Susan's Place Transgender Resources

Hey All:

Can someone of of you who have had brow ridge reduction give me some opinions about my brow ridge .Thanks
I think my brow ridge is not too bad ,but the surgeon recommend me do it for better .What you think ,Do you think I will be benefit form the Brow ridge reduction surgery?


http://liangjinhan.blogspot.com/2018/01/brow-ridge.html


It cost a lot of money ,I want make sure I will be benefit from the FFS.Do you think I need it or I can get away without it .I appreciate all the replied

Many thanks


Han

Are you Asian?  I'm guessing you are Asian, based on your name and the web address and picture you linked.  I'm Asian too.

I believe that for Asian transgender women, brow ridge reduction surgery is critically important.  A lot of western transgender women can get away without getting brow ridge reduction, because some western cis women have slight brow ridges.  But Asian cis women?  None of them have brow ridges at all.  None.

Any type of brow bossing/brow ridges on an Asian woman will instantly clock her as a transgender woman, especially in the eyes of other Asians.  If passing (especially amongst other Asians) is important to you, brow ridge reduction surgery will be very beneficial.  I had it done myself, and it was very much worth it.

Quote from: echo7 on January 06, 2018, 09:48:46 PM
Are you Asian?  I'm guessing you are Asian, based on your name and the web address and picture you linked.  I'm Asian too.

I believe that for Asian transgender women, brow ridge reduction surgery is critically important.  A lot of western transgender women can get away without getting brow ridge reduction, because some western cis women have slight brow ridges.  But Asian cis women?  None of them have brow ridges at all.  None.

Any type of brow bossing/brow ridges on an Asian woman will instantly clock her as a transgender woman, especially in the eyes of other Asians.  If passing (especially amongst other Asians) is important to you, brow ridge reduction surgery will be very beneficial.  I had it done myself, and it was very much worth it.

Thanks for replying,Dear.Yes .I'm Asian.I'm Taiwanese live in the State now

Pass is very important to me since I'm very tall like 5'11

Do you think my brow ridge is visible in the picture,so you do think the surgery will helped me a lot in my case ?

I kind of undecided.

Yes, your brow ridge is visible to me in your pictures.  From one Asian trans woman to another, I recommend you to get the surgery if you can afford it.  I also had my doubts before I had brow ridge reduction surgery, because most of my non-Asian trans friends said that I did not need it.

But I had an Asian trans friend who told me to do the surgery, and I'm glad I did. I noticed a difference in how other Asians looked at me after I had it done.

Quote from: echo7 on January 06, 2018, 10:25:53 PM
Yes, your brow ridge is visible to me in your pictures.  From one Asian trans woman to another, I recommend you to get the surgery if you can afford it.  I also had my doubts before I had brow ridge reduction surgery, because most of my non-Asian trans friends said that I did not need it.

But I had an Asian trans friend who told me to do the surgery, and I'm glad I did. I noticed a difference in how other Asians looked at me after I had it done.

Thanks for sharing dear .I will take in my consideration.hugs

I'm Eurasian and now live in Bangkok. I had a slight brow which was shaved and my thai tg friends have two options, some shave and others add fillers. Asian female foreheads are rounder and for the best aesthetics the appropiate method should be selected for the roundness. Best to consult an open minded surgeon.

I do not see much of a brow ridge. People of Asian origin naturally have less brow ridge than other ethnic groups.
Perhaps just a minimal brow shave is sufficient for you.

Due to my ethnic heritage, I needed a type 3 brow reshaping. My surgeon removed  the entire brow bone, reshaped to a flatter contour and then placed the bone back in my head.  This is extensive surgery and expensive. If you can do without type 3, then by all means go with the least invasive surgery that works for you.

Quote from: Dani on January 07, 2018, 06:21:32 AM
I do not see much of a brow ridge. People of Asian origin naturally have less brow ridge than other ethnic groups.
Perhaps just a minimal brow shave is sufficient for you.

Due to my ethnic heritage, I needed a type 3 brow reshaping. My surgeon removed  the entire brow bone, reshaped to a flatter contour and then placed the bone back in my head.  This is extensive surgery and expensive. If you can do without type 3, then by all means go with the least invasive surgery that works for you.

