Facial Feminization

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Facial Feminization Basics

When we meet individuals in our everyday lives, faces are regularly what we notice first. Naturally, everyone wants their face to accurately represent their identity. When a transgender individual feels that their actual self isn't in congruity with what the world sees from an external perspective, it can cause unnecessary pain. While there is no standard template of what a female face "looks like,” Dr. Stiller can assist you in identifying some common differences of masculine and feminine facial features. During your consultation, Dr. Stiller will help identify what triggers your gender dysphoria and help make your ideas a reality. There are many facial feminization procedures he offers, such as brow lift, brow shave, rhinoplasty, tracheal shave, chin augmentation, cheek augmentation, lip lift, lip augmentation, and buccal fat pad removal.

Brow

Brow Shave

A brow shave involves the reduction of the frontal sinus wall to create a feminine-looking forehead. Most commonly, males tend to have a prominent brow bone that is flat or may even slope backwards. With the removal of bone in this area, it can give a rounded, smooth, and more vertical forehead that is more consistent with female facial features. This done through a coronal incision along the hairline that is easily hidden within the hairline. Most commonly, patients will combine a brow shave with a brow lift or hairline advancement as they are performed through the same incision. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

Brow Lift with Hairline Advancement

A brow lift involves the lifting of both eyebrows to sit above the brow bone, as this is a more typical position for the feminization of the face. Most commonly, patients desire a hairline advancement with their brow lift. The desire for a hairline advancement is due to the fact that a masculine forehead is higher and is typically shaped like an “M.” A feminine forehead is lower and is shaped like an inverted, oval “U.” With advancing the hairline, this can give patients a more feminine look to the face along with their brow lift making it a great combination. Most commonly, these two procedures are done through the coronal incision along the hairline. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

Rhinoplasty

Rhinoplasty involves reshaping of the nose and is one of the most popular facial feminization procedures as having a smaller, more delicate nose can give a softer appearance to the face.  Most commonly, noses that develop under testosterone are longer, wider, more prominent and have a down-pointed tip. Attempting to alter these features to a more feminine appearance can make you feel more confident and congruent with how you feel on the inside. The procedure involves an incision made inside the nose to avoid visible scarring. Cartilage may be removed, or tissue can be added to achieve the correct shape you are looking for. Dr. Stiller can reshape the nose to become smaller, change the angle of the nose, remove bumps, indentations, or other unwanted defects. After surgery, a splint is placed outside of the nose to assist with recovery for 1 week. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

Tracheal Shave

Tracheal shaving is a shaving of the Adam’s Apple to achieve a more feminine neck. It is not always present in every male and can even be present in some adult natal females. Nevertheless, a noticeable Adam's Apple can demonstrate a more masculine appearance which can be triggering for many transgender women. The procedure involves making a small incision, no more than 2 inches, and removing excess cartilage. This creates a smoother neckline in a profile view or when extending the neck. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

Chin and Cheek Augmentation

Chin Augmentation

More commonly, feminine attributes of the lower portion of the face involve a slimmer jaw line and rounded chin that give a "heart-shaped" appearance to the face. Dr. Stiller performs two different types of chin augmentation to create a more feminine look for patients which include an implant or chin shave. If needed, a silicone implant can be placed in the chin to create a more oval or softer shape of the face. This can also be beneficial to patients who have a receded chin, balancing the proportions of the face.

If you struggle more with a more masculine chin, most commonly a square or wide chin, you may be a great candidate for a chin shave. This involves Dr. Stiller removing portions of the bone to help achieve a more feminine shape to the chin. Both procedures are done through a small incision under the chin, no more than 2 inches in length. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

Cheek Augmentation

For many cisgender females, cheek bones are higher, fuller and more prominent than that of cisgender males. With the help of cheek augmentation, fillers, fat transfer or implants, can help to enhance the cheeks and add volume to give a more heart shaped appearance to the face. There are multiple types of fillers that can be placed in the cheeks however these are more temporary, usually lasting 9-12 months, as your body begins to absorb the hyaluronic acid. This option is less permanent than others however is a great option for individuals who do not desire surgery. Fat transfer involves liposuction of another area of the body and redistributing the fat to your cheeks and temples. This is a longer lasting option than fillers however, there is the possibility of fluctuation if you fluctuate in weight. Cheek implants are a great option for patients who desire a more permanent option. This is most commonly done through an external incision near the eye. During your consultation with Dr. Stiller, your goals will be discussed to decide what option is best for you. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

Lip Lift and Lip Augmentation

Most commonly, patients assigned male at birth have more thin, flat lips as well as an increased length between the upper lip and nose compared to those assigned female. With lifting the upper lip and decreasing the length between the lip and nose, a much more feminine and softer look to the face is achieved. Lip lifts are performed with one incision under the nostrils that hides very nicely and eventually fades to a thin white line. Most commonly, patients will opt for lip filler after their lip lift. This helps to not only enhance the bottom lip as well but create structure and a more defined cupid's bow. Combining both a lip lift and filler helps give your lips the luscious, kissable look you desire. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

Buccal fat pad removal

Removal of the buccal fat pads are a great option for transgender women who desire a more slender appearance to the face both enhancing your cheek bones and jawline. Buccal fat pads are found in the mid-cheek area and depending on the individual can appear more prominent giving you a fuller face look. The procedure is quick and easy, leaving you with small incision on the inside of your cheek. You will be provided with detailed post-operative instructions upon completion of your procedure. If at any time you should have any questions or concerns after surgery, please contact our practice immediately.

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