Facial Feminization Surgery

Facial Feminization Surgery (FFS): Transforming Masculine Features to Feminine

Facial feminization surgery (FFS) is a comprehensive set of procedures designed to transform traditionally masculine facial features into more feminine ones. Testosterone exposure often results in characteristics such as frontal bossing, lower eyebrows (at the orbital rim), a prominent frontal nasal angle (the transition between the forehead and nose), a larger nose, flatter and wider cheeks, and a square jawline. FFS addresses these features to create a softer, more feminine appearance.

Who is a Good Candidate for FFS?

The ideal candidates for FFS are healthy individuals with realistic expectations. The World Professional Association for Transgender Health (WPATH) provides guidelines to ensure patients are medically optimized before surgery. This includes:

• Pre-operative evaluation and counseling by a psychologist or psychiatrist.

• Medical clearance from a primary care physician.

• A CT scan of the face for detailed surgical planning.

How is FFS Performed?

FFS is meticulously planned using virtual surgical techniques. CT images of the patient’s skull are overlaid with a female reference skull to guide proportional reductions. Common procedures include:

• Forehead Reduction: Contouring or reshaping the forehead to reduce frontal bossing.

• Orbital Rim Reduction: Softening the brow bone for a more feminine appearance.

• Mandible Reduction: Refining the jawline for a narrower, softer look.

• Feminizing Rhinoplasty: Reshaping the nose to achieve a more delicate profile.

• Fat Transfer: Restoring volume to areas like the cheeks, temples, and lips for a youthful, feminine contour.

Skeletal modifications are performed using pre-cut templates from virtual planning, ensuring precision and consistent results.

Recovery After FFS

Recovery varies depending on the number of procedures performed. Here’s what to expect:

• Swelling and Bruising: Significant swelling and some bruising are normal.

• Hospital Stay: An overnight stay may be required for extensive procedures.

• Downtime: Most patients need 1-2 weeks of recovery before resuming normal activities.

• Pain Management: Discomfort is manageable with prescribed pain relief.

• Suture Removal: Sutures are typically removed one week after surgery.

Forehead and Hairline Reduction in FFS

Forehead and hairline reduction are almost always part of FFS. Dr. Outerhoust, a pioneer in facial feminization surgery, classified forehead shapes into four types:

1. Type I: Minimal or no frontal sinus. Contouring is achieved by shaving the bone.

2. Type II: Protruding frontal sinus with a normal frontal nasal angle. Contour improvement involves augmentation above the protrusion using implants or bone cement.

3. Type III: Over-projected frontal sinus with a sharp frontal nasal angle. This requires anterior wall osteotomy (removing and reshaping the sinus wall) and shaving down the frontal nasal angle.

4. Type IV: Small, under-projected forehead. Augmentation of the entire forehead with implants or bone cement is needed.

The majority of patients fall into the Type III category, and virtual surgical planning ensures precise and safe reductions.

Hairline Reduction: This involves releasing the posterior scalp and advancing it forward to shorten the forehead and reduce temporal recesses, creating a more feminine hairline.

Common Procedures in FFS

Facial feminization often requires a combination of procedures tailored to each patient’s needs. The most commonly performed surgeries include:

• Fat Transfer: Adds volume to areas like the cheeks, temples, and lips for a softer look.

• Forehead and Hairline Reduction: Essential for creating a feminine upper face.

• Rhinoplasty: Refines the nose for a delicate, balanced profile.

• Jawline and Chin Reduction: Frequently performed to narrow and soften the lower face, though not always necessary.

Facial feminization surgery is a transformative journey, combining advanced surgical techniques with personalized care to help you achieve your goals. With virtual planning and precise execution, FFS delivers natural, harmonious results that enhance confidence and self-expression.

If you’re ready to explore your options, consult with Dr. Han Hoang, a board-certified, UCLA-trained craniofacial surgeon, to create a customized plan tailored to your unique needs.

​​​​​​​ 📞 Call us at 714-584-3507
 📧 Email us at hanhoangmd@gmail.com