Facial Feminization Surgery: A Guide for Transgender Women and Non-Binary People

Facial feminization surgery (Facial Feminization Surgery) is a type of gender-affirming surgery that aims to modify the facial features of transgender women and non-binary people who were assigned male at birth (AMAB) to make them more feminine and congruent with their gender identity. Facial Feminization Surgery can help reduce gender dysphoria, improve self-esteem, and increase social acceptance for trans and non-binary people.

In this article, we will explain what Facial Feminization Surgery is, what procedures it involves, what the benefits and risks are, how to prepare for it, and what to expect after it. We will also answer some frequently asked questions about Facial Feminization Surgery.

What is Facial Feminization Surgery?

Facial Feminization Surgery is a term that covers a range of surgical procedures that can alter the shape, size, and position of various facial features, such as the forehead, eyebrows, nose, lips, cheeks, chin, and jaw. The goal of Facial Feminization Surgery is to reduce the masculine characteristics of the face and enhance the feminine ones, creating a more harmonious and balanced appearance.

Facial Feminization Surgery is not a one-size-fits-all surgery. Each person has a unique facial structure and aesthetic goals. Therefore, Facial Feminization Surgery is customized to suit the individual needs and preferences of each patient. Some patients may only need one or two procedures, while others may need several. Some patients may opt for subtle changes, while others may want more dramatic ones.

Facial Feminization Surgery is usually performed by a plastic surgeon who specializes in facial surgery and has experience in working with transgender and non-binary patients. The surgeon will evaluate the patient’s facial anatomy, medical history, psychological status, and expectations. The surgeon will also discuss the possible outcomes, risks, complications, costs, and recovery time of each procedure.

Facial Feminization Surgery can be done under general or local anesthesia, depending on the extent and complexity of the surgery. The duration of Facial Feminization Surgery can vary from a few hours to several hours or even days. The surgery may be done in one session or in multiple stages, depending on the patient’s preference and the surgeon’s recommendation.

What are the common Facial Feminization Surgery procedures?

The following are some of the most common Facial Feminization Surgery procedures that can be performed separately or in combination:

Hairline correction

The hairline is the line where the hair starts on the forehead. AMAB people tend to have a higher and more receded hairline than AFAB (assigned female at birth) people. They also tend to have more prominent corners or “M-shaped” hairlines.

Hairline correction is a procedure that lowers and rounds the hairline to create a more feminine shape. This can be done by either advancing the scalp (moving it forward) or transplanting hair follicles from other parts of the body (such as the back or sides of the head) to fill in the gaps.

Hairline correction can also be combined with forehead recontouring (see below) to achieve a smoother transition between the hairline and the forehead.

Forehead recontouring

The forehead is one of the most noticeable features of the face. AMAB people tend to have a larger and flatter forehead than AFAB people. They also tend to have a bony ridge or bossing above the eyebrows that creates a shadow effect.

Forehead recontouring is a procedure that reshapes the forehead to make it more feminine. This can be done by either reducing or removing the bony ridge (also called brow bossing) or adding volume to the upper part of the forehead (also called forehead augmentation).

Forehead recontouring can also be combined with brow lift (see below) to raise the position of the eyebrows and create a more open and expressive look.

Brow lift

The eyebrows are another important feature of the face. They help convey emotions and expressions. AMAB people tend to have lower and flatter eyebrows than AFAB people. They also tend to have thicker and coarser eyebrow hairs.

Brow lift is a procedure that elevates the eyebrows to create a more feminine arch. This can be done by either cutting or lifting the skin above the eyebrows (also called coronal brow lift) or using small incisions along the hairline or within the eyebrows (also called endoscopic brow lift).

Brow lift can also be combined with eyelid surgery (see below) to enhance the appearance of the eyes.

Eyelid surgery

The eyes are one of the most expressive features of the face. They help communicate emotions and feelings. AMAB people tend to have smaller and deeper-set eyes than AFAB people. They also tend to have more excess skin and fat around the eyes that create a hooded or droopy look.

