Learn about the procedures that can change facial features to better match gender identity.
Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. Examples include having the hairline moved to create a smaller forehead, having lips and cheekbones augmented, or having the jaw and chin reshaped and resized. Skin-tightening surgery, such as a face-lift, is another option.
Facial feminization surgery might be done as a step in the process of treating discomfort due to a difference in gender identity and sex assigned at birth (gender dysphoria). The techniques can help transgender women transition physically to their self-affirmed gender.
Many facial features, such as the eyes, jaw and brow, reflect sex differences. While other body parts can be covered or hidden, facial features are readily seen. For some transgender people who have a gender identity that differs from the sex assigned to them at birth, altering these characteristics can be essential in their transition.
Like any other type of major surgery, many types of feminizing surgery pose a risk of bleeding, infection, damage to nearby structures, an imbalance in facial features and an adverse reaction to anesthesia. Other complications might include:
Additional surgery may be needed to correct an imbalance in facial features and improve the final outcome.
Feminizing surgeries are typically deferred until adulthood.
Before facial feminization surgery, you'll meet with your surgeon. Consult a surgeon who is board certified and experienced in the procedures.
Every person has a unique facial structure. Your surgeon will ask you about your own ideas about your face and recommend procedures that will most effectively contribute to the feminization of your face. Your surgeon will also describe your potential results.
To plan your surgery, you might need a CT scan. This will allow your surgeon to obtain detailed anatomical information. Also, your face will be photographed before surgery and at several intervals after your surgery.
The surgeon will refer you for an appointment to discuss your anesthesia. Follow the specific instructions on preparing for your procedures, including guidelines on eating and drinking, adjusting current medications, and quitting smoking. You'll also receive instructions to follow after your surgery to improve your results.
In addition, before you can have certain feminizing surgeries, you'll be required to meet specific criteria. To start, your health will be evaluated to rule out or address any medical conditions that might affect treatment. You'll also need a letter from a mental health provider stating that you meet World Professional Association of Transgender Health (WPATH) standards of care criteria for facial feminization surgery.
Since facial feminization surgery might cause irreversible physical changes, you must give informed consent after thoroughly discussing:
You might also consider talking to others who've had facial feminization surgery before taking this step. They can help you shape your expectations of what can be achieved.
Health insurance might not cover surgical procedures considered cosmetic for the cisgender population — people whose gender identity matches the one they were assigned at birth — even though these procedures are medically necessary to alleviate gender dysphoria.
Facial feminization surgery might include:
Other possible head and neck procedures include:
You might also consider skin-tightening surgery, such as a face-lift or other treatments.
After surgery, expect to experience pain, redness and swelling in your face, most noticeably in your eyes, nose, jaw and chin. Avoid overexertion for one month. You can begin moderate exercise within 3 to 6 months.
Chewing and swallowing might be difficult due to incisions and swelling. Your surgeon might recommend that you work with a nutritionist to make sure you get enough nutrients following surgery. A healthy diet is an important part of your recovery.
Definitive and stable results might not appear until up to a year after facial feminization surgery. During your recovery period, you'll continue to talk to specialists involved in your treatment about the evolution of your facial features and any concerns you might have.