Narrative Review of Facial Gender Surgery: Approaches and Techniques for the Frontal Sinus and Upper Third of the Face

April 2021 in “ Annals of Translational Medicine ”

Matthew R. Louis, Roberto Travieso, Norah Oles, Devin Coon

facial gender confirmation surgery FGCS hairline modification pharmacotherapy hair transplantation virtual surgical planning VSP forehead recontouring

Studysummary This review discusses facial gender confirmation surgery, particularly focusing on the upper third of the face, and reports no new clinical results; it emphasizes virtual surgical planning and postoperative care. Our plain-language summary of this paper — not a Tressless recommendation.

The narrative review discussed the evolution and practices of facial gender confirmation surgery (FGCS), emphasizing its medical necessity and positive impact on transgender individuals' quality of life. It highlighted the role of virtual surgical planning (VSP) for precision and discussed surgical and non-surgical options for addressing hairlines, such as hormone therapy, medications, and various hair transplantation techniques. The review focused on approaches for the frontal sinus and upper third of the face, detailing surgical processes and noting rare complications like cerebrospinal fluid rhinorrhea and alopecia. High patient satisfaction was reported, with a 97% satisfaction rate in a review of 550 patients. The review called for more research and standardized training to ensure high-quality care in FGCS.

View this study on atm.amegroups.com →

Discuss this study in the Community →

Research cited in this study

23 / 23 results

research Follicular Unit Transplantation

8 citations , April 2020 in “Facial Plastic Surgery Clinics of North America”

This article discusses the advancements in follicular unit transplantation for hair restoration and reports no clinical results; it emphasizes improved aesthetic outcomes using updated techniques.

research Minoxidil and Its Use in Hair Disorders: A Review

August 2019 in “DOAJ (DOAJ: Directory of Open Access Journals)”

This review discusses the pharmacology, mechanism of action, clinical efficacy, and adverse events of topical minoxidil for hair loss but reports no new clinical findings.

research Minoxidil And Its Use In Hair Disorders: A Review

117 citations , August 2019 in “Drug Design Development and Therapy”

This review article provides an updated overview of the pharmacology, mechanism of action, clinical efficacy, and adverse events associated with topical minoxidil, a widely used treatment for androgenetic alopecia and other hair loss conditions, while noting that its exact mechanism is still not fully understood.

research Forehead Reduction and Orbital Contouring in Facial Feminization Surgery for Transgender Females

17 citations , February 2018 in “British Journal of Oral & Maxillofacial Surgery”

This paper reviews the evolution and classification of forehead reduction and orbital contouring techniques in transgender females, but reports no new clinical findings.

research Understanding and Addressing Hair Disorders in Transgender Individuals

32 citations , January 2018 in “American Journal of Clinical Dermatology”

This article provides a framework for understanding hair disorders and treatment options in transgender individuals undergoing hormonal therapy and reports no new clinical results.

research Interventions for Female Pattern Hair Loss

15 citations , January 2017 in “JAMA Dermatology”

This study found that topical minoxidil improved female pattern hair loss, finasteride was not more effective than placebo, and laser devices showed inconsistent results but increased hair count compared to baseline.

research Facial Feminization: Systematic Review of the Literature

157 citations , May 2016 in “Plastic and reconstructive surgery/PSEF CD journals”

This review of facial feminization surgery literature suggests it is generally safe and satisfactory for patients, though more research is needed to establish best practices and quality-of-life outcomes.

research Scalp Hair Regrowth in Hormone-Treated Transgender Woman

23 citations , January 2016 in “Transgender health”

In this case report, a transgender woman experienced scalp hair regrowth after approximately six months of oral estradiol and spironolactone treatment, achieving testosterone levels within the normal female range.

research Classifications of Patterned Hair Loss: A Review

101 citations , January 2016 in “Journal of Cutaneous and Aesthetic Surgery”

This review discusses various classification systems for patterned hair loss in both sexes and reports no new clinical findings, highlighting the Hamilton-Norwood and Ludwig systems as the most commonly used.

