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

Video

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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!