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

    Keith Altman
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    TLDR Forehead reduction and orbital contouring are important for satisfactory facial feminization in transgender females, with high satisfaction and low long-term problems.
    In the 2018 paper, the author examines forehead reduction and orbital contouring in facial feminization surgery for transgender females, detailing the classification of forehead shapes, surgical techniques, and potential complications. The paper describes three groups based on forehead shape and the corresponding surgical approaches, including the use of CT scans for planning, contouring techniques, and osteotomy with miniplate fixation for the most severe cases. Complications such as anesthesia of the supraorbital nerves, eyelid edema, and cerebrospinal fluid rhinorrhoea are mentioned, with the latter being serious but uncommon. The paper reports a 3% incidence of telogen effluvium but no cases of total loss of the anterior table. It concludes that these procedures are significant for achieving satisfactory aesthetic outcomes and are medically necessary for transgender individuals, with patients generally experiencing high satisfaction and minimal long-term morbidity.
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