Facial Feminization Surgery

 

Facial Feminization refers to a combination of surgical procedures, which aim to reduce what we call 'masculine facial features' by giving the face a softer and more feminine look. FFS is performed to both the bone and the soft upper tissue that covers the bone.

The procedures that are necessary for the individual depends on what the individual wishes to see, or what points s/he is uncomfortable with.

Facial Feminization Surgery (FFS) is the key for all women with masculine facial features or trans women, helping them feel secure and happy.

 

Why Facial Feminization Surgery?

- To balance the face proportions according to the upper, middle and lower face proportions.

- To eliminate masculine features and create feminine looks by treating facial features including hairline, cheeks, chin as required.

- For feminine facial features and balance of soft tissues.

- For a rejuvenated face.

Procedures of facial feminization surgery include the following:

- Hairline lowering surgery

- Adam's Apple (Tracheal)

- Brow bone reduction

- Brow lift

- Eyelid surgery

- Canthoplasty

- Cheek augmentation

- Nose feminization surgery

- Chin reduction

- Jaw surgery

- Lip lift

- Facelift surgery

 

What are the things that make the face masculine?

There are 6 basic differences between male and female facial features. These differences, which cause the face shape to be more masculine, are eliminated by facial feminization surgery.

 

Men

Men have a wider nose structure. The back may be slightly curved and protruding in the noses of men.

Eyebrows are thicker, straighter and in a closer proximity to the eyes in men.

There is a protrusion called the "brow ridge" on the upper edge of the eye sockets in men.

Men have thinner and longer lips compared to the women. The distance between the lip and the nose is greater compared to the women.

The chin structure of men has a square shape, and it is wider.

Men have Adam's apple.

 

Women

Women have a narrower nose structure. The nasal profile is more concave, the angle between the nose and lips, and the lips in general, are larger compared to the men.

Eyebrows are thinner and curved in women. Curved eyebrows make the distance between the eyes longer, and the eyes look more open.

Women have little or no protrusions on their foreheads.

Women have fuller and larger lips. The distance between the lip and the nose is short.

The jaw structure of women is more rounded, and the jaw lines are not as pronounced as in men.

Women do not have Adam's apple.

 

Forehead reduction (Hairline lowering)

Hairline is a defining feature for gender. Therefore, hairline lowering, also called forehead reduction or contouring, is an important procedure of Facial Feminization Surgery.

It is a procedure performed for balancing the disproportion of the face by narrowing the length of the forehead and creating a feminine forehead.

 

Adam's Apple Reduction (Tracheal Shave)

Tracheal shave, also called Adam's apple reduction or chondrolaryngoplasty, aims to remove Adam's apple. The presence of Adam's apple is an uncomfortable situation for trans women. This is why tracheal shave is one of the most common surgical procedures among trans women. It is usually performed alone or in combination with other procedures of Facial Feminization Surgery.

 

Brow bone (Supraorbital Rim) Shave/Reduction

The main difference between male and female foreheads is that males usually have a bony prominence called the "brow ridge" on the upper edge of their eye sockets. Women's foreheads have little or no protrusion.

The forehead is one of the most obvious markers of gender. With the brow bone shave (also known as forehead shaping) procedure, a masculine forehead can be transformed to fall into the female range.

 

Brow lift

Brow lift surgery is an aesthetic procedure performed to bring the eyebrows back to their old and youthful form by reducing the scars formed in the area due to frown and sagging eyebrows caused by forehead sagging.

 

Eyelid

The sign of the aging face is bags under the eyes with sagging upper eyelid skin.

Eyelid surgery is usually performed for cosmetic reasons; however, if there is excessive sagging on the eyelid, it can also cause problems related to vision.

This surgery, which is also known as blepharoplasty, can be performed simultaneously with Facial Feminization Surgery, or it can be performed separately.

 

Canthoplasty (Almond/Cat Eye)

Canthoplasty is a surgical procedure that aims to create an upward slope in the outer corner of the eyelid or to correct the sagging appearance in this part of the eye. In addition, canthoplasty is performed for cosmetic purposes in order to achieve almond-shaped eyes. It can be included in the Facial Feminization Surgery when necessary, or it can be performed alone.

 

Cheek/Cheekbone Augmentation/Enhancement

Since women tend to have fuller cheeks compared to men, prominent cheekbones are considered signs of beauty and femininity. Therefore, cheekbone augmentation procedures are among the highly popular aesthetic procedures, both as a part of Facial Feminization Surgery and alone.

Cheekbone implant, injections made with the patient's own fat or soft tissue filling are also popular among the procedures that can be performed for enlarging the cheeks.

 

Nose Feminization

Nose is the most prominent feature of the face. Nose feminization is one of the most popular Facial Feminization Surgery procedures, as many trans women believe that nasal correction can result in significant improvements in female facial appearance. Procedures such as narrowing the nose and, if necessary, correcting it from the inside, or reshaping the nasal cartilage are determined according to the requirements of the patient.

In addition to having a nose with feminine features, other benefits of the procedure are that it deflates the eyes, reveals the cheekbones and adds refinement to the general appearance of the face.

 

Mandible Bone Shaving

Along with the forehead, eye area and nose, the most important feature of a feminine face is the delicate line, which is usually determined by the shape of the chin. Mandible bone shaving or reduction is a procedure for patients who wish to have a more delicate and smaller jawline.

