I recently performed a procedure to feminize the upper face of a male to female transsexual. To obtain the correct exposure, a coronal incision is first made. Then the bony ridge over the eyes is burred down using an electric hand drill. Following this, an arch to the eyebrows is created, as with a standard open browlift. Finally, there was filling in and rounding out of a depression over the ridge with methyl methacrylate. Though most patients do not need the synthetic augmentation, occasionally it is necessary to obtain the optimal, more feminine result.