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Forehead defect successfully treated along with eyebrow correction (Blepharoplasty)

10/7/2014

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A 23-year-old man reported to our hospital seeking to correct his drooping left eyebrow. He gave a history of having met with a vehicular accident several months ago following which he noticed a depression in his forehead causing his left eyebrow to be at a lower level than the right, affecting his appearance.

A 3D CT scan revealed a fracture of the frontal bone on the left side. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the forehead defect reconstruction. Lid crease incision was placed over the left eye to avoid scar. Skin, subcutaneous tissue was tunneled through to reach the forehead defect. The forehead bone was drilled above the left eye & a bioresorbable endotine spike implant fixed to elevate the bone depression & raise the eyebrow to about 10 mm from the orbital rim. The pericranium was raised and the bone depression above the left eye towards midline was reconstructed with a rib graft. 

Immediately after surgery, the man’s appearance improved greatly. The reconstructed defect & normally-positioned left eyebrow restored the facial symmetry and the man was very happy with the scarless correction. 
Preoperative view showing asymmetrical eyebrow level with excessive bulkiness in left eyelid
Lid crease incision made to avoid scarring postoperatively
Through tunneling the forehead defect was exposed after raising the pericranium
Distal aspect of the supraorbital rim was prepared to receive endotine spike implant
Endotine implant fixed successfully in the prepared region to raise the eyebrow equivalent to opposite side
Harvested costochondral graft fixed in the mesial aspect of supraorbital rim to correct the forehead defect
Immediate postoperative view showing corrected eyebrow level and lid crease incision was completely closed which gives scarless results
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