Can An Upper Blepharoplasty Lower The Eyebrows?

Q: Dr. Eppley, I am a transgender man with several body contouring questions: 

1) Would it be possible to reduce the female pevis area in such a way that it is similar to a male pelvis? (Iliac crest reduction, Q angle reduction, etc.) 

2) Is it possible to widen the shoulders at all? 

3) How effective is liposuction of the saddle area for those transitioning from female to male? I’m struggling to find results of this as those who receive liposuction to their hips don’t tend to go as far as I would be wanting (as far as possible) 

4) Have you had Female to Male patients in the past and if so, could you share some of the procedures they typically have to result in a full transformation as well as other procedures you would recommend? 

5) I have ptosis with both of my eyes and will be needed upper and lower belpharoplasty and I am wondering if it is possible to lower the eyebrows during this? I have two other family members who have had blepharoplasties, however, they both received brow lifts. Does this procedure naturally lower the eyebrows if you do not ask for a brow lift? 

6) How far can the width of the face be reduced? I would say I have very wide cheekbones though I think it may be my head in general as I also have a wide lower jaw. I understand there is jaw shaving for the lower part but what about the eye / under eye section of the face? 

Thank you so much for your time, I very much appreciate it.

A: Thank you for your inquiry. In answer to your body contouring questions:

1) The iliac crest bone can be reduced at its widest mid portion. It may also be possible (although I have not done it as no one has requested it) to reduce the anterior superior iliac spine which is what I think you are referring to when mentioning the Q angle.

2) Shoulders can be widened by three methods including deltoid muscle fat grafting, deltoid muscle implants and clavicular bone lengthening, each with their own advantages and disadvantages.

3) Saddle bag or outer/upper thigh liposuction is commonly done. But you are not likely to find a straight line result as that is not how it is commonly done in cis-females. (over correction) Whether you would be able to a achieve a straight line result with aggressive liposuction depends on the fat component of your saddle bag areas.

4) Regardless of the direction of the gender change every patient has different needs and different levels of effectiveness with various procedures. Each patient has to be assessed for what procedures would have the greatest value to their gender transitioning. In the face as well as the body computer imaging is very helpful in making these determinations.

5) An upper blepharoplasty will not lower the eyebrows. Actually there is no surgical procedures that can lower the eyebrows short of creating more forehead tissue through tissue expansion.

6) Facial width reduction is most commonly done by cheekbone osteotomies and lower jaw shaving/ostectomies.

Dr. Barry Eppley

Indianapolis, Indiana