Gender affirming and aesthetic cranioplasty: what's new?

PURPOSE OF REVIEW: Esthetic cranioplasty is an important part of facial feminization surgery. Additionally, it is an often underappreciated procedure for facial beautification. This chapter reviews current trends in esthetic cranioplasty for transgender women and others. Valuable techniques and innovations that do not advance the field are reviewed.

RECENT FINDINGS: Although promoted in recent literature, among the key concepts discussed in this review are the limitations of cutting guides, the rare indications for preoperative imaging, and when burring the glabellar area is appropriate rather than doing a full osteoplastic flap setback.

SUMMARY: Forehead feminization cranioplasty is a highly dependent upon the surgeon's artistic ability. Modeling and guides are potentially helpful for the novice surgeon but better is to learn appropriate anatomy for a more refined result.