This 47 year old registered nurse did not like the severe slope of his forehead. He came to Minneapolis Plastic Surgery for forehead augmentation, which was performed in an outpatient operation using methylmethacrylate (commonly used as bone adhesive in joint replacement) as an onlay graft over titanium screws for rigid fixation. This outpatient operation was performed via the same incision used for forehead lift surgery, which (if needed) could easily be combined with cranioplasty (skull augmentation). His hair did not require shaving, and his results were visible immediately. This gentleman liked his results so much he returned to MPS 4 years later and requested even more forehead straightening (additional onlay grafting), which required adding a second layer of methylmethacrylate to the first. His third photo shows his final outcome one year after his second cranioplasty procedure.