Hey , there . Do you think I can get away without the surgery.sugery cost money and time to recovery.if I don't have to , I prefer not have it .

You don't think I have much brow ridge .so I might not need one ?

Thanks sis

Your orbital rim and brow ridge are fine, but the middle of your forehead would benifit very much from forehead surgery, if you desire to look very female. That being said, none of it is a requirement. You don't *have* to do anything. However, if you are asking for aesthetic, feminizing reasons, I would suggest you get it done. Especially if you indeed are Asian, because as someone else pointed out, certain gender markers are more common to different ethnicities, and an absess of a brow bone does seem more appropriately Asian.

To the people who recommend brow shaving, that really isn't up to the patient, nor is it tomdo with the severity of the protrusion, nut rather the thickness of the skull covering the sinus cavity. If it is very thin and hollow, a brow shave cannot safely be performed, and therefore a type 3 reconstruction must be attempted.

Quote from: IsabellaSwan on January 07, 2018, 10:54:45 AM
Your orbital rim and brow ridge are fine, but the middle of your forehead would benifit very much from forehead surgery, if you desire to look very female. That being said, none of it is a requirement. You don't *have* to do anything. However, if you are asking for aesthetic, feminizing reasons, I would suggest you get it done. Especially if you indeed are Asian, because as someone else pointed out, certain gender markers are more common to different ethnicities, and an absess of a brow bone does seem more appropriately Asian.

To the people who recommend brow shaving, that really isn't up to the patient, nor is it tomdo with the severity of the protrusion, nut rather the thickness of the skull covering the sinus cavity. If it is very thin and hollow, a brow shave cannot safely be performed, and therefore a type 3 reconstruction must be attempted.

Hey .Thanks for replied.There is no way ever I will do the type 3 reconstrucation. Tooooooo. much for me

You said my middle of forehand  will be benefit from surgery,Can I ask you talking about I will be benefit from the brow ridge reduce or other type of forehead surgery? 

Thanks

If anyone passed by please give me some of your options

Thank You

Yes, you will benefit from a brow ridge reduction, that's for sure from my point of view.

Quote from: Celia0428 on January 08, 2018, 08:24:36 AM
Yes, you will benefit from a brow ridge reduction, that's for sure from my point of view.

How and why you think from your point of view ?

  Hi  Han,
   I'm Laurie, I see that you are new here. So please let me say, Welcome To Susan's Place! Come on in and take a good look around.  Perhaps I can even get you to hop on over to the Introductions (https://www.susans.org/forums/index.php/board,8.0.html) Thread and  create a post to tell us a little bit more about yourself so we can get to know you a little better and greet you properly. I'll add some links and information below that can help you get more out of our site. Please take time to become familiar with them especially the RED one as we are always getting questions that are answered there.
 
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Hi Han,

I am not sure what are the female beauty standards where you are. The pics show brow bossing and a bit of bulging at the sinus plate. If you were to do top of face bone work you will only want to do it one time. Perhaps saving for the brow and a type 2 or 3 forehead procedure would provide optimum results.

The do nothing is a good option for a while and until you get a few estimates to do brow and a type 3 forehead procedure at the same time. I know it is expensive. The pain of the skin lowering and the recovery would better be done once. Do you think if you did the brow now that in the future you would want to do the forehead? If so then wait and do it together.

Just my opinion.

Quote from: Rachel on January 08, 2018, 06:50:13 PM
Hi Han,

I am not sure what are the female beauty standards where you are. The pics show brow bossing and a bit of bulging at the sinus plate. If you were to do top of face bone work you will only want to do it one time. Perhaps saving for the brow and a type 2 or 3 forehead procedure would provide optimum results.

The do nothing is a good option for a while and until you get a few estimates to do brow and a type 3 forehead procedure at the same time. I know it is expensive. The pain of the skin lowering and the recovery would better be done once. Do you think if you did the brow now that in the future you would want to do the forehead? If so then wait and do it together.

Just my opinion.

