CPT® Code 21139

Forehead reduction surgery, specifically described by CPT® Code 21139, is a surgical procedure aimed at reducing and reshaping a prominent or asymmetrical frontal bone in the forehead area. This procedure is particularly indicated for patients with large brow bones resulting from overgrowth of the underlying frontal sinus. The surgery begins with an incision made at the junction of the forehead and the hairline, allowing access to the underlying structures. The skin and soft tissues of the forehead are carefully undermined to the level of the brows, exposing the frontal bone. This exposure is crucial for the subsequent steps of contouring and reshaping the bone. Unlike other related procedures, such as those coded under 21137 and 21138, which focus on contouring alone or contouring combined with the use of prosthetic materials or bone grafts, the procedure associated with CPT® Code 21139 involves not only contouring but also the setback of the anterior frontal sinus wall. This means that the frontal table of the frontal sinus is removed, reshaped, and repositioned in a flatter, more recessed position, which is then secured using internal fixation. The final steps involve replacing the skin and soft tissues over the newly contoured frontal bone, excising any excess skin, and meticulously closing the incision in layers to promote optimal healing and aesthetic outcomes.