Do I need facial feminization surgery? (Photo)

Question

Hello. I’m a 26 years old trans woman. I had a conversation last week with a surgeon and he said i need to get forehead contouring, brow lift, chin and jaw reduction. I spoke with my family and they are concerned about me getting this surgery. They say i already look feminine and i don’t need it so maybe i can improve my look with some alternative small surgeries like brow lift or double chin removal. Let me know what you think and if i need ffs or it’s better to have another small surgeries?

Timothy Osborn, MD · Answer

There are many surgical procedures to choose from. It all depends on what YOU want and feel comfortable doing. As a surgeon, I can give you recommendations and options, but in the end this is about what makes you feel the best about yourself. If you want to do a full facial feminization surgery, we can do it. If you want to divide up into smaller procedures, we can do that as well. In the end, my recommendation would be to have all the procedures you choose done at once: even if it's just 1 or 5. One recovery is much better than several. That being said, here are some options:
1. Brow bone reduction - a strong brow bone is a feature characteristic of male anatomy. Shaving it down will give you a softer transition to your nose and more feminine profile.
2. Genioplasty with jawline contouring - the lower portion of your face is considered short compared to the rest. By bringing your chin forward and down, we would create a more facial balance while adding some projection. In doing so, this also elongates your jawline. The contouring would help to create a "V" shape and reduce the width of your lower face (similar to jaw reduction). 
3. Buccal fat removal - this will reduce some of the fullness on your cheeks and creating some more contour.
You may also consider a rhinoplasty, or cheek implants to add more structure to the cheek bones. Again, these are just options. If some of these things do not bother you, then don't worry about it! You can mix and match procedures as you like. Our office provides simulated morph photos of expected outcomes and we are happy to schedule a virtual or in-person consult to discuss things further!

Joshua D. Rosenberg, MD · Answer

Your family is right, you do have a very feminine appearance. 
“Need” is challenging word here. It really depends on your goals. If having the most feminine appearance possible is that goal, then some aspects of feminization surgery may help you achieve it. 
Brow/orbit reduction would likely be the most powerful procedure for you. The prominence of the brow and orbital rims is a strong subconscious indicator of masculine vs feminine for most people. Reducing this and creating a smooth transition from the brow to the nose and midface will definitely help you look more feminine. 
Depending on the height of your hairline the incision for this surgery can be hidden in the hair, making this essentially “scarless.”
If you are decidedly surgery adverse, consider Botox to your masseter muscles. It will be a nice touch for you. 
Finally, jaw and chin reduction could also be nice for you but I would consider them a second priority to your brow.

Toby Mayer, MD · Answer

You look female and if you’re not misgendered then you don’t need any surgery! Definitely you don’t need jaw surgery based on my almost 50 years of FFS! Make sure you see numerous photos of results and meet with the surgeon’s patients.

Do I need facial feminization surgery? (Photo)

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Do I need facial feminization surgery? (Photo)

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