What parts of my face and what fillers should I use for a feminine face? I am working on my male to female transition. Thank you

In my practice I like to think of facial feminization surgery for transgender women no different from aesthetic refinements in cis-gender women.  At the end of the day all faces have masculine and feminine components.  I feel a lot of bad decisions can be made by considering FFS a bucket list of procedures including skull alterations and hairline surgery.  In my opinion these procedures considered as the mainstay of FFS should be reserved as final options after the more significant aspects with lower risks are completed.  From analyzing your pictures I think volume redistribution to balance your face would be the most beneficial and simple.  I use a technique that I call Aesthetic Facial Balancing to achieve feminized and lifted appearances using either off the shelf fillers or your body's own fat.  Focusing on the area around your eyes, brows and high cheeks would give you the biggest bang for the smallest buck.  If you are considering more surgical approaches,  a rhinoplasty to shorten your nose and rotate the tip upwards would be a nice enhancement as well.  An osseous genioplasty where the chin bone is cut and contoured could enhance your presentation although I would have to see a profile to advise precisely on these changes.  Avoid chin implants as these cannot achieve ideal position and can result in many long term complications.   I hope this helps!

All the best,

Dr. Rian         

Hello,Fillers can alter some areas, such as your cheeks and lips, but for dramatic facial changes (making a face more feminine), this generally will require bony augmentation, such as with surgery. To create a more feminine face, often the jaw and shaved and the angles and the chin is shaved to have a more smooth contour. Also, a rhinoplasty can create a more petite nose. There is nothing better than an in-person exam to see what would be best for you, so I recommend getting a plastic surgery consultation. All the best in your journey,Dr. BlaggAustin, TX

I think you need to ask "what are the best things I can I do to make myself look more feminine?"  Your brow is strong and very masculine followed by your jaw and nose.  There is no good way to actually reduce your brow with filler.  You can add juvederm or restalyne to your cheeks (the front of your cheeks under your eyes).  Full cheeks are very feminine, and they will help to balance your strong brow and make it look smaller.  You can also add some Juvederm ultra to the top of the bridge of your nose (the radix) and this will make your bow look smaller. Filling your lips with Juvederm can also look feminine.  If you want to have a significant amount of filler placed by a skilled physician, though, it will add up quickly.  Often surgery will be the best and cheapest way to reach your goals.  Have a face to face discussion with a surgeon who both performs facial feminization and injects fillers.  They can help you decide the best way to reach your goals.

Hi There and thank you for your questions and photos which are very helpful.  Firstly, you have lovely eyes and a great mouth/smile!  I like to ask my patients what they see in the mirror which makes them look male!  Once I understand your goals then we can work out together a surgery plan to achieve these goals.  From your photos - you may benefit from brow contouring, hairline lowering and brow lift.  To enhance you cheeks the options would be fat grafting or implants.  Your nose can be feminized by reducing the size and refining the tip.  Your chin can be softened, to make it more refined.  I recommend that my patients have 3D simulation images to give you the best visualization of your face and your goals in order to plan your FFS.  Hope that this is helpful and best of luck.

It is difficult to assess based on your photographs which fillers would be best suited to provide the results you desire.  There are various fillers on the market, each of which has their own particular characteristics.  An evaluation by a board certified plastic surgeon can help you to understand what your options are.