Forehead feminization in Barcelona
Brow bone reduction and forehead reshaping with Dr. Javier Gutiérrez, planned on your own CT scan before anything is decided.
Medically reviewed by Dr. Javier Gutiérrez. Updated October 2026.
- €8,500
- Including CT scan, planning, anaesthesia and one night in hospital
- 2 hours
- Approximately, under general anaesthesia
- 1 night
- In hospital, then recovery near the clinic
- Day 8
- Stitches out, and you can fly home
- 3 weeks
- Recommended time off work
Forehead feminization softens the brow bone, the nasal root and the outer rim of the eye socket, and can raise the brows in the same operation. At ARQÉA it takes about two hours under general anaesthesia, with one night in hospital. The stitches come out on day 8, Dr. Gutiérrez recommends about 3 weeks off work, and it costs €8,500, with the CT scan and planning included.
Who it is for, and what it changes
The gender reading of a face starts at the eyes, and the forehead is the roof of that region. People looking at a face they read as masculine spend longer on the forehead (Gupta et al., 2022), and in a study of 303 patients the area between the brows and the top of the nose weighed most in how gender was read (Choe et al., 2023). That is why, on a limited budget, the forehead usually comes first.
It is for trans women and non-binary people, as part of facial feminization or on its own, and for anyone with a prominent brow ridge, including cisgender women and men.
- It treatsThe frontal bossing, the brow ridge above the eyes, the nasal root, the outer rim of the eye socket and the height of the brows.
- It does not treatThe length of the forehead or the shape of the hairline. Bringing the hairline forward is a separate step, through hairline lowering, or a hair transplant.
- HormonesHormone therapy does not change the bone of the forehead, so you do not need to wait for it to plan this surgery.
- The limitAnatomy sets the limit, not desire. When your anatomy allows less change, we tell you at the consultation, before operating.
- A very marked browSometimes the cause is pneumosinus dilatans, an expansion of the frontal sinus. It is rare and usually benign, and it is ruled out on the CT scan. We explain it in our post on pneumosinus dilatans.
How brow bone reduction is done at ARQÉA
Behind the forehead there is an air-filled cavity, the frontal sinus. The bone you feel above your brows is its front wall, and in most people it is about 3 mm thick (Lee et al., 2010). Shaving it barely changes the contour before it breaks through.
Why brow bone reduction is rarely just shaving
In around 95% of the foreheads Dr. Gutiérrez operates on, the front wall is not only shaved: it is also removed with a guided ultrasonic cut, reshaped outside the face and fixed back further in with titanium miniplates and microscrews. This is the anterior wall setback, Type III in the surgical classification. Between 5% and 10% of people have a solid or very small sinus, and then shaving can be enough. We explain it in our post on Type III forehead reconstruction.
Planned on your CT scan, decided with you
The plan is drawn on your own CT scan, with virtual planning. We review it together at the consultation, area by area: the frontal bossing, the brow ridge, the nasal root, the outer rim of the eye socket and the height of the brows.
- One technique per areaBurring, or cutting and repositioning, depending on what each area needs.
- The sinusOnce the wall is lifted, we check that the lining and the drainage duct of the sinus are healthy.
- The browsThey can be raised and anchored in the same operation, evenly or more on the outer side.
- No single mouldSome patients want a very soft forehead. Others prefer to keep some character. Both are valid.
What decides the technique is not what you see from the outside, but what lies behind the bone.
Where the incision goes, and the scar it leaves
There are three ways in, all running from ear to ear. What changes is where the scar sits and what else each one allows. We choose it with you, according to your forehead length, your hair, the brow lift you need and how you feel about a visible scar.
| Approach | Where the scar sits | What it allows |
|---|---|---|
| Hairline | Along the front of the hairline, so more exposed | The only one that brings the hairline forward, up to around 3 cm |
| Coronal | Hidden within the hair | A significant brow lift. It usually raises the hairline by 2 to 5 mm |
| Posterior | Behind the crown, where tension is lowest | A scar that is practically imperceptible in most cases. Less control over the brow lift |
- Hair transplantWith the coronal and posterior approaches, on average around 2,000 follicular units can be taken from the scar area for a hair transplant in the same operation.
- Hair lossIn advanced hair loss, a coronal scar can end up more visible. The posterior area is the least affected by hair loss.
