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FOREHEAD IMPLANTS

Custom Brow Bone Implants

A more masculine and prominent brow bones is sought after by some men. Since there are no preformed brow bone implants available, a custom implant made for the brow bone is the only option. The key to designing a brow bone implant is three fold. First, the prominence of the additional brow bone projection needs to be low enough to have the proper effect. Positioning the projection too high creates an unnatural lower forehead appearance. Secondly, the additional projection along the brow ridges afforded by an implant must take into account the supraorbital nerve locations at their exiting foramens along the superior orbital rim. Such relief must be put into the implant design. Lastly the brow bone implant must flow smoothly into the upper forehead so an unnatural brow bone break is not created.

Custom male brow bone implant to increase the projection of the brow prominences particularly out on the lateral brow/upper lateral orbital rim areas.
How much projection the custom brow bone implant should have over the eye is a matter of patient preference
The greater the brow bone projection in the custom brow bone implant the more surface area the footprint of the implant needs to be to blend into the surrounding forehead and not look unnatural.
Custom male brow bone implant to augment a congenitally flat brow bone area.
Custom reconstructive brow bone implant to restore lost brow prominences from prior trauma and reconstruction.
Custom brow bone implant design extends down past the frontonasal junction to build up the flattened frontons/upper nasal region from the prior trauma.
Some men may prefer to augment the entire periorbital region through combined custom brow bone and infraorbital-malar implants
Combined custom brow bone and infraorbital-malar implants may be designed to connect or not connect across the lateral orbital rim.
A very unique form of a custom brow bone implant is the supra lateral brow-orbital implant design. In this case done to complement a prior infraorbital rim implant to achieve a more complete periorbital augmentation effect.
The supra-lateral brow-orbital rim implant is placed through a lower eyelid incision.
In custom brow bone implant designs for men the important footprint question is how far the implant design should go laterally, which is usually down to the frontozygomatic suture line.
How much projection a custom brow bone implant should have and how low on the brow bone it should go are important features in the profile design of the implant.

Male custom brow bone implant design for flat brow ridges.

Male extended custom brow bone implant design with a higher brow bone break.

Extended lateral orbital rim custom brow bone implant design.

Custom brow bone and infraorbital rim implant designs to create a near circumferential periorbital augmentation effect.

Custom supra brow bone break implant with prior history of Radiesse injections into the lateral brow bone break areas.

Custom lateral brow bone implant designs to join up with previously placed infraorbital rim implants.

Large custom brow bone and jawline implant designs for a strong facial masculinization effect.

Custom brow bone implant design combined with custom nasal, cheek and jawline implant designs for an overall facial masculinizing effect.

Custom Forehead Implants

Augmentation of the forehead is sought by men that have too much of a retroclined forehead slope and by women who desire a more prominent but rounder and convex forehead shape. (i.e., the forehead is too flat) A custom forehead implant offers the easiest and most reliable method for augmenting this large upper facial area. Most of the time a forehead implant is designed to include the brow bone area to create an overall total forehead effect. When adding horizontal projection to the forehead it is important to factor in the width of the forehead between the anterior temporal lines. In small amounts of horizontal forehead augmentation the implant can remain completely on bone, stopping at the forehead bone to temporalis fascial/muscle transition area. But when the forehead augmentation becomes larger it is important to carry the implant design over the ‘side’ and onto the upper temporal region to avoid creating a forehead bossing/protrusive appearance.

Male custom forehead implant design for correction of a backward sloped forehead.

Male custom forehead implant design to reduce the prominence of the brow bones. (brow bone reduction forehead implant)

Female custom forehead implant design for creating a more vertical fore-head profile and a higher top of the head.

Female custom forehead and midface implants to improve projections of the upper and central face.

Female custom forehead-brow bone implant to provide projection for a flat upper third of the face.

Two different styles of male custom forehead-brow bone implants with different brow bone footprints and shape.

Custom forehead-brow bone implant with a more square forehead shape.

Extended custom forehead-brow bonetemporal implant design for creating a rounded upper facial shape into the anterior sides of the head.

Custom forehead implant design that crosses over the bony temporal lines for increased forehead width and a flatter frontal profile.

Custom male forehead implant design for correction of a narrow fore-head that avoids the more prominent medial brow bone, widens the sides of the forehead and also extends back onto the top of the head for a wid-ening skull effect.

Small custom male forehead implant design to fill in a suprabrow bone depression.

Male custom forehead implant with eagle-shaped brow bone implant de-sign for an upper facial masculinization effect.

Extended custom forehead-brow bone-temporal implant design for a rounder and more projected upper face.

