Brow Bone Contouring

 

683. <Brow Bone Contouring>
Brow bone contouring refers to reshaping the brow ridge—either reducing a prominent brow bone or augmenting a flat one. If the brow bone protrudes, it can be shaved down or pushed inward. Whether shaving or repositioning is appropriate depends on the size of the frontal sinus and the bone thickness, which must be evaluated through a facial CT scan.

We refer to shaving the bone as PBBS (Prominent Brow Bone Shaving), and pushing the bone inward as PBBR (Prominent Brow Bone Reduction).

🔧 How is it done?
In PBBS, the bone is accessed through an incision at the eyelid crease or just below the eyebrow. A surgical burr is used to shave the bone, and bone dust is flushed out before suturing. If a visible scar is a concern, a hairline incision is preferred. The forehead skin is lifted to expose the brow bone, shaved down, and then the incision is closed at the hairline.
While endoscopic shaving is possible, it tends to flatten the brow rather than give it a natural curve, so it’s usually not recommended.

In PBBR, the forehead is accessed either directly through the hairline or 2cm behind it. If the patient has a long forehead, we use the hairline incision to reduce forehead height as well. The brow bone is then exposed, and based on the size of the frontal sinus, a portion of the bone is cut and carefully pushed inward, ensuring the sinus lining is not damaged. The repositioned bone is secured with micro-fixation pins, and if needed, the outer parts of the brow bone are also refined for aesthetic balance.

✨ For brow augmentation, especially in cases of over-reduction or naturally flat brows, rather than using implants (which carry infection risks), we prefer using autologous rib cartilage. The cartilage is finely ground into a paste-like filler and inserted above the brow bone via a hairline incision. This method allows for precise volume control, and stored cartilage can be used for touch-ups later.

In summary, brow bone contouring is a procedure that can reduce, augment, or reshape the brow area, giving you the exact degree of projection you desire—while always considering the anatomy of the frontal sinus.

🧠 [Brow bone contouring is brow reshaping with respect to the frontal sinus.]

—683mm Growing Pine—