FFS Brow Bone Reduction Facial Surgery
Is Brow Bone Reduction Surgery for Feminization painful?
Several small parts of the face help distinguish it as masculine or feminine. This is why facial feminization surgery (FFS) often includes a customized suite of surgeries to address different areas of the face. When it comes to the forehead and brows, many know that a brow lift can aid in feminizing the face. However, another commonly performed surgery during FFS is brow bone reduction. Dr. Javad Sajan at Allure Esthetic Plastic Surgery offers among the best brow bone reduction results in the region.
A heavy or prominent brow bone can make your face look more angular and masculine. For many individuals, especially those pursuing facial feminization, this feature becomes a key area of focus. Brow bone reduction, or cranioplasty, in this case, can help smooth the forehead and create a softer and more traditionally feminine contour. Whether part of a gender-affirming surgery or a step towards facial harmony, this procedure can have a powerful impact on overall appearance and confidence.
Dr. Javad Sajan performs brow bone reduction to help patients feel at ease with their facial features. This procedure plays a key part in facial feminization. Let’s have a closer look at what it means, the cost, and the procedure details.
What is Brow Bone Reduction?
Brow bone reduction, also known as forehead contouring or frontal bone reduction, is a facial feminization or cosmetic surgery designed to reshape and soften the prominent bones of the forehead. It is suitable for those looking to bring more softness or femininity to their facial features and reduce the brow ridge. This procedure is also referred to by several other names, such as brow bossing reduction, frontal bossing reduction, forehead cranioplasty, and frontal bone cranioplasty. While the terminology may vary, all of these refer to the same technique aimed at creating a smoother and balanced upper facial appearance.
Depending on the thickness of the bone and size of the frontal sinus, Dr. Sajan will choose the appropriate surgical technique. To access the brow bone, a carefully placed incision is made just behind the hairline, ensuring the scar remains discreet and hidden within the hair.
Candidates for Brow Bone Reduction Surgery
Brow bone reduction surgery is for anyone who feels that a prominent brow ridge affects the way they look or how they feel about themselves. It’s a highly personalized procedure and can serve different goals depending on the individual. Some of the ideal candidates for brow bone reduction are:
- Transgender women and nonbinary individuals
- Cisgender women
- Cisgender men
- Anyone with post-traumatic or developmental brow bone irregularities
- Individuals with gender dysphoria
- Those undergoing facial reconstructions
Benefits of Brow Bone Reduction Surgery
Brow bone reduction, often part of facial feminization surgery, provides a range of benefits. By creating a smoother, more feminine forehead, the procedure can help reduce feelings of gender dysphoria. Here are some of the key benefits of choosing this procedure:
- Less prominent brow bone
- More feminine forehead contour
- Flatter forehead
- Helps reduce gender dysphoria
- Easy to combine with other gender-affirming surgeries, such as hairline lowering and a brow lift
- Hidden incisions
- Personalized to match the patient’s facial features and goals
- Natural results
- Permanent
Types of Brow Bone Reduction
There are four main types of surgical brow bone reduction. To determine the right option for every patient, Dr. Sajan’s facial feminization and brow bone reduction patients undergo a CT scan before surgery. This helps him determine bone thickness, the size of the frontal sinus, and other details of the anatomy that impact the correct surgical technique.
The types of brow bone reduction are:
Type I
A type I brow reduction involves burring, or shaving, down the bone. To qualify for this method, a patient must have a thick anterior wall covering the frontal sinus. This means that the bone can be shaved down at least 5 millimeters. This will only occur for about five percent of all patients. Additionally, it is not always possible to reduce a male brow bone to female contours by only burring down the bone.
Type II
A type II brow reduction has a small candidate pool. It involves shaving down the bone and then using bone cement to fill in the resulting space. The type II technique should only be used when the angle between the forehead and nose is within the feminine ideal already.
Type III
The most performed and arguably most effective brow bone reduction method for transgender patients is Type III. During this procedure, Dr. Sajan removes the frontal sinus bone and shapes it before placing it back over the frontal sinus. Occasionally, the frontal sinus itself is reshaped to accommodate the new forehead contour. This step is not necessary for all patients.
Type IV
This brow bone reduction technique usually refers to a Type III brow bossing reduction, where bone cement is also used to achieve the ideal contour. Compared to Type III, this is less common.
Beyond the way Dr. Sajan reduces the brow bone, the surgical procedures are otherwise quite similar. Types III and IV use titanium microscrews. These extremely small screws generally go unnoticed by metal detectors and airport security. The heads of the screws are also removed so that they are not visible through the skin.
Procedure Walkthrough
At Allure Esthetic, we understand that choosing facial surgery is a deeply personal decision. Whether you’re seeking softer features or overall facial harmony, understanding the surgical process can build confidence. This step-by-step walkthrough of the procedure is designed to guide you through the process, so you can move forward with clarity:
Personalized planning:
Dr. Sajan will examine your facial structure during the initial consultation and also review imaging, usually a CT scan, to understand the thickness of your brow bone and the size of the frontal sinus behind it. This will determine the best surgical approach.
Hidden incision:
A discreet incision will be made just behind your hairline. This will allow Dr. Sajan to carefully lift the scalp and forehead tissue, allowing access to the underlying brow bone. The incision is placed within the hairline so the scar remains hidden and heals naturally over time.
Closing and Dressing:
Once the reshaping is complete, the tissue is repositioned, and the incision is closed with fine sutures. A compression dressing or light bandage may be applied to control swelling and protect the area.
Anesthesia and comfort:
On the day of your surgery, you’ll be placed under general anesthesia, ensuring you are completely asleep, comfortable, and pain-free throughout the entire procedure.
