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Case Reports in Surgery
Volume 2018, Article ID 1947807, 8 pages
Case Report

Feminizing the Face: Combination of Frontal Bone Reduction and Reduction Rhinoplasty

Division of Plastic, Reconstructive, Transgender, and Aesthetic Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA

Correspondence should be addressed to C. J. Salgado; ude.imaim.dem@2odaglasc

Received 24 December 2017; Revised 23 April 2018; Accepted 6 June 2018; Published 2 July 2018

Academic Editor: Gaetano La Greca

Copyright © 2018 C. J. Salgado et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Gender affirmation surgeries in male-to-female patient transitioning include breast augmentation, genital construction, and facial feminization surgery (FFS). FFS improves mental health and quality of life in transgender patients. The nose and forehead are critical in facial attractiveness and gender identity; thus, frontal brow reduction and rhinoplasty are a mainstay of FFS. The open approach to reduction of the frontal brow is very successful in the feminization of the face; however, risks include alopecia and scarring. Endoscopic brow reduction, in properly selected patients, is minimally invasive with excellent outcomes avoiding these risks. Since both reduction rhinoplasty and frontal brow reduction are routinely performed in FFS, a combined approach provides superior control over the nasal radix and profile when performing surgery on the frontal bone region first followed by nose reduction. We present a case series of four transwomen undergoing frontal bone reduction in combination with a reduction rhinoplasty. All had excellent results with one DVT that resolved with treatment. Transgender patients frequently require multiple operations during their transition increasing their hospital stay and costs. This combined approach offers superior control over the nasofrontal angle and is not only safe but reduces hospitalizations and costs and is a novel indication to reduce gender dysphoria.