Facial Feminization (FFS)

An Overview of Facial Feminization Surgery (FFS)

Facial feminization Surgery (FFS) is one of the aesthetic procedures that, for many male to female transformation (MTF) patients, complete the process of leaving a man’s body behind and embracing the feminine identity with which they identify. While not every patient goes through the same set of procedures when it comes to facial feminization, the overall goal is to change facial features that are typical for a man and make them resemble, in size and shape, facial features that are typical to a woman.

Some of the procedures that can make up a facial feminization surgery (FFS) protocol include cheek implantation, lip augmentation, rhinoplasty and brow lift. Faces have characteristics that make it easy to tell a female face from a male one. Generally, a woman’s chin has more of a point, while the nose is not as prominent. The nasal tip on a woman is not as angular. Men and women have differences in the middle of the forehead and the area around the eyebrows. The skull shape differences also influence the contour and draping of a person’s skin, and so in some cases changing the skull shape is necessary.

Many trans women (patients transitioning from male to female – MTF) find facial feminization surgery (FFS) necessary for their gender dysphoria, which refers to identification with the opposite gender of one’s body. Because people spend so much time looking at their faces — and because the face is often the first thing that other people see of us — facial feminization surgery (FFS) can be the most important part of gender reassignment surgery (GRS), depending on the individual patient, particularly when it comes to eliminating gender dysphoria, as well as integrating trans women into society as feminine individuals. Research studies have concluded that trans women who go through facial feminization surgery (FFS) have a significantly better quality of life with regard to mental health than those who do not.

There are several different procedures that make up a potential FFS protocol. The first is hairline correction, as men often have a higher hairline than women, and the hairline frequently recedes to form corners over the temples creating the shape of an “M.” A scalp advance moves the hairline forward, and hair transplantation can also move the hairline.

Another FFS procedure is forehead recontouring. Men have a bone ridge going horizontally across the forehead, just beneath the level of the eyebrows, while women have a flatter, smoother forehead at that point. This procedure involves grinding down the supraorbital rims, which are the outer parts of the eyebrow ridge where the eyebrows rest. In cases where the rims are too thin for grinding, some surgeons use bone cement to build up the surrounding area to make a flatter appearance, while others take apart the glabella bone, thin it and put it back in with a more feminine position.

Because men often have lower eyebrows than women, a lift makes the eyebrows rest in a more feminine spot on the face. Because women often have thinner and smaller noses than men — and the base of a woman’s nose tends to point at least somewhat upwards when compared to men’s noses, rhinoplasty procedures can easily make a biological man’s nose look more feminine. Women’s cheekbones often project forward more noticeably than men, and so facial feminization surgery (FFS) often involves cheek implants to create a more feminine look, either through the use of silicone implants, bone cement or fat from other areas of the body.

Chin and jaw contouring and a tracheal shave are also procedures that can feminize a biologically male face. The tracheal shave grinds away the “Adam’s apple” look in the throat. Jaw contouring shortens and thins the jaw to make it look more like a woman’s, and chin contouring rounds and shortens the shape to take away the masculine scale.

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