By Dr Leow Aik Ming
The forehead is one of several facial features that can appear more masculine or feminine depending on the shape and size. The shape of the forehead is one of the key differences between males and females. For example, masculine foreheads usually have a heavy, bony ridge, known as “brow bossing” whereas feminine foreheads are smoother and less ridged. In some ethnic groups, females may have masculine foreheads and likewise males may present with feminine foreheads.
Forehead contouring and reduction is a surgical procedure used to reduce the appearance of a prominent or masculine forehead. This procedure reduces these prominent ridges and reshapes the brow bossing, creating a softer, more feminine appearance. It is also performed on women who feel their brow and forehead appear too prominent or masculine. Forehead contouring and reduction surgery focuses on three primary areas to achieve a more feminine appearance, namely:
- Brow bossing
- The slope of the forehead
- The flat spot
To access the forehead area, an incision is made either right at or behind the hairline, depending on whether or not the hairline position needs to be changed. Although the exact procedure depends on the individual patient, most often the brow ridge (brow bossing) is osteotomized and reconstructed to reduce the appearance, and the orbital bones are shaped to reduce masculine characteristics.
Typically the frontal bone (between the eyebrows) is removed, shaped and then reattached so that it does not interfere with the underlying sinuses. If the forehead must be reshaped, to fill in a ridge or concavity, a synthetic material (synthetic bone graft) or alloplastic implant (forehead implant) can be used to create the desired more rounded shape. Occasionally, fat grafting can be used to create a more natural rounded appearance of the forehead. Due to the location of the incision, forehead contouring is often done in conjunction with blepharoplasty, brow lift or hairline restoration.