Finesse in Gender Affirming Frontal Contouring With Corrugator Resection

Abstract

Abstract Background Given the significance of forehead aesthetics to facial gender identification, frontal sinus setback and brow contouring are frequent components of facial feminization surgery (FFS) in transgender female patients. Objectives This study presents a safe and reliable technique for corrugator muscle resection during FFS to provide enhanced feminization of the forehead. Methods This technique was performed in 12 patients between 27-58 years of age. Following bone reduction and sinus setback, the corrugator is located on the undersurface of the forehead flap and dissected through the reflected soft tissue of the forehead, with care taken to protect the supraorbital nerve. Patient satisfaction and complications such as infection, poor wound healing, scarring, and desire for revision surgery were assessed at follow-up visits. Results All patients showed improved feminization of the forehead. No complications were reported intra- or post-operatively, and no patients required hospitalization beyond the expected overnight admission. No patients reported anesthesia or hypoesthesia in the distribution of the supraorbital nerve at 6-months postoperatively. Patients reported high satisfaction with their FFS outcomes. Conclusions Performing corrugator resection in conjunction with FFS is a safe and rapid technique that may significantly enhance the feminizing effects on the forehead of frontal sinus setback and brow contouring.