In the realm of cosmetic surgery, the correction of narrow head width has become increasingly achievable through advanced custom implant designs. However, the term “head widening” is not universally applicable; it requires careful qualification to meet the specific needs of each patient. Surgeons categorize head widening requests into two primary types: those aimed at increasing head width without involving the forehead, and those that necessitate crossing the forehead area. This distinction is crucial, as it significantly influences both the design of the implants and their surgical placement.
To simplify, head widening procedures are classified into two types: Type 1 implants, which remain within the bony temporal line, and Type 2 implants, which extend across this line. The surgical implications of these classifications are notable. Type 1 implants are positioned in a submuscular pocket, while Type 2 implants require placement more superficially, atop the muscle and deep temporal fascia. This technique ensures a smooth transition in contour from the forehead to the temples, enhancing the overall aesthetic result.
A recent case study illustrates the application of Type 2 head widening implants in a male patient undergoing a comprehensive three-level facial augmentation procedure. Although his 3D CT scan did not indicate an unusually narrow head shape, the decision was made to also widen the upper face for proportionality. Customized Type 2 implants were designed to extend onto the bony forehead, with a maximum thickness of 5mm and a volume of 30cc per side, providing a modest augmentation effect. The surgical process involved marking the implant outlines under general anesthesia, developing pockets through postauricular incisions, and securing the implants to the upper bony forehead and temporal bone using microscrews, resulting in a harmonious facial enhancement.
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