Forehead reduction: What does it consist of?

Differences between masculine and feminine foreheads

The differences between masculine and feminine foreheads are significant and play a crucial role in the perception of a person’s gender. These characteristics usually develop during adolescence due to the changes of this stage. Known as secondary sexual dimorphism, these differences also affect cranial structures.

As a result, transgender facial feminization surgery is more common among trans women who transition later in life, after male hormones have influenced their physical development.

A masculine forehead tends to be higher and wider, with an M-shaped hairline and more pronounced bony features, such as the brow ridge above the eyebrows. In contrast, a feminine forehead is generally shorter and rounder, with a lower, continuous hairline that curves gently. These structural differences are key in facial feminization, as a smoother, rounder forehead contributes to a more feminine appearance.

Dr. Mañero explains sexual dimorphism in the following video:

There are several techniques for forehead reduction and softening its features. The choice of technique depends on various factors evaluated by the medical team. The most common techniques include hair grafting, hairline advancement surgery, and bone contouring surgery.

Hair grafting, or hair transplantation, involves transferring hair follicles from a donor area of the scalp (typically the back) to the hairline. This technique is useful for creating a rounder, more feminine hairline and is particularly beneficial for patients with an M-shaped hairline and good hair density in the donor area.

Hair grafting is less invasive and has a shorter recovery time than other surgical techniques. The results are a rounder, typically feminine hairline.

Bone contouring surgery, also known as frontal bone reshaping or forehead remodeling, modifies the frontal bone’s shape to reduce forehead size and soften the prominence of the frontal sinuses.

Forehead feminization surgery can involve various levels, such as: lowering the temporal crest, enlarging and rounding the orbital bones and flattening the frontal sinuses

The choice of technique depends on the results of prior assessments of the patient’s bone structure.

The best forehead reduction technique varies for each patient. A consultation with a facial feminization surgeon is essential. They will evaluate factors such as hair density, scalp elasticity, bone structure, and personal expectations. Additionally, they will conduct studies on bone structure to determine the most suitable technique.

In some cases, a combination of techniques may be the most effective option to achieve natural and satisfactory results.

Forehead reduction surgery is often combined with other facial feminization procedures to achieve complete facial harmony. Surgeries that may be performed alongside forehead reduction include:

• Rhinoplasty: To refine the nose and create a more feminine appearance.
• Jaw and chin contouring: To soften facial lines.
• Blepharoplasty: To rejuvenate the eyelids and soften facial expressions.
• Lip lift: To achieve a more feminine proportion between the lips and nose.
• Feminizing facelift: To reshape the face and create more feminine features.
• Feminizing lipofilling: To add typically feminine facial volumes.
• Cheek augmentation: To soften facial features.
• Tracheal shave: To reduce Adam’s apple.
• Brow lift: To elevate the eyebrows and open the eyes.