research Effect of Minoxidil Topical Foam on Frontotemporal and Vertex Androgenetic Alopecia in Men: A 104-Week Open-Label Clinical Trial

20 citations , September 2015 in “Journal of The European Academy of Dermatology and Venereology”

This study found that 5% minoxidil topical foam was effective in stabilizing hair density and scalp coverage in men with moderate androgenetic alopecia over 104 weeks, with good safety and tolerability.

research Follicular Unit Extraction: A Comprehensive Overview of Techniques and Best Practices

41 citations , August 2013 in “Facial Plastic Surgery Clinics of North America”

This article discusses the benefits, techniques, and unique considerations of follicular unit extraction for hair grafting, but reports no new clinical results.

research Hair Regrowth in a Male Patient with Extensive Androgenetic Alopecia on Estrogen Therapy

18 citations , August 2012 in “Journal of The American Academy of Dermatology”

This report describes a case where a sex reassignment patient on estrogen therapy experienced complete hair regrowth on a previously fully alopecic scalp.

research Interventions for Female Pattern Hair Loss

35 citations , May 2012 in “Cochrane Database of Systematic Reviews”

This review found evidence supporting the effectiveness and safety of topical minoxidil for treating female pattern hair loss, though many included studies were at high risk of bias.

research Facial Determinants of Female Gender and Feminizing Forehead Cranioplasty

131 citations , September 2010 in “The Laryngoscope”

This study found that forehead feminization significantly contributes to recognizing female gender and reported that feminizing forehead cranioplasty is a safe procedure with a low complication rate.

research Naturally Occurring Female Hairline Patterns

58 citations , April 2009 in “Dermatologic Surgery”

This study presents guidelines for designing female hairlines, noting that most women in the sample had a widow's peak and specific average measurements for hairline features.

research Hair Transplantation: Current Concepts and Techniques

30 citations , October 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This article reviews modern hair transplantation techniques, noting that while many innovations have improved natural-looking results and expanded candidate eligibility, some may have hidden drawbacks, and it reports no new results.

research Influence of Estrogens on Androgen Metabolism in Different Subunits of Human Hair Follicles

41 citations , July 2001 in “PubMed”

This study reported that while finasteride and progesterone significantly inhibited dihydrotestosterone synthesis in dermal papillae, estrogens were less effective.

research Incidence of Female Androgenetic Alopecia (Female Pattern Alopecia)

6 citations , January 2001 in “Dermatologic Surgery”

This study observed that female androgenetic alopecia is common among Caucasian women, starting in the late 20s and peaking after age 50.

research Incidence of Female Androgenetic Alopecia (Female Pattern Alopecia)

89 citations , January 2001 in “Dermatologic Surgery”

Hair loss in women is common, starts in late 20s, and affects 30% of women over 50.

research Effects of Sex Steroid Deprivation and Administration on Hair Growth and Skin Sebum Production in Transsexual Males and Females

176 citations , August 2000 in “The Journal of clinical endocrinology and metabolism/Journal of clinical endocrinology & metabolism”

In this study, cross-sex hormone therapy affected hair growth patterns differently, with estrogen reducing hair growth in male-to-female transsexuals and testosterone increasing it in female-to-male transsexuals; however, male typical hair diameters were not fully reached in the latter group after 12 months.

research Treatment of Hair Loss

370 citations , September 1999 in “The New England Journal of Medicine”

This article discusses the treatment of androgenetic alopecia and alopecia areata with finasteride and minoxidil but reports no new clinical results.

Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

research Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

416 citations , September 1997 in “Journal of Investigative Dermatology”

People with hair loss have more androgen receptors and enzymes in certain follicles, with men and women showing different patterns.

research Long-Term Efficacy of Topical Minoxidil in Male Pattern Baldness

41 citations , March 1987 in “Journal of The American Academy of Dermatology”

This study observed that 2% minoxidil solution was at least as effective as 3% for increasing hair growth and stabilizing bald areas in men with male pattern baldness.