What can be done to remove fat deposit to reduce the prominence of my puffy brow ridge?

Question

I'm a transgender person, MTF. I'm not ready to have FFS surgery, but notice that the brow ridge I have is mostly fatty tissue/skin. Is there anything that can be done to remove this fat deposit to reduce the prominence of my brow ridge? I was thinking spot fat reduction injections but haven't seen this advertised as a possibility anywhere. Is it too near the eyes? Thanks.

Bryan Rolfes, MD · Answer

Everyone has some fat and muscle in their brow.  The best way to reduce brow bulk non-invasicely is probably botox.  It will paralyze the muscle and cause it to shrink over time (the way your arm would shrink if you had it in a cast for a couple months).  The issue with minimally invasive injections that reduce fat is that nerves in the body are often insulated with fat cells.  These injections can only be done in area where there are no important nerves, and the forehead is not one of those areas.  -Dr. Rolfes

Javier Rossi, MD, FACS · Answer

It would be very unlikely that a brow bossing projects
because of having fat. The typical causes for the prominence of the browbossing are protruding bone and, to a much lower extent, thick muscle.

Christopher J. Inglefield, MBBS, FRCS(Plast) · Answer

Thank you for your question.  Without photos it would be difficult to advise you on the treatment options.  Most soft tissue bulk in the brow are is due to muscle enlargement which is treatable with botulinum toxin injections every 3 to 4 months.  Fat dissolving injections are not recommended in this area due to the high risk of blindness.  You would need to have an XRay of your skull to best advise you.  Good luck

Sarah Saxon, MD · Answer

The brow ridge is mostly composed of bone but has overlying soft tissue of varying thickness. I have seen some patients with very thick muscles in their brow ridge which can be reduced with botox repeated over time. Trying to remove subcutaneous fat in that area, either with liposuction or injection, would not give you anywhere near the result you are looking for and comes with risks of damage to nerves and blood vessels in the area. 
You could have skin laxity there which would be better improved with a brow lift. In general, the best result in feminizing the upper third of the face comes with setting back the brow bone, raising the eyebrows, and lowering the hairline. Without photos it is difficult to give you much direction, but a video or in-person consultation would give you more clarity in which treatment options are best for you.
Best of luck to you,
Sarah Saxon, MD

What can be done to remove fat deposit to reduce the prominence of my puffy brow ridge?

Answers (4)