Facial feminization surgery: what is it and what are its risks?

Facial feminization is the process of minimizing the harshness or masculinity of some facial features. This can be done in both transgender and cisgender women.

Last update: November 17, 2021

The concept of facial feminization refers to a set of cosmetic surgeries aimed at changing certain features of the face of the person. Of course, the aim is for the result to be as natural and harmonious as possible.

In general, it is more in demand by transgender women in the process of physical transition. However, it is also common in cisgender women, who seek to soften some rather masculine features, such as the square chin or the marked brow ridges.

There are several surgical procedures within facial feminization. They can be carried out simultaneously, combining several interventions. Or you only work on a specific area of ​​the face.

What is facial feminization and why is it done?

With the exception of what happens in some cultures, the face is the part that we show the most to the world. Hence, for many people, having a pleasant or harmonious face is essential.

The female face tends to have finer features compared to that of man. In particular, this is observed in details such as the narrow forehead, the small and profiled nose, the full lips, the oval face or the prominent cheekbones.

But a person may not feel comfortable or at ease with their appearance, considering that their features are more tough. For this, a facial feminization can be done, which consists of a series of surgical interventions for aesthetic purposes.

As far as possible, work is done so that the results correspond both to the bone structure and to the wishes of the person. Therefore, it is intended that the features not only have a feminine appearance, but also be harmonious.

In people whose gender identity differs from the sex they had at birth (gender dysphoria), the surgical process is considered important. It is even necessary to modify some characteristics of the face, especially when the process of physical transition to its self-affirmed gender takes place.



How is the facial feminization procedure?

To achieve the changes It must be based on a personalized and very detailed study of the face, because the bone and facial structure is unique in each person.

In some cases, various techniques are required, including X-rays and computed tomography, as well as photographs. In this order of ideas, the changes sought may be related to the following:

  • Hairline and forehead size.
  • Superciliary arches.
  • Eyelids and eyes.
  • Lips.
  • Cheekbones
  • Jaw and chin.
  • Nose.
Surgery first requires a careful study of the features to establish a projection of the changes.

What surgeries can be performed?

The work of facial feminization can be done jointly or simultaneously, as well as by zones. Among the different surgeries to be performed are the following:

  • Smoothing of the frontal sinus and superciliary arches.
  • Frontoplasty: descent of the hairline.
  • Modification of the jaw angles to accentuate or give the oval shape.
  • Mentoplasty: changes in the chin for thinning or sharpening of the face.
  • Thyroplasty: to stylize the Adam’s apple.
  • Blepharoplasty: to remove bags under the eyes.
  • Lifting upper lip: to give projection, as well as definition and volume on the lips.
  • Cheek augmentation.
  • Rhinoplasty: Although there are different types of nose, in general, the female one is usually finer and pointed. Failing that, rhinomodeling can be done, which is a simpler procedure.
  • Bichectomy: removal of fat bags on the cheeks.
  • Lifting facial: It not only adds smoothness and firmness, but also accentuates the look of a well-groomed complexion.
  • Facial hair removal.


Preparation for facial feminization

As in other surgeries, before performing a facial feminization a series of examinations and medical check-ups must be carried out to rule out any condition. This includes the following:

  • Review of medical history, both personal and family.
  • Complete physical exam.
  • Laboratory tests: lipid profile, blood glucose, blood count, liver enzymes.
  • VDRL serology, HIV and other sexually transmitted diseases.

The patient should inform the team of surgeons if she is under treatment. You may need to stop some medications, such as blood thinners.

In addition, an evaluation by a mental health professional is recommended. It must be determined whether the person is in full use of their powers before signing any consent.

Care after the procedure

Taking into consideration that during facial feminization several interventions can be performed at the same time, a recovery period is required. Therefore, recommendations must be taken into account to help in the process.

Take rest

Recovery times may vary from one patient to another or depending on the type of intervention. Nevertheless, it is recommended that the first 24 hours be of complete rest. Then, you must wait between 1 and 2 weeks to return to work.

Take prescribed medications

Some medications may be prescribed, such as antibiotics, pain relievers and anti-inflammatories, and even corticosteroids. To avoid complications, it is suggested to follow the medical team’s recommendations regarding medication to the letter.

Apply cold if necessary

You may experience a feeling of tightness, warmth, or tightness in the treated areas. In addition to medication for pain and inflammation, local cold can be placed after the first 24 hours after the intervention.

Avoid touching wounds

As it should happen after any surgery, avoid touching the wounds, pull the stitches or scratch the scabs from the scars.

Wounds must remain clean and dry. Cleaning with physiological saline or antiseptic soap is recommended. If the wound bleeds a little during washing, there is no need to worry.

Do not sunbathe

It is recommended do not expose yourself to the sun during the first week after the intervention. Then, in the following months, you should use a cream with protection factor 50 to prevent the appearance of spots on the skin.

All of these procedures are surgeries. Therefore, the same risks and contraindications apply as in similar processes.

For whom is facial feminization not recommended?

This surgery only has to be performed when the person has finished growing and the bones of the face and skull have finished forming. On the other hand, not recommended for uncontrolled mental health conditions, that it is thought that they may affect the possible reactions to the results or that they limit the ability to make decisions.

Other health conditions that discourage facial feminization include bleeding disorders, a history of deep vein thrombosis, heart disease, and kidney disease.

Feminization and self-acceptance

In the end, we all want to feel good about ourselves. Be accepted and feel accepted. And in part this happens to be comfortable with the body that we have and the face that we see in the mirror.

However, in the particular case of facial feminization, we must limit some issues. First, patients do not necessarily have to undergo all interventions. Similarly, these should not always be done at the same time.

It is stated that, for the results to look natural, the operations must be done progressively. In this sense, the evolution after each of the interventions should be observed. The definitive results will not be appreciated until months.

The greatest risk is that the person is not satisfied with what they observe after the process. Therefore, to avoid problems and minimize impacts, in addition to the importance of the patient raising her expectations to the surgeon, the surgeon must also be assertive when communicating the possible expected results.

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