Eyes: My eyes have a prominent, rounded appearance, sometimes referred to as “puppy dog eyes.” I believe this might be due to proptosis or larger eye openings (palpebral fissures). I would like to understand if there are options to make my eyes appear less prominent and more in harmony with the rest of my facial features.

A: Thank you for your inquiry and sending your pictures. What you actually have is pseudo frontal bossing…meaning it looks like frontal bossing but only appears that way because the bones around the eye (periorbital) area are deficient. This can be seen when the periorbital bones are augmented that the frontal bossing goes away. (see attached imaging) The concept of combining a custom brow bone implant with a custom infra/lateral orbital-malar implant is the only way to achieve this effect (see attached image designs) and optimally addresses your listed forehead, brow ridge and eye area concerns/objectives.