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Given the significance of forehead aesthetics to facial gender identification, frontal sinus setback and brow contouring are frequent components of facial feminization surgery (FFS) in transgender female patients. This study presents a safe and reliable technique for corrugator muscle resection during FFS to provide enhanced feminization of the forehead. This technique was performed in 12 patients between 27 and 58 years of age. Following bone reduction and sinus setback, the corrugator is located on the undersurface of the forehead flap and dissected through the reflected soft tissue of the forehead, with care taken to protect the supraorbital nerve. Patient satisfaction and complications, such as infection, poor wound healing, scarring, and desire for revision surgery, were assessed at follow-up visits. All patients showed improved feminization of the forehead. No complications were reported intraoperatively or postoperatively, and no patients required hospitalization beyond the expected overnight admission. No patients reported anesthesia or hypoesthesia in the distribution of the supraorbital nerve at 6 months postoperatively. Patients reported high satisfaction with their FFS outcomes. In conclusion, performing corrugator resection in conjunction with FFS is a safe and rapid technique that may significantly enhance the feminizing effects on the forehead of frontal sinus setback and brow contouring.
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http://dx.doi.org/10.1093/asjof/ojae108 | DOI Listing |
Arch Craniofac Surg
August 2025
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA.
Pott puffy tumor (PPT) is characterized by frontal bone osteomyelitis associated with a subperiosteal abscess, presenting as a localized, firm swelling of the forehead. This report describes the first documented case of PPT in a patient following facial feminization surgery. We present a case involving a 30-year-old transgender female who developed PPT 1 year after undergoing upper third facial feminization surgery, specifically frontal bone reduction osteoplasty and anterior table frontal sinus setback osteoplasty.
View Article and Find Full Text PDFPlast Reconstr Surg
August 2025
Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine.
Background: Facial feminization surgery (FFS) defines a group of procedures including frontal sinus setback, genioplasty, and gonial angle reduction that are utilized to increase concordance between gender identity and physical appearance. Virtual surgical planning (VSP) is often used preoperatively by the surgeon to create operative plans customized to the patient's unique anatomy. However, the accuracy of these VSPs has been poorly documented in the literature.
View Article and Find Full Text PDFJ Craniofac Surg
April 2025
Division of Plastic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston.
Facial feminization surgeries (FFS) aim to feminize facial features in transgender women and include frontal sinus setback, rhinoplasty, and genioplasty. FFS may be performed with virtual surgical planning (VSP) to help generate reproducible and predictable results. However, quantification of changes is challenging because these changes often occur in multiple axes and dimensions that are not easily reduced to a single error metric.
View Article and Find Full Text PDFAesthet Surg J Open Forum
November 2024
Given the significance of forehead aesthetics to facial gender identification, frontal sinus setback and brow contouring are frequent components of facial feminization surgery (FFS) in transgender female patients. This study presents a safe and reliable technique for corrugator muscle resection during FFS to provide enhanced feminization of the forehead. This technique was performed in 12 patients between 27 and 58 years of age.
View Article and Find Full Text PDFAesthetic Plast Surg
December 2024
Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California, 200 Medical Plaza Suite 460, Los Angeles, CA, 90095-6960, USA.
Background: Feminizing fronto-orbital reconstruction involves one of four possibilities with the Ousterhout Type III anterior table frontal sinus osteotomy and setback performed in most patients while the Type I reduction recontouring is reserved for patients without frontal sinuses or thick anterior tables. However, patients with frontal sinuses and either a moderately thick anterior table or a shallow frontal sinus in the sagittal plane represent an intermediate morphology. For such morphologies, we introduce the novel Type I+ fronto-orbital reconstruction technique, consisting of frontal bone recontouring supplemented with anterior table reconstruction and split cranial bone graft.
View Article and Find Full Text PDF