Forehead reduction
Gender-affirming forehead correction for trans* women
Medically reviewed by: Dr. med. Timo Spanholtz
Specialist in Plastic and Aesthetic Surgery | Medical Director
Forehead feminization is a central component of facial feminization surgery (FFS). The goal is to reduce masculine forehead features – in particular pronounced supraorbital ridges ("brow bossing") – and to create a softer, harmonious contour with a feminine eyebrow position.
At the Praxisklinik am Rosengarten in Bergisch Gladbach, Cologne and Hamburg, we perform these procedures with a high level of specialization in gender-affirming facial surgery – taking into account functional safety, aesthetic precision and individual identity.
Why does the forehead appear "masculine"?
The gender-specific differences in the upper third of the face concern in particular:
✔ stronger protrusion of the forehead above the eyes (supraorbital region)
✔ pronounced frontal bossing
✔ lower-set eyebrows
✔ flatter or less convex forehead course
These features are shaped hormonally (testosterone effect during puberty) and can no longer be changed by hormone therapy alone.
Surgical techniques of forehead feminization
The choice of technique depends on anatomy, the extent of the frontal sinus and bone thickness. We want to inform you comprehensively about all options and therefore also present procedures that we currently do not offer ourselves. This way you get a comprehensive overview!
- Bone contouring (shaving technique) - currently not offered by us
With moderate severity, the front bone contour can be carefully shaved down.
Suitable for:
- minor frontal bossing
- sufficient bone thickness
Advantage: less invasive
Limitation: only limited reduction possible
- Type III reconstruction (frontal bone repositioning) - currently not offered by us
With strong brow bossing, the frontal sinus is often very pronounced.
Here the front bone plate is carefully removed, modeled and reinserted in a feminine position.
Suitable for:
- distinct supraorbital protrusion
- thin bone plate
- strong projection
This is the most common and most effective technique for trans women.
- Brow Lift
In addition, a brow lift is often performed in order to:
- visually enlarge the eye opening
- achieve a softer, slightly curved brow shape
- support the overall feminine expression
- Hairline correction (hairline lowering)
If there is a high forehead, a simultaneous hairline lowering can be useful.
This significantly improves the proportions of the upper third of the face.
Incision and scars
Access is made either:
- coronally (in the hair-bearing area of the head)
- pretrichial (directly at the hairline)
The decision depends on:
- hairline height
- desired hairline change
- individual scar healing
Scars are usually well concealed by the hair.
Safety & medical aspects
As a procedure in the area of the frontal bone and the frontal sinus, the operation requires:
- preoperative 3D imaging (CT of the frontal sinus)
- precise analysis of the sinus anatomy
- neurovascular preservation (supraorbital nerve, supratrochlear nerve)
- sterile surgical conditions
Possible risks:
- swelling and hematoma
- temporary sensory disturbances
- very rarely: sinus problems or contour irregularities
In experienced hands, the complication rate is low.
Healing process
- Swelling: clearly visible for 2–4 weeks
- Sutures: after approx. 10–14 days
- Presentable in public: after approx. 2–3 weeks
- Final result: after 3–6 months
The feminizing result usually looks very natural and subtle – with great psychological impact.
Who is the operation suitable for?
- Trans women with pronounced brow bossing
- Non-binary people who wish for a softer forehead contour
- Cis women with strong supraorbital projection
Requirements:
- psychological indication for gender-affirming procedures
- stable health situation
- realistic expectations
Frequently asked questions about Forehead Reduction
This varies depending on the individual case, psychological indication, and insurance status. Individual consultation is required before the facial adjustment.
We use state-of-the-art techniques to conceal scars as much as possible. Incisions are often placed within the hairline, inside the mouth, or in natural skin folds (such as under the chin or on the neck). After complete healing, these are usually extremely inconspicuous or no longer visible at all.
This is individual, but for facial harmonization we often begin with the upper face (forehead and hairline design), as this has the strongest effect on how one is perceived by others. However, many people opt for a combination of several procedures in one session in order to minimize downtime and achieve an immediate, holistically harmonious result.
Not necessarily. However, it is often combined with rhinoplasty, jaw, or chin feminization.
No. After puberty is complete, the bony structure remains unchanged.
A facial adjustment is highly individual. Common procedures include the reduction of the forehead bossing (forehead remodelling), correction of the hairline, nose correction (rhinoplasty), reduction of the chin or the jaw angles, as well as the surgical reduction of the Adam's apple. We will create a treatment plan for you that is precisely tailored to your bone structure and soft tissues.
Our approach
At the Praxisklinik am Rosengarten we place value on:
- individual 3D analysis
- aesthetic harmony instead of overcorrection
- functional safety
- respectful support of transgender patients
Forehead feminization is often the decisive step that brings the face "into harmony" – not through exaggeration, but through anatomical precision.
Schedule an appointment
Get non-binding advice on forehead reduction now. We clarify all open questions and talk about your desired change.
Completely without pressure, completely non-binding and above all at eye level and without prejudice!