What you need to know about facial feminization surgery
in New York City, Manhattan, New Jersey, and Flushing

About the facial feminization surgery process

Most often, when we see a face, we can identify it as male or female. Yet, if pressed to explain exactly why, most people would not be able to answer. There is not a specific trait or facial characteristic that differentiates a person’s perceived gender. Instead, there are subtle variations of each facial feature, making it appear more masculine or feminine. The cumulative effect of these factors gives the person’s face a definitively male or female appearance.

In order for facial feminization to be effective, with a beautiful and natural looking result, the surgeon must modify various features, usually involving multiple procedures. The process is highly customized, and different for each patient. Facial feminization procedures usually include some or all of the following:

• Rhinoplasty – Usually called a nose job, the rhinoplasty procedure sculpts the nasal area. The goal is to reshape the nose, creating a more feminine form, while maintaining a size that it in proportion to the rest or the face. Depending on the specific changes needed, it may be performed using incisions inside the nasal cavity with no external scarring. In some cases, an open rhinoplasty technique is needed, which can leave a very fine scar between the nostrils, but it is well disguised and not noticeable.
• Cheek augmentation – Full, nicely rounded cheeks are associated with a female face. This can be accomplished surgically, via fat grafting or implants. However, it is rarely necessary for individuals who are taking synthetic hormones as part of a gender reassignment. The hormones stimulate relocation of some fat on the body and face, usually causing cheeks to fill out.
• Lip surgery – The mouth is one of the most defining facial features in terms of gender perceptions. A masculine face tends to have less curvature to the lips, and greater distance above (between lips and nose) and below (between lips and chin) them. A lip lift procedure can decrease the distance, while adding a feminine upward curl. Lip augmentation may be used to create fuller lips, which are associated with female beauty.
• Forehead contouring – A prominent, angular forehead is a classically masculine feature. Correcting it involves shaving off excess bone and sculpting the brow area. Depending on the thickness of the browbone and the amount of protrusion, different techniques may be used. When surgery is minor, Dr. Kwan will open the area and shave the bone while it remains in place. If surgery is more extensive and there is risk to the sinus cavity, he may temporarily remove the bone, shape it, then replace it at an optimal angle.
• Chin surgery – Known medically as genioplasty, this encompasses both chin reduction and chin augmentation. In some cases, it may involve reduction in some areas and augmentation in others, in order to create a shapely, feminine chin. Chin surgery usually involves shaping the bone, or sometimes cutting and relocating part of it. When appropriate, a chin implant may be used.
• Jaw reduction – The jaw has a significant impact on the shape, proportions, and overall appearance of the face. Like the brow, thick, angular bones give a distinctly masculine appearance. Jaw reduction involves shaving or cutting away a small amount of bone, which reduces the width of the jaw and softens the angles. Also masseter muscle is partially removed and reduced.
• Tracheal shave – Males have prominent thyroid cartilage, which is usually called an Adam’s Apple. Because it is so distinctive and gender-oriented, reduction of this cartilage is an important part of feminization surgery. The tracheal shave reduces the size of the Adam’s Apple, and sculpts it to a feminine appearance.
• Soft tissue surgery – Minor surgeries or non-surgical aesthetic procedures may be included in facial feminization, giving the “finishing touches” to one’s facial transformation. These may include eyelid surgery, dermal fillers, or facial treatments.