Thanks for replied
I would never want be some "Beauty" .Not every cis-woman is a beauty.I just want be a simple passable woman.That is all.

There is no way ,I will ever consider Type 3 forehead surgery.Ever. I don't spent a lot money an pain to become some " Pretty woman"

I just want be pass and a  simple woman.

The reason I consider brow ridge reduction is my surgeon said my brow bossing is not very noticeable but if I do will be better .This is reason I take it as consideration.

I will never do type 3 forehead  surgery 3 ,Do you think the brow reduce will still be worth it ?

Hugs

I'm sorry, but it's not really up to you. If you're gonna do your forehead/brow, you're gonna get the type done that fits your forehead type. Type 3 might be your only choice. I already explained this.

Han, sweetie, you are asking us, a bunch of people in a similar situation for our opinion if you needing brow reduction.  Most say yes and you seem to not want to hear it.  I am one too.  I see bossing that would be better if it was not so prominent.
But there are options on opinions.  I was over looking at Virtual FFS last night.  She is a very professional authority on what makes an AMAB look feminine. She uses pictures you provide and does a careful scientific analysis of your facial features based on doing over 2000 evaluations to help you know what is possible and what is not necessary for you to become more feminine looking.  She is not a surgeon nor affiliated with any practice, but seems to be respected by many FFS surgeons for her expertise.  Whether she will be able to help with which type (1,2,3) you need, I don't know but doubt it. 
To me, it is $375 well spent.  I would suggest you get a second opinion from her.

Quote from: IsabellaSwan on January 08, 2018, 11:23:22 PM
I'm sorry, but it's not really up to you. If you're gonna do your forehead/brow, you're gonna get the type done that fits your forehead type. Type 3 might be your only choice. I already explained this.

I'm not you ,You are not me .Not everyone is going to need forehead type 3 surgery.Fortunately last year when I had my FFS ,my surgeon checked my X-ray and told me If I want do my brow bridge I only need a Minimum  brow shave   


But thanks for your explanation about type 3 thought 

Quote from: JulieOnHerWay on January 08, 2018, 11:51:25 PM
Han, sweetie, you are asking us, a bunch of people in a similar situation for our opinion if you needing brow reduction.  Most say yes and you seem to not want to hear it.  I am one too.  I see bossing that would be better if it was not so prominent.
But there are options on opinions.  I was over looking at Virtual FFS last night.  She is a very professional authority on what makes an AMAB look feminine. She uses pictures you provide and does a careful scientific analysis of your facial features based on doing over 2000 evaluations to help you know what is possible and what is not necessary for you to become more feminine looking.  She is not a surgeon nor affiliated with any practice, but seems to be respected by many FFS surgeons for her expertise.  Whether she will be able to help with which type (1,2,3) you need, I don't know but doubt it. 
To me, it is $375 well spent.  I would suggest you get a second opinion from her.

Thanks for the helpful information .Hugs

I think there are very few trans women who would not profit from a surgery of the bones of brow, forehead and orbital bones above the eyes. I think for Europeans, the brow ridge is less important than for others as its a genetic trait in Europe (I personally think it has to do with the Neanderthal population bringin in some parts of the local gene pool, while other regions did not have that). For other ethnicities however it is more important. But even for Europeans, I believe that its not so much the brow ridge that is important, but the brow bossing, the bones around the eyes and the shape of the forehead. Many women have significant brow ridge, but it is located closer to the eyes in males than in females, causing an "overhang" over the eyes. Also it can increase the perception of a fleeting forehead, if it already is fleeting a bit. A more vertical forehead shape is more feminine, even with a brow ridge.
For example she has a rather pronounced brow ridge, but its not identified as male at all, even though her lower facial features are not overwhelmingly feminine, but the brow ridge sits higher than in men and her forehead is not sloping back, her hairline is oval and not M shaped.
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fwww.btchflcks.com%2Fwp-content%2Fuploads%2F2014%2F06%2Fthe100two.jpg&hash=3a0f344d73c8eeda6b119b16bb29fe4f523a1ebb)

