Forehead shaping and brow bossing reduction

Forehead shaping can be applied in a variety of cases such as when the forehead is flat or when there is an accident or curvature due to a preceding procedure. The material used for forehead shaping is called bone cement or osteobondand it is a harmless and permanent material.This has been used in place of bones when bone tissue is impossible to implant such as in depressions and defects in the spine, joints or skulls since the 1940s. Osteobonds have been used for plastic surgery purposes starting in the 1960’s as it has a high affinity to the human body and adheres highly to bones, it does not damage existing bone tissue, nerves, blood vessels, etc., and it can be maintained permanently without any deformation after surgery. It is very stable and permanent, and most of all, it can be manufactured in various ways to suit the head or face shape. It is a much more stable and viable option compared to other methods like fat transplantation that requires partial absorption and regular fat filling after transplantation or silicon sheets which can result in various problems such as the presence of foreign objects and the immobilization of the implants, resulting in water filling and protruding edges. A full and smooth forehead results in a more pleasant overall appearance and proportionate facial features.

Compared to women, the men’s foreheadshave a more inclined angle and the eyebrow bones are curved and protruded. If the eyebrow bone is very prominent, simple forehead shaping may not be enough to give a softer, more proportionate appearance. Since brow bossing reduction is not common in other hospitals, the most common procedure done is increasing the height of the forehead by using a fat transplant or a filler to fit the protruding brow bone whichleadsto a more unnatural looking result.If the brow bone is not so prominent, grinding will be done on the protruding part. But in most cases, the pressure is applied to the protruding part of the bone and pushed inward to the boundary of the internal frontal sinus then smoothing will be done on the sharp edges.

Forehead shaping is needed

• Forehead surface is uneven and not smooth

• Have regular fillers or fat transplants because of a flat forehead

• Forehead dip due to an accident

Brow bossing reduction is needed

• Strong facial features because of the protrudingbrow bone

• If you prefer more feminine facial features

• Brow bone protrusion appears more severe due to the forehead being hollowed

Forehead shaping and brow bone reduction are needed at the same time

• Forehead is low and the brow bone is protruding meaning only one procedure may not be sufficient

• Forehead is flat even though brow bossing hasbeen reduced and a three-dimensional appearance is not achieved.

• If you want overall attractive and proportionate facial features

Getting ready for forehead shaping and brow bossing reduction surgery

Take note of the doctors instructions before the surgery during the consultation. This includes instructions about smoking, medications taken, tickets, what to bring during the stay, length of stay after discharged, and fasting before surgery.

Below are some things to keep in mind to prepare for and recovery from surgery.

• Smokers should quit smoking for two weeks before and two weeks after surgery. Smoking increases the risk of side effects. When smoking, the chemicals in cigarettes act as free radicals and interfere with the postoperative recovery process. Long recovery periods can cause scars to form in large or strange shapes, cause inflammation due to poorly healed scars, and serious side effects that require removal of the implant. If you continue to smoke, your doctor may not proceed with the surgery.

• You should not drink alcohol one week before surgery.
• Do not consume any food or drink, including water, at least six hours before your surgery.

• Aspirin, anti-inflammatory medications that can cause bleeding, and vitamins, fish oils, and herbal supplements that can cause swelling should be stopped two weeks before surgery.

Process of forehead shaping and brow bossing reduction surgery

1. Make an incision about 5 to 6 centimeters from the parietal hairline (aka headband line). The scar will not be noticeable after the incision has healed.

2. Lift the periosteum and use bone cement to design for the patient’s head. In the case of brow bossing reduction,apply pressure evenly on the protruding part and push it in safely.

3. Suture up when the cement starts to harden and the heat generated subsides sufficiently.

4. Secure the scalp incision with a stapler.

After forehead shaping and brow bossing reduction surgery

Surgery is usually performed over two hoursand done under general anesthesia. After surgery, the patient recovers for about an hour under the observation of the anesthesiologist in the recovery room and then transferred to the room. You will be discharged depending on the surgery you have had.The pain, swelling, red eyes or bruises may persist for two to three days. After a week, follow up check-up will be done by your doctor for abnormalities or remove the stitchesthen you can go back to your home if there are no abnormalities found. The swelling gradually subsides and disappears over 3-6 months.

• Avoid drinking, smoking and eating hard foods for at least one month and get plenty of rest.

• Intense activities and sports should be avoided for at least one month.

• Avoid physical contact on surgicalarea for at least 3-4 weeks.

Risks of forehead shaping and brow bossing reduction surgery

• Bleeding and hematoma formation

• Fluid collection

• Inflammation

• Slow recovery of the incision site and temporary hair loss

• Keloid or asymmetrical scar formation

• Temporary or permanent sensory changes

• Asymmetry

Q & A

Q: Is the forehead bone cement harmless to humans? Should I remove it over time?

A: This cement used for surgery is a material that is harmless to the human body, which has an FDA approval from the USA.It is a material that is used for damaged bone grafts even in orthopedic surgery field, and there are no side effects like other implants, such as water filling or film formation.It is a permanent surgery and there is no need to remove it unless there is reason to do so.

Q: If I have a filler on my forehead, do I need to wait for the filler to melt or get rid of the filler to have forehead bone cement surgery?

A: If you have a filler that disappears over time or has a solvent, you can get the surgery right away without removing it before surgery. However, most of the fillers will be lost during surgery. In the case of illegal fillers that have not been proven to be stable, they are often entangled with the subcutaneous tissue and remain in shape and do not disappear soit needs to have detailed consultation with the attending physician.

Q: I want to have both forehead shaping and brow bossing reduction at the same time. And also can I proceed with other surgeries at the same time?

A: Yes, it is possible. In addition, most plastic surgeries can be done simultaneously.

Q: How long does the swelling lasts?

A: Swelling around the face will be maximized until the 3rd day of the surgery. Then it will subsides greatly after 7~10 days of the surgery and also bruise or red eyes will disappear. After one month, you will not be noticed for facial swelling and it will totally disappear over 3~6 months.

Q: I am a transsexual patient. I’m worried about the protruding bones of the face, especially the brow bones. Will my facial features look more feminine after brow bone reduction surgery?

A: Brow bone reduction surgery may be unfamiliar to some people since it is one of the less common cosmetic surgeries, but it is one of the most common surgery for transgender patients in Yanhee, which offers a variety of transgender-related surgeries and procedures. This is preferred for those not only for transgender patients but also men and women. Plus, it is a highly satisfying surgery that has less pain or swelling and changes the facial features very naturally.

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