Today we are going to tackle the interesting and not often-covered topic of facial feminization surgery (FFS). To begin with, many readers may be wondering, what is facial feminization? It is a series of procedures, usually surgical, on a person’s face used to create a more feminine appearance. Usually, many features that would make a face look more masculine would be the forehead, brow-line, jaw, and even the eye area. Who would be looking to have such a procedure? FFS usually is performed for transgender patients who have a gender identity that differs from the sex assigned to them at birth.
When a transgender person is able to alter these characteristics, it can be essential in their transition. In the case of FFS, the techniques can help transgender women transition physically to their self-affirmed gender. Being seen as women can also help transgender women avoid harassment and discrimination that is, unfortunately, far too common. This is not to say that there aren’t also genetically female candidates for FFS, but primarily, the following are the top performed surgeries for transgender women:
Forehead reduction surgery is an operation that can improve the appearance of a wide forehead. With an incision along the hairline, the scalp is lowered towards the forehead to reduce the width of the forehead. The incision scar is invisible and the shape and hairline are natural, making the face more complete. This type of procedure is ideal to achieve the face ratio of 1:1:0.8 for the forehead, eyebrow to nose, and nose to chin. Usually, a forehead reduction surgery is performed under sleep anesthesia. The surgery usually takes about an hour, and the stitches can be removed after about a week, making the recovery period fairly short.
It is especially useful in FFS because a broad forehead may make women appear more masculine. A forehead reduction can help balance the face and give more feminine features. You can read more in-depth about this type of procedure here: Everything You Need To Know About Forehead Reduction Surgery
Fat Transfer/Fat Grafting
Women’s bodies and faces generally have more fat than men’s. To address such an imbalance, FFS patients can opt for fat grafting in order to increase facial volume and achieve a refreshed and brighter complexion. Those who wish to have a more symmetrical face shape can also choose to go for fat grafting to have a more defined look. Fat grafting is an out-patient treatment and hospitalisation is not required. Firstly, a local anesthetic will be given via injection to the site where fat is to be removed through liposuction through a few small incisions. Thereafter, the fat is processed by centrifuging, filtering or rinsing to filter out contaminants and impurities for the extraction of the most pure, natural fat. The doctors will then carefully inject the pure fatty tissue to the new site, sometimes massaging or using placement techniques in order to get the contour just right.
FFS candidates may be undergoing hormone therapy and should consider whether, when they begin taking hormones, there may be additional fat added to their face. Therefore, Eunogo would advise this procedure for someone who has already tried hormone therapy as a first line of addressing the issue of a softened facial appearance. As mentioned above, the forehead is one of the most prominent features on the face that may look masculine. Unfortunately, it is unlikely that hormone therapy may stimulate additional fat in the forehead, so fat grafting and transfer may be an option in the forehead as well. Those interested in learning more about fat transfer can read our previous Beauty Journal here: All You Need To Know About Fat Grafting Surgery
Chin Implant (Genioplasty)
A genioplasty, commonly referred to as a chin implant, is a common way of also balancing facial features. If a trans woman does not have a well defined jawline but a square chin, a genioplasty will be a good way to balance this feature. Although it is a relatively minor procedure, it makes an immediately noticeable difference in the appearance of your face.
Two incision types are commonly used for a genioplasty procedure: external or internal. An internal, or labial vestibule, incision on the inside of the mouth at the base of the lower lip usually provides no visible scar but involves a slightly higher complication rate due to the presence of saliva. In many cases, Doctors will use an external incision, just under the chin. A pocket is created to secure the implant in position and then is closed with stitches, which are removed an average of about 5-7 days later.
To read more about chin implants, click here: A Complete Guide to Chin Augmentation and Implant Surgery
Many say Seoul is the place where the V-line surgery began, but whether that is true or not, we know that it is definitely where the procedure has been perfected. V-line surgery is not only one of the most common FFS procedures, but it is also one of the top 3 procedures performed in all of Korea! Once you understand the huge difference a softened jawline can make for a face in terms of feminizing features, it is easy to understand why.
V-line surgery reshapes the bone along the jawline from a "U" shape to a more streamlined, feminine "V" shape, from just under your ears to the tip of your chin. Sometimes it also involves a genioplasty (see above) and overall the surgery is meant to balance the lower portion of your face. It is also one of the more complicated procedures involved in FFS because it requires a thorough and careful evaluation of your overall proportions of chin, jaw and facial anatomy as a whole, since it is all related with nerve position on the face. Any V-line surgery patient will need to get pre-operative analysis via 3D-CT scan for the safest surgery process.
You can read more about YouTube influencer, MandyCandy’s V-line procedure here: Mandy Candy's Cosmetic Surgery Makeover In Korea
And watch a video of her journey with FFS here:
It is worth noting that FFS will have your surgeon conduct an assessment of a patient’s mental health. For the purposes of our Eunogo Beauty Journal on FFS we will not delve into the mental health screening details, as Eunogo provides information on the plastic surgery and medical procedures. However, because it is an important requirement, you may read more about it here.
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