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Dr. Narendra KaushikPlastic Surgeon
MBBS; MS; MCh; DNB
JD- 3 b PITAMPURA (DELHI)(+91-1145028004)
True Shape Forehead
Feminization
Forehead Gender differences
• Hair line
• Brow ridges
• Brow level
• Temporal crests
• Slope of forehead
• Overall contour
• Eyes
• Naso frontal angle
Gender DifferencesHair line
“M” Pattern Inverted “U”
Gender DifferencesBrow Ridges
Prominent Absent/ Flat
Gender DifferencesBrow Level
Lower Higher
Gender DifferencesTemporal crests
Prominent Absent / Flat
Gender DifferencesSlope of forehead
Backward Vertical
Gender DifferencesOverall contour
Irregular with bossings Smooth with mild glabellar dip
Gender DifferencesEyes
Deep Seated Wide with open expression
Gender DifferencesNaso frontal angle
More (36) Less(34)
Facial Feminization Surgery- Forehead leads to striking change
• Nose
• Eyes
• Malar augmentation
• Lips
• Chin
• Jaw
• Adam’s apple
Ancillary feminizing procedures
Aims of TrueShape Forehead Feminization – No shortcut
• Lowering of hairline with invisible scar by instant camouflage with small session of Hair transplant
• Smooth regular contour of forehead with vertical slope
• Smooth brow areas (no ridges)
• Smooth temporal areas (no temporal crests)
• Open expression of eyes
• Feminine naso frontal angle
• Subtle brow lift
• Subtle midline dip in lower central forehead.
Aims of TrueShape Forehead Feminization – No shortcut
• We must explain to the patient that second session of hair transplant may be needed
– Either for reinforcement of density
– Or for further lowering of hair line
Brow bossing correction
• Shaving with or without filling.
->Sinus wall thickness is 2.6 to 2.9 mm in most of the cases, hence only shaving is not sufficient.
• Forehead reconstruction(frontal wall setback) is needed in most of the cases.
Brow bossing:- only shaving won’t do
More Common (95%) Less Common (5%)
Brow bossing:- only shaving won’t do
• Shaving is sufficient if anterior wall of frontal sinus is thick, and shaving leads to smooth contour without breaking through into the sinus
• This is true in few cases (5% cases)
• Just shaving and filling around makes the forehead more prominent and masculine (DOLPHIN FOREHEAD)
• Usually this is the shortcut- because either the surgeon don’t want to do or is scared to open the sinus
Usual Shortcuts (Must be avoided)
• No Temporal crest shaving
• No Lateral brow rim shaving
• Leftover forehead bossings
• Only shaving of brow ridges (No Reconstruction)
• Left over prominent brow soft tissues, procerus and superciliimuscle
• No camouflage of the scar
Thank you!