Quantitative Assessment of Forehead Morphology Following Facial Feminization Surgery

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Gender-Affirming Care

Background:

• Forehead feminization is a key aspect of gender-affirming surgery.
• Quantifying morphological changes is crucial for understanding surgical outcomes.

Purpose of the Study:

• To quantitatively assess forehead morphology changes after facial feminization surgery (FFS).
• To utilize computerized tomography (CT) imaging and a novel segmentation technique for precise measurements.

Main Methods:

• Retrospective analysis of 22 patients undergoing FFS with available preoperative and postoperative CT scans.
• Measurements included forehead volume, surface area, frontonasal angle, and bossing angle using specialized software.
• Inter-rater reliability was assessed, and patient satisfaction was evaluated using FACE-Q.

Main Results:

• Significant reductions were observed in forehead volume (2,558 mm³), surface area (505 mm²), frontonasal angle (9.6°), and bossing angle (9.9°).
• High inter-rater reliability (ICCs 0.62-0.87) confirmed measurement consistency.
• Patients reported significant improvements in satisfaction across most FACE-Q modules post-surgery.

Conclusions:

• FFS effectively reduces forehead dimensions and modifies key angles, contributing to feminization.
• These quantifiable changes are vital for aligning facial features with feminine ideals.
• The study highlights the positive impact of FFS on gender transition and patient quality of life.