Forehead / Brow Ridge Contouring by Dr. Rushapol Sdawat

February 27, 2019

Dr. Rushapol Sdawat

Definition & Overview

Forehead contouring is a surgical procedure that involves reconstructing the protruding brow bone and reshaping the orbital bones. When a patient undergoes this procedure, the earlier mentioned facial area is made slightly smoother and less protrusive to achieve a softer, more feminine appearance. Additionally, it is important to know the 3 most important differences between male and female foreheads:

First is the brow bossing, males often have a ridge of bone around the upper edge of the eye sockets called the “brow ridge” or “brow bossing” while female foreheads tend to have little or no bossing. Secondly, between both of the brow ridges a flat spot can be visible. However, as women don’t have the ridges, the flat spot between them is not present. Lastly is the slope of the forehead, since women often do not have brow ridges, they have a more vertical appearance of the forehead in lateral view, and the angle between nose and forehead is more open. Meanwhile, in males the general angle of their forehead is steeper, and the angle between the forehead and nose is sharper in lateral view.

In summary, an attractive female forehead has 4 components:

  • Attractive Female skull shape (Central forehead round prominence) without lateral skull prominence
  • Less deep eye socket with less shadow
  • Wider orbital cavity (more eyelid opening space)
  • Higher brow level (0.5 cm above upper orbital rim)

Cost: THB 220,000
Operation Time: 4.5 hours

Surgical Process / Techniques:

Forehead recontouring involves surgically shaving and reshaping the bone.

The outer segments of the bossing that the eyebrows sit on are solid bone and can simply be filed down.

The section of bossing (flat spot area) between the eyebrows sits over an area called the frontal sinus. Because the frontal sinus is hollow, it is more difficult to remove bossing there, therefore it involves removing this plate of bone, reshaping it, and placing it back in position with small titanium screws to hold the bone in place while it heals.

There are four steps in forehead/brow ridge contouring: Shaving, Reconstruction 1, Reconstruction 2, Forehead and Eyebrow Scalp Lift

  1. Shaving – Shaving down the protruding male bony prominence along the 3 main areas: Brow Ridge (glabella or frontal bossing), lateral skull prominence above temporal crest, lateral & upper orbital rim (expanding orbital body aperture).
  2. Reconstruction 1 – This step involves reconstructing the central forehead prominence with bone cement.
  3. Reconstruction 2 – This step includes reconstructing the bone level over the sinus area by combining and repositioning the reshaped bone and artificial bone replacement.
  4. Forehead and Eyebrow Scapl Lift – This step includes using Endotine, Lactosorb, and Skull Drilling to complete the procedure.

Post- Surgery Recovery

  • You will spend three nights in the hospital after the surgery.
  • Patients from abroad should stay for 10 more days in Phuket after the surgery for further observations.
  • Pain may occur for a few days, which is manageable with normal painkillers.
  • Many patients can go back to work within two weeks following this surgery (as a stand-alone procedure).
  • Avoid physical activity that causes sweating or a rise of blood pressure for eight days.
  • Expect your forehead to be numb for about 3 months.
  • Due to the swelling around the eyes, some patients have noticed some degree of vision blurriness for a few months.

Risk Factors

No matter how simple a surgery might be, one should still be cautious for it can still be associated with risks which cannot be avoided. Fortunately, it is very unlikely for a forehead contouring by shaving or reconstruction to present any complications when performed by a qualified facial feminization surgeon.

  • Adverse reactions to anesthesia.
  • Even if the surgeon would mark the appropriate areas carefully, asymmetry still can never be avoided.
  • Infections can sometimes occur, although they are very unusual if you take the right antibiotics.
  • Uneven surface.
  • Nerve damage.
  • Hair loss on the scar line area due to extreme adhesion.
  • Bad or hypertrophic scarring.
  • Titanium or other implants rejection (rarely happens).
  • Palpability. The heads of titanium screws or the edges of titanium mesh can become touchable. This is acceptable as long as they don’t become visible.

About the author

Dr Rushapol

Dr. Rushapol was a University Professor and a General Surgeon before joining PIAC (now PPSI) as one of the founding Plastic Surgeons. His 20 years of vast experience in Plastic Surgery is a testament to his expertise. He specializes in Facial Surgeries, Breast Surgeries, and Body Contouring Surgeries. His patients describe him as charismatic and kind. Inside the Operating Room, he is a notable perfectionist with precise attention to detail.

Apart from being a well sought-after Plastic Surgeon, Dr. Rushapol is also an accomplished musician. He plays several musical instruments with Guitar being his favorite. He even designed and custom-made his own guitar and owns one of the most astounding guitar collections in Thailand.

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