眉骨缺乏陽剛感
後腦勺扁平、歪斜
頭型線條從側面看起來扁塌
｜手術計畫｜
昊昊是一位跨性別的男生(trans man)，他一直都在尋找能幫助他在外貌上，能更符合自我認同的方法，於是他來尋求謝醫師的建議。
男性的眉骨通常較為突出，形成深邃的眼神以及較強烈的輪廓感，並且額頭的線條會向後傾斜。
經過電腦斷層的診斷，謝醫師使用3D列印技術製作植入物，精準增加眉骨突出度，打造出陽剛的深邃眼神，並且改變額頭弧度，使其向後傾斜，謝醫師利用眉骨連接到眉心的設計，更增加了額-眉-鼻的立體度!
另外昊昊還提出，是否能在同一次手術，改善他的扁頭和歪頭，所以謝醫師也一起設計了後腦勺的植入物，讓整顆頭更立體、更對稱。
除了跨性別男性(trans men)外，很多順性別男性(cisgender men)也會因為臉部特徵過於柔和或缺乏陽剛感，用透過臉部男性化手術(facial masculinization surgery, FMS)的方式，讓自己看起來更man，更符合自己的性別表達。
Haohao is a transgender man who has long been seeking ways to make his appearance more aligned with his gender identity.
To that end, he consulted Dr. Hsieh for professional advice. In general, male brow bones are more prominent, contributing to a deeper gaze and stronger facial contours. The forehead also typically slopes backward.
After performing a CT scan, Dr. Hsieh used 3D printing technology to create custom implants, precisely enhancing the projection of Haohao’s brow bones to produce a masculine, deep-set gaze.
The forehead curvature was also modified to tilt backward, and with a design that connects the brow ridge to the glabella (the space between the brows), Dr. Hsieh further enhanced the three-dimensional harmony of the forehead-brow-nose region.
Additionally, Haohao asked whether we could address his flat and asymmetrical back of the head at the same time. Dr. Hsieh then designed and inserted occipital implants to make the overall skull more defined and symmetrical.
Apart from transgender men, many cisgender men with naturally soft facial features or less prominent bone structure also turn to facial masculinization surgery (FMS) to achieve a more masculine appearance that better matches their gender expression.
男性特徵的方大額頭及後移的髮際線
中臉凹陷、下眼眶骨支撐不足
臉有輕度的歪斜，屬於偏長臉、下巴後縮、嘴唇閉合困難
手術計畫
髮際線前移
前額及中臉拉提
3D客製化下眼眶骨重建
3D客製化正顎手術
這是一個高難度的case，而這個挑戰來自於很多面向。
第一個挑戰是，當愛里走進診間時，她說她想詢問臉部女性柔化手術，但當時我對她的第一印象是，她其實已經很漂亮了，我心裡想，我要怎麼讓她更漂亮、更有女人味。
第二個挑戰是，她之前在臉部已經做過了一些手術，可以說在外科學理上是一個重修的case。
第三，愛里本來就是一位高人氣的漂亮網紅，深受大家喜愛，我能讓她變得更漂亮、更受歡迎嗎？
經過電腦斷層的診斷以及非常仔細的溝通，我們還是達到了共識，決定進行一系列的“微調”手術。
首先，從電腦斷層上看的出來，她的臉有輕度的歪斜，並且是屬於偏長臉、下巴後縮臉型，所以導致她有些許嘴唇閉合困難(平時會不自主用力閉唇)。
再來是她很在意她的中臉凹陷，雖然臨床上並不會很明顯，但確實女生的中臉應該比男生要膨潤。
額頭部分有兩大重點，一是外眼角的下垂讓她看起來沒精神，二來是具有男性特徵的方大額頭及後移的髮際線。
我們計畫用一次性的複合式手術來做全臉的調整(柔化)。
正顎手術來縮短臉型、讓臉更對稱以及改善嘴唇的閉合不全，搭配客製化下眼眶骨(蘋果肌)手術打造飽滿的中臉，額頭的部分則是用眼尾提拉、髮際線前移及圓弧化，讓她散發女性的自信美。
雖然手術步驟眾多，但都不是為了大改，目的只是讓跨性別者的臉型基底變得更細緻、柔化。
This is a challenging case, and the challenge comes from many aspects.
The first challenge was that when Allie walked into our office, she wanted to inquire about facial feminization surgery（FFS）.
My first impression of her, however, was that she was already very beautiful. I wondered if I could make her even more feminine.
The second challenge is that she had quite a few previously done facial surgeries, making this technically a revision case from a surgical perspective.
The third challenge is that Allie is already a popular and beautiful influencer loved by many. Can I make her more attractive and more popular?
After CT scan diagnosis and detailed communication, we reached a consensus with a series of "fine-tuning" procedures.
First, the CT scan showed that her face had a slight asymmetry and a relatively long face with a retruded chin, which caused her some difficulty in closing her lips (she unconsciously applied force to close her lips).
Next, she was very concerned about the hollowness of her midface. Although it is not very noticeable clinically, it is true that women usually have plumper midface than men.
There are two main points regarding her forehead: one is the drooping eyes, making her look tired, and the other is the masculine features of a broad forehead and a receding hairline.
We plan to use a all-in-once combined procedures to adjust her entire face: orthognathic surgery to shorten the face, make it more symmetrical, and improve the incomplete closure of her lips, combined with a customized implant of cheek augmentation to create a fuller midface.
For her forehead, we did a forehead lift (more on the tails of the brows), and hairline advancement.
Although these involved multiple procedures, none were made for major changes.
