I am 31 years old. I have a gaunt face. I had nose job two years ago so that I would look more feminine but I still have muscular face. Should I go for another nose job for my nose tip? Should I go for fat transfer to recontour my face? What surgeries do I need for my face to look pretty? I really need some expert opinion. Please help.
How Can I Make my Gaunt Face More Feminine?
Doctor Answers (11)
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.
Web reference: http://drbrent.com/Live-Fill.html
Options for a less gaunt and more feminine face.
Fat transfers can be done for a gaunt face if there is fat atrophy and lipodystrophy present. Cheek augmentation can also be performed with cheek implants into the hollow malar areas to give a more fullness to the face. Injectable fillers can be used around the nasolabial fold areas. Face/neck lifting is typically performed to remove any sagging and excess skin in the jowl and neck area.
Web reference: http://www.seattlefacial.com
Liquid facelift can add nice volume to the gaunt or hollow face
Seek consultation with a board cefrtified plastic surgeon who has experience with facial fillers. Try fillers before having surgery or fat injections.
The liquid face lift using facial fillers like Juvederm, radiesse, etc can add volume to the cheeks and mouth area and ad pleasant fullness to the face.
Fillers are not permanent, thus you have the opportunity to try to find the look you want without oirreversable changes.
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.
Fillers are the way to go for gaunt face
Fillers are the answer here and there are many of them out there. The first natural filler that comes into mind is autologous fat transfer. Fat is removed from one part of the body and injected in the face. The problem with fat is that it may require multiple sessions for it to fully settle. Once it does, however, the results are satisfying and long term.
Fillers using hyaluronic acid and calcium hydroxylapatite can also be used with great results too. They provide a better outcome in terms of assurance of results and its longevity. HAs are the safest and the most commonly used. Radiesse is a great volumizer and when used correctly has tremendous results. Sometimes a combination of both can also provide great results that are longer and satisfying.
Other fillers such as poly-l lactic acid or Sculptra can also be injected and provide great volume. With the right dilution, these fillers are safe. Problems include nodule formation. Sculptra will require multiple sessions to achieve the long term result, but combination with an HA can provide instant gratifying results.
In the end, though there are many fillers out there, the female facial structure should be known to the injector and that is key in making this procedure a success. Each patient is different and many facets of cosmesis should be take into consideration, including the rule of thirds on the face, the inverted triangle and last but not least is the global harmony and end result when all fillers are injected.
The beauty of such materials is that the patient is awake and immediate feedback from them can help steer the injector towards what the patient deems is "right" for their face.
IF your face is gaunt, sometimes facial fillers whether it is autologous using fat or non-autologous like juvederm, restylane, radiesse or sculptra can be helpful. A good exam will also point out features that you may want to improve if the gauntness is moe from masculinized features.
Feminization of the gaunt face.
Clearly there may be many approaches to feminize your face. These may range from hair patterns, frontal bossing, tip rotation, cheek prominence/fullness, chin projection, jaw size, adam's apple, etc.
However, if your priary concern is the gaunt appearance, use of facial fillers whether they be autogenous, biologically derived or manufatured, may be an option that you should discuss with your surgeon.
WITH OUT A DOUBT THE BEST WAY IS TO USE FAT GRAFTING
With out seeing your face or a photo it is difficult to make any recommendations but if your face is what I think you are saying then fat grafting of your face is the best and most effective and permanent method to feminize your face. Make sure you find a plastic surgeon with a lot of experience with these techniques because learning these techniques require a very step learning curve. Yes Sculptra and other fillers can help but for the volume you probably need and the longevity you probably desire grafting your own fat will give you the best results.
See a plastic or facial plastic surgeon who is a Feminization expert.
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.
A gaunt face needs more fullness
Without seeing your face it is hard to tell exactly what will make it more feminine. You describe your face as gaunt and that generally means that you have very little fullness and some hollowing.
Depending on the shape of your face you need some filling to expand the hollow areas and give you some normal contour. This can be done with fat transfers or other facial fillers. You need to consider all of the pros and cons of each technique and see which is best for you.
Discuss the options with your plastic surgeon where you can be examined and find a plan that is right for you.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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