21139 Reduction forehead; contouring and setback of anterior frontal sinus wall

Name of the Procedure:

Reduction forehead; contouring and setback of anterior frontal sinus wall
Common Name(s): Forehead reduction, skull reshaping, forehead contouring, frontal sinus wall setback

Summary

The procedure involves reshaping and reducing the size of the forehead by contouring the bones of the frontal sinus and setting them back. This surgical intervention modifies the forehead's appearance, creating a more desired profile and facial balance.

Purpose

This procedure addresses aesthetic concerns caused by a prominent or oversized forehead. It aims to create a more proportional forehead, enhancing facial harmony and improving the patient's overall appearance.

Indications

• Prominent or protruding forehead.
• Forehead deformities due to congenital conditions or previous trauma.
• Patients seeking a more feminine or refined facial structure.
• Individuals dissatisfied with their forehead contour.

Preparation

• A thorough medical evaluation and imaging studies, such as CT scans, to assess the frontal sinus and forehead structure.
• Pre-operative consultations to discuss expectations and planning.
• Fasting typically required 8 hours before surgery.
• Adjustments or temporary discontinuation of certain medications as advised by the surgeon.

Procedure Description

1. Incision: An incision is made along the hairline or in a location that minimizes visible scarring.
2. Exposure: The forehead skin and underlying tissues are carefully lifted to expose the frontal bone and sinus wall.
3. Resection and Contouring: The anterior wall of the frontal sinus is precisely cut and removed. The bones are contoured to achieve the desired shape.
4. Setback and Fixation: The reshaped bone is set back and secured in its new position using titanium plates or screws.
5. Closure: The skin is repositioned, and the incision is closed with sutures.

Tools: Surgical saws, drills, fixation devices (plates, screws) Anesthesia: General anesthesia or deep sedation.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity.

Setting

Performed in a hospital or accredited surgical center.

Personnel

• Plastic or craniofacial surgeons.
• Anesthesiologists.
• Surgical nurses and assistants.

Risks and Complications

• Infection
• Bleeding or hematoma
• Scarring
• Nerve damage leading to numbness or reduced sensation.
• Asymmetry or dissatisfaction with the aesthetic outcome.
• Sinus complications.

Benefits

• Enhanced facial symmetry and aesthetic appearance.
• Improved self-esteem and psychological well-being.
• Immediate visual improvement after recovery, although final results become prominent as healing progresses.

Recovery

• Initial swelling and bruising for the first few weeks.
• Pain management prescribed by the surgeon.
• Follow-up appointments for monitoring recovery.
• Avoidance of strenuous activities for 4 to 6 weeks.
• Specific instructions on wound care and hygiene to prevent infection.

Alternatives

• Non-surgical options (botox, fillers) are available but provide temporary and less dramatic results.
• Forehead lift or brow lift procedures for minor contour improvements.
• Each alternative comes with its own set of pros and cons related to outcome, recovery time, and risks.

Patient Experience

Patients may experience discomfort, swelling, and bruising immediately post-procedure. Pain is typically managed with prescribed medications. Most patients report significant improvements in their facial aesthetics, boosting their confidence and self-esteem as recovery progresses.