Facial Feminization Procedures Explained
Facial Feminization Surgery (FFS) can involve one or more procedures, such as forehead sculpting and contouring, mandible contouring, tracheal shaving, jaw and chin shaving, chin implants, rhinoplasty and cheek augmentation. Trans women can pick and choose which procedures to have based on their personal transition goals and their Surgeon's recommendations.
Brow Lift refers to a surgical procedure that repositions the eyebrows higher, resulting in a more feminine appearance. This is considered one of the most effective procedures to feminize the upper face.
Many FFS Surgeons will also perform Forehead Recontouring and Hairline Correction along with a Brow Lift as this typically produces better results and all three procedures use use the same incision. Learn more »
The male nose tends to longer and wider, consistent with its overall larger size. The nose is more likely to be angled downwards. A female nose tends to be narrower, shorter, directed upwards, and slightly concave.
The shape of the nose is altered by changing the underlying bone and cartilage. Lateral and medial tissue can be removed from inside the nose to make it narrower. A bump can be smoothed out if desired. Also, the tip of the nose can be raised and reduced. Often done in conjunction with forehead recontouring.
The male chin tends to be wide, flat and square. The distance between the end of the chin and the lower lip is increased. Females have smaller chins that project forward slightly.
An incision is made through the chin to make a wedge of bone. This wedge can be advanced or retracted, or removed, to change the shape of the chin. Also, a chin implant may be used to give the desired forward projection of the chin.
Females more often have full, round cheeks. Cheek implants or bone filler can be used to give the cheeks the desirable full, round appearance.
Lip Lift and Reshaping
To feminize the lips, an incision is made under the nose and part of the skin is removed; the remaining skin is resutured to the base of the nose, pulling the top lip up and shortening the distance between the top lip and nose. Lips can also be made to look more full.
The male forehead, in addition to being overall larger, has thick bony ridges over the eyes known as "brow bossing" (more prominent orbital rims) and may slope foreward; the female forehead is flatter and convex in all planes.
Using either a separate incision, or the incision made for a scalp advance, the skin from the forehead can be turned downward to reveal the bones underneath. For some patients, it may be adequate to shave down the orbital rims to a flat, smooth contour. Other patients may require forehead reconstruction for optimal results. In this case, the bones overlying the frontal sinuses are removed, reshaped, and replaced using surgical-grade screws. Often done in conjunction with Rhinoplasty and/or Hairline Correction.
Males have more prominent thyroid cartilage. In a Tracheal Shave, the thyroid cartilage ("Adam's apple") is shaved down to a more feminine size. The procedure is typically done on an outpatient basis with local anesthetic. Risks include removing too much cartilage and affecting the vocal chords, which may permanently affect the voice.
The male jaw tends to be wider and larger, as does the overlying masseter muscle. The angle of the mandible forms a right angle, whereas in females the angle curves much more gently, approaching a straight line.
The angle of the jaw is cut or filed down to achieve a feminine contour and the jaw may be narrowed as well.
In males, the hairline tends to be higher on the face and imparts the forehead with a box shape; in females, the hairline tends to be lower on the face and imparts the forehead with a semicircular shape.
This procedure is relatively straightforeward. An incision is made along the hairline. A section of skin is removed from the forehead, and the scalp is literally pulled down to its new position and stapled to the rest of the forehead. At the same time, the brows can be elevated to a higher position. Often done in conjunction with Forehead Recontouring and/or Rhinoplasty.
Additional FFS Procedures
- Blepharoplasty: "Eyelid Lift"
- Otoplasty: Reshaping of the ear
- Rhytidectomy: "Face Lift"
- Temporal fossa augmentation: Filling in the temples; improves facial contour.