Due to the fact that doctors usually use medical language and I'm not a native speaker, I struggle to understand the difference between type I and type III?

What more do they do in type III that they don't do in type I? I've read that in the most invasive reconstructions they take the plate of your skull and then re-attach it with metal screws?

I'm curious cause I would like to have as flat forehead as possible, but dr Bart van der Ven who I chose to go with, suggested type I, however when I look on his before and after pics, I can't really pinpoint which one is type I or III because in all of them he seems to shave them to a similar degree, and sufficiently so

Thanks for answering!

http://www.virtualffs.co.uk/Forehead.html
It would be hard to explain it as well as Alexandra has on her website.
I also highly suggest dr. Ousterhout's book Facial feminization surgery.


Two examples of similar forehead before surgery.. type1 and type3, just for comparison...

http://content.screencast.com/users/ma5642/folders/Jing/media/e788dab8-4376-4ef4-bc02-9d3959850094/2016-01-13_1947.png

http://content.screencast.com/users/ma5642/folders/Jing/media/d97ff599-0554-4a94-9ea4-d3108ec47498/2016-01-13_1946.png

From everything I've read, the first one basically grinds down the edges to smooth things out (that part of your skull is hollow so there's a limit to how much they can safely do), the other is grinding things down AND cutting the bone out over your sinuses and replacing/reconstructing it so that your sinus cavity is smaller. Not every place does type 3, it's a more complex. Also there are different benefits and risks with each one.

Quote from: Kova V on January 13, 2016, 01:19:42 PM
Also there are different benefits and risks with each one.

Technically there are no risks involved with type3 reconstruction IF a surgeon has appropriate training and experience with this technique. If someone who isnt skilled and trained enough performs it, then yes there are risks for serious complications.

Oh I see, makes more sense now.

Looks like type I is often what's enough, but when I see type III I get so jealous of how flat their forehead is and I'd ideally like to achieve it..

It's the other way around, a type 3 is often more required to bring the forehead into a female range. I was advised to get a type 1, which I am still conflicted about. Especially after comparing the two pictures.

Quote from: crowcrow223 on January 13, 2016, 02:26:32 PM

Looks like type I is often what's enough...

This is very individual, the only thing that really matters is what is enough for you, what are your expectations and what kind of result you want. Some are indeed happy with only little smoothing and subtle feminizing effect, while others want typically feminine forehead shape.

I thought that type lll involved grinding down the bone over the sinus cavity to the mucosa membrane, and then covering it with a Titanium mesh? Whereas type l involved grinding it down to a reasonable thickness.

Quote from: Christina308 on January 13, 2016, 05:53:49 PM
... Whereas type l involved grinding it down to a reasonable thickness.

Sometimes also to unreasonable thickness!

With type 3 they remove the frontal sinus wall, and reshape/remodel it as desired. They place it in new position and shave down the bone around it to create uniform forehead shape. 
Surgeons in FFS field who do type3 reconstructions usually doesnt mess much with sinus cavity. Except in cases where patients had underdeveloped sinus and really small cavity to start with. Which would be even smaller, like non existant, after surgery, therefore in small percentage of patients (like 1-3%) it is better to just fill up whole remaining micro cavity with bone paste. Most surgeons use special titanium screws and plates to hold reconstructed bone plates in place, except or dr. Di Maggio who shapes modified frontal bone in a conical shape which holds itself (forehead skin holds it from the other side), with which he avoids using any titanium screws.     

That was a good explanation.....I guess i'm going to have rethink my situation.

Your result is very impressive..... Was it DiMaggio?

Dr. Meltzer

Well, type 1 can certainly be indicated, but that can only be decided based on X-rays. Did Dr Bart look at any cephalograms?

To whom is that question directed? 

I suppose you and crow

No he didn't he just looked at my face and pushed hard at a few places. Point is I don't know to just go along with the type 1 or specifically ask him to do a type 3. I think he is able to make that judegement call right...

And what happens if I ask him to do a type 3? is it possible that I turn up with a too flat forehead? isn't it true you need to also maintain a sort of slope with a certain angle to make it not look weird?

Quote from: JaniceNL on January 16, 2016, 09:52:58 AM
No he didn't he just looked at my face and pushed hard at a few places. Point is I don't know to just go along with the type 1 or specifically ask him to do a type 3. I think he is able to make that judegement call right...

And what happens if I ask him to do a type 3? is it possible that I turn up with a too flat forehead? isn't it true you need to also maintain a sort of slope with a certain angle to make it not look weird?

You could post your side-profile pic here... or if you are uncomfortable with that, you can send PM.

Dr. Bart often recommends type 1. I have seen more than few results from him, where type1 wasn't enough, and result could be better if done with type3 reconstruction. I think you should make this decision... 

I was always a Type III ( as Dr O advised me) but I was sold on burring sadly that has been the cause of all my problems ...

way too much trouble to go through all that to post a pic. Why doens't this site just allow to just insert a pic ?

I had Type III with Facial Team and I am very happy. It looks 100% natural feminine even for a MD. I have very small titanium screws in my forehead now (and in my chin). Only remaining side effect is that my nose is running when going from cold into warm air and vice versa.

I would not choose a surgeon who uses bone paste. There are many short and long term complications connected.