Eyelid surgery is a procedure that modifies the shape and size of the eyelids to make them more feminine. This can be done by either removing or repositioning excess skin and fat from the upper eyelids (also called upper blepharoplasty) or creating a crease in the upper eyelids (also called double eyelid surgery).

Eyelid surgery can also be done on the lower eyelids to remove or reposition excess skin and fat that create bags or dark circles under the eyes (also called lower blepharoplasty).

Rhinoplasty

The nose is one of the most prominent features of the face. It helps define the character and personality of a person. AMAB people tend to have a larger and wider nose than AFAB people. They also tend to have a more angular and protruding nasal bridge and tip.

Rhinoplasty is a procedure that reshapes the nose to make it more feminine. This can be done by either reducing or increasing the size of the nose, refining or lifting the nasal tip, narrowing or widening the nostrils, or smoothing or straightening the nasal bridge.

Rhinoplasty can also be combined with septoplasty (see below) to correct any breathing problems caused by a deviated nasal septum.

Septoplasty

The nasal septum is the wall of cartilage and bone that divides the nose into two nostrils. Sometimes, the nasal septum can be crooked or deviated, causing breathing difficulties, snoring, or sleep apnea.

Septoplasty is a procedure that straightens the nasal septum to improve the airflow and function of the nose. This can be done by either removing or repositioning parts of the septum that are causing obstruction.

Septoplasty can also be combined with rhinoplasty (see above) to enhance the appearance and shape of the nose.

Cheek augmentation

The cheeks are one of the most attractive features of the face. They help create a youthful and healthy look. AMAB people tend to have flatter and less defined cheeks than AFAB people. They also tend to have more fat in the lower part of the face that creates a square or rectangular shape.

Cheek augmentation is a procedure that adds volume and contour to the cheeks to make them more feminine. This can be done by either inserting implants under the cheekbones (also called malar augmentation) or injecting fillers or fat into the cheek area (also called soft tissue augmentation).

Cheek augmentation can also be combined with buccal fat removal (see below) to reduce the fullness of the lower cheeks and create a more oval or heart-shaped face.

Buccal fat removal

The buccal fat pads are pockets of fat located in the lower part of the cheeks. They help cushion and protect the facial muscles and nerves. However, some people may have too much buccal fat that creates a chubby or round face.

Buccal fat removal is a procedure that reduces the size of the buccal fat pads to make the face more feminine. This can be done by making small incisions inside the mouth and gently removing excess fat with a special instrument.

Buccal fat removal can also be combined with cheek augmentation (see above) to enhance the shape and definition of the cheeks.

Lip augmentation

The lips are one of the most sensual features of the face. They help express emotions and feelings. AMAB people tend to have thinner and less plump lips than AFAB people. They also tend to have less defined lip borders and peaks.

Lip augmentation is a procedure that increases the size and fullness of the lips to make them more feminine. This can be done by either injecting fillers or fat into the lips (also called lip enhancement) or surgically lifting and reshaping the lips (also called lip lift).

Lip augmentation can also be combined with lip reduction (see below) to balance the proportion and harmony of the lips.

Lip reduction

Some people may have naturally large or thick lips that create an unbalanced or disproportionate look. This may be due to genetic factors, ethnic background, or previous lip augmentation procedures.

Lip reduction is a procedure that decreases the size and thickness of the lips to make them more feminine. This can be done by making small incisions along the inside or outside of the lips and removing excess tissue.

Lip reduction can also be combined with lip augmentation (see above) to enhance the shape and contour of the lips.

Chin recontouring

The chin is one of the most defining features of the face. It helps create a strong and confident look. AMAB people tend to have a larger and more prominent chin than AFAB people. They also tend to have a more square or pointed chin shape.

Chin recontouring is a procedure that modifies the shape and size of the chin to make it more feminine. This can be done by either reducing or increasing the projection of the chin, narrowing or widening the chin base, or smoothing or curving the chin contour.

Chin recontouring can also be combined with jaw recontouring (see below) to achieve a more harmonious and balanced facial profile.

Jaw recontouring

The jaw is one of the most masculine features of the face. It helps create a powerful and dominant look. AMAB people tend to have a wider and more angular jaw than AFAB people. They also tend to have a more prominent jaw angle and a more square or rectangular jawline.

