10 Most Common Procedures for Facial Feminization Surgery

Facial feminization surgery (FFS) refers to a host of procedures that contribute to a more feminine-looking face. This surgery serves both cosmetic and reconstructive interests, depending on the patient. FFS as a cosmetic procedure may be used by women who have a broader face, a square jaw, or a receding hairline and large forehead – all staples of male facial anatomy. FFS, therefore, allows women to achieve their ideal facial shape and contours.

FFS is also often a part of the gender reassignment process for transgender women, i.e., women assigned a male gender at birth who want to transition to a female body. Since there are apparent differences between male and female facial structures, FFS is often life-changing for transwomen. It not only changes how the world sees them but also how they see themselves. In these instances, FFS is a reconstructive procedure that helps these women function normally on a daily basis.

Overall, facial feminization surgery is a transformational procedure that significantly boosts self-esteem and lets women feel more comfortable in their bodies.

10 Common Procedures in Facial Feminization Surgery

As mentioned earlier, FFS includes a set of procedures. Some of the most common procedures under this include:

1. Forehead Recontouring
2. Orbital Recontouring
3. Brow Lift
4. Scalp Advancement
5. Rhinoplasty
6. Buccal Fat Removal
7. Cheek Implants
8. Facial Fat Grafting
9. Jawline Contouring
10. Genioplasty

Each face is different. Depending on the individual face requirements and the patient’s priorities, any 1 or more of these procedures may be chosen to constitute FFS for a particular woman.

Let us take you through each of these procedures in-depth to understand precisely how each procedure helps with facial feminization.

Forehead Recontouring in Facial Feminization Surgery

The differences between male and female foreheads are significant. Female foreheads are usually smaller, with a low hairline. The characteristic female face comes from the widow’s peak in the low set hairline, which makes the face heart-shaped instead of square or round. Male foreheads, on the other hand, are usually flat and wide, as opposed to the rounded contours of a feminine face.

Forehead recontouring is a highly specialised procedure that alters the bony architecture of the forehead region. The procedure is specifically tailored for the individual patient depending on one’s exact shape change requirements. But most often, it entails trimming out the prominent bony ridges on the forehead bone to even out the sharp male contours and give a soft rounded shape.

The characteristic protruding bone between the male eyebrows is also removed, shaped, and reattached inwards to reduce the bulge. Often, there is also the shaving of the bone for better, more refined contours. This procedure is usually done alongside a brow lift or other procedures in the upper face for better results. Doing these procedures simultaneously ensures symmetry and a more aesthetically appealing face.

Facial Feminization Surgery: Orbital Recontouring

Orbital recontouring or brow bone contouring refers to contouring the bone under the eyebrows for a more feminine look. One of the main differences between male and female facial anatomy is the brow ridge. This ridge is made of protruding bone between the eyes and is typically present in males. Meanwhile, females have no such ridge and, instead, sport smooth brows.

This procedure is done under general anaesthesia in combination with forehead recontouring. It involves removing the prominent bony brow ridge and making the brows smoother and more feminine. This not only softens the brow bone, but also makes the eyes appear bigger and popped out, which is a feminine aesthetic. Surgeons may also perform this procedure alongside upper eyelid blepharoplasty for more youthful and feminine features.

Brow Lift for Facial Feminization Surgery

A brow lift or forehead lift repositions the underlying muscles and tissue. Through this repositioning, the forehead lifts, the eyebrows are lifted to a high position on the forehead and wrinkles across the forehead are reduced. Apart from imparting a more youthful appearance, this procedure also makes the forehead seem smaller. Since women typically have smaller foreheads than men, this procedure makes faces look more feminine.

The procedure is performed through the same incision and in the same operation as the forehead reduction. It involves taking a strong suture bite through the soft tissues under the eyebrows and suspending them to a point high up on the forehead bone or scalp.

Scalp Advancement: Benefits in Facial Feminization Surgery

Scalp advancement refers to surgically bringing forward the hairline to shorten the apparent size of the forehead. Scalp advancement or hairline lowering is another avenue of forehead reduction apart from forehead and orbital recontouring.

In this procedure, your surgeon removes a carefully planned section of the forehead skin under general anaesthesia. The surgeon takes great care to keep your hair follicles intact when making the incision along the hairline. They then remove the marked section of the forehead skin after separating the skin from the tissue underneath.

The gap is then closed, shortening the forehead. The resulting scar is usually hidden in the hairline, almost invisible once new hair grows.

Including Rhinoplasty in Facial Feminization Surgery

Rhinoplasty or nose surgery is very common today. Both men and women undergo rhinoplasty for various reasons. Men usually have stronger and wider noses, which are more prominent and large but still proportionate to the rest of their face.

