Pre-testosterone trans FTM. I know that testosterone is known to cause cartilage in your nose to grow, would it cause an issue?

Question

Hi all, Im a pre-testosterone trans ftm guy and Im looking into getting a rhinoplasty. I know that testosterone is known to cause the cartilage in your nose to grow, and im wondering if this would cause an issue with a nose job? If so, would it be best to wait until i’ve started testosterone and most substantial changes have already take place before getting this procedure, or would a nose job be possible and safe before testosterone? Thanks in advance for any insight!

Richard H. Tholen, MD, FACS · Answer

Testosterone is indeed an anabolic steroid, and numerous studies have shown that T is necessary for cartilage and soft tissue repair. But testosterone is not exclusively a male hormone, and you and cis-females have both active levels of T as well as normal cartilage structures, right? From the standpoint of a transman considering both rhinoplasty and testosterone therapy, the changes in nasal structures and cartilage via rhinoplasty are definitely visible, whereas the effects secondary to testosterone therapy (or not) are microscopic and NOT visible.I have operated on hundreds of transmen over the past thirty years, both on T, and not on T therapy, and I can definitively tell you that rhinoplasty results are NOT related to being on testosterone (or not). The outcome of rhinoplasty surgery is dependent on your choice of surgeon, the skill and experience of the surgeon, and individual healing factors, to a couple degrees of magnitude beyond what might be due to higher testosterone levels.You can safely undergo rhinoplasty anytime, whether on T or not. No need to be on testosterone for a period of time "just to be safe," because surgical changes (even swelling and/or scar tissue) are MUCH more visible than any effect that T might cause. Choose your rhinoplasty surgeon with as much care as choosing your surgeon for top surgery. Best wishes! Dr. Tholen

Regina Rodman, MD · Answer

Thanks for sharing your question.  I'm Dr Rodman, a facial plastic surgeon, and work with many trans patients.  My question for you is, are you planning a rhinoplasty for breathing issues or to help masculinize your face?If you need the surgery for breathing/functional issues you should go ahead and do it.  There will be changes to your face as the hormones take effect, but it is not worth going years without breathing.  If you are doing it only to change the appearance of your face, I would recommend waiting about two years after starting to hormones.  I do surgery for MTF and FTM trans patients, but I see far less FTM patients in my practice.  This is because testosterone creates changes in the soft tissue that are usually sufficient and most patients are satisfied with their face with hormones alone.  Some patients do still desire surgery; rhinoplasty, jaw implants, chin implants, and/or genioplasty to masculinize the face.  In these cases it is better to start surgeries after the significant changes have taken place.  It is easier to hit the end target when I know exactly where I am starting from!  For MTF I will opt to do surgery sooner, because the bones of the face are generally what need to be altered and these don't change much with hormones.  Feel free to message me with more questions, best of luck on your journey!Dr Rodman

Pre-testosterone trans FTM. I know that testosterone is known to cause cartilage in your nose to grow, would it cause an issue?

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Pre-testosterone trans FTM. I know that testosterone is known to cause cartilage in your nose to grow, would it cause an issue?

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.