Jaw recontouring is a procedure that modifies the shape and size of the jaw to make it more feminine. This can be done by either shaving or cutting the bone of the jaw (also called mandibular reduction) or injecting fillers or fat into the jaw area (also called mandibular augmentation).

Jaw recontouring can also be combined with chin recontouring (see above) to achieve a more harmonious and balanced facial profile.

What are the benefits of Facial Feminization Surgery?

Facial Feminization Surgery can have many benefits for transgender and non-binary people who want to feminize their facial features. Some of the benefits are:

• Facial Feminization Surgery can help reduce gender dysphoria, which is the distress or discomfort caused by the mismatch between one’s gender identity and assigned sex at birth.
• Facial Feminization Surgery can help improve self-esteem, self-confidence, and self-image, which are essential for mental and emotional well-being.
• Facial Feminization Surgery can help increase social acceptance, safety, and comfort, as it can make it easier for trans and non-binary people to pass as their desired gender in public and avoid discrimination, harassment, or violence.
• Facial Feminization Surgery can help enhance personal and professional relationships, as it can make trans and non-binary people feel more comfortable and authentic in expressing themselves and interacting with others.
• Facial Feminization Surgery can help complement hormonal therapy, as it can create a more consistent and natural appearance between the face and the body.

What are the risks of Facial Feminization Surgery?

As with any surgery, Facial Feminization Surgery carries some risks and complications that should be considered before undergoing it. Some of the risks are:

• Facial Feminization Surgery can cause bleeding, infection, swelling, bruising, pain, scarring, or nerve damage that may affect the sensation or movement of the face.
• Facial Feminization Surgery can cause asymmetry, overcorrection, undercorrection, or dissatisfaction with the results that may require revision surgery or additional procedures.
• Facial Feminization Surgery can cause psychological distress, such as depression, anxiety, or regret, if the results do not meet the expectations or preferences of the patient or their loved ones.
• Facial Feminization Surgery can be expensive, as it is not covered by most insurance plans and may require traveling to another country or state to find a qualified surgeon.
• Facial Feminization Surgery can be time-consuming, as it may require multiple consultations, tests, procedures, and follow-ups that may interfere with work, school, or personal obligations.

How to prepare for Facial Feminization Surgery?

Facial Feminization Surgery is a major surgery that requires careful preparation and planning. Some of the steps to prepare for Facial Feminization Surgery are:

• Find a reputable and experienced surgeon who specializes in Facial Feminization Surgery and has a portfolio of before-and-after photos of previous patients. Ask for referrals from other trans or non-binary people who have undergone Facial Feminization Surgery or consult online forums or websites that review surgeons.
• Schedule a consultation with the surgeon to discuss your goals, expectations, preferences, medical history, current medications, allergies, and lifestyle habits. The surgeon will examine your facial anatomy, take measurements and photos, explain the options and outcomes of each procedure, answer your questions and concerns, and provide you with a quote and a treatment plan.
• Do your research on the procedures you are interested in and understand the benefits, risks, complications, costs, and recovery time of each one. Compare different surgeons’ opinions and recommendations and weigh the pros and cons of each option. Make sure you are fully informed and comfortable with your decision and consent.
• Follow the pre-operative instructions given by your surgeon and their team. This may include stopping smoking, drinking alcohol, or taking certain medications or supplements that may interfere with the surgery or anesthesia. This may also include undergoing blood tests, urine tests, or other exams to ensure you are healthy and fit for surgery.
• Arrange for transportation, accommodation, and aftercare for yourself and your companion (if any). You will need someone to drive you to and from the surgery center, stay with you for the first night, and help you with your daily activities for the first few days or weeks. You will also need to book a hotel room or an apartment near the surgery center, as you will need to visit your surgeon regularly for check-ups and dressing changes.
• Pack your essentials for your trip, such as your passport, visa, insurance card, medical records, medications, comfortable clothes, toiletries, entertainment devices, and snacks. You may also want to bring some items that can make your recovery more comfortable, such as ice packs, pillows, blankets, scarves, sunglasses, hats, or masks.

