A type 3 forehead reduction (also referred to as a type 3 brow bone reduction or type 3 cranioplasty) is performed for people with excessive brow bossing who wish to undergo forehead reduction surgery. This type of procedure is commonly performed for transgender women; however, it is also done for cisgender women and cisgender men who are dissatisfied with the appearance of their forehead. This is one of the few surgical procedures that are commonly used for Forehead Feminization as part of more general Facial Feminization Surgery.
The term “type 3” comes from the original research performed by Dr. Douglas Ousterhout. In his original research on the topic, he noticed there were three types of foreheads he encountered when performing modifications of frontal bossing with surgery. A type 1 forehead was one where the brow bossing can be addressed with burring alone. A type 2 forehead was one where the brow bossing was addressed by burring the bone low on the forehead and using the addition of an artificial material higher on the forehead to improve the transition. A type 3 forehead was one where the brow bossing needed to be addressed by making cuts in the bone and repositioning that bone. Type 3 brow bone reduction refers to this procedure.
Contouring the forehead can rarely involve simply burring the bone in that region. More commonly, cuts need to be made into the frontal sinus in order to move the bone backwards. If one were to simply shave down the bone at the forehead, holes would be produced into the frontal sinus and a large setback would be unobtainable.
When there is a large frontal sinus, it can be necessary to make cuts into the frontal sinus in order to move the outer surface of the bone. This is more easily explained using a cross-section of the skull. The image below demonstrates a cross-sectional view down the center of the face. It shows brow bossing from a profile (sagittal) view. In this view, the frontal sinus is shown in black. It is bordered by bone on the front (anterior) and back (posterior) sides.
When there is a large frontal sinus, it can be necessary to make In order to reposition the outer piece of bone (the anterior table of the frontal sinus), cuts need to be made around the edges of the frontal sinus.
This allows the front part of bone to be removed and contoured to the appropriate forehead shape. After removing the bone from the patient, the piece is contoured to create a round forehead.
The anterior table of the frontal sinus is then replaced at a position behind (posterior to) to its original position. In this position, the brow bossing is removed and a more feminine facial profile is obtained.
Type III Forehead Bone Reconstruction can certainly produce some amazing results and should be strongly considered when the patient’s anatomy requires it for the best results. It is, however, important to note that some patients can achieve equally impressive results with conventional contouring. This depends on the patient’s anatomy. An ethical surgeon will always help the patient to select procedures which will produce the desired results with the lowest risk of complications. In other words, if more than one procedure would produce the desired result, the procedure with the lowest risk should be recommended instead of the procedure with the highest cost. Facial Feminization Surgery is certainly not a one-size-fits-all set of procedures and must be customized for each patient.
Iranian surgery is an online medical tourism platform where you can find the best doctors and plastic surgeons in Iran. The price of FFS in Iran can vary according to each individual’s case and will be determined by an in-person assessment with the doctor.
For more information about the cost of Facial Feminization Surgery in Iran and to schedule an appointment in advance, you can contact Iranian Surgery consultants via WhatsApp number 0098 901 929 0946. This service is completely free.
Source:
https://transop.com/type-iii-forehead-bone-reconstruction/
https://paulmittermillermd.com/blog/how-is-a-type-3-cranioplasty-performed
https://pubmed.ncbi.nlm.nih.gov/3575517/