- SleepingWith the posterior approach you rest on the scar in the first days, so we recommend a pillow with cervical support for 3 to 4 days.
We compare the three in detail in our post on forehead feminization approaches.
Before surgery
Everything starts online. In a free video consultation with Dr. Gutiérrez we look at your forehead, your goals and your medical history, and you receive a written quote.
- CT scanIt is what decides the technique. You can have it near home and send it in advance, or we take it in Barcelona the day before surgery.
- TestsA health questionnaire and blood tests, done near you at least 2 weeks before surgery.
- MedicationTell us everything you take. Some medicines, such as blood thinners, and some supplements may need to be paused.
- NicotineNone, in any form, for at least 3 weeks before and after surgery.
- Hair removalLaser or electrolysis in the areas to be operated on stops 3 weeks before surgery.
- Your hairNo need to shave it.
Surgery day and your stay in Barcelona
Plan to arrive in Barcelona at least 2 days before surgery. The day before, the team takes the CT scan if you did not bring one, photos and a 3D facial scan, and Dr. Gutiérrez goes through the operation with you step by step.
On the day, you arrive fasting at IM Clinic Gournay, Barcelona, a private hospital with the latest surgical technology. The operation takes about two hours under general anaesthesia, and you spend one night in hospital. The nursing team explains your care before discharge.
We strongly recommend that someone stays with you during the hospital night and the first two or three days afterwards.
Forehead feminization recovery, week by week
| When | What to expect |
|---|---|
| Surgery day | About two hours under general anaesthesia, then one night in hospital. |
| Days 2 to 4 | Swelling peaks at around 72 hours and then starts to go down. Bruising around the eyes is common. |
| Day 8 | Stitches out and check-up. This is the visit that usually clears you to fly. If you live a short trip away, you can go home on day 3 or 4 and come back for it. |
| Weeks 3 to 4 | Your appearance is normal to others. Dr. Gutiérrez recommends about 3 weeks off work. |
| From week 4 | Intense or structured exercise, for most patients. |
| Up to 12 months | The soft tissue settles onto the new contour. The forehead is one of the areas that settles earliest. |
Day to day, while you recover
- SleepingHead raised, with two pillows or semi-upright, for the first 7 to 10 days.
- Normal lifeWalking, talking and eating are normal from the first day.
- Hair washingFrom 48 hours after surgery, gently, as the team explains at discharge.
- SensationThe scalp behind the incision can feel numb while the nerves recover. Full sensation usually returns at around a year; the scar line itself can take several years.
- SunNo direct sun on the scar for 6 to 12 months. Use a cap or hat as well as sunscreen.
- Call us ifYou notice swelling that keeps increasing, fever, or a discharge from the wound.
Four check-ups are included: at 7 days, 1 month, 3 months and 12 months, in person or by video call. We explain how recovery feels phase by phase in our post on swelling after facial surgery.
Results
The new contour shows as soon as the swelling goes down, and by weeks 3 to 4 you look normal to others. The soft tissue keeps settling for up to 12 months, and the forehead is one of the areas that settles earliest.
The bone that is reshaped and fixed in its new position does not grow back. Your face will still age, as every face does, but the change to the bone stays.
Before deciding, we show you real cases of patients with similar anatomy at the consultation, with each patient's permission, in date order and without retouching.
How much does forehead feminization cost?
One price, stated upfront. The surgical fees are the same for shaving and for setback. If only shaving is needed, the final price is slightly lower, because no fixation material is used.
- Surgery with Dr. Javier Gutiérrez
- CT scan and virtual planning
- General anaesthesia
- Surgical centre: IM Clinic Gournay
- Titanium fixation material
- One night in hospital
- Stitch removal on day 8
- Four check-ups over the first year
| Combined with | Price |
|---|---|
| Forehead feminization on its own | €8,500 |
| Forehead and tracheal shave | €13,000 |
| Forehead, and jaw and chin | €14,500 |
| Three-procedure FFS package, for example forehead, jaw and chin, and tracheal shave | €16,000 |
| Forehead, rhinoplasty and tracheal shave | €20,000 |
| FUS hair transplant in the same operation | + around €6,000 |
The quote you receive after the consultation is final and binding. A 20% deposit reserves your date and fixes the price for six months. We explain what goes into the price in why forehead surgery costs €8,500, and you can compare countries in our guide to FFS costs in Europe.