So in the end, if people misgender you or if you feel dysphoric about the face and a particular feature, then a surgery makes sense, you can ask several surgeons what they recommend and get simulation photos done

Quote from: Han on January 09, 2018, 12:18:36 AM

I'm not you ,You are not me .Not everyone is going to need forehead type 3 surgery.Fortunately last year when I had my FFS ,my surgeon checked my X-ray and told me If I want do my brow bridge I only need a Minimum  brow shave   


But thanks for your explanation about type 3 thought

I never said everyone is going to need it. I said that you don't make a decision about which type you get based on preference, but rather based on which type your forehead is. If you had informed us that you'd already had an X-ray, this entire conversation could have been a spared expense.

Quote from: IsabellaSwan on January 09, 2018, 08:46:48 PM
I never said everyone is going to need it. I said that you don't make a decision about which type you get based on preference, but rather based on which type your forehead is. If you had informed us that you'd already had an X-ray, this entire conversation could have been a spared expense.

Thank you for your participating .Have a good day

Quote from: Han on January 10, 2018, 09:09:28 AM
Thank you for your participating .Have a good day

It would be really helpful to see your X-ray to see what type of forehead structure you were dealing with.

Quote from: myfairlady49 on January 10, 2018, 06:17:49 PM
It would be really helpful to see your X-ray to see what type of forehead structure you were dealing with.

Yes, and this is why strangers on the Internet is probably not a great place to get this sort of advice.

In my particular case, reconstruction of the bone plate covering the frontal sinus is the right way to go, as the bone is not thick and the sinus cavity is fairly large.   If the brow ridge were formed by thick bone backed by a narrow sinus cavity, simply removing bone would be the right way to go.

This is something best determined between an individual and their surgeon, over X-ray or CT scans and coffee.  (Been there, did that!)

Let's not forget about the many surgeons who recommend brow shaving because they can't adequately perform a forehead reconstruction, or is that not a probldm anymore? Also, the doctors that claim to do it, yet never seem to achieve results worthy of Dr O, Dr Suporn, Dr Van der Dussen etc. This used to be a big problem a few years ago.

Yes its a problem. Somehow the "type 1 versus type 3" distinction moved from the original Dr O definiteion of  how to do the surgery depending on the physiology of a patient to "how prominent is the bossing, if it is little we just do type 1".
So 2 surgeons recommended me type 1 wothout even knowing my X rays or scans just by looking at photos or me in real life and judging this from the lack of pronounced brow ridge. The scans however show a very thin brow bone - thin enough that I am even worried to get some titanium mesh when I do the type 3 procedure to stabilize it. So they could not know what is needed there unless they basically would have kept the sinus as it is and just shave the orbitals and temporal ridges - that may have worked, considering the brow bossing is not large, but of course it would not have adressed the brow bossing at all then, I suppose.
I did however see a few results of forehead work with shaving only that were interestinly quite different from before, even though there was some brow bossing visible. Not sure what they did - shave in the right parts, fill some parts with bone cement maybe... Dr Z only does shaving, as he works endoscopically... some people in Korea also do the same thing...
Generally I would say though the type of work needed depends on a) if you need setback at all and then b) what thickness your sinus bone and sinus cavity have

Yes, exactly as I thought. I remember some girls talking about "not wanting a type 3", as if it was merely a procedure, instead of a forehead type that requires a certain procedure. Certainly, many of us also call the procedures used on the different types of foreheads "type #", but it is important to remember that the forehead dictates the technique that should be used, not vice versa, ESPECIALLY in type 3 cases. Perhaps type 1 foreheads could technically speaking be treated with an osteotomy (I don't know for certain), but it just seems wholly unnecessary, doesn't it. However, merely shaving the bone on type 3 foreheads (i.e. applying the technique used on Type 1 foreheads) is at best ineffective, and at worst potentially dangerous. Dr Suporn actually developed a technique that is proprietary and exclusive to him, where he resets the forehead in type 1 patients. From how I understand it, he shaves the bone and then, with a controlled fracture, "pushes" the forehead further back. He doesn't even mention type 2 on his page, so I'm assuming it's because he perhaps doesn't really treat foreheads with bone paste, and therefore lets the sinuses decide, so to speak. I can understand this, as I have been unimpressed with the alleged type 2 foreheads and treatments I have seen. It is a rather rare forehead type, though, because the entire idea behind type 2 is that your forehead projection is already within the normal female range, so it's very possible that I have seen results of women who weren't truly candidates for this procedure. Please read Dr O's book for more information.

