I would like to get surgery to burr the forehead bone to make it as flat as possible, as mine extends outwardly, and also to lower my hairline a little bit down. I would like to know do what type of doctor (if any) performs this surgery and how much it costs. Thanks.
Can I Get Cosmetic Plastic Surgery to Flatten my Forehead?
Doctor Answers 16
Plastic Surgery to Flatten Forehead
Any procedure that would flatten, or reduce the convexity of the forehead involves contouring the frontal bone. The frontal bone is a very thick, diploic form of bone which can be amenable to some degree of contouring, but only under very specific conditions: 1) a preoperative CT scan to assess bone thickness and position/size of the frontal sinuses, 2) a Surgeon who is well versed in craniofacial work, 3) a Patient who has reasonable expectations; understanding that the procedure may be limited in the results that are safely possible.
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Forehead recontouring with bone reduction and shortening
The shape of the forehead can be changed through a combination of bone reduction and forehead skin shortening. This would be done through a pretrichial or hairline incision. The frontal bone can be reduced by about 5mms through burring in most people. This can be enough to decrease the convex bulge, particularly in the upper forehead area. The hair-bearing scalp can be advanced forward by about 1 to 1.5 cms and the excess forehead skin removed, thus lowering the hairline and shortening the forehead. Because a hairline incision is needed, this is almost exclusively a female procedure.
Frontal bossing (Neanderthal look) can be reduced and hairline lowered in one operation!
In order to "get to" the frontal bone area beneath our brows, the best access is via a forehead or browlift incision. This can be either bicoronal (from ear to ear through the hair) or at the anterior hairline if one wants to lower a too-high hairline (reducing the height of the forehead). In your case, the hairline incision provides the best approach to treating both your prominent frontal bossing and your high hairline.
Though the bone over your frontal sinuses can be thinned only a certain amount (without additional techniques to ablate the sinuses, which can indeed be done if necessary, but at additional time, cost, and slight risk), this is something that can make really wonderful changes in the right patient. Any board-certified plastic surgeon or facial plastic surgeon with experience in craniofacial techniques, facial fractures or reconstruction, and cranial bone graft harvesting and use, is quite comfortable with contouring the bone for you. I operate in an accredited in-office surgical facility and own the bone tools to do this procedure, so a hospital or academic surgeon is not required, just someone who does this operation frequently.
As mentioned elsewhere, the hairline closure (tricophytic) is critical to minimizing the scar, which can be visible as it heals, but is concealed by growing hairs and fades beautifully if skillfully performed.
BTW, bone grafting or methylmethacrylate onlays can be performed as well in select individuals to improve the bony contours of the forehead. Go for it, and best wishes!
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Burring down the Frontal Bone
Depending on the person, we have variable thickness to the frontal bone. Some of it can be burred down, but, unfortunately, most people with the "crowmagnon man" look is from a hyperaerated frontal sinus. This can be tough to fix and still make it look natural. Make sure you chose someone who not only understands the forehead and brows, but also understands the frontal sinus anatomy and the way it drains. Because of the frontal sinus location, you do have some limits as to how far down you can burr the bone. As far as brow position is concerned, if you are a man, the best incision would be through a wrinkle in your forehead (mid-forehead). If you are a woman, a bicoronal or trichophytic incision should work well.
Forehead Lift to Lower Hairline and Remove the Frontal Bone Excess
Frontal hair line can be very easily lowererd. Most importantly, the result should remain proporitional and natural in comparison to other facail features.
Lowering the bone of the forehead is possible but requries precise planning with CT Scanning.
Hope this was helpful
Facial plastic surgeons are excellent physicians to lower your hairline and reduce your brow bone prominence
Facial plastic surgeons are excellent physicians to lower your hairline and reduce your brow bone prominence. This is usually done through an incision just in the front of your hairline. It requires some release of the hair behind it and advancing the hair line forward by tacking the hairline to the bone anteriorly and in a more forward position. A brow lift can then be done in conjunction with removing of some of the muscles that make you frown. And during this time, you can bur the bone down to reduce the prominence.
I often do this for my transgender population and for my female patients that have a more prominent brow. Reducing the brow bone can also be done through an eyelid incision as well as removing the muscles that cause frowning. Another option for lowering the hairline can be through hair transplantation to the front of the hairline by taking hair from the back of the scalp.
Brow bone can be reduced
If your brown bone protrudes more than you would like, it can sometimes be burred or shaved down. Patients who come in with this often say that have a "neanderthal" or "cromagnon" look. I also do brow bone reduction for male-to-female transgender patients. If it's the entire forehead and not just the brow bone, this will be trickier and may not be possible.
Whether it can be reduced depends on the thickness of the bone. The frontal bone (above the brows) covers the sinus which are holes in the bone containing air cavities. You dont want to thin the bone too much because it can impede on the sinuses. I do require my patients get a CT scan before surgery so that I can assess the thickness in relation to the sinuses.
Hairline lowering and forehead softening
Lowering the hairline surgically is a commonly performed procedure. Softening a prominent forehead is also possible; the degree of softening achievable depends upon the amount of bone available for "shaving".
This particular combination of procedures is most common in M to F gender reassignment (facial feminization surgery). If this is your ultimate goal, I would recommend seeking out a surgeon with particular expertise in this specific arena, as their esthetic judgment will be especially valuable.
Flatten Forehead with Surgical Hairline Advancement
Yes, this is a possible technique. What you are describing is the surgical hairline advancement (SHA) combined by rasping/filing of the forehead/brow bones. The SHA allows for the advancement of the entire frontal hairline by anywhere from ½ to 1 1/2 inches, depending on the elasticity of your scalp.
Tricophytic browlift can be used to lower the hairline
A tricophytic browlift (what my fellow commenters have also been describing) will allow the hairline to be lowered. The cautions regarding visible scars have been mentioned. Seek a facial plastic surgeon who is familiar with the tricophytic approach and knows where the place the scar and how to bevel the incision to provide maximum camouflage to the scar. The approach would also allow the forehead contouring that you seek.
Stephen Weber MD, FACS
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.