手術成效因人而異，需由專業醫師評估
Results of surgery vary among patients. Please consult your doctor
Before and After Surgery Comparison
髮際線稀疏向後，額頭高
額頭肌膚下垂，眼睛無神
更換額頭植入物
手術計畫 ：
額頭美型手術
髮際線前移手術（額頭縮小手術）
前額拉提手術
雪碧曾經在9年前找謝醫師做過額頭美型手術，隨著時間流逝，她的髮際線逐漸後退，上半臉肌膚也有鬆弛下垂的趨勢，整體額頭顯得又高又方，眼睛也下垂無神。謝明吉醫師為她設計整體的額頭美型手術，新式的客製化額頭植入物，讓額頭形狀更立體飽滿，搭配額頭拉皮手術，使眼神散發精神，最後透過額頭縮小手術（髮際線前移），將髮際線降低約3公分左右，整體臉型更顯精緻、小巧。
手術前後照片對比
案例提供照片
男性化陽剛特徵
額頭扁平
眉骨突出
下顎骨外擴
骨骼生長異常
國字臉型
臉部女性柔化手術
3D客製化下顎骨削骨手術
臉部女性柔化手術是一種複合式的手術。結合多項手術以達成「將陽剛的臉部改變為女性柔順特徵」的效果。建議跨性別族群在接受變性手術前先接受臉部女性柔化手術，從外表開始適應女性的日常生活。謝醫師會依據每一位患者的情況不同，提供不同的治療建議，其中有可能包含額頭整體雕塑（有時會建議搭配髮際線前移手術）、蘋果肌植入手術、顴骨削骨、下顎骨削骨等。
這一個案例的臉部有著陽剛的男性化特徵，包含眉骨突出、額頭扁平以及外擴且方的下顎骨角。透過磨平她的眉骨合併客製化額頭植入物，為她打造飽滿圓弧的額頭。再利用3D客製化削骨導版為她執行下顎骨削骨手術，除了確保兩側削骨的對稱性，且能安全避開神經，讓整體臉型不僅符合女性柔美的特徵，更顯小巧精緻。
術前症狀：
額頭扁平，眉骨突出。
女臉部女性柔化手術
臉部女性柔化手術(FFS)的目標就是希望將男性化的臉龐，透過複合式的手術將臉部變得更加女性化。在謝醫師的治療哲學中，額頭整形手術是使臉部女性化的關鍵項目之一。男性與女性的額頭有非常大的差異。男性的額頭會有突出的眉骨，並且有扁平且向後傾斜的線條。眉骨與鼻子之間形成一個銳利的角度。反觀女性的額頭不僅飽滿眉骨滑順，額頭與鼻子間的夾角也非常平滑。該名患者來找我們進行額頭女性化手術，以改變他較為男性化的臉龐。我們結合眉骨磨平、客製化額頭植入物與髮際線前移等手術。照片中顯示他在手術前與術後６個月的比較圖，可以看出術後渾圓飽滿的小巧額頭讓整體臉型輪廓充滿女人味。
手術說明
術後3個月受邀2018-01-11〈同學！搞什麼鬼〉節目採訪-〈整型大改造 醜小鴨變天鵝〉：
<br>
下顎突出合併中臉凹陷，戽斗臉型。
3D客製化額頭美型手術
3D客製化下巴整形手術
透過3D電腦斷層掃描(CT SCAN)得知患者的上下顎結構與術前咬合情況，於手術時能精準地將患者的上下顎及咬合調整到最適合的位置，大幅縮短手術時間，也縮短了後續所需的恢復期。
手術前後咬合對比
為什麼想要做這個手術呢？為什麼選擇風華？
因為從小就被嘲笑有戽斗，所以想做手術。因為有個姊姊介紹的，然後自己也有上網查過。
術後的恢復過程
現在都還是吃粥為主，但已經可以吃小塊的肉和比較沒那麼硬食物了，線頭也開始在掉了！臉現在也消腫的差不多，可以微笑，臉比較沒那麼僵了！現在還是很勤勞的做張口練習、熱敷和按摩。咬合都正常了，戽斗終於不見了！一開始有鼻塞，持續了3天候就好了，其他都沒什麼不適。但一定要多下床走動多吃流質，這樣才不會跟我一樣被餓醒。千萬不可以擤鼻涕，不然會造成額外腫脹。
恢復紀錄影片
恢復週記
臉部男性化手術 眉骨重建手術 後腦勺植入手術
臉部柔化手術 髮際線前移 前額及中臉拉提 客製化下眼眶骨重建 客製化正顎手術
Hairline advancementsurgery surgery Forehead reduction surgery
Hairline advancement Frontal bossing 3D Custom-Made Reductdion malarplasty 3D Custom-Made Reduction mandibuloplasty Masseter muscle myotomy
額頭美型手術 額頭縮小手術 額頭拉提手術
額頭美型手術 3D客製化下顎骨削骨手術
額頭美型手術 額頭縮小手術
3D Forehead Contouring Surgery 3D Orthognathic Surgery 3D Chin Implant Surgery / Genioplasty
3D Forehead Contouring Surgery 3D Cheekbones Contouring Surgery 3D Orthognathic Surgery 3D Chin Implant Surgery / Genioplasty
Facial Feminization Surgery 3D Forehead Contouring Surgery 3D Orthognathic Surgery
3D Forehead Contouring Surgery 3D Cheekbones Contouring Surgery 3D Lower Jaw / Square Face Contouring Surgery
3D 额头美型 发际线前移 3D脸型雕琢术-苹果肌 3D导航削骨-颧骨雕塑手术 3D导航削骨-下颚骨雕塑手术 3D下巴整形手术
額頭縮小手術
Copyright © 2007-2017
All Written Contents and Pictures Created by Dr. Adrian M. Hsieh and Dr. Scott H. Jiang
Aesthetic Medicine Department Plastic Surgery DepartmentAesthetic Dentistry Department
Results of surgery vary among patients. Please consult your doctor.
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