Facial Feminization Surgery and The Standards of Care

Facial Feminization Surgery – Forehead ContouringDr. Chettawut, ThailandDescription about the procedures:Forehead contouring for type 3 by orbital rim burring / frontal sinusset back, done together with forehead/ brow lift.The rhinoplasty and otoplasty were done separately as additionalprocedures.•Comparing the degree of deformity and treatment necessary to correct thecorresponding deformity, the various forehead contours have been divided intothree groups.•Group 1 includes those patinets with normal or slightly anterior projection of thesupraorbital rims, minimal to moderate bossing and thick skull bone over thefrontal sinus and/or absence of the frontal sinus. These deformities can becorrected by bone reduction alone utilizing a surgical burr.•Group 2 includes those individuals with slightly anterior projection of thesupraorbital rims but in whom the frontal bossing is combined with relatively thinbone over the frontal sinuses, the sinuses being of normal size. Correctionrequires completing as much contouring of the bones as possible withoutentering the sinus and then augmenting the concavity above the frontal bossingwith methyl methacrylate and contouring to a final desired shape.•Group 3 includes those patients in whom the anterior projection of thesupraorbital rims is so excessive that adequate bone reduction contouring isimpossible without entering the frontal sinus. In thesse individuals, the frontalsinus must be opened through a sinus osteotomy and the entire anterior sinuswall and associated supraorbital rim set back and fixed into position by usingwires or micro-titanium plates and screws.Source: http://www.chet-plasticsurgery.com/forehead_bone.html