Certain facial features are more quintessentially associated with being masculine-looking and gender-affirming than others. The forehead is one such facial feature that can appear more masculine or feminine depending on its shape and size. If you are seeking to masculine gender confirmation, the shape and size of the forehead is absolutely critical because it comprises almost 30-40% of your overall facial appearance. The masculine forehead is taller and more angular. The male forehead typically has a heavy-set, prominent, horizontal ridge of bone just above eyebrow level called the brow ridge or glabellar bossing. In comparison, female foreheads are usually lower in height, rounder, and softer in appearance.Male face. Image credit: Chris Gralapp
Lengthening and augmenting the forehead tofurther the goals of FTM facial gender confirmationis one of the most critical procedures included in the cluster of surgeries that work to permanently modify facial features and accompanying underlying facial structures. Masculinizing the forehead includes two distinct procedures that are undertaken during the same surgical session. Depending on your desired outcome, one, or both of these procedures may be required:
- Forehead Lengthening: increasing the height of the forehead from the eyebrows to the hairline
- Forehead Augmentation: enlarges the forehead, brow ridge and glabellar bossing
During your initial consultation, Dr. Deschamps-Braly will create a customized plan for the desired shape of your forehead. Surgical planning is based on science, extensive facial masculinization experience, artistry, and aesthetic intuition. The exact procedure will, of course, vary for each patient, but most often bone is reconstructed to increase the size of the forehead, and the orbital bones are shaped to modify feminine characteristics. Typically, forehead lengthening and augmentation focuses on three primary areas to achieve a more masculine appearance:
- Brow bossing (brow ridge)
- The slope of the forehead
- The flat area of the forehead
Forehead lengthening involves making an incision closely aligned to the hairline. The scalp is then lifted and moved back to a more masculine position. In comparison, forehead augmentation surgery involves an incision either right at, or behind the hairline — depending on whether or not the hairline position needs to be changed. Although the exact procedure for each patient is different, most often the brow bone is osteotomized and reconstructed and the orbital bones are reshaped to reflect masculine characteristics. Typically the frontal bone (between the eyebrows) is augmented with a biologically compatible synthetic material and this does not interfere with the underlying sinuses.
Forehead lengthening and augmentation are appropriate for adults in good health who desire to masculinize the appearance of their brow and forehead — and overall facial features. This surgery is typically recommended within the context of facial masculinization by either cisgendered males (male assigned male at birth) who are seeking a more masculine appearance, or by transitioning FTM transmen.
Bruising and swelling are the most common side effects and typically resolve within a week or so. Yet, it is also common to have some minor swelling that lasts up to one month. A decrease in sensation in the forehead area, which is normal, resolves on its own within four to six months. Be assured that while this may feel uncomfortable, it is temporary. Any external sutures will be removed at a follow-up appointment five days following surgery. Two to three days after surgery, you may begin gently washing your hair.
Since the incision is made at the hairline, any scarring is minimal and almost invisible. When making the incision, we are very careful with the placement to minimize scarring. When done in conjunction with hairline lowering the scars are virtually invisible.