Facial feminization surgery improves gender dysphoria in trans women

When it comes to trans women, most, if not all undergo hormone replacement therapy with estrogen and/or progesterone, and many also start taking testosterone-blocking medication. The net effect is a reduction or elimination of facial hair and a softening of the facial features. If any remnants of facial hair remain ater the use of hormone replacement therapy or other medications, some women may even undergo laser hair removal or electrolysis.

However, despite these feminizing changes in the face, there may still be some masculine features that remain, which can be a tremendous source of dysphoria for a lot of transitioning women.

What is facial feminization surgery?

Facial feminization surgery is a combination of procedures – and there are many available – designed to soften the facial features and feminize the face. It is important to note that facial feminization surgery is not a one-size-fits-all approach. A good surgeon will not only assess each patient individually but also ascertain what the patient's goals are.

For example, a certain facial feature that could be considered masculine may be a source of dysphoria for one patient but may not bother another patient. Thus, the patient's preferences and opinions on what causes their dysphoria is the most important contributing factor on which procedures are performed.

What are some of the surgical options for facial feminization surgery?

In general, the surgical techniques for facial feminization surgery consists of hairline lowering, forehead reduction, brow lift, upper and lower blepharoplasty, feminizing rhinoplasty, cheek augmentation, upper lip lift, lip augmentation, chin recontouring, jaw recontouring, facelift, necklift and thyroid cartilage reduction. Vocal feminization surgery performed by a qualified ENT surgeon is another option that can be offered to the patient.

What to expect after facial feminization surgery

Facial feminization surgery can be performed as either an inpatient or outpatient procedure, depending on the number of procedures performed. The majority of patients can expect facial swelling and bruising in the first week after surgery.

Most patients require about four weeks before they are cleared to return to work depending on the work they've had done. There are some physical restrictions that are placed during this initial recovery period, but most trans women are able to exercise without restrictions by eight weeks after their procedure.

Improved confidence and a sense of alignment with one's gender identity

Many trans women experience a significant improvement, if not resolution, of their gender dysphoria almost immediately after surgery. As the healing process transgresses over the first several months, trans women grow accustomed to the new features and appearance of their face.

Having a feminine appearing face allows the patient to identify more closely with their gender identity. Most trans women have improved self-esteem and confidence in their appearance.

Choosing your plastic surgeon

Not all plastic surgeons have experience with performing facial feminization surgery. If you prioritize your safety, good results and quality of care, it's likely you won't choose an inexperienced surgeon.

Ask your board-certified plastic surgeon if they are a member of the World Professional Association for Transgender Health. Members of WPATH are committed to continuing education and advancement of knowledge in the field of transgender health.

Since the appearance of the face after surgery is of the utmost importance in helping to alleviate gender dysphoria, be sure to look at photographs of the plastic surgeon's work. After all, one of the goals of facial feminization surgery is to give you confidence!