Forehead Reduction Surgery and Forehead Contouring Surgery

Forehead Contouring Methods, Procedures, Recovery and Care

Women tend to have curved, rounded, and contoured foreheads coupled with arching brows and minimal to no protruding brow bones. Men, on the other hand, have generally broader foreheads and thicker brow bones. It is possible to change an existing male forehead to create a more feminine look through forehead contouring.

Transgender Thailand offers:
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1.  Forehead Contouring
2. Brow Bossing Contouring
3. Brow Reduction

Forehead Contouring

There are three different types of forehead contouring available. Each patient is unique and will have to decide on the procedure best suited to them and their needs after consulting with the surgeon and having a CT scan.

• Procedure Type I or Forehead Implant – In this procedure, the surgeon uses an implant in the mid-forehead to help improve the forehead curve. Implants can be either injectable materials, fat grafts, or permanent implants
• Procedure Type II or Forehead and Brow Bone Shaving– This type of forehead contouring surgery involves shaving the brow bone right above the patient’s eye and frontal sinus area with a contouring burr. The brow bone may be reduced by about 3-5mm. The incision for this procedure is made on the scalp hidden behind the hairline.
• Procedure Type III or FOrehead Compression – This is the procedure done when the bone in the frontal sinus can’t be shaved because it is too thin. In this type of surgery, the bone is removed and reshaped. Once completed, it is then repositioned in its original place.

All three types of forehead feminization procedures offer generally the same final result. The choice of type depends on each patient’s biology. Surgeons will try to choose the procedure with the least visible scars but it will depend largely on the patient.

Candidates for Forehead Contouring

Good candidates for this procedure meet the following criteria:

• Patients who have a typical protruding masculine frontal sinus bone
• Patients who have realistic and healthy expectations for surgical outcomes.
• Patients who fully understand the potential risks of the surgery.

Preparing for Forehead Contouring Surgery

Patients must take the following steps leading up to forehead contouring.

• Consult with a skilled plastic surgeon with expertise in facial structure. Patients must discuss their goals and disclose medical conditions and current treatments.
• Patients will be evaluated physically and psychologically including tests such as blood tests, chest x-ray, electrolyte level tests, and HIV tests.
• Patients will undergo a CT scan.
• Patients must stop smoking a minimum of 2 weeks before the procedure.
• All blood-thinning medications like Aspirin, Ibuprofen, hormones, and some supplements must be stopped 2 weeks before the surgery.
• Patients shouldn’t eat and drink for a minimum of 6 hours before the procedure.

Forehead Contouring Procedure

The procedure is performed under general anesthesia and takes approximately 2-3 hours.

Forehead Contouring Type II

This procedure is suitable for patients with a thick brow bone or protruding anterior walls of the frontal sinus but not with feminine forehead features above the eyes or standard frontal nasal angles. The surgeon will grind down the bone wall as much as possible without breaking through to help give the bone a smoother more curved appearance.

Usually, with this procedure, the bone can be reduced by about 2-3mm with an electric high-speed burr. The incision is made on the scalp and the scar is hidden behind the hairline. 

Forehead Contouring Type III

This is for patients who have a prominent forehead bone with deep-set eyes. In this surgery, the frontal wall of the sinus is removed. It is then ground down and reshaped before being put back into position with a titanium microplate and screws. During the procedure, the surrounding bones are contoured too. The orbital rims are ground down to help increase the anterior orbital rim dimensions. 

Post-Surgery Recovery 

Patients will be given medical ice packs to help with the pain and to reduce swelling and redness.

• Avoid all strenuous activities for 3-4 weeks.
• Gently apply an ice pack to the forehead 20 minutes each time, several times throughout the day, for the first few days to reduce pain and swelling.
• Keep head elevated for 1-2 weeks post-surgery to help reduce swelling.
• Use button-up shirts during the recovery process to avoid irritating the scalp.
• Wear the compression garment as much as possible for a minimum of two weeks.

Forehead Contouring Complications and Risks

Complications and risks are rare, but there are major surgery risks of infection, bleeding, and risks associated with anesthesia. Other risks may include:

• Incision line suture rupture
• Scarring
• Seroma or fluid accumulation under the skin
• Hematoma
• Injury to the facial nerves
• Avoid salty food to help decrease the swelling.

And, although very rare, in some cases an added complication may require additional surgery to address facial asymmetry and improve overall outcome.

Forehead Contouring Recovery

Patients may return to work two weeks after the surgery. Heavy activities and exercise must be avoided for a minimum of six weeks after the surgery. Final results from the procedure will  be seen until around three months after the operation although improvements will continue up to 12 months after.