Feminizing Forehead & Brow bone surgery

Male to Female Forehead contouring surgery & Forehead reconstruction surgery

Overview of Forehead Contouring

Forehead/brow ridge bone contouring is one of the most common facial feminization procedures. It can be performed as a stand-alone procedure or combined with other FFS procedures if needed. This surgery aims to change all male gender indicators on the forehead and upper eye areas to be completely feminine.

Surgical Techniques by Dr. Chettawut

Dr. Chettawut carefully selects the most appropriate surgical method based on the patients’ individual bone anatomy. There are three areas of masculine bony prominences to consider:

1. Brow Ridge or Brow Bossing

This is the horizontal ridge of bone across the lowermost part of the forehead, also known as the upper orbital ridge. It tends to protrude around eyebrow level and sometimes shows a “deep set orbit” appearance.

2. Forehead Bone

The lower forehead, located right above the brow bossing, is the anterior wall of the frontal sinus. In males, the forehead bone can vary from an indented area over the bossing to a notable part of the brow ridge bone. In females, the forehead shape is vertically rounded and smooth without stepping.

3. Lateral Orbital Rim

This is the side of the orbit where the cheekbone joins with the upper orbital ridge. It can be very prominent in males, and Dr. Chettawut always contours this part during surgery.

Dr. Chettawut’s Surgical Techniques

Dr. Chettawut’s surgical techniques for forehead and brow ridge bone contouring are classified as C-1, C-2, and C-3 based on the method of surgical interventions:

C-1 Method

This method is suitable for patients with no sinus cavity or a very small frontal sinus (around 10% of cases). The outer surface of the frontal bone and/or anterior wall of the sinus is thick enough to be shaved down to the desired contour. This method involves only simple bone shaving without reconstruction.

C-2 Method

This method is for patients with a small frontal sinus (around 10% of cases). The anterior wall of the frontal sinus is thin and cannot be shaved down without involving the sinus cavity. It includes bone shaving beyond the sinus cavity and a small sinus setback, covered by a synthetic bone substitute. No titanium sheet is applied.

C-3 Method

This method is for patients with a moderate to large frontal sinus (around 80% of cases). It involves setting back the thin anterior wall of the frontal sinus to a more posterior position for a feminine forehead. The C-3 method requires four steps:

1. Setback of the anterior wall of the frontal sinus while preserving the sinus membrane.
2. Meticulous bone shaving along the periphery of the frontal sinus.
3. Reinforcement of the new contoured forehead with a micro titanium sheet and screws for rigid fixation.
4. Application of a synthetic bone substance to cover the entire defect and ensure a perfect shape of the new forehead.

Benefits of Forehead Contouring

Forehead contouring effectively feminizes the forehead and upper eye area, contributing to a more feminine facial appearance. By addressing the brow ridge, forehead bone, and lateral orbital rim, the procedure achieves a smooth and rounded forehead contour characteristic of a female profile.