Brow Lift and Brow Position for Gender Affirmation

Aesthetic Considerations for Neuromodulator Use in Transgender Patients

BACKGROUND

The aesthetic dimension of transgender experiences involves various aspects linked to the visual representation and expression of one's gender identity. Nonsurgical cosmetic procedures, such as neuromodulators, have consequently become a viable treatment option for patients with gender dysphoria because of the ability to yield significant, although temporary, results with minimal associated risks and downtime.

OBJECTIVE

To comprehensively review literature pertaining to the aesthetic considerations for use of neuromodulators in transgender and nonbinary individuals.

MATERIALS AND METHODS

A literature review of PubMed/MEDLINE for studies was published through January 2024 for nonsurgical facial and body modification using neuromodulators. Searches were conducted with relevant keywords. Peer-reviewed articles and their references published within the past 10 years were given emphasis in the review.

RESULTS

Based on the limited publications to date, the authors prepared a comprehensive review on indications for neuromodulator treatment in this population, including brow positioning, lower face contouring, lip eversion, trapezius slimming, and leg contouring.

CONCLUSION

Dermatologists play a crucial role in facilitating the achievement of gender affirmation goals.

Secondary Forehead Lift in Transgender Women

Facial feminization surgery includes a series of procedures that aim to attenuate the masculine features of the face and make the face more feminine and harmonic. During the past few years, several feminization techniques have been developed or adapted to this discipline. The current intervention of the forehead for feminization is based on the setback of the anterior wall of the frontal sinus and the remodeling of the supraorbital and glabellar region, associated to brow lift and hairline advancement. Primary forehead feminization yields high patient satisfaction, quality of life, and aesthetic outcomes, with few complications. Despite this, secondary forehead lift in feminization surgery has grown rapidly in recent years due to two main reasons: (1) patients that had their primary forehead surgery 5 or more years ago kept aging; and (2) there was also a great increase in the primary surgeries, which also comes with increased unsatisfied patients that want a revision. In the present study, we will present our current approach for secondary forehead lift in transgender women and tips to avoid a revision when performing the primary forehead reconstruction.

Expert Opinion on Non-Surgical Eyebrow Lifting and Shaping Procedures

Eyebrow elevation and reshaping are common concerns that we handle in everyday practice, and we have noticed that the trend is shifting from a medical concern to a cosmetic one. Several eyebrow lift methods are available, both invasive and non-surgical. The method of choice depends on several factors, such as patient expectations and beliefs, financial budget, acceptance of downtime and the available tools in the practice. In this article, we review the recent literature on non-surgical eyebrow lift methods to provide an overview of the current state of this field. We discuss seven different methods for eyebrow lift and reshaping, including botulinum toxin, dermal fillers, fractional radiofrequency, high-intensity focused ultrasound, thermo-mechanical ablation, lasers, and threads. Moreover, we provide practical insight into the procedure, injection techniques, expected results, and patient satisfaction rate.