Evaluation and treatment of facial feminization surgery: part I. forehead, orbits,
eyebrows, eyes, and nose
Facial feminization surgery (FFS) incorporates aesthetic and craniofacial surgical
principles and techniques to feminize masculine facial features and facilitate gender
transitioning. A detailed understanding of the defining male and female facial characteristics
is essential for success. In this first part of a two-part series, we discuss key
aspects of the general preoperative consultation that should be considered when evaluating
the prospective facial feminization patient. Assessment of the forehead, orbits, hairline,
eyebrows, eyes, and nose and the associated procedures, including scalp advancement,
supraorbital rim reduction, setback of the anterior table of the frontal sinus, rhinoplasty,
and soft tissue modifications of the upper and midface are discussed. In the second
part of this series, bony manipulation of the midface, mandible, and chin, as well
as soft tissue modification of the nasolabial complex and chondrolaryngoplasty are
discussed. Finally, a review of the literature on patient-reported outcomes in this
population following FFS is provided.
