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The authors present the upper third of the facial feminization techniques in the context of transgender surgery. These techniques adapted to patients "male to female" are proposed to strong masculine facial features of the patients and for the upper third of the face, based on transfer of adipose tissue, fronto-orbital remodeling and correction of the hairline by scalp advance., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

The serrato-costal free flap provides a large costal flap vascularized by a digitation of the serratus anterior muscle supplied by the dorsal thoracic artery. The flap is easy and rapid to raise with low morbidity. The repair obtained is functionally very satisfactory, but does not allow insertion of an implant. Six cases are reported. The indications of this technique of mandibular reconstruction are discussed.