Forehead Depressions: When to See a Specialist

Q: Forehead Depressions: When to See a Specialist

Hello： In response to your question, the field of orthopedics encompasses bones, joints, muscles, and the nervous system; however, some areas fall under other specialties, such as the skull, which is associated with neurosurgery, and the facial bones, which are related to plastic

Inquire again about the indentation on the forehead (referring to previous articles)?

Dear Dr.
Lee,
I have a similar condition as the previous patient, with a depression on the upper left side of my forehead.
However, it seems to be more severe, and I have also noticed a depression on my head (which I rarely paid attention to before).
It appears to have deepened over the years (which I previously overlooked).
In your 2003 article, you mentioned seeing a neurosurgeon or a plastic surgeon; why not an orthopedic specialist? Will a plastic surgeon be able to identify the underlying cause? I am very concerned about potential effects on my brain.
I'm worried about which department to visit at the hospital, so I would like to confirm which specialty would be more suitable for our condition.
Additionally, I would like to know if you have encountered similar cases and if you could provide me with some advice, as I am quite anxious about this.
Thank you :)
Best regards,
Xiao Feng

Xiao Feng, 20~29 year old female. Ask Date: 2005/07/05

Dr. Li Wenlin reply Orthopedics

Hello: In response to your question, the field of orthopedics encompasses bones, joints, muscles, and the nervous system; however, some areas fall under other specialties, such as the skull, which is associated with neurosurgery, and the facial bones, which are related to plastic surgery.
In rare cases, interdisciplinary collaboration may be required.
Your situation may not necessarily involve a bone lesion; sometimes, changes in the subcutaneous tissue can also cause depressions.
Generally, this should not affect the brain.
If the depression is below the hairline (visible in the mirror), please consult a plastic surgeon first.
If it is within the hairline (hidden under the hair), please consult a neurosurgeon first.
If you have any questions, seek medical advice as soon as possible; there is no need to be overly anxious.
Wishing you happiness every day.

Reply Date: 2005/07/05

More Info

Hello Xiaofeng,
Thank you for reaching out with your concerns regarding the depressions on your forehead and head. It’s understandable to feel worried about changes in your body, especially when they seem to be worsening over time. Let’s break down your questions and concerns regarding this issue.

First, the presence of depressions or indentations in the forehead or skull can be caused by various factors, including congenital conditions, trauma, or even certain medical conditions that affect bone density or structure. While it may seem like a cosmetic issue, it’s important to consider the underlying causes, especially if you notice that these depressions are deepening over time.

You mentioned that you are unsure about which specialist to consult. In this case, both neurosurgery and plastic surgery are appropriate fields to consider. Neurosurgeons specialize in conditions affecting the brain and nervous system, which includes the skull and any potential implications for brain health. If there is a concern that the depressions could be affecting the brain or are a result of a neurological condition, a neurosurgeon would be the right choice.

On the other hand, plastic surgeons are trained to handle cosmetic and reconstructive issues, including those related to the skin and underlying structures of the face and skull. They can assess whether the depressions are purely cosmetic or if they indicate a more serious underlying condition. They can also provide options for treatment if necessary.

You asked why not to see an orthopedic specialist. While orthopedic surgeons do deal with bone-related issues, their focus is primarily on the limbs and spine. The skull is a specialized area that often requires the expertise of neurosurgeons or plastic surgeons who understand the complexities of craniofacial anatomy.

Regarding your concern about potential impacts on the brain, it’s crucial to have a thorough evaluation. If the depressions are due to a condition that affects the skull's integrity, it could potentially lead to complications. Therefore, it’s advisable to seek medical attention sooner rather than later. A detailed examination, possibly including imaging studies like a CT scan or MRI, can help determine the cause of the depressions and whether they pose any risk to your brain health.

In terms of similar cases, there have been instances where individuals have experienced changes in skull shape or indentations due to conditions like craniosynostosis (premature fusion of skull bones), Paget's disease (which can affect bone remodeling), or even after trauma. Each case is unique, and a specialist would be able to provide insights based on your specific situation.

In summary, I recommend that you schedule an appointment with either a neurosurgeon or a plastic surgeon who specializes in craniofacial issues. They will be able to conduct a thorough assessment, determine the cause of your symptoms, and discuss any necessary treatment options. It’s always better to address these concerns early, especially when it comes to your health and well-being.

Take care, and I hope you find the answers and reassurance you need soon.

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