I'm a transsexual MTF. Any suggestions? (photos)

Dear Dee,           
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.  Definitely avoid cheek implants.  Jaw surgery would be helpful but not as important as basic volume redistribution to balance and feminize.  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         

RhinoplastyChin shaping to make less square (can be done transoral and burr the lateral aspects).  hairline advancement (forehead shortening and open browlift).  Burr reduction of the full lower forehead bone.

Hello. I agree with the need for Forehead reduction, nasal feminization surgery, cheekbone implant placement and chin reduction surgery. In my area, you can actually expect to spend a little less than the budget that you mentioned. Not all plastic surgeons are experienced in facial feminization, so I suggest that you research your physician in order to determine his expertise.