Pott puffy tumor following upper facial feminization surgery: a case report and literature review

Pott puffy tumor (PPT) is characterized by frontal bone osteomyelitis associated with a subperiosteal abscess, presenting as a localized, firm swelling of the forehead. This report describes the first documented case of PPT in a patient following facial feminization surgery. We present a case involving a 30-year-old transgender female who developed PPT 1 year after undergoing upper third facial feminization surgery, specifically frontal bone reduction osteoplasty and anterior table frontal sinus setback osteoplasty. The patient experienced rapid resolution following operative exploration with thorough irrigation, in conjunction with intravenous antibiotics. Importantly, the aesthetic outcome post-resolution of PPT was satisfactory, with no observed soft tissue distortion or irregularity that compromised the feminizing effect of her previous surgery. This case underscores that such complications can be managed successfully without sacrificing the aesthetic goals of gender-affirming procedures.