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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

 

          Typically, women have curved, rounded, and well-contoured foreheads, arching brows with little or no protruding brow bones. By comparison men's foreheads are generally broader and higher with a receding hairline. Men often have raised thicker brow bones located lower on the foreheads. It is possible to change men's forehead features to create a more feminine look by forehead contouring. Our highly skilled and specialised 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 and as each person is unique we may not know which type you need until you've had a CT scan with us.  

Procedure Type 1: This forehead contouring procedure uses an implant in the mid-forehead area to improve the curve of the forehead. Options for implant materials include: Injectable material, fat graft or permanent implants.

Procedure Type 2: This forehead contouring procedure involves shaving the bone above the eye area and 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 and isn’t visible.

Procedure Type 3: This forehead contouring procedure is used when the bone in the frontal sinus area is too thin to simply shave down. The bone is removed, reshaped and then replaced. 

          All the above types of forehead feminisation surgery have more or less the same final result and which surgery you need very much depends on your individual biology. We will always endeavor to perform the least invasive procedures where possible. All above procedures have no visible scars as the incisions are behind the hairline.


To enhance femininity and reduce the masculinity of the upper facial features, forehead feminisation is a critical procedure. 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. The expression of the masculine forehead can often make one look harsh or angry. In forehead feminisation the forehead is feminised for a smooth and balanced appearance.

 

 

Shows differentiation between male and female foreheads Shows differentiation between male and female foreheads

Male

Female

Picture 1. Shows differentiation between male and female foreheads

 

A Good Candidate for forehead contouring

  • You have typically masculine protruding frontal sinus bone.
  • You are healthy and have realistic expectations.
  • You know the risks of the procedure that you are considering.

 

Preparation for the forehead contouring

  1. Consult with the plastic surgeon who is highly skilled and experienced in adjusting facial structure. You will discuss your surgical goals, any medical conditions and current treatments.
  2. Health status and psychological examination including blood test, chest X-ray, electrolytes level, HIV.
  3. CT scan.
  4. Stop smoking and drinking alcohol for at least one week before surgery.
  5. Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding and bruising.
  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 but more feminine forehead features 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 scar is hidden as 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 achieve the perfect appearance and you may need implants or bone cement to smooth out the whole area to a feminine shape.

 

Shows the detail of frontal bone in Male.

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 involves the removal of the frontal wall of the sinus. Once removed it is ground down, reshaped and then put back into position and fastened in place with a titanium microplate and screw. The surrounding bones are also contoured. The orbital rims are ground down to increase the dimensions of the anterior orbital rim. This procedure is mainly for those who have prominent forehead bone and deep-set eyes.

 

Post-operative Recovery

To control pain, redness, and swelling in your face, most likely around the eyes, you will be given medical ice packs to apply. 

  1. Avoid strenuous activity for three to four weeks.
  2. Apply ice compresses to your forehead for 20 minutes at a time throughout the first few days of recovery to reduce swelling and discomfort
  3. Keep the head elevated for 1-2 weeks after surgery to reduce post-op swelling
  4. Have a selection of button-up shirts ready to wear during recovery to prevent irritating the scalp.
  5. We will provide you with a compression garment which you should wear as much as possible for at least two weeks in order to reduce swelling.

 

Risks and Complications for Forehead contouring

Complications are very rare but like any major surgery there may still be a risk of bleeding, infection and adverse reaction to anesthesia. Other complications may include:

  • Suture rupture along an incision line
  • Visible scarring
  • Fluid accumulation beneath the skin (seroma)
  • Hematoma
  • Facial nerve injury
  • Although exceptionally rare, sometimes additional surgery needs to correct facial asymmetry and improve the outcomes.

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

 

Recovery

          You can return to work within 2 weeks. Avoid heavy exercise for at least six weeks after surgery. You will be close to the final results three months after surgery although small changes and improvements will still take place for up to 12 months. Forehead surgery is usually one of the the most important surgeries for facial feminisation and can dramatically improve the quality of life of transgender women.


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