Q: Dr. Eppley, I am a 21 year-old transsexual male. (female to male) I have been on hormones for a year and a half and my face has changed in sufficient ways. However, I still lack much masculinity in my facial features, and the bones don’t face drastic changes at my age. I also know that I have a bulbous tip to my nose and a weak chin. I have been considering plastic surgery not only for aesthetic reasons, but for the more masculine appearance I could gain from it. My goal isn’t to correct the flaws in my facial balance as much as it is to “masculinize” it. A strong chin, a strong straighter tipped nose would be my goals. I am wondering if you think you could achieve what I am asking of you. I can send pictures and you could give me your input. I will send them from different angles, completely neutral appearing. Thank you for your help in this matter.
A: As a general statement about facial gender transformation, it is usually easier to make a face appear more masculine than more feminine. This is because augmentation of the facial bones, usually by implants, can produce a more noticeable change than trying to reduce the size of any facial bone. This, of course, depends on the facial bone structure that one has to work with but augmentation by millimeters will always be greater than what bone reduction in millimeters can be achieved.
In making a face more masculine the jawline is always of great importance. Whether it is just chin augmentation or a more complete jawline enhancement including jaw angle implants, one of the defining male features is a strong jawline. While the nose is not as important a male feature as the jawline, a nose and a rhinoplasty that creates a high dorsal line and a well defined tip goes along with a good jawline that makes a very masculine statement in profile. Computer imaging will show how much of a difference these changes can make in the appearance of your face.
Dr. Barry Eppley