Treatment of facial hollowness

As the other esteemed surgeons point out, there are many features, not just volume deficit, that can lead to masculinization of a feminine face.  Each case is highly individual.

However when a volume deficit is present, I prefer autologous tissue (from the patient's own tissues whenever possible.  Fat injection is a fine and accepted method of filling volume.  We prefer fat-fascial grafts in our practice, since they have greater viability than fat injection grafts in our studies, and therefore reduce some of the potential pitfalls of fat injection such as inconstant take and reaction to nonviable material.

We have an interesting published case of high volume LiveFill (R), autologous fat-fascial grafts, in which a woman with very masculine features underwent a single surgery. We have documented the survival of the grafts with 3-D CT scans in her case and a number of other cases.

 There are a handful of plastic surgeons who do facial feminization. After more than 30 years of doing this for gender reassignment patients, we find several things that make the face more feminine. Go to various websites and see which of these apply to you.

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This is a very specialized area of surgery. Without seeing any pictures it is difficult to make recommendations. It usually involves a lot more than nasal surgery. Google the topic and look at appropriate web sites.

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