Older Facial Feminization Surgery

Q: Dr. Eppley, I am interested in Facial Feminization surgery. I am 55 years old so I know that adds to the complexity to it. I have attached pictures for your review and recommendations.

A: Thank you for sending your pictures. Your FFS surgery is more challenging to image/predict because you have a major facial aging component to it. (older facial feminization surgery) The need to get rid of loose skin in the upper eyelids and the neck /jawline (upper blepharoplasties and lower facelift) as part of the FFS procedure makes looking at the skeletal changes more difficult. I think they are best illustrated in the side view picture.

FFS is a large number of facial reshaping procedures of which not all apply to every patient. What I look for is those facial procedures which I think would have the greatest impact on feminizing the face. These will be different for each patient. In looking at your pictures, I feel the following would be most beneficial:

1) Brow Bone Reduction/Browlift
2) Rhinoplasty
3) Upper and Lower Lip Advancements
4) Earlobe reductions

I think if you put these four facial reshaping procedures with the previous anti-aging facial procedures mentioned (upper  and lower blepharoplasties and lower facelift) as a combined FFS procedure. These would have the biggest impact on making a positive facial change.

Dr. Barry Eppley
Indianapolis, Indiana