Facial feminizing surgeries (FFS) are cosmetic procedures that aim to reshape a person’s facial features to create the appearance of what people would typically see as “feminine”.

These surgeries may involve procedures to change the hairline, nose, jaw, and Adam’s apple.

For people who experience gender dysphoria, FFS can be a key part of their gender-affirming care plan. These procedures may eliminate feelings of dysphoria and allow them to present in a way that feels more in line with who they are.

This article will look at what FFS involves, the reasons why a person may choose to have surgery, and the associated benefits and risks.

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FFS is a range of procedures that aim to create facial features that society typically sees as more feminine. A plastic surgeon who specializes in face and neck surgeries, as well as possibly specializing in gender-affirming care, will perform them.

Some common FFS procedures include:

  • Hairline and forehead contouring: This involves reshaping the hairline to an oval shape, rather than square or “M” shaped, as well as reducing the size of the forehead. The surgeon may also reshape the forehead by shaving down bone and replacing it with a smoother bone graft.
  • Brow lift and eyelid lift: These procedures aim to give a softer appearance to the brow and open up the eyes by reducing excess tissue in the upper and lower eyelid areas.
  • Rhinoplasty: This procedure aims to reshape the nose. A surgeon will do this by manipulating bone and cartilage in the area.
  • Cheek augmentation: This procedure involves a surgeon inserting either implants or fat from somewhere else in the body to reshape the size and angle of the cheeks.
  • Jaw shave and chin reduction: These procedures involve the surgeon shaving down bone in the jaw area and chin to create a softer and more “V” shaped jawline, giving the face a generally more oval shape.
  • Neck lift: Some people who undergo chin reduction may also receive a neck lift to tighten the skin in the neck.
  • Adam’s apple shave: This procedure involves the surgeon shaving down the cartilage of the Adam’s apple to give it a smoother appearance.

Some people may also choose nonsurgical procedures such as injectables, fillers, and laser hair removal.

FFS can help a person who wishes to have more feminine facial features achieve that goal. For people who experience gender dysphoria, FFS can be a key step in their gender-affirming care.

Gender dysphoria is a condition that describes the discomfort a person feels when their sex assigned at birth does not align with their gender identity.

For people who feel their innate sense of gender is more feminine, FFS can help alleviate feelings of dysphoria. It allows them to present in a way that feels more in line with who they are.

For those in the transgender community or those who experience gender dysphoria, these procedures can both impact their appearance and mental health. They can reduce the discomfort of experiencing dysphoria on a daily basis and allow a person to present more in line with their identity.

A 2023 review found that facial feminizing procedures play a key role in alleviating gender dysphoria. Transgender individuals who had the procedures reported improvements in their quality of life.

Similarly, a 2021 paper investigated the effects that gender-affirming surgeries can have on transgender participants. It found that they had an association with lower levels of severe psychological distress and reduced suicidal ideation.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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As with most surgeries, FFS comes with associated risks. A healthcare professional can help a person weigh the risks and benefits of surgery.

Some possible side effects and complications include:

  • bleeding
  • infection
  • scarring
  • prolonged swelling
  • hair loss around the incision for hairline and forehead contouring
  • numbness
  • anesthetics-related risks

Before FFS, a person will have a consultation with a surgeon to discuss topics such as their transition process (if applicable), their goals for surgeries, and their medical history.

The surgeon will thoroughly examine the area. They will measure certain features, asses the skin quality, and possibly perform X-ray imaging and CT scans to fully capture a person’s facial structure. This can take several hours depending on the individual and how many procedures they are having.

After surgery, a person will typically have bandages and gauze on areas of their face, as well as a support garment that will help minimize swelling. The surgeon may also place a small tube under the skin to act as a drain for blood and fluid buildup.

They will give specific instructions on how to care for surgical sites after surgery. At a later date, they will remove the drains, dressings, and bandages.

After FFS, a person will experience pain and discomfort that will gradually improve as they recover.

Swelling and bruising can take several weeks to resolve. The final results may not be fully appreciable for several months to a year.

During their consultation with their surgeon before surgery, a person may wish to ask questions involving:

  • their expected recovery time
  • possible complications and steps to take
  • the surgeon’s experience
  • how the person may go about revisions if they are dissatisfied with their results
  • before-and-after pictures of other surgery results

FFS describes a range of procedures that aim to reshape facial features to appear more feminine.

Each person has their own idea of femininity and what it means to them, meaning the procedures and goals they have during FFS can vary.

Like most surgeries, FFS comes with associated risks. However, for many, it can improve their quality of life and allow them to feel their appearance more closely matches who they are.