Mandible shaving is the reduction of the size and thinning of the jaw and jaw bones on both sides. It is beneficial for patients with a protruding and square chin to achieve feminine smaller and more delicate facial features.

 

Chin Surgery

Chin surgery, which is also known as genioplasty or mentoplasty, is the process of reshaping the chin, either by healing with an implant or by bone shaving surgery.

It can usually be performed in the lower jawline and chin area to improve the proportions of the face, provide a masculine chin appearance, and reinforce self-confidence. This procedure is an option that yields satisfactory results for individuals who wish to improve the facial harmony, and balance of the chin, cheek and forehead.

In addition, the jawbone can be moved forward with this surgery or shaped silicone implants can be used to give more projection to the jaw, if it is believed to be necessary for the patient. In jaws with protruding lines, bone can be removed to eliminate this appearance.

The chin contour is often combined with chin reduction and is considered an important part of Facial Feminization Surgery, as the chin is an important marker of gender. These procedures can range from simple to very complex, depending on the needs of the patient.

 

Lip lift

A lip lift is a simple surgical procedure that can be performed in the clinic with local anesthesia, with the aim of lifting the upper lip. On the other hand, it is performed in the hospital and under general anesthesia when combined with another surgical procedure. It is performed to shorten the distance between the nose and the upper lip, or to increase the prominence of a very thin lip.

 

Facelift

Facelift, which is also known as rhytidectomy, is an aesthetic surgical procedure performed to provide a younger appearance to the face that has sagged and lost its vigorous appearance due to aging. During a facelift, the skin flaps on both sides of the face are retracted and the tissues under the skin are surgically changed in order to return the facial contours to their former youth.

 

How is the recovery process after FFS?

The duration of hospitalization is 2 days as long as the patient does not encounter any complications during the period after the surgery. After the surgery, patients are administered medications against the risk of pain and infection, and follow-ups are performed on the dates specified by the surgeon.

The healing process can take from 2 weeks to 6 weeks, depending on the procedures performed. In the first weeks, you should avoid all kinds of strenuous physical activities. Therefore, it will be beneficial for the patient to have a company to help in daily routines. After the first 10 days, you can start doing the daily work that will not tire you; however, you should avoid tiring sports and exercises for a little longer period.

General conditions you can expect during your recovery include the following:

- Numbness

- Tightness

- Swelling and bruising

- Difficulty in breathing through the nose

- Difficulty in eating

 

Risks of Facial Feminization Surgery?

Serious risks are rare, and the post-operative satisfaction rate is high in facelift procedures.

Yet, all surgical procedures have a certain degree of risk. Some of the possible complications of all surgical procedures include:

 

- Reaction to anesthesia

- Hematoma or seroma (accumulation of blood or fluid under the skin, which requires removal)

- Infection and bleeding

- Changes in skin sensation

- Scarring

- Allergic reactions

- Damage to lower layers

- Unsatisfactory results that may require additional procedures

- Blood clots in the legs or lungs

- Malaise or feeling depressed - there may be a possibility of depression about three weeks after surgery.

 

When can the final result of the procedure be evaluated?

The healing process is different for each patient; however, the bruising usually disappears after two to four weeks. The final result can be visible after an average of 6 months, or it may also take longer than one year. It takes about one year for the scars to heal. Therefore, it may take up to one year (or longer) before you can see the final result.

 

Process

- Following all the instructions given by your surgeon is very important for the healthy progress of your healing process (such as post-operative bandage, drain, incision care, medication/cream use, etc.).

- Your surgeon will advise you about the signs of problems that you need to pay attention to, such as the signs of infection. The recovery period will vary depending on the patient and the scope of your surgical procedure.

- The duration of stay in the hospital is 2 days unless there is a medical necessity.

- After being discharged, you will have post-surgical follow-ups on the days to be determined by the surgeon. Your drains will be removed after the follow-up of your surgeon, or if necessary, the removal may be delayed until the next follow-up.

- Do not take aspirin or any anti-inflammatory drugs two weeks before and two weeks after surgery.

- For the first ten days, it is recommended to sleep with your head elevated at forty degrees. One extra pillow or two pillows can help if necessary.

- Avoid lifting heavy objects for a week. This can cause swelling, or it can trigger bleeding by causing your blood pressure to rise.

- Report excessive bleeding that continues after fifteen to twenty minutes of applying pressure.

- Do not swim, dive or participate in any strenuous activity for at least one month.

- Avoid exposure to direct sunlight, prefer clothes that protect you from sunlight, and use sunscreen.

- You may feel tightness and some pain in your incision area for a few days. This can be relieved with painkillers.

- There may be a feeling of numbness in some areas. This process differs according to each patient, and it will decrease as the recovery period progresses.

- You may need to be accompanied by a relative for a few days as you may feel tired and sensitive due to your surgery.

- Do not drive during the first 10 days.

- Smoking reduces circulation, delays wound healing and significantly increases the likelihood of serious complications; therefore, you should discontinue smoking at least four weeks before and four weeks after your procedure.

- There is a possibility that you may experience an emotional reaction such as depression after the surgery. This is a possible situation.