Custom forehead widening implant for a more square male forehead shape with more prominent temporal lines. Adds angularity and width to the narrow forehead.
Custom forehead implant design for the male show wants more prominent brow bones and to correct a sloped forehead above it. The brow bone design incorporates a ‘eagle wing’ shape to the brow ridge area.
Custom forehead implant design for the male who wants a fuller and less sloped forehead above his brow bones and with added forehead width and frontal skull height.
A very unique type of forehead augmentation is the custom supraorbital implant. This is for men who have strong brow bone prominences but do not or can not undergo brow bone reduction surgery. Instead the deep brow bone break or supraorbital region is built up to soften the string brow bone appearance.
Custom supraorbital/brow bone break forehead implant to soften the strong male brow bone appearance.
A custom forehead widening implant style for a female who wants a rounder/fuller forehead that has a more vertical inclination.
One of the key elements in the custom forehead widening implant is that its design must cross over the bony temporal line and extend over the temporal region on top of the deep temporal fascia. A common and often difficult to correct problem is when the temporal part of a forehead implant is placed under the temporal muscle after releasing it as I have seen numerous times from other surgeon’s implant designs and placement techniques. This creates an aesthetically devastating muscular contraction/fullness of the lower temporal region that is very difficult to repair secondarily.
This is a classic male forehead-brow bone implant design to add both a stronger brow bone appearance as well as a straighter and wider forehead shape. The topographic feature of the ‘eagle wing’ design for the brow bones is a key feature of this type of upper facial augmentation in men.
Male custom forehead-brow bone implant design for a stronger brow bone appearance and a broader and less round forehead shape.
Male custom forehead-brow bone implant creating a less retroclined forehead shape. To do so the implant design must go back further on top of the skull to keep a natural transition between the implant and the bone.
When designing a custom forehead implant, whether it is for a male or female, there are numerous design considerations which start with the implant footprint or surface area coverage.
When the custom forehead implant needs to extended beyond the bony temporal lines at the sides of the forehead for anterior temporal widening the footprint of the implant must extend further back on top of the head to create a smooth natural transition into the rest of the head shape.
For the male with a rounder and softer forehead shape that lacks much visible brow bone prominences the combined forehead-brow bone implant provides increased brow bone definition as well as improves the width of the forehead.
Custom forehead implant design (minus the brow bones) to correct a backward sloped and narrow forehead in a male.
Male custom forehead implant design for correcting a backward sloped and narrow forehead. The key in the design is how wide should the implant go to or beyond the bony temporal line.
New three-piece fronto-temporal head widening implants with a forehead overlay piece to replace previous fronto-temporal implants. The objective of the new implant designs was to make the forehead a little less square with some increased forehead augmentation and increased augmentation at the posterior temporo-parietal area on the back of the skull.

Custom Temporal Implants

The temporal area is a unique facial implant site for augmentation because it is not a skeletally based site. It is really augmentation of the temporal muscle, whether it is the non-hair bearing traditional temporal hollows (anterior temporal zone) or the hair-covered posterior temporal zone above and around the ears. While there is currently a standard temporal implant style and sizes, it provides augmentation for the temporal hollow region just above the zygomatic arch and to the side of the eye. More extended anterior temporal augmentation that extends up to the forehead (temporal line) or augmentation of the side of the head (head widening) requires custom implant designs. These custom temporal implants are placed in the subfascial location on top of the temporalis muscle where they create the appearance of greater muscle mass and an increased fullness.

Custom high anterior temporal implant design for augmentation of up-per temporal hollowing by the side of the forehead

Custom lateral forehead-temporal implant design to widen the side of the forehead over the bony temporal lines.

Custom temporal implant design for correction of the entire anterior temporal hollowing area.

Custom temporal implant design to go along with a jawline implant to match its masculinization effect by creating a forehead widening effect.

Custom temporal implant design for replacement of prior PMMA bone cement augmentation placed down at the bony temporal fossa.

Custom temporal implant design for augmentation of the posterior tem-poral and anterior parietal skull areas.

Custom posterior temporal implant design for a head widening effect.

Custom anterior temporal implant design for a head widening effect.

Widening the head through a combined anterior and posterior custom temporal implant.

Custom forehead-temporal widening implants for the narrow head shape.
Custom forehead-temporal (head widening) implants must cross over the bony temporal lines to create a confluent head widening effect that flows naturally onto the top of the skull.
A head widening implant must wrap around the side of the head, crossing both anterior and posterior temporal lines, for a smooth and continuous look. They are placed through a post auricular incision (behind the ear) supplemented with two very small positioning/fixation incisions in the scalp.
Patients often learn what their ideal aesthetic needs are by having an initial custom implant design placed. In this case of a custom forehead-temporal implant the patient decided that some dimensional changes of the implants would look even better better. Thus a new custom forehead-temporal implant was designed with less temporal line prominence at the sides of the forehead and a new thin forehead piece which connected the two larger side pieces for a better forehead shape result.
The new custom forehead-temporal implant replacements provided a different type of forehead shape with more fullness along the posterior temporal regions at the back of the head. Only by having the first custom forehead-temporal implant in place would one ever know how to make these type of aesthetic implant design changes.