Am I A Good Candidate For Facial Feminization Surgery?
Q: Dr. Eppley, I am sending you some pictures for consideration for facial feminization surgery. (FFS) I am a 25 year-old transgender who wants to really make the change and be accepted for who I really am on the inside. What FFS procedures do you think I need and how successful will the change be in your opinion?
A: In assessing your pictures, I can see where the following procedures would be very help in achieving your goal of softening and feminizing your face and I would place them in the following order of importance:
1) Forehead Augmentation/Brow Reduction/Browlift (the issue here is whether a hairline advancement can be done with any appreciable forehead reduction of vertical skin length from the hairline to the brows) But reducing the brow prominence, getting rid of the brow break and increasing the convexity of the forehead are key elements of your facial appearance change.
2) Jawline/Chin Reshaping/Tapering (reduce jaw angles and square chin in the frontal view) The horizontal chin projection as it is now is perfect for a female as you naturally have a convex facial profile due to your chin position)
Lip Advancements (increase vermilion exposure and cupid’s bow enhancement) While injectable fillers or fat injections could also work on your lips, if you are undergoing surgery for other facial procedures then it makes sense to take this opportunity for a permanent lip enhancement change.
Cheek Augmentation (this is not on your list and may be surprising to you but I actually rate it as more important than the rhinoplasty) The flatness/gaunt appearance of your midface would benefit by some voluminization to create more of an ‘apple cheek’ effect. It not only would look more feminine but also creates a ore healthy appearance as well.
Rhinoplasty Very slight changes to your nose is all that is needed. Some tip narrowing and slight rotation upward would change your already thin nose to a more feminine one.
I think your face is a very good ‘canvas’ to work with to become very feminine and with a few of these changes can become so. Not every patient that undergoes even extensive facial feminization surgery can always become highly feminine in their facial appearance.
Dr. Barry Eppley