Frontal Sinus Setback

Reshaping the bone structure of the face and head for a more feminine appearance can provide tremendous self-esteem and confidence in the MTF client.

The female face has a softer look due to a higher brow and more recessed forehead, which gives their eyes a brighter, more open aesthetic. During frontal sinus setback, the anterior wall of the frontal sinus is moved to a more feminine position, which affects every aspect of the face, from the forehead to the eye sockets and the cheekbones.

Only doctors such as Dr. Satterwhite, Dr. Pang, and Dr. Gurjala with extensive craniofacial surgical skill and experience should attempt such a procedure, for it is highly delicate and complex, with the frontal sinus being dangerously close to the cranial cavity. Imaging is typically performed preoperatively to help determine the appropriate and safe amount of setback that will retain the patient's individuality while still accomplishing their cosmetic goals.

In cases where only a mild reduction is needed, or in the rare cases where there is very little (hypoplastic) or no (aplastic) frontal sinus, then the brow region can simply be burred or augmented to achieve an appropriate contour (Type 1 or Type 2 Forehead Reconstruction). In the vast majority of cases, the outer table of the frontal sinus must be cut (osteotomy), contoured, and then placed back over the area in a recessed fashion (Frontal sinus setback). This is referred to as a Type 3 Forehead Reconstruction (originally coined and described by the surgical pioneer Dr. Doug Ousterhout), and it is an essential maneuver in most patients to maximize results.