Travelling to Barcelona for forehead feminization
Most of the preparation happens online, before you travel. Plan about ten days in Barcelona, or two shorter trips if you live close.
Video consultation
Free. CT scan near home if you can, written plan and quote.
Arrival
CT scan if needed, photos, 3D scan and pre-operative consultation.
Surgery
About two hours, then one night in hospital.
Flight home
Stitches out and check-up, then follow-up by video call.
Stays, flights and accommodation for every procedure: travelling to Barcelona for FFS.
Dr. Javier Gutiérrez
Oral and maxillofacial surgeon and founder of ARQÉA. He assesses you, plans the operation on your CT scan, operates on every forehead himself and follows you up. He has operated on more than 1,250 foreheads.
- MD, PhD and Fellow of the European Board of Oral and Maxillofacial Surgery
- Former senior surgeon at Facialteam for 11 years and founder of Facialteam Barcelona (2021 to May 2026)
- Over 17 years of experience, more than 1,050 facial surgeries and more than 3,000 procedures
- Trained at Hospital Universitari Vall d'Hebron, Barcelona
- Barcelona Medical Council, no. 08-43588
Frequently asked questions
What is forehead feminization?
It is surgery that softens the brow bone, the nasal root and the outer rim of the eye socket, and can raise the brows. At ARQÉA it takes about two hours under general anaesthesia, with one night in hospital.
Is brow bone reduction just shaving the bone?
Rarely. The front wall of the frontal sinus is usually about 3 mm thick, so shaving barely changes the contour. In around 95% of cases Dr. Gutiérrez also removes the wall, reshapes it and fixes it back further in. Shaving is enough only when the sinus is solid or very small.
How much does forehead feminization cost in Barcelona?
€8,500 at ARQÉA, with the CT scan, virtual planning, general anaesthesia, the surgical centre and one night in hospital included. With jaw and chin it costs €14,500, and the three-procedure package costs €16,000.
How long does forehead feminization surgery take?
About two hours, under general anaesthesia. It takes longer when other procedures are done in the same operation.
Will the scar be visible?
It depends on the approach. The coronal scar is hidden within the hair and the posterior one, behind the crown, is practically imperceptible in most cases. The hairline approach leaves the scar at the front of the hairline, so it is more exposed.
Can my hairline be lowered at the same time?
Yes, through the hairline approach, the only one that brings the hairline forward, up to around 3 cm. The coronal and posterior approaches do not lower it.
How long do I need to stay in Barcelona?
About ten days: arrive at least 2 days before surgery and fly home after the stitches come out on day 8. If you live a short trip away, you can go home on day 3 or 4 and come back for the removal.
How much time off work will I need?
Dr. Gutiérrez recommends about 3 weeks. If your work is very physical or depends on your appearance, it can take a little longer. Intense exercise usually waits at least 4 weeks.
When will I see the final result?
By weeks 3 to 4 you look normal to others. The soft tissue keeps settling for up to 12 months, and the forehead is one of the areas that settles earliest.
Do I need to be on hormones before forehead surgery?
No. Hormone therapy does not change the bone of the forehead, so it does not need to come first.
Is forehead feminization permanent?
The reshaped bone does not grow back, so the change to the bone stays. Your face will still age, as every face does.
Will my scalp feel numb afterwards?
It is common for the scalp behind the incision to feel numb while the nerves recover. Full sensation usually returns at around a year, and the scar line itself can take several years. We review your own risks at the consultation.
Can I have a hair transplant in the same operation?
With the coronal or posterior approach, a FUS hair transplant can be done in the same operation, using hair from the scar area, for around €6,000. You can also have it near home later, waiting at least 4 months after forehead surgery.
What if my brow is very prominent?
Sometimes the cause is pneumosinus dilatans, a rare and usually benign expansion of the frontal sinus. It is ruled out on the CT scan, and when you want to correct the contour, the forehead and brow ridge are remodelled.
How often is a second operation needed?
Rarely. Over the last six years, each type of complication in Dr. Gutiérrez's cases, such as a haematoma or a reoperation, has stayed below 1%. We go through your own risks at the consultation.
