A prominent brow ridge can strongly influence how the upper face is perceived, particularly in side profile and in photographs. Brow bone reduction is a facial bone contouring procedure designed to soften the shape of the bone above the eyes, helping the forehead and brow area look less prominent and more balanced with the rest of the face. It is commonly requested as part of gender-affirming facial surgery, and it may also be chosen by people who feel their brow prominence affects facial harmony regardless of gender identity.

What brow bone reduction aims to change

The goal is to reduce the forward projection and sharpness of the brow ridge and, where appropriate, refine the upper edges of the eye sockets. By smoothing and reshaping this area, the upper face can appear softer and more open, and the transition from forehead to nose can look less angular.

Because the brow ridge sits close to the frontal sinus (an air-filled space behind the brow in many people), the surgical plan depends on your individual anatomy. Some patients can achieve the desired change with careful burring and contouring of the outer bone. Others need a more structural approach that involves temporarily removing and reshaping a thin bone segment over the sinus and securing it back in a flatter position.

Who may be suitable, and when it may not be the right option

Brow bone reduction may be considered if:

• The brow ridge is noticeably prominent and feels out of proportion with other facial features
• The upper face reads as more angular or heavy than desired
• There is a gender dysphoria-related concern about brow prominence
• Previous soft-tissue procedures (such as eyelid surgery) did not address an underlying bony prominence

It may be less suitable, or require careful discussion, if:

• There are medical conditions that increase surgical or anaesthetic risk
• Smoking or nicotine use cannot be stopped around the time of surgery (this can impair healing)
• Expectations are not achievable for your bone and sinus anatomy
• There is significant hair thinning that could make a hairline scar more visible (this does not always rule surgery out, but it affects incision planning)

A personalised assessment is essential, as the safest and most effective technique depends on brow projection, frontal sinus size and position, forehead shape, and hairline characteristics.

Specialist assessment and surgical planning

At your consultation, our facial surgery team will discuss what you would like to change and what “natural” means for your face. A detailed facial assessment is performed, including evaluation of:

• Brow ridge prominence and symmetry
• Forehead slope and overall facial proportions
• Hairline position and hair density
• Skin thickness and soft-tissue characteristics

Imaging may be recommended in some cases to understand the frontal sinus anatomy and help choose the safest technique.

If brow bone reduction is part of a broader plan, options such as a brow lift and/or hairline advancement can be discussed. These procedures are often considered together because they use a similar surgical access area and can complement the overall upper-face result.

How the procedure is generally performed

Brow bone reduction is usually carried out under general anaesthesia.

Incision and access

Access to the brow bone is commonly achieved through an incision placed at or just behind the hairline. This approach is designed to keep the scar as discreet as possible and may also allow hairline adjustment when planned. The exact incision placement is tailored to your hairline, forehead anatomy, and any additional procedures.

Bone reshaping

Once the brow area is reached, the bone is reshaped according to the pre-operative plan:

• In selected cases, the outer layer of bone can be contoured and smoothed to reduce prominence.
• When the frontal sinus limits how much bone can be safely reduced, a technique may be used where a thin bone segment is carefully removed, reshaped, and secured back in a flatter position.

The aim is to create a smoother, more harmonious contour while maintaining structural safety.

Closure

The incision is closed carefully to support neat healing. Dressings may be applied, and specific aftercare instructions are provided.

Recovery and what to expect over time

Recovery varies between individuals and depends on whether additional procedures were performed.

The first days to two weeks

• Swelling and bruising around the forehead and eyes are common.
• Tightness, pressure, and a headache-like sensation can occur early on.
• Discomfort is usually manageable with prescribed pain relief.
• Temporary numbness of the scalp or forehead is common because the tissues have been lifted from the bone. Sensation typically improves gradually.

Many people feel ready for light daily activities within 1 to 2 weeks, but this depends on the extent of surgery and the nature of your work.

Activity and healing

• Strenuous exercise and heavy lifting are usually restricted for several weeks.
• Sleeping with the head elevated can help reduce swelling in the early period.
• The incision line often looks red or more noticeable at first and then fades over time.

When results become clearer

Initial changes are visible once early swelling settles, but the brow and forehead area can take weeks to months to fully refine. Scar maturation is gradual and can continue improving over many months.

Risks, limitations, and important considerations

All surgery carries risk. Your surgeon will explain the risks that apply to your specific plan and health history. Potential risks and considerations include:

• Bleeding or haematoma
• Infection
• Poor scarring or a more visible scar, particularly if hair density is low
• Temporary or, rarely, persistent numbness or altered sensation of the forehead/scalp
• Asymmetry or contour irregularities
• Under-correction or over-correction relative to expectations
• Prolonged swelling
• Risks related to general anaesthesia

Because the frontal sinus may limit how much reduction is possible, there are anatomical boundaries to what can be safely achieved. A careful pre-operative discussion is important so the likely outcome is clear.

Your consultation, follow-up, and ongoing support

From the first appointment through recovery, care is coordinated by our specialist facial surgery team. The consultation focuses on understanding your goals, assessing your anatomy, and agreeing a plan that prioritises safety and natural-looking facial balance.

You will receive clear pre-operative guidance, including instructions about medications and supplements to avoid, and support with stopping nicotine if relevant. After surgery, follow-up appointments are arranged to monitor healing, manage swelling and scar care, and address any concerns promptly.

If brow bone reduction is part of a gender-affirming pathway, our team can also help coordinate a broader facial plan so that each step supports the overall result in a considered, staged way.

If you are considering brow bone reduction, a consultation is the best way to understand which technique is appropriate for your anatomy, what changes are realistically achievable, and what recovery is likely to look like for you.