Transgender Facial Surgery

Also known as FFS – facial feminisation surgery – the procedure aims to transform facial features that are masculine into a more feminine appearance to help match patients’ gender identity. Multiple cosmetic procedures are performed, often at the same time, to help men who are now transgender and want to look more feminine.

Why are these procedures considered by people who are transitioning?

There are a number of reasons why this type of surgery is considered, the main being to create a more feminine appearance from the neck up.

Feeling and looking masculine when transgender can have a significant impact on self-confidence and make patients feel embarrassed and self-conscious all the time. Causing them to avoid social situations and even leading to a depressive state of mind.

This is especially due to the differences between a woman’s and a man’s facial features being very rapidly noticeable.

What are the most common differences in male and female facial anatomy?

• Face Shape and Forehead: Men are known for having bigger faces than women. The male foreheads tend to grow forward and their faces look longer, whilst female faces tend to be more round.
• Facial Hair: Natural growth of facial hair is a distinct difference, which is usually treated with non-surgical methods like lasers.
• Nose and Jaw: are much more dominant features in a man with strong and sharp lines and edges
• Hair Line: Men commonly have a much higher hairline than women, and as they age, it is considerably more noticeable, especially during MPB – male pattern baldness – also known as androgenetic alopecia. Male hairlines tend to have sharper angles while female hairlines have a more rounded and curved appearance.

What options are available in transgender facial surgery?

• Lip surgery, whereby the lips can be lifted and filled.
• Cheek augmentation to enhance the cheeks with the use of implants or fat transfer.
• Nose surgery, also known as a nose job or rhinoplasty.
• Eyebrow uplift
• Cat Eye lift, also known as lateral brow lift, and canthoplasty
• Forehead contouring to reshape the head and change its appearance.
• Jaw / Chin contouring.
• Facelift.
• Blepharoplasty, also known as eyelid surgery.
• Chondrolaryngoplasty, also known as tracheal shave or Adam’s apple reduction to reduce the size of the thyroid cartilage.

What can you expect from the process?

If you are considering transgender facial surgery, the first step is to arrange a consultation with a specialist surgeon who has the knowledge and expertise to perform such surgery to find which one of these procedures is the best one for your needs.

Since it is such a specialist subject, it is important to find out as much as you can about your surgeon to ensure that they have performed these procedures before and have expertise in facial feminisation surgery.

Each case is assessed on a personal level due to the wide spectrum of possibilities in what can be achieved and on what type of face you have.

It is not uncommon for patients to also be in contact with a counsellor during transgender transition, along with taking hormone therapy medication before undergoing surgery. Hormone therapy can also change the way the face and skin appear over a set period of time.

Surgery of such kind is not something to be taken lightly, especially due to the nature of the operation and the multiple surgeries involved. Your consultant will be able to discuss your needs and options with you to ensure you are an ideal candidate for each procedure while explaining to you what outcomes and results can be achieved for you.

How are the procedures performed, and how long does it take?

These types of cosmetic procedures are primarily performed under general anaesthetic so that you are asleep during your procedures. Each procedure takes a different amount of time to perform and can vary from patient to patient due to the differences in appearance of each individual.

How does each one of the procedures feminise the face?

The most common cosmetic surgery procedures performed in transgender facial feminisation surgery are designed to rectify the differences between male/female features, including:

• Eyebrow / forehead surgery to smooth and flatten the bone in the forehead and reduce the brow ridge just above the eyebrows.
• This creates softer facial features commonly associated with a female face Lip uplift and filling to lift the lip to a more feminine position so that the distance between the nose and the top lip is shorter, and to make the lips plump and appear fuller.
• Jaw / Chin contouring to reduce the height and make the chin more rounded, along with reducing how prominent the jaw looks.
• Bone can be shaved so that the jaw and chin appear more feminine and less pointy.
• Tracheal shave to significantly reduce the size of the Adam’s apple, which is a distinct male feature.
• Cheek augmentation to create a forward, fullerlooking set of cheeks with the use of cheek implants or fat transfer.
• Nose jobs and alarplasty to reduce how large and wide the nose is, along with pointing downwards more so that it looks more feminine.

When considering surgery for transgender transformations, it is important to fully understand each procedure that you are undergoing so that an appropriate aftercare plan can be put in place for recovery.

Some cosmetic surgery procedures can take up to 2 months to heal and for the results to be visible; therefore, aftercare is especially important if you are undergoing multiple surgeries at the same time. This will allow you to have the best results possible.