Facial Feminization Surgery

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WHAT IS FEMINIZATION SURGERY? Feminization surgery is a set of surgical procedures that are used to change masculine features to feminine features. These surgeries are performed on males who wish to be transgenic and can be referred to as “trans-feminine surgery”. TYPES OF FEMINIZATION SURGERY The different types of feminization surgery include: Voice Feminization Surgery […] Read More

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Facial Feminization Surgery

WHAT IS FEMINIZATION SURGERY? Feminization surgery is a set of surgical procedures that are used to change masculine features to feminine features. These surgeries are performed on males who wish to be transgenic and can be referred to as “trans-feminine surgery”. TYPES OF FEMINIZATION SURGERY The different types of feminization surgery include:
  • Voice Feminization Surgery
Also known as “vocal feminization surgery”, this surgery aims at lightening the voice of the patient by widening the vocal cords and creating a higher pitch and smoother voice tone.
  • Body Feminization Surgery
This surgery aims at changing the bodily features of the patient from masculine to feminine. Months before this is done, the patient is placed on female hormonal medications to increase feminine qualities and medications to reduce the testosterone levels. Body feminization surgery can include genital changes, boob job, butt augmentation, etc.
  • Facial Feminization Surgery
This surgery is performed to change the masculine facial features to that of a female. All these surgeries can be done together to completely change a person’s gender from male to female. Although it should be carried out in series over months. We will be emphasizing facial feminization surgery. WHAT IS FACIAL FEMINIZATION SURGERY? Facial feminization surgery (FFS) is a set of cosmetic surgical procedures that can be performed to give female facial features to a male face.  The cosmetic modification of your facial characteristics involves a change of your masculine features into feminine facial features.  These may include having your hairline removed to create a smaller forehead, having your lips and cheekbones augmented, and/or having your jaw and chin reshaped and resized.  FFS mostly concentrates on bone structure and nose shape. However, soft tissue works such as face-lifts and neck-lifts can be incorporated as well, when necessary. PURPOSE FOR FACIAL FEMINIZATION SURGERY
  • It gives the male personal freedom to choose the gender he wants to be identified with.
  • It grants cisgender women the opportunity to alter their typically male facial features.
  • It also helps transgender women avoid harassment and discrimination from social hostilities.
NON-CANDIDATES FOR FACIAL FEMINIZATION SURGERY Your doctor will discourage facial feminization surgery if you:
  • Are aged 18 years and below.
  • Have unmanaged mental health condition.
  • Are identified with any condition that limits your ability to give your informed consent.
  • Have a noticeable health condition, such as:
RISKS OF FEMINIZATION SURGERY Facial feminization surgery (FFS) poses some risks and complications, including:
  • Pains.
  • Bleeding.
  • Visible scarring.
  • Risk of infections.
  • Facial asymmetry.
  • Facial nerve injury.
  • Damage to nearby facial structures.
  • Unfavorable reaction to anesthesia.
  • Suture rapture along the incision line.
  • Non-satisfaction of your appearance after surgery.
  • Hematoma (swelling of clotted blood within your tissues).
  • Accumulation of fluid beneath the skin (known as a seroma).
Sometimes, another surgery is needed to correct facial asymmetry and improve the outcome. HOW TO CHOOSE AN FFS SURGEON Choosing the right surgeon is the starting point of a successful facial feminization surgery (FFS).  Pursue in-person or Skype discussions with as many surgeons as possible. Ask many questions as possible. Many surgeons make presentations at transgender conferences in major cities.  You can also get information from former patients of the surgeon that interests you via online forums, support groups, or mutual friends. The surgeon must be board-certified and experienced in the procedures you desire. PREPARATION FOR FACIAL FEMINIZATION SURGERY Since a facial feminization surgery might cause irreversible physical changes, surgeons always need a defensive backing against any potential legal fallout in the future.  You must give a documented informed consent, and may be required to a mental health evaluation by a provider with experience and expertise in health transgender health.
  • Mental Health Evaluation
The evaluation might assess:
  • Sexual health concerns.
  • Your gender identity and dysphoria.
  • Mood or other mental health concerns.
  • Protective factors such as social support from peers, friends, and family.
  • The effects of your gender identity at:
    • Work.
    • Home.
    • School.
    • Social environments, including issues related to:
      • Discrimination.
      • Minority stress.
      • Relationship abuse.
  • Risk-taking habits, including:
    • Drug and alcohol usage.
    • Use of non-medical-gradee silicone injections.
    • Unapproved hormone therapy or supplements.
  • Informed Consent
You must give informed consent after a thorough discussion on:
  • Cost.
  • Risks.
  • Benefits.
  • Other alternatives.
  • Potential complications.
  • Procedure irreversibility.
  • Social and legal implications.
 