Since facial feminization surgery focuses on narrowing the face, rhinoplasty is often an essential part of the procedure. It typically involves making the nose thinner and more pointed. Rhinoplasty can also solve other problems like a dorsal hump or saddle, deviated septum, or a crooked nose. These options ensure a more aesthetic result with a proportionate, balanced face.

The process usually involves removing bone and cartilage and reshaping the nose to make it slimmer and more pointed. At RG Aesthetics, the surgeons use the latest ultrasonic bone technology or piezosurgery for better results. Piezotomes allow for precision that prevents any damage to nearby blood vessels or nerves.

Buccal Fat Removal for Facial Feminization Surgery

Buccal pad fat is the fat stored in your cheeks. Removing it tones your face, emphasises your cheekbones and jawline, and prevents your skin from sagging. Buccal fat removal helps achieve the desirable heart-shaped, feminine face and defined, pointed jawline and cheekbones that many women covet.

For FFS, the procedure is usually done under general anesthesia in combination with other procedures. Using a ½ cm incision in the mucosa in the oral cavity, the surgeon gently teases out the fat from inside the cheeks, making them slimmer. The incision is then closed with absorbable sutures that heal within a few days.

This is a simple and safe 10 – 15 minute procedure that can give a remarkable improvement in the face contour.

Cheek Implants in Facial Feminization Surgery

The square, masculine face often looks flat compared to the rounder, more voluptuous feminine face. A large part of this lies in rounding the cheeks, making them more prominent and having the characteristic high cheekbones that every woman desires. Cheek implants help you achieve this during your facial feminization surgery.

The procedure, done under general anesthesia, involves insertion of pre-fabricated or custom designed implants under both the orbits. This is done through an incision made inside the mouth or under your eyelid.

Recovery usually takes several weeks, but the initial swelling and bruising die down relatively quickly. Implants are used as an alternative to cheek fat grafting for more permanent and predictable results.

Facial Fat Grafting: Role in Facial Feminization Surgery

The cheeks are the primary site for facial fat grafting for facial feminization since this procedure adds a significant amount of volume to them. With this procedure, one can achieve the prominent and high cheekbone look that every woman desires. It is one of the safest and simplest methods of enhancement since the fat is coming from your own body. Therefore, your face is completely compatible with the injected fat cells and does not have an adverse reaction.

The projected cheek appearance contributes greatly to the overall feminine heart shape of the face, in combination with the forehead procedures at the top and jawline narrowing at the top. Performed together, facial fat grafting brings the whole look together and rejuvenates the face.

Jawline Recontouring in Facial Feminization Surgery

As the name suggests, jawline recontouring is a procedure intended to reshape the lower jaw to give a more desirable outline. Male jawlines are strong, sharp, more angular and square in shape. So jawline recontouring for facial feminization involves slimming down the jaw and making it more soft and pointed for women.

The procedure is performed by a maxillofacial surgeon in Delhi under general anaesthesia. It involves shaving down the sharp and angular edges of the lower jaw bone so that the jaw is more V-shaped than square. This process creates a more feminine look that appeals to the patient’s sensibilities.

Jawline contouring is pre-planned on patient face scans to pre-determine the intended jaw profile. The surgery is performed from inside the mouth, leaving no scars on the face. Using advanced piezosurgery technology and 3D simulation surgical planning ensure extreme precision and minimal risk to the vital nerves and teeth in the area, reducing recovery time.

Genioplasty for Facial Feminization Surgery

Genioplasty is a procedure designed to modify the position, shape and size of the chin. This may include bringing it forward, setting it back, decreasing or increasing its height, broadening or narrowing the chin, or centering an asymmetrical chin.
A male chin is generally wider and larger, and a woman may prefer a slightly shorter chin that is relatively pointed. Therefore, a genioplasty performed for facial feminization aims to remove a small portion of the chin bone to reduce its height and width. Maxillofacial surgeons in Delhi often perform genioplasty in combination with jawline contouring to achieve a characteristic V-line jaw.

The genioplasty procedure is quite simple, straightforward and safe. Performed under general anaesthesia, the bony chin is separated from the lower jaw and reattached using plates and screws after shaving off a few millimetres of bone from the middle. The wound is washed and closed with a few stitches, and the entire procedure only takes around 60 minutes. The entire procedure is performed from inside the oral cavity, leaving no stitches or scars on the face.

Modern technology like the piezotome is available at RG Aesthetics for bone cutting. Piezosurgery provides a high level of precision and its ability to cut bone exclusively minimises risk to vital nerves and teeth. The procedure becomes much safer as a result, and recovery is far more comfortable.

Such natural-looking, aesthetic results are only possible under the hand of an expert in facial feminization surgery like Dr Sanchaita Kohli. Dr Kohli’s extensive knowledge in her field and unwavering attention to detail and patient safety ensures that she approaches every patient in RG Aesthetics with compassion and international standards of care. She minimises surgical downtime with access to the latest medical technology and ensures a speedy and comfortable recovery for all her patients!