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Date of last update: 8/19/2017.

Forum Name: Surgery Topics

Question: Orbital Rim Contouring Questions

 Takahashi - Tue Jun 29, 2010 9:39 pm

For awhile now I have been greatly disturbed with how my forehead has changed. I have never had a raised brow whatsoever in no way shape or form during my childhood to my mid teenage years, yet now all of a sudden I have a Neanderthal forehead. It emotionally tears me apart since it has greatly affected my appearance. I really want to get my previous appearance back with a highly experienced surgeon. Orbital Rim Contouring or forehead reshaping is still relatively new to my knowledge. In plan I'd visit a specialist with present (not too young) photographs of myself then have them aged to now to get an idea of what can be done to get my previous appearance without a protruding forehead/brow. Who might specialize around Southeast VA or Northeast NC for this particular issue? What technology is available for this operation or can better the outcome of an operation? Are there additional operations that might be required if I were to have...? What are the risks associated with this or related operations? Any tips or recommendations? Thank you! :)
 Dr.M.Aroon kamath - Tue Jul 13, 2010 6:10 am

User avatar Hi,
Compete transformation of a male to female involves among others,
- hormonal treatment and
- sex reassignment surgery (SRS).

The number of individuals seeking Facial feminization surgery (FFS) has steadily increased over the years. A vast majority of them are transsexual women.This is so because, a womanly facial appearance is highly important to help them integrate socially as women. Some non-transsexual women who feel that their faces are too masculine also opt for FFS.

A male skull has a prominent fullness over the brow bone known as 'brow bossing' or a 'supraorbital prominence'.A female forehead lacks this and their foreheads are smoothly rounded.
These two features have to be addressed in most individuals undergoing FFS.

As with any other surgery there are a number of risks common to any type of surgery under an anesthetic.I will not discuss them here.

There are some 'specific' complications related to this form of surgery which include,
- Numbness: to varying extents may occur. This may render the person unaware of saliva or food on the face and cause social embarrassment. Also, the affected is at increased risk from potentially damaging hot or cold things.

- Visual changes: Some clients report visual problems due to tightened tissue and swelling in the vicinity of the orbits. Those who have diplopia(double vision) or distortion in one or both eyes which usually resolve in course of time. In severe cases, one may require a temporary eye patch and rarely, even surgical correction. Potential for blindness exists,but is fortunately extremely rare.

- Pain: permanent pain in some areas arising from a severed nerve may occur.

- Hyperasthesias: (increased skin senstivity) may occur.

- Scarring (variable), keloids( racial predilection).

The worst possible outcome from a plastic/reconstrutive surgical viewpoint is unsatisfactory cosmesis.
This includes,
- too much or too little change,
- Sometimes changes following surgery make the face appear disproportionate, as they throw off the balance of one's facial features. This can make it look like "you had work done"!, and
- Facial asymmetry.

Before contemplating this form of surgery, one should seriously weigh the potential gains against the complications enumerated above.
Best wishes!

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