Scalp advancement for transgender women: Closing the gap

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The Laryngoscope


OBJECTIVES/HYPOTHESIS: Hairline advancement is a powerful procedure to shorten the forehead and eliminate areas of hair loss, especially along the temporal recesses. This study was undertaken to report the typical hairline advancement possible with the senior author's method for scalp advancement at the time of forehead feminization.

STUDY DESIGN: Retrospective chart review.

METHODS: A review was conducted of 29 consecutive cases that met inclusion criteria from January to March 2018 at an academic medical center. Sex, gender, age, whether galeatomy was performed, and additional variables were recorded. The distance of hairline advancement was measured in the midline and at the left and right midpupillary line. Galeatomies and rapid intraoperative tissue expansion were performed as per standard surgical protocol.

RESULTS: For the group of 29 individuals who underwent the specified method for scalp advancement, the average differences for the glabella to the trichion, the right midpupillary line, and the left midpupillary line were 1.90 cm, 2.07 cm, and 2.07 cm, respectively. These differences between the pre- and post-observations were statistically significant at the 0.1% level (P < .001). The overall average difference in scalp advancement was 2.01 cm (also significantly different pre- and post-measurements at the 0.1% level; P < .001).

CONCLUSIONS: Our technique of hairline advancement provides a significant improvement in the hairline in patients seeking out advancement due to an elongated forehead while undergoing facial feminization.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2019.

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ePub ahead of print