  • Before The Procedure
  • You’ll meet with your surgeon, who will ask about your ideas about your face and recommend procedures that will most effectively contribute to the feminization of your face since everyone has a unique facial structure.
  • He/she will likely also describe your potential results.
  • He/she may send you for a CT scan, to allow him to give you specific instructions, including guidelines on eating and eating, adjusting current medications, as well as quitting smoking.
  • He/she will give you instructions to follow after your surgery, for better results.
  • To meet the criteria for the surgery, he/she will evaluate your health to rule out or address any medical conditions that might affect or contraindicate treatment. These might include:
  • A review of your immunizations.
  • Age-appropriate and sex-appropriate screenings.
  • Discussing contraception and future fertility.
  • To review your personal and family medical history.
  • Doing a physical exam, including assessing your internal reproductive organs.
  • Identifying and managing:
    • Drug abuse.
    • Tobacco use.
    • Alcohol abuse.
    • HIV and other STIs.
  • Lab tests, to know your:
    • Lipids.
    • Blood sugar.
    • Blood count.
    • Liver enzymes.
    • Electrolyte levels.
PROCEDURE FOR FACIAL FEMINIZATION SURGERY Facial feminization surgery comprises a variety of surgical procedures, performed in combination to produce a powerful and elegant effect. They might include:
  • Forehead Contouring
In men, the bony ridge above the eye sockets tends to be more prominent. In women, the outline of the forehead tends to be higher, smoother, and more vertical.  There may be a rounded protrusion. To make the forehead look more feminine, part of the forehead is cut, removed, reshaped, and put back into place.
  • Eye and Lid Modification (Blepharoplasty)
This cuts away excess tissue, to feminize the upper eyelids.
  • Cheek Augmentation.
Women tend to have characteristic prominent round cheeks in the middle third of their faces.  This feminine appearance can be achieved by cheek augmentation done with implants, or done by fracturing and removing the cheekbones into a different position.  It can also be done by taking fat from another part of the body, such as the belly and thighs, and placing it in the cheeks to alter their size and shape.
  • Lip Lift and Augmentation
The distance between the base of the nose and the border of the upper lip tends to be shorter in females than in men. Masculine faces have longer upper lips.  Lips can be augmented through the use of implants or fillers, or transferring fat from another part of the body and placing it in the lips.
  • Nose Reshaping (Rhinoplasty)
This involves reducing the overall size of the nose and its angles.
  • Chin Width Contouring (Geniopathy)
The chins of males tend to be longer and wider than the females, have a more square base, and project outward more than the female chin.  To shorten and narrow the chin, a horizontal cut is made along the chin bone and a small wedge of bone is removed. After that, the chin bone is reattached.
  • Mandibular Angle Reduction
Typically, male jaws are larger and broader than female jaws. Reduction of the jaw can be done by sculpting or removing outer layers from the lower jaw. 
  • Hairline Lowering
Female hairlines appear to be located lower than male hairlines. An incision is made at the meeting point of the hair-bearing and non-hair-bearing skin. Then the scalp is raised, placed back, and fixed to the bone. The excess forehead is removed.
  • Tracheal Shave
This reduces your thyroid cartilage or ‘Adam’s Apple’. In this procedure, a small incision will be made under your chin, in the shadow of your neck, or in a skin fold to conceal the scar. Then the cartilage will be reduced and reshaped. After the Procedure, After the facial feminization surgery, you may experience the following in your face, mostly the eyes, nose, jaw, and chin:
  • Pain.
  • Swelling.
  • Redness.
You need rest, no over-exertion for at least a month. Moderate exercise can start within 3─6 months. Because of incisions and swellings on your face, chewing and swallowing might become a difficult task.  You may need the services of a nutritionist to make sure you get enough nutrients. A healthy diet plays important role in your quick recovery. Remember to keep up with your doctor’s instructions. Report any serious health challenges to your doctor. Keep strictly to the follow-up appointments. FACIAL FEMINIZATION SURGERY COST FFS hasn’t been covered by health insurance or government healthcare. However, some insurance companies have started the move to cover facial feminization surgery but are restricted to selected surgeons.  Most expenses are at individual cost, and this out-of-pocket cost of facial feminization surgery usually ranges from $20,000─$50,000 and above, depending on the surgeon and how extensive the procedure performed is. CONCLUSION Definite and permanent results might not be possible until up to a year after surgery. Recovering from facial feminization surgery (FFS) is a gradual process.  During this recovery period, continue to talk to your specialist surgeon about the evolution of your facial features and any complications you experience.  FFS is an important aspect of gender transition. Research suggests that these surgeries can add a great deal to the perspectives of transgender people and dramatically improve the quality of life of transgender women.

Symptoms

Can females get facial feminization surgery?

Facial feminization surgery is included most typically in gender confirmation surgeries for transgender persons, including females.

How painful is facial feminization surgery?

Most patients report that the pain after FFS is no worse than a headache or hangover. Painkillers are prescribed to be taken for a few days after the operation, but in many cases, a basic analgesic like paracetamol or acetaminophen is enough to manage discomfort.

What happens after facial feminization surgery?

Swelling and bruising around the eyes are the major after-effects of FFS, usually peaking 2─3 days after surgery. Sometimes, the eyes will be swollen shut but improve after a few days. It can take up to several months or even a year for the swelling to go away completely. 

Is FFS permanent?

Your results may be permanent, but FFS can not stop the natural aging process. As you age, you may need tweaks here and there to maintain feminine looks.

Is FFS safe?

Facial feminization surgery is associated with the risk of bleeding, damage to facial structures, hematoma, infections, swelling, bruising, and pain.

FAQ

Can females get facial feminization surgery?

Facial feminization surgery is included most typically in gender confirmation surgeries for transgender persons, including females.

How painful is facial feminization surgery?

Most patients report that the pain after FFS is no worse than a headache or hangover. Painkillers are prescribed to be taken for a few days after the operation, but in many cases, a basic analgesic like paracetamol or acetaminophen is enough to manage discomfort.

What happens after facial feminization surgery?

Swelling and bruising around the eyes are the major after-effects of FFS, usually peaking 2─3 days after surgery. Sometimes, the eyes will be swollen shut but improve after a few days. It can take up to several months or even a year for the swelling to go away completely. 

Is FFS permanent?

Your results may be permanent, but FFS can not stop the natural aging process. As you age, you may need tweaks here and there to maintain feminine looks.

Is FFS safe?

Facial feminization surgery is associated with the risk of bleeding, damage to facial structures, hematoma, infections, swelling, bruising, and pain.