Procedures - Facial Feminization

Facial Feminization refers to an array of procedures designed to create or enhance one’s feminine features. It is commonly undergone by male to female transgender women and biological women aiming to reduce facial features commonly associated with the male gender. All facial feminization procedures are completed under general anesthesia. One could undergo one or more of the following procedures to acquire a more feminine look.

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Forehead Contouring

The shape of the eyebrows and forehead contour are one of the most apparent differences in facial structure between the sexes. Males tend to have a heavy, rounded, prominent lower forehead behind their eyebrows while a female’s forehead typically curves continually outward with less forward projection.

Forehead contouring combines the reduction of the "brow bossing," the reduction of the overall forehead height, and the elevation of the eyebrow with an emphasis on turning a straight eyebrow into a curved elevated feminine brow. Each individual case requires various degrees of bone shaving, forehead height reduction and brow elevation. The incision made to start the procedure can either be placed at the front of the hairline or a few inches behind the hairline.

After undergoing forehead contouring there is soreness, swelling and numbness at the incision site and throughout the face. Pain medication is prescribed to help manage these side effects. Results are generally noticeable immediately post operatively, however, it takes six months to a year to see the full result.

Scalp Advancement/Hairline Reduction

High hairlines and vertically long foreheads are commonly associated with the male gender rather than female. Typically, women with high hairlines or large foreheads use their hair or other methods to contour their look. Scalp advancement surgery aims to create a more feminine hairline, thus reducing the question of one’s gender or attractiveness. This procedure is commonly done with forehead feminization and the brow lift because all three procedures can share the same incision and produce a highly effective outcome for feminization.

The incision is made along the existing hairline and curved upwards to hide inside the hair bearing temple scalp. The partial or entire scalp will be lifted and the underlying fascia can be loosened by surgical intervention. Then the scalp becomes more elastic enabling it to be stretched and advanced to lower the hairline. Stitching and sometimes surgical plate and screws are used to secure the new position of the anterior hairline. The incision is finely stitched so that it heals properly with less to hardly visible scarring. The hair also usually grows through the incision line so it will eventually cover the scar.

Chin Contouring

A prominent chin is another feature that may need to be addressed in the course of facial feminization. The male chin is generally wider and taller than that of a female’s chin. Chin shaving aims to contour the bone so that it appears less prominent, creating a softer, more rounded facial structure.

During this procedure, the doctor works inside of the mouth to reduce visible scarring. The bone shaving and soft tissue re-draping soften the chin creating a more tapered look. In some cases more aggressive bone reduction with cutting a wedge of the chin bone is required. At times, a chin implant can also be applied to balance facial symmetry and produce the desired feminizing effect.

After chin surgery swelling will occur in the face and will eventually subside over time. Gently massaging the swollen areas beneath the chin in using your fingertips in a circular motion is recommended to help reduce swelling. Numbness may occur and can last several days to several months.

Jaw Contouring

The shape of the lower jaw can contribute to determining one’s gender. Males tend to develop a wider, fuller and outwardly bowed lower jaw in comparison to that of a female. Jaw contouring is a beneficial procedure used to soften and reduce prominent structure of the jaw line.

The shape of the lower jaw in a female tends to have a more gradual curve, similar to a "V" line. The concept of this procedure is to contour the jaw line so that it is femininely small, smooth and sloping. Completed under general anesthesia, incisions are made orally along the sulcus between gum and cheek mucosa to access the prominent areas of jaw bone. The marked area of prominent bone is cut with surgical drill and micro-saw, curving down from back to front, to achieve the best rounded contour.

Post-surgery swelling will occur and some bleeding may occur. The inner wounds from the scarring of where the incision was made will heal overtime.

Tracheal Shaving

Tracheal shave, also known as Adam's Apple reduction, is an effective way to eliminate an obvious sign of masculinity. The incision is made in the skin crease above the Adam's Apple and every attempt is made to have a short thin minimally visible scar. There may be some hoarseness for 2-3 days after surgery, and the bruising is minimal.