Forehead Reconstruction: Type 1 & 3

An incision is made along the hairline of the patient. This gives access to the patient’s forehead. The periosteal flap is pulled back in order to expose the bone underneath. Exact size, shape, and location of the frontal sinus are determined through the process called Transillumination. When the thickness of the bone is determined, bone shaving is done.

In type I forehead reconstruction, surgeon grinds the frontal and orbital rims using a bone contouring burr. This helps to flatten the supra-orbital prominence and also to reduce the heavy orbital bone. This type of forehead reconstruction can be used in those having small or absent frontal sinus.

In type III reconstruction, the outer table of frontal bone is cut along the lines marked and is removed from its position. It is reshaped on a work station and then is placed back on the forehead. Titanium screws or titanium mesh are used to keep it in place.

Forehead bone reconstruction is more invasive than forehead contouring, which is why there is a risk of frontal sinus osteonecrosis or bone tissue death. However, it is uncommon but can occur in the body which fails to re-establish sufficient blood circulation to the bone. In the technique used by Dr Parag Telang, the forehead reconstruction is covered with a vascular flap from the scalp called as pericranial flap. This ensures good blood supply to the frontal bone and excellent healing. In more than 250 FFS forehead reconstruction surgeries done at our centre, we have not encountered any problems with healing of the forehead area.