Forehead reduction surgery (AKA forehead reshaping and contouring) is a craniofacial surgical procedure typically performed for aesthetic purposes and as a part of facial feminization surgery. The procedure requires the highly advanced surgical skill set of a cross-trained surgeon who is skilled in both general plastic surgery AND craniofacial surgery. A high level of skill is needed because the surgeon will not only be altering the soft tissues of the face (plastic surgery) but also the skeletal (bony) structure of the skull.
How Does Forehead Reduction or Contouring Enhance Your Appearance?
The forehead makes up almost 35-40% of the entire facial surface. It dominates and aesthetically affects all other facial features so if it is out of balance in some way it will affect your whole facial shape. For example, you may feel that your forehead and brow area are too broad or too prominent creating an ‘overhanging’ effect over the eyes. Your forehead may also be asymmetrical in shape, or appear too masculine or too feminine for your specific gender expression, or out of balance with your other facial features in some way.
For trans and cisgender women, forehead reduction improves the facial profile by creating a more feminine and harmonious interplay of how the forehead aesthetically relates to other facial features. The procedure shapes the forehead–and also the delicate bones around the eye socket–to minimize the bony ridge of an overly-prominent forehead. Reduction and reshaping of the brow also work to “open up” the eyes, helping to transform and feminize the upper facial area.
For trans and cisgender men, the challenge may be that the forehead is not masculine enough in appearance. In such cases, depending on your existing facial features and the desired result, we may instead recommend forehead lengthening and augmentation.
Are You An Ideal Candidate For Forehead Reduction?
You are an ideal candidate for forehead reduction or reshaping if you are a relatively healthy adult who feels that your forehead and brow is in some way detracting from your appearance.
Our most common forehead reduction patients are trans women as a part of their facial feminization surgery or cisgender women who feel that their brow and forehead is too prominent or ‘masculine-looking.’ However, we may also perform forehead reshaping and contouring on trans or cisgender men who feel that their forehead is too ‘feminine’ or oddly-shaped in some way.
How Is Forehead Contouring Surgery Performed?
As with most craniofacial procedures, forehead reduction is performed under a general anesthetic. Your surgeon will begin by accessing the forehead by making an incision right on, or right inside, the hairline–depending on if your hairline position also needs to be lowered (see: Feminizing Hairline Lowering AKA Scalp Advancement).
The exact procedure will vary slightly from patient to patient but most often the brow bone is osteotomized (the bone is cut to shorten or lengthen it or to change its alignment), and then reconstructed to reduce the size of the forehead. The orbital bones (around the eyes) are also shaped to modify brow shape.
The frontal bone (between the eyebrows) is then removed, shaped and contoured, and reattached in such a way that it does not interfere with the underlying sinus cavity structures.
Are Steel or Titanium Wires Used for Forehead Reshaping?
In the past, we have used titanium plates and screws for many different applications in craniomaxillofacial surgery. In fact, our surgical practice had used them since the 1980’s when they were first introduced and became commercially available. However, we don’t find them ideal for forehead surgery. Today, we prefer to use a non-magnetic stainless steel wire for securing the bones during forehead contouring. We use them because they are lower profile than are titanium plates, and we achieve a more secure fixation based on being able to put compression on the healing bone. These wires do not create unwanted delays in airport security or issues during MRI imaging.
If your forehead needs augmenting or filling out of a concavity, the doctor will use a biologically inert synthetic material to create a more rounded feminine shape.
Will There Be Visible Scars?
As with any surgery, scars may occur, however, because the primary incision is made at (or inside) the hairline, any scarring is minimal and barely visible. When creating an incision, we are very careful with placement to minimize scarring. And when forehead reduction is performed in conjunction with hairline lowering the scars are virtually invisible.
What Is The Price for Forehead Reduction Surgery?
The price of forehead reduction surgery will vary depending on your circumstances and the degree of change required for a satisfactory result. In fact, it is almost impossible to forecast the financial commitment that is needed until your surgical consultation.
However, when considering the price of your surgery, there are a few factors to take into consideration:
- Your existing features: the degree of forehead reduction, contouring, and/or reshaping you may require
- If any additional procedures are necessary, for example, a brow lift and/or hairline lowering
- Any pre-existing health conditions that may affect your surgery
How Long Does It Take To Recover From Forehead Reshaping Surgery?
Typically, you will stay overnight in the hospital for the first night after surgery. Your surgeon will perform a post-op examination before allowing you to go home or back to your hotel.
We take steps before surgery to ensure that your bruising and swelling is kept to a minimum. However, you may still have some swelling for at least a week or two. Also, it is common to have some minor swelling that may last up to two months.
You may also experience some temporary loss of sensation in the forehead area, this is normal and resolves on its own within two-to-four months. In some patients, it may take up to 10 months for their feeling to return to normal and although this may feel uncomfortable, it is not long-term and part of the healing process.
Why Choose a Surgeon with Cranio-Maxillofacial Training for your Surgery?
Because forehead contouring and reshaping surgery involve altering your actual facial skeleton (the bones), it is critical that your surgeon is a board-certified plastic surgeon with craniofacial and maxillofacial surgical training and qualifications. Only highly-skilled surgeons who are cross-trained in general plastic surgery AND craniofacial surgery possess the advanced skill set to ensure a successful result.
Dr. Deschamps-Braly is a board-certified plastic and craniofacial surgeon specializing in facial plastic surgery, orthognathic (jaw) surgery, and craniofacial surgery for adults and children. He is also one of the world’s foremost leaders and innovators in facial gender confirmation surgery.