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Brow Bone Reduction, Forehead Reduction, Brow Bossing Reduction, Forehead Feminization

A common feature of a maculine face is a pronounced brow bone (brow bossing). The prominent bone is visible in profile and causes shading of the eyes when viewed from the front.  Studies have shown that brow bossing is one of the strongest gender markers, and brow bone reduction is often the first procedure we recommend for patients looking to make their face more feminine. In this procedure this brow bone is lowered so that the forehead flows smoothly into the nose, the orbital rims and bone over the eyes is reduced to open the eyes, and forehead is rounded and softened. During the same procedure we can reshape and lower the hairline and lift and shape the eyebrows to make them more feminine.  Because there are so many aspects to the procedure, not just a reduction of the brow bone, we commonly refer to this procedure as “forehead feminization.”

What is a brow bone reduction consultation like?

During your consultation your surgeon will ask you to discuss your goals and point out the features you would like to improve. They may make some additional suggestions of adjustments that you didn’t mention that they think would help you achieve the goals you discussed.  They will discuss the location of the incision, review the steps involved in the procedure, and explain the typical recovery. Any possible complications will be explained.  

What is a brow bone reduction surgery like?

An incision is made, either within the hair where it is well hidden right away, or right in front of the hair which allows for more adjustment of the hairline.  Hairline incision scars are typically hard to find after several months, but they can be very visible at first. Through this incision the brow bone and orbital rims are reduced.  The bone of the upper forehead can be softened and rounded, and the eyes are made to appear brighter and more open. We can also lift the eyebrows and create a more feminine brow curve.  

In most patients, to achieve the most feminine forehead shape, the front wall of bone has to be taken off, the bone around it is reduced, and the front wall is replaced (this is also known as an Ousterhout type III procedure).  In a small percentage of patients the brow bone is very thick, and the proper feminine contour can be achieved with just shaving down bone (Ousterhout type I). It is important that you see an experienced surgeon for this procedure who is able to perform a bone setback procedure rather than just shaving down the bone.  Dr. Rolfes performs a type III setback in over 90% of his cases.

How long does it take to recover from brow bone reduction?

Forehead feminization is typically performed as an outpatient procedure.  Discomfort after surgery varies widely, but most patients report pain and soreness for 3-4 days that is well controlled with medication.  Complete scalp numbness can expected above the incision, but feeling slowly returns over the course of months. If an incision is made along the hairline it will have stitches that have to be removed at about one week.  The scar from the incision will be visible for several months, but will slowly fade away. New hairs will eventually grow through the scar and help to hide it. We send patients home with pain medicine, an anti inflammatory, a medication for nausea, and an antibiotic.  We have them follow up in clinic the day after surgery and at one week to have their stitches removed.  

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