Hairline and Brow Management in Facial Feminization

Abstract

Introduction: Soft tissue management of the upper third of the face is a common component of gender-affirming facial surgery, particularly in facial feminization surgery, and is frequently performed alongside feminization cranioplasty to harmonize forehead height, hairline contour, and brow position.

Materials and Methods:

Here, we describe the surgical technique routinely used for hairline and brow management in facial feminization surgery by the authors at Virginia Mason Franciscan Health. The surgical goals of this procedure include hairline advancement with temporal rotation flaps, lateral canthal release, and a brow lift.

Results:

This video demonstrates hairline and brow management in facial feminization surgery that is routinely used by the authors in their practice.

Conclusions:

To our knowledge, this is the first video documentation of hairline and brow management in facial feminization, particularly including hairline advancement, temporal rotation flaps, and brow lift using bone tunnels, lateral loose areolar flaps, and lateral canthal release. The authors have found this approach to be safe, reproducible, and effective in achieving desired facial feminization outcomes.

IRB/Ethics Approval:

This work does not meet criteria for human subject research and is therefore exempt from IRB approval. All procedures performed were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from this patient for inclusion in education material such as this.

Author Disclosure Statement:

No competing financial interests exist.

Funding Information:

Virginia Mason Franciscan Health, University of Washington Department of Otolaryngology, Seattle, WA. There are no conflicts of interest or obligations related to the source of work.

Runtime of video: 7 mins 3 secs.