Bone contouring or reconstruction:
For mild cases, Dr. Sajan carefully shaves or burrs down the bone to create a smoother contour. In more prominent cases, a bone setback is performed, where the anterior wall of the frontal sinus is surgically removed, reshaped, and repositioned to achieve a flatter, more feminine brow profile.
Immediate Post-Op Care:
Once the procedure is complete, you’ll follow a specific ice protocol to reduce swelling and must adhere to sinus precautions. Some patients return home the same day, while others may stay overnight depending on the extent of the procedure and personal recovery needs.
Recovery & Aftercare
While initial downtime only lasts about 1-2 weeks, full recovery can take several months. Most individuals can expect about 10-14 days of social downtime, with a return to desk jobs in roughly two weeks. You can start exercising lightly around weeks 2-4. While early improvements are noticeable within the first weeks, final results typically take 2-6 months to fully appear as swelling fades.
Also, after surgery, it’s important to keep your head elevated, even while sleeping. Use two to three pillows or a wedge pillow to prop yourself up, which helps reduce swelling and supports proper healing during the first week.
Here are the aftercare guidelines along with the time:
Initial downtime (Week 1): During the first week after surgery, taking rest is essential. Apply ice for 20 minutes every hour during the first 72 hours to reduce swelling and bruising. Follow sinus protection carefully, avoid nose-blowing, sneezing, or bending forward to protect the surgical site and sinus area. Prescribed pain medications will keep you comfortable. Gentle hair washing is safe after a week.
Weeks 2-4: Healing in Progress: Continue icing lightly, especially in the evenings or after activity. You may start with light exercise, but avoid anything that can raise your heart rate too much. Most patients start regaining energy with visible signs of improvement in this period.
Weeks 4-6: Back to Routine: At this stage, you can return to regular activity, including exercise. However, it’s important to avoid heavy lifting for at least six weeks.
To further support healing and maintain your results, there are a few extra aftercare tips to keep in mind. Protect your incisions from direct sunlight for at least six weeks by wearing a wide-brimmed hat outdoors and even applying high-SPF sunscreen once the area has fully healed. It’s better to avoid alcohol and smoking during the initial recovery period. If your incision is near the forehead, avoid resting glasses or sunglasses on the area.
Also, pay clear attention to your emotional well-being, as it’s normal to feel self-conscious while waiting for swelling to subside.
The Cost of Brow Reduction Surgery
The cost of brow reduction can vary widely depending on the extent of bone work required, the surgeon’s expertise, and your location. For patients using insurance, Allure Esthetic accepts many major providers, including Aetna, Cigna, Premera, Regence, Blue Cross Blue Shield, First Choice, and others. While costs can vary, many patients qualify for full or partial insurance coverage when the procedure is deemed medically necessary for gender affirmation. For those paying out of pocket, we also offer competitive pricing and special discounts to help make the procedure more accessible.
FAQ
How painful is brow bone reduction surgery?
While performed under general anesthesia, brow bone reduction surgery is usually manageable with prescribed pain medication. There can be post-operative pain and discomfort.
Is brow reduction covered by insurance?
Brow bone reduction may be covered by insurance if it’s part of gender-affirming care. Coverage usually depends on your plan and requires documentation.
Will I feel pain during the operation?
As you will be kept under general anesthesia, you won’t feel any pain during the operation. However, you may experience some discomfort or pain after the surgery.
How long is the recovery, and when can I go back to work or exercise?
Recovery after brow reduction surgery typically involves a return to normal activities within a couple of weeks, but high-intensity exercises should be avoided for about 2-4 weeks.
Will there be visible scars?
Yes, brow bone reduction surgery will result in scars, as incisions are required to access and reshape the bone. However, these scars can be well-hidden, often within the hairline, and will fade with time.
Are results permanent?
Yes, the results of brow bone reduction surgery are generally considered permanent.
When will I see my final results?
You can expect to see the initial improvements immediately, but the final results can take up to 6 months to fully develop.
Can this be done without changing my hairline?
What if I have minimal brow bossing—do I still need surgery?
Even with minimal brow bossing, surgery might be an option depending on your goals and specific characteristics of your brow bone prominence.
Can cisgender men undergo this procedure?
Yes, cisgender men can undergo the brow bone reduction procedure.
Is forehead reduction the same as brow bone reduction?
While both procedures address the forehead area, forehead reduction and brow bone reduction are not exactly the same. Forehead reduction typically refers to reducing the overall height of the forehead, while brow bone reduction focuses on reshaping and reducing the prominence of the brow ridge.
How much does it cost, and will insurance cover it?
Brow bone reduction typically starts around $6,000 but can cost more depending on the complexity of the procedure. While insurance doesn’t always cover it, some plans may include it as part of gender-affirming care.
When can I wash or color my hair post-surgery?
You can start washing your hair carefully after a week post-surgery, avoiding the incision area, and can return to normal washing after 1-2 weeks. However, you should avoid coloring hair post-surgery for several weeks, possibly months, until the incision is fully healed.
The Best
Why Choose Dr. Sajan?
Dr. Javad Sajan is a world-renowned plastic surgeon who specializes in gender-affirming surgeries. His patients come from around the globe for his expertise and dedication to serving the trans community. Dr. Sajan customizes every procedure to fit the patient’s anatomy and goals. Alongside transgender surgery, he performs traditional plastic and reconstructive surgery. Dr. Sajan understands the intricacies of transgender surgery.
To learn more and schedule a consultation, call us at (425) 409-5830. Patients can also reach out online via chat, contact form, and Price Simulator.
Allure Esthetic Plastic Surgery
