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Facial Surgery @ Kamol Hospital - Thailand Cosmetic & Plastic Surgery


Forehead Shaving / Forehead contouring type III



Forehead Contouring / Brow Bossing Contouring/ Brow Reduction

In Bangkok Thailand

 

          Despite the differences in the appearance between men's and women's foreheads, it is possible to change men's forehead features to create a more feminine look by forehead contouring. Typically, women have curved, rounded, and well-contoured foreheads, arching brows with little or no brow bones protruding. By comparison, men's foreheads are generally broader and higher with a receding hairline. Also, men often have raised thicker brow bones located lower on the foreheads. For your consideration, our highly skilled and specialized surgeons offer the following procedures:

- Forehead Contouring
- Brow Bossing Contouring
- Brow Reduction

Forehead Contouring  

Figure 1: Forehead Contouring

 

Forehead Contouring

There are three categories for forehead contouring:

Procedure 1: Forehead contouring procedure that involves implant at the mid-forehead area to improve the curve of the forehead profile. There are options for implant materials: Injectable material, fat graft, or permanent implants.

Procedure 2: Forehead contouring procedure that involves bone shaving above the eye area or brow bossing, and the frontal sinus area by using contouring bur. The bone can be reduced by approximately 3-5 mm. The incision is on the scalp behind the hairline.

Procedure 3: Forehead contouring procedure that involves anterior walls of the frontal sinus, can be performed to set back and reshape the forehead. This procedure reserved for those who have prominent forehead bone and deep-set eyes. This procedure, the surgeon obtains pre-operative computed tomography (CT) scans to confirm the forehead types.

          To enhance femininity and reduce the masculinity of the facial features, forehead shaving or forehead contouring type III and brow bone shaving are the most critical procedures for the upper part of your face. There are many differences between men's and women's foreheads. First is brow bossing, or a ridge of bone at the eyebrow level consisting of a frontal sinus which is in the middle and orbital rims above the eyes. Male foreheads are often sloped slightly backward, also known as Samurai's forehead. The expression of the masculine forehead can always make one look harsh or "angry." In this procedure, the surgeon shaves the frontal sinus and orbital eye rims to reduce and adjust the forehead bone for a smooth and balanced appearance.

Male

Female

Picture 1. Shows differentiation between male and female foreheads

 

A Good Candidate for forehead contouring

You will be a right candidate if

  • You feel have bony and big frontal sinus bone, need to reduce or to shave
  • You are a healthy and realistic expectation
  • You know the risk of the procedure that you are considering

 

Preparation for the forehead contouring

  1. Consult with the plastic surgeon who has highly skilled and experienced for adjusting facial structure that is high risk and complication. You will discuss your surgical goals, medical condition, and treatments
  2. Healthy status and psychological examination, including blood test, chest X-ray, electrolytes level, HIV
  3. CT scan is required
  4. Stop smoking and drinking alcohol at for least one week before surgery
  5. Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding and bruising at least two weeks
  6. Stop eating and drinking at least 6 hours before surgery

 

Procedures for forehead contouring

The surgery is performed under general anesthesia, taking 2-3 hours to complete.

  • Forehead contouring Type II

          This procedure is suitable for patients who have a thick bone over the frontal sinus and desirable female forehead protrusion with both standard bossing and concavity above the eye area. The surgeon grinds down the wall of the bone as much as possible without breaking through frontal sinus to give a smooth and curved appearance. The bone can be reduced approximately 2-3 mm by a high-speed electric burr. The incision is on the scalp behind the hairline.

          Type II foreheads have protruding anterior walls of the frontal sinus, but standard frontal nasal angles. Sometime forehead shaving alone may not be perfect appearance, augmentations of the area above the protrusion can perform with implants or bone cement.

Picture 2. Shows the detail of frontal bone in Male.

Shows the  thin bone over frontal sinus suitable for forehead contouring type III

Picture 3. Shows the thick bone over frontal sinus
that is available for shaving (Forehead Type II)

Shows the thick bone over frontal sinus that is available for shaving (Forehead Type II)

Picture 4. Shows the  thin bone over frontal sinus
suitable for forehead contouring type III

 

  • Forehead contouring type III

          This procedure performs by removing and reshaping the frontal wall of the sinus. Then the area around the frontal sinus bone is grounded down and reshape the forehead with titanium microplate and screw. Sometimes wires may be used instead of screws and plates. The surrounding bone can also contoured. The orbital rim can grind down to increase the dimensions of the anterior orbital rim. The procedure reserve for those who have prominent forehead bone and deep-set eyes.

 

Post-operative care for Forehead contouring

After forehead shaving and brow bossing, you will concern as follows:

  1. To control pain, redness, and swelling in your face, most noticeably in your eye, by medication or cold compression is easy
  2. Strenuous activity can resume within three to four weeks after forehead contouring
  3. Apply ice compresses to your forehead for 20 minutes at a time throughout the first few days of recovery to reduce swelling and discomfort
  4. Keep the head elevated for 1-2 weeks after surgery to reduce post-op swelling
  5.  Have a selection of button-up shirts ready to wear during recovery to prevent irritating the scalp
  6. Waring facial bandage at least two weeks to reduce swelling
  7. Follow all post-operative instructions and attend all post-operative appointments

 

Risks and complications for Forehead contouring

Like any major surgery, there may still be a risk of bleeding, infection, damage to the forehead bone structures, facial asymmetry, and adverse reaction to anesthesia. Other complications may include:

  • Suture rupture along an incision line
  • Visible scarring
  • Fluid accumulation beneath the skin (seroma)
  • hematoma
  • Dissatisfaction with appearance after surgery
  • Facial nerve injury

Sometimes additional surgery needs to correct facial asymmetry and improve the outcomes.

 

Recovery

          After surgery for 2 weeks, you can go back to work as usual. Definitive and stable results might not be evident until up to a year after surgery, during your recovery period. Avoid heavy exercise at least six weeks after surgery. The appearance will be close to the final results three months after surgery. Forehead surgeries can dramatically improve the quality of life of transgender women.


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