Frontal Bone Remodeling for Gender Reassignment of the Male Forehead: A Gender-Reassignment Surgery – Review

This study describes a surgical technique for making a more feminine forehead.

Twenty-one male-to-female patients were given the surgery. The results of the surgery were independently evaluated one year later using a four-point scale (excellent to poor).

“The aesthetic results were considered good to excellent in 15 cases and satisfactory in two cases. The contour results were stable in long-term follow-up evaluations.”

The study does not say what the results were for the remaining four patients; presumably they were poor. This would give results of 71% good or excellent; 10% satisfactory; and 19% poor.

The study does not break down how many of the surgeries were rated excellent vs. how many were rated good.

The study includes before-and-after photographs for three patients. For two of the three patients, I could not see why the after pictures were more feminine. I thought they would have been able to pass before the surgery.

The patients were followed for 18 months and there were no complications.

The paper is by one of the people who developed the surgical technique. This creates a potential for bias, although the use of an independent evaluation counteracts the bias.

On the other hand, the author of the study sidesteps an important issue: were 19% of the results poor?

The study would be improved by an evaluation of whether or not photographs of the patients were perceived as women more often after the surgery.

Original Article:

Frontal Bone Remodeling for Gender Reassignment of the Male Forehead: A Gender-Reassignment Surgery by Johannes Franz Hoenig, in Aesth Plast Surg (2011) 35:1043–1049.

Note: This study includes photos of surgery.