Another area where you girls need to be mindful is the chin! Some surgeons only perform burring procedures, trying to shave down the chin, but you can only shave so much without causing damage, and if your face needs shortening (which most trans faces probably do), you need a sliding genioplasty. This is why it's so important to go to someone who specializes in bone work - they won't cut corners or have an incentive to sell you procedures that will ultimately underwhelm you. Maxillofacial and craniofacial surgeons who are also certified in aesthetic plastic surgery.

I have thought hard about these surgeries etc my personal opinion is i am going to wait 2 to 3 years after hrt has took affect, then make a judgement then i want to transition just as much as everyone else but i want to do it graceful, if that makes sense. But what i do will be in my own time when i feel i need to i am living my life for me and no one else, and everyone looks different so there is no right or wrong. There is just you and do what makes you happy.

In forehead feminisation, the object is to remove the brow bossing.

You can't tell from the outside whether the bone over the frontal sinus is thick or thin. In most people it is thick - between 2.6 and 2.9 mm. This means that in the vast majority of cases, it's not possible to remove a significant amount of bossing just by shaving down the bone.

Even in a case where there is no frontal sinus (a small percentage of the population) it can still be a good idea to do a forehead reconstruction. This is because bone is generally hard on the outside and softer in the middle. If you just use shaving, you make that strong outer layer thinner, and that can weaken the forehead, but it you reconstruct the forehead, you move that solid layer back, retaining its full thickness and full strength. Within a few weeks of the surgery, your forehead is a strong as it was pre-op, and that wouldn't be the case if you had only shaved down the hard outer layer.

Many people think that a forehead reconstruction is a much bigger and more dangerous operation than shaving. This isn't really the case. Shaving can thin the bone excessively, even in cases where there is no frontal sinus, and you are more likely to end up having a revision because shaving alone has a limited feminising effect in most cases.

Some surgeons use a shave and fill technique - they shave the bone down and then add fillers around the bossing to disguise it. This does result in a smoothly rounded forehead which is feminine, but it also often results in a forehead that bulges forwards unnaturally (I call this a "dolphin forehead"), and it can leave your eyes deep-set.

Everyone is different. If your outer bone layer is really thick, you might get away with shaving without compromising the strength, but that would be unusual - in the vast majority of cases, you have thin bone over a frontal sinus, and the only way to feminise that effectively, and safely, is to set the bone back with a reconstruction.

Some people also worry that the frontal sinus is a pristine cavity that should not be exposed, but actually, your frontal sinus is not sealed - it is open to the nose so outside air circulates around it all the time.

Keep in mind that some surgeons who don't do forehead reconstructions tell all their patients that they don't need a forehead reconstruction.

Quote from: anjaq on January 09, 2018, 04:03:43 PM
I think there are very few trans women who would not profit from a surgery of the bones of brow, forehead and orbital bones above the eyes. I think for Europeans, the brow ridge is less important than for others as its a genetic trait in Europe (I personally think it has to do with the Neanderthal population bringin in some parts of the local gene pool, while other regions did not have that).

Actually, East Asians have more Neanderthal DNA than Europeans, so that's probably not the reason. Interesting theory though.

https://www.nytimes.com/2015/02/20/science/a-new-theory-on-how-neanderthal-dna-spread-in-asia.html?_r=0 (https://www.nytimes.com/2015/02/20/science/a-new-theory-on-how-neanderthal-dna-spread-in-asia.html?_r=0)

My point exactly, Alexandra! And some of the surgeons who allegedly do forehead reconstructions aren't skilled enough to do them well. There's a popular, but cheap surgeon I see all over this forum, and his work makes no difference, yet everyone sings him praises.