What is it about?

This video article demonstrates a key surgical procedure for transgender women and other patients seeking facial feminization, particularly forehead reshaping. The shape of the forehead and brow area is one of the most noticeable differences between typically masculine and feminine faces. A masculine forehead often has a prominent, rounded brow bone and a heavier, lower brow line. This procedure aims to change those features for patients. Surgeons carefully reshape the bone at the front of the skull to create a smoother, flatter forehead with a more open and elevated brow area. The goal is to soften the entire upper third of the face. This is often combined with a brow lift to adjust the soft tissue for a final, harmonious, and more feminine appearance. The video shows the step-by-step technique, which the authors find safe, reliable, and effective for helping patients achieve their desired aesthetic goals.

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Why is it important?

This work is unique because it is the first video guide to the most complex part of facial feminization surgery: reshaping the forehead. While the surgery is known to many surgeons alike, a clear, step-by-step video from expert surgeons has never been published before. This publication is very timely. More patients are seeking this care, and more surgeons need to learn how to perform it safely and well. Our video provides a standardized, reproducible technique that surgeons anywhere can watch and learn from. By visually sharing this "how-to," we aim to directly improve surgical training, standardize best practices, and ultimately help more patients achieve their goals with greater safety and consistency. For any clinician in this field, this video is an essential educational resource.

Perspectives

As a future surgeon dedicated to advancing surgical care, I am particularly proud of our publication from Virginia Mason Franciscan Health, a national leader in these procedures. My personal perspective is that visual learning is transformative, especially for complex three-dimensional procedures like this one. Reading a description of bone contouring is one thing; seeing the precise angle of a burr, the management of soft tissue, and the sequence of steps is entirely another. This video represents a significant move from theory to tangible technique. I believe it will help demystify the procedure for trainees and serve as a vital reference for experienced surgeons refining their approach, ultimately raising the standard of care for all patients seeking this gender-affirming surgery.

Dr. Christopher P. Kruglik
Emory University

Read the Original

This page is a summary of: Feminization Cranioplasty, FPSAM Video Journal, January 2025, SAGE Publications,
DOI: 10.1089/fpsamv.2025.0003.
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