Forehead Contouring Augmentation Surgery with Particulated Mandibular Bone Graft

ABSTRACT

Up to this date, the forehead contouring augmentation surgery was perfomed with silicone or microfat graft. However, augmentation with silicone has given complications such as postoperative infection, extrusion, long linear scar, and displacement of implant. Moreover, augmentation using microfat graft often requires re-operation due to fat resorption. Surgical technique was performed in 10 patients from September 2008 to April 2009. Eight patients had macrogenia and two had prognathism. Particulated bone was harvested from squared mandibular bone. The particulated mandibular bone was then grafted on the frontal bone through a 2cm incision posteriorly to the midforehead line. As a result from the three-dimensional Computer Tomogram, the frontal bone was engrafted 6 months after the particulated bone graft. Even though, traditional concept using prothesis for forehead augmentation is still popular, the author suggests autologous augmentation can make better facial contour which is named as 'facial bone redistribution concept'. Facial bone redistribution concept is the distribution of residual bone(mandible or zygoma) to deficient area(frontal bone) to achieve better facial contour. To achieve better survival rate of bone, bone marrow stem cell and platelet rich plasma(PRP) should be applied in next study to increase the survival rate of particulated bone.