American Society of Plastic Surgeons
For Medical Professionals

Facial feminization for cisgender women with masculine-looking faces

facial feminization

Facial feminization is a defined set of plastic and craniofacial surgical procedures that work to reshape masculine facial features to make them appear more feminine. Most typically, these procedures are included in gender confirmation surgery for transgender individuals. However, the same procedures may also help cisgender women (female assigned female at birth) with masculine-looking faces who want to appear more feminine.

Are you an ideal candidate for facial feminization?

You may be an ideal candidate for facial feminization if you feel that your face is too masculine-looking. The most common complaints heard from women who are ideal candidates for this type of surgery are:

  • My forehead is too high or too "bold"
  • My brow sticks out too far; it's too prominent or "heavy"
  • My eyes look "dark" or "deeply set"
  • My jawline and chin is too wide, too angular or too sharp

Which surgical procedures are typically included in facial feminization?

It all depends on your existing facial features and the area of your face that you may consider being too masculine. After an in-depth consultation, your surgeon may recommend a combination of both plastic and craniofacial procedures, or just a single procedure, to make your face look more feminine. Common feminization procedures include:

  • Forehead reduction and contouring
  • Scalp advancement
  • Brow lift (browplasty) or temple lift
  • Rhinoplasty (nose surgery)
  • Lip reshaping (upper lip lift, lip filling, corners-of-mouth lift)
  • Cheek enhancement
  • Chin recontouring (genioplasty)
  • "Asian" V-Line surgery (suitable for all ethnicities)
  • Jaw contouring and tapering
  • Adam's apple reduction
  • Earlobe reduction

What happens during facial feminization? How is the surgery performed?

Facial feminization surgery is most commonly undertaken in one "long format" surgical session with the surgeon performing sets of procedures depending on the surgical site: upper-, mid- or lower-face.

For example, if your surgeon is reducing a heavy brow and overly prominent forehead, he may also need to perform a rhinoplasty (nasal surgery) because the forehead and the nose are inextricably linked; physically and aesthetically. So if you change the shape of any significant feature, such as your forehead and brow, you will most probably need to change the profile of your nose to keep your face in aesthetic harmony and balance.

Depending on the number of feminization procedures you may need, you will be in the operating room for 3-10 hours. This type of long format surgery is made safer by the use of a very light general anesthesia--limiting the body's exposure to narcotics and other anesthetic agents which also improves the recovery process.

You may also choose to have your surgery broken up into two phases: an "upper" and "lower face" phase. These phases may be performed a few days, weeks, or even years apart. But most patients choose to have all of their feminization procedures completed during one session to save on downtime and expense.

How much will facial feminization surgery typically cost?

The cost for facial feminization will vary depending on several factors:

  • Existing features - the degree of "masculinity" in your facial features that you're seeking to be feminized
  • The number of procedures required to achieve your ideal result
  • If you choose to have everything done at once or broken up into two sessions
  • Any pre-existing health conditions that may affect the surgery
  • Hospital-specific fees

As these factors vary widely from person to person, it is almost impossible to predict the cost of feminization surgery until your initial surgical consultation.

Will there be any scarring after facial feminization?

Most of the facial feminization procedures described above should result in minimal visible scarring. A skilled and board-certified surgeon will ensure that any scarring is carefully hidden, for example inside the hairline, behind the ears, or inside the nose or the mouth.

How long is the recovery period?

Most feminization patients spend the night after their surgery in hospital but usually recover well enough to head home the next day. During the first few days you may experience facial swelling and also mild discomfort. Within about seven days after your surgery, most of the swelling and bruising will resolve. After about three to four weeks you should have a full recovery and be able to resume your usual activities and wear makeup.

What kind of results should you expect?

The results of your feminization surgery will continue to improve over the following months, with the final optimal result being evident at six-to-twelve months. Ideally, if your surgery is performed by a board-certified surgeon trained in plastic, craniofacial, and maxillofacial surgery, your face will appear as a more feminine version of you, but you should still look like "you."

Why choose a plastic surgeon with craniomaxillofacial training for your feminization surgery?

Only a small number of plastic surgeons are capable of performing facial feminization. For a successful and long-lasting result, bone work on the facial skeleton needs to be performed by a highly-skilled surgeon with craniofacial and maxillofacial surgery background. Surgeons who are cross-trained in general plastic surgery AND craniofacial surgery possess the advanced skill set to successfully perform facial feminization. Ultimately, your surgeon should not only possess the technical abilities to feminize your face but also an in-depth understanding of what constitutes a 'female face' and the eye of an artist to enhance your natural, inherent feminine beauty.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.


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