Contouring the forehead and rhinoplasty in the feminization of the face in male-to-female transsexuals.

Transsexualism is a gender identity disorder in which there is a strong and ongoing desire to live and be accepted as a member of the opposite sex. In male-to-female transsexuals with strong masculine facial features facial feminization surgery can be performed as part of gender reassignment. The male forehead has extensive supraorbital bossing, and above this there is often a flat area before the convex curvature of the upper forehead begins. In the female, the supraorbital bossing is considerably less, often nonexistent, and above this the flattening is usually less marked and more of a continuous mild curvature. The female nose is relatively smaller than the male nose. The glabellar and the nasolabial angle are less acute. The female nose is regarded as attractive if it shows a straight or mildly concave dorsum and an accented tip. We present a case of treatment of a 26-year-old male-to-female transsexual to demonstrate that contouring the forehead combined with a rhinoplasty can lead to significant feminization of the face. The procedures described seem to be safe and reliable.