Your Questions
Your Questions
Q: Dr. Eppley, I am interested in forehead reshaping. I have two large forehead bumps that can be easily seen, even from a distance. I was wondering if these could be smoothed down and what the cost would be? Also how long it would take to get in for an appointment and if anything else like a CT scan would need to be done?
A: Your forehead reshaping concerns present a common forehead anomaly that I see. Your forehead bumps are classic for what I call ‘forehead horns’. I have seen these many times and why they occur I can not tell you. But they tend to appear exactly where they are in you and are almost always bilateral. (on both sides) They are fairly easy to reduce and do not require a CT scan or x-ray before doing so. They involve the outer cortex of the skull bone and do not go ‘deep’ or past the diploid layer of the skull bone. When taking them down there often is an indentation below the bumps that, when the bumps are taken down, can make the forehead appear sloped backward. In these cases, I often apply a thin layer of bone cement to correct the forehead inclination. Whether this issue applies to you would require assessment of better pictures from different angles.
The forehead inclination issue aside, the far more important issue is how to get in to do the forehead bump reduction. This requires an incision somewhere and it is an issue of whether to use a more wide open scalp incisional approach or more limited incisions directly over the bumps. That is an issue for further discussion.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I have been self conscious about these bumps on my forehead ever since high school and that has been 8 years ago. It all started when I shaved my head and a friend asked me how I got the horns (bumps) on my forehead. Then my girlfriend (ex-girlfriend now) said the same thing and then my cousin. So every morning I wake up since then I have been wearing a hat, every day all day. I constantly look at my head and notice these bumps. It’s really noticable when the light hits my forehead from certain angles. I have never heard of anyone having this problem before. What causes this and how do I get rid of it? I am so self-conscious about it.
A: Most likely what you have are known as osteomas. These are the development of a benign bony mass, much like a stalagmite. Why they develop is not well known although a history of trauma to the area can cause bleeding. When blood gets under the cover of the bone, known as periosteum, they will usually calcify creating a hard mass. Your forehead issue may well be osteomas and I have seen them on both sides of the foreheasd before, looking like horns.
Skull or foreheads osteomas are fairly easy to remove. They ‘chip’ off of the underlying skull bone with a chisel or sharp instrument. They can also be burred down. While they are easy to remove, you have to have an access point, i.e., an incision somewhere. Direct access by an incision over them is the easiest and if a forehead wrinkle is close by that is an opportune place to put a small incision. They can also be removed with an endoscopic approach with the small incision back in the hair-covered scalp.
Indianapolis, Indiana