Q: I am a transgender patient and I am looking for information regarding facial feminization surgery. I am interested in getting some work done. I think I may need full facial feminization surgery.
A: One of the most important transformations that a transgender patient needs to make is in facial appearance. The potential to be seen and accepted socially as a female is of major physical importance. There are numerous facial changes that can be done, most prominently brow reshaping, rhinoplasty, cheek enhancement, and jawline contouring. These are changes in the support structure of the face that can change the gestalt of sexual orientation. Soft tissues changes such as blepharoplasty, canthoplasty, lip augmentation and shaping, and facelifting are complements to structure changes but, in and of themselves, are not primary facial feminization changes. The prominent adam’s apple (thyroid cartilages) is the lone non-facial feature whose reduction makes for a softer more feminine neck profile.
In considering facial feminization surgery (FFS), there is no standard set of procedures that works for everyone. The total face must be taken into consideration and changes selected that will make for the greatest improvement in appearance. Some patients may benefit by only two or three while others may get half a dozen or more. In considering what changes may work, computer imaging can be very helpful. Such imaging is not a guarantee of outcome but a method of communication and education about useful possibilities.
Whatever changes are selected, it is best to do the whole package in a single operation. The recovery may be longer but a one-time commitment for ‘changing face’ is better psychologically.
Dr. Barry Eppley