Facial Feminization Surgery (FFS) and
Forehead Bossing Surgery
A long forehead is generally acceptable for the male, but not the female.
Male foreheads often have a heavy bony ridge just above the eyes in a line
beneath the eyebrows, which is called brow bossing.
Forehead bossing surgery is a facial feminization surgery that can involve
brow shaving or surgically altering the bone. In severe cases, forehead
bossing involves taking out the bone, reshaping it, and placed back in the
skull. In some cases, forehead bossing requires small titanium wires or
screws to hold the bone in place while it heals.
Forehead bossing can involve an implant or fill to round out a flat forehead,
giving a more feminine appearance. Porous materials or acrylate fill are
used for this type of forehead bossing to emulate bone.
Forehead Bossing Surgery Procedures
- To access forehead bones, an incision is made across the top of
the scalp from ear to ear, The incision may be done at the front
of the hairline to advance the hair at the same time.
- Forehead skin is pulled forward to reveal the bones.
- The solid bone, known as orbital rims, are shaved down.
- Bone over the frontal sinuses is more difficult and may require
- Shaving - If the bones over the front sinuses are thick enough,
they can be shaved down to give a flatter and more female contour
- Implants and Fills – If shaving alone is not enough to achieve
the desired result, especially if the bones over the sinuses
are too thin to be shaved down, a
bone-filler may be used to fill in hollow areas around the forehead.
- Forehead Reconstruction - This is the most complex and invasive
forehead bossing surgery. The orbital rims are shaved, but the
bone over the frontal sinuses is removed, re-shaped and set
with wires or titanium screws. This forehead bossing technique
is very powerful and can transform a severely male forehead
into the normal female ranges.
- An alternative forehead bossing technique involves shaving the
bones over the sinuses thin enough so they become flexible and
can be pressed into the correct position
Forehead Bossing Surgery Recovery
- Most patients will spend one night in the hospital following surgery
- A dressing is placed around the forehead after surgery, and left
in place during the first night. It can be removed the day after
- After removing the dressing, daily showering and gentle washing
of the hair should be done for a few days.
- Pain may occur for a few days
- Many patients can go back to work within two to four days following
- Avoid physical activity that causes sweating or a rise blood pressure
for eight days
- Sutures and staples are generally removed within nine days
Forehead Bossing Surgery Complications
- Infections are extremely rare, but antibiotics are used to avoid
- Swelling and black and blue coloring may occur around the eyes,
but will dissipate within ten to twelve days
- Forehead numbness may last several weeks to possibly years
- Nerve injury might rarely occur