What to expect after Facial Feminization Surgery?

Facial Feminization Surgery is a complex and invasive surgery that requires a long and gradual recovery process. Some of the things to expect after Facial Feminization Surgery are:

• You will wake up in a recovery room with bandages, drains, and tubes attached to your face. You may feel groggy, drowsy, or nauseous from the anesthesia or painkillers. You may also feel some discomfort, tightness, or numbness in your face. Your surgeon or nurse will monitor your vital signs and provide you with instructions and medications to manage your pain and prevent infection.
• You will stay in the hospital or surgery center for one or two nights, depending on the extent and complexity of your surgery. You will need to rest and avoid any strenuous activity or pressure on your face. You will also need to follow a liquid or soft diet and drink plenty of water to stay hydrated.
• You will visit your surgeon regularly for follow-ups and dressing changes. Your surgeon will remove your bandages, drains, and stitches after a few days or weeks, depending on the healing process. Your surgeon will also evaluate your results, address any complications, and advise you on how to care for your scars and wounds.
• You will notice some swelling, bruising, redness, or itching in your face that will gradually subside over time. You may also experience some temporary changes in your facial sensation, expression, or function that will improve as the nerves regenerate. You may also need to wear a compression garment or tape on your face to reduce the swelling and support the healing tissues.
• You will resume your normal activities gradually as you recover. You may need to take some time off work, school, or social events until you feel comfortable and confident with your appearance. You may also need to avoid sun exposure, alcohol consumption, smoking, or vigorous exercise until your surgeon clears you for them. You may also need to use some makeup, hair styling, or accessories to conceal or enhance your results until they settle.
• You will see the final results of your Facial Feminization Surgery after several months or even years, as the swelling subsides, the scars fade, and the tissues settle into their new shape and position. You may be amazed by the transformation of your face and how it reflects your true self. You may also feel more happy, confident, and comfortable in your own skin.

FAQs

Here are some frequently asked questions about Facial Feminization Surgery:

Q: Is Facial Feminization Surgery necessary for transgender or non-binary people?

A: Facial Feminization Surgery is not necessary for transgender or non-binary people who are happy and comfortable with their facial features and do not experience gender dysphoria or social distress because of them. Facial Feminization Surgery is a personal choice that depends on each individual’s goals, preferences, and needs. Some trans or non-binary people may not want or need Facial Feminization Surgery, while others may consider it essential for their well-being and happiness.

Q: How much does Facial Feminization Surgery cost?

A: The cost of Facial Feminization Surgery varies depending on the surgeon, the location, the procedures, the anesthesia, the hospital fees, and other factors. Facial Feminization Surgery can range from a few thousand to tens of thousands of dollars, depending on the extent and complexity of the surgery. Facial Feminization Surgery is usually not covered by most insurance plans, unless it is deemed medically necessary by a mental health professional. Therefore, trans or non-binary people who want to undergo Facial Feminization Surgery may need to save up, fundraise, or seek financial assistance from various sources.

Q: How long does Facial Feminization Surgery take?

A: The duration of Facial Feminization Surgery depends on the number and type of procedures involved. Facial Feminization Surgery can take from a few hours to several hours or even days, depending on the complexity and extent of the surgery. Facial Feminization Surgery may be done in one session or in multiple stages, depending on the patient’s preference and the surgeon’s recommendation.

Q: How painful is Facial Feminization Surgery?

A: The pain level of Facial Feminization Surgery depends on the patient’s pain tolerance and the procedures performed. Facial Feminization Surgery is usually done under general or local anesthesia, which means that the patient will not feel any pain during the surgery. However, after the surgery, the patient may experience some discomfort, tightness, or numbness in their face that can be managed with painkillers and anti-inflammatory drugs prescribed by their surgeon.

Q: How long does it take to recover from Facial Feminization Surgery?

A: The recovery time of Facial Feminization Surgery depends on the patient’s healing ability and the procedures performed. Facial Feminization Surgery can take from a few weeks to several months or even years to fully heal and show the final results. The patient will need to follow their surgeon’s instructions and recommendations carefully to ensure a smooth and successful recovery.