close up of a blond woman's face and her hand on her cheek

In order to make one’s outward appearance more adequately reflect their gender identity, facial feminization procedures can go a long way. Such procedures can not only be a massive boost to self-esteem, they can reduce symptoms of gender dysphoria by helping you feel more comfortable in your own body. Many trans women opt for some variety of facial feminization at some point in their transition.

There is no single facial feminization procedure. It’s an umbrella term for a vast range of procedures that aim to create more feminine facial features overall. This can include anything from chin implants to a brow lift. If you’re considering facial feminization, deciding on the right procedures for you will be a long process. A lot is contingent on your personal goals and current facial structure.

A qualified plastic surgeon can go over your options with you, and help you decide which procedures will best suit your personal needs. Below, we’ll break down some of the basics to help you get the general idea of what your options are, and what the process of facial feminization entails.

Types Of Procedures

There are myriad procedures that fall under the umbrella of “facial feminization,” so we won’t cover every single one in detail here. However, we can provide you with a brief breakdown of some of the more popular options.

Eye and Lid Modification

Also called a blepharoplasty, this surgery removes excess tissue near the upper eyelids to help feminize the appearance of your eyes.

Nose Reshaping/Nasal Refinement

Rhinoplasties associated with facial feminization usually seek to reduce the overall size of the nose and smooth out its angles.

Cheek Augmentation

The main goal of cheek augmentation is to create more prominent, rounder cheeks. This can take many forms. A surgeon may insert cheek implants, fracture and move the cheekbones, or even take fat from another part of the body and graft it into the cheeks.

Jawbone Reduction

As male jaws are often larger and broader, a jaw reduction aims to create a more feminine jawline. A surgeon sculpts or removes bone from the lower jaw to make it smaller and more delicate.

Chin Width Reduction

To create a shorter, more feminine chin, a surgeon makes a horizontal incision along the chin bone to remove a small wedge, also called a genioplasty.

Frontal Bone Reduction

Frontal Bone Reduction is repostioning of the forehead and brow bones to create a more feminine shaped brow. This is usually done with plates and screws and/or addition of bone substitute.

Tracheal Shave

This minimizes thyroid cartilage to reduce the size of the Adam’s apple by making a small incision under your chin and then reducing and reshaping the cartilage.

In addition to the procedures outlined above, there are also a variety of non-invasive procedures like lip augmentation, facial fillers, and eyelash enhancement. These can be used instead of facial feminization surgeries, for patients who want to avoid invasive procedures. They can also be used to enhance the results of surgery later on.

How Do You Prepare?

If you’re considering facial feminization, the first thing you’ll need to do is make an appointment with a qualified, board certified plastic surgeon with experience with these types of operations.

Determining the best treatment plan can be a long process, and it’s dependent on both your personal goals and current facial structure. Not every person needs every one of the procedures outlined above, so your surgeon will make recommendations to help you get your desired results.

Another part of preparation is a health assessment. Doctors need to make sure you’re in good enough health to undergo surgery. You’ll need to give a detailed medical history, undergo a physical exam, and do routine blood work.

Not everyone can have surgery right away. Depending on your current health, you may need to make certain lifestyle changes – like getting to a healthy weight or quitting smoking – before you can safely undergo a facial feminization procedure. 

What Happens During The Procedure?

This varies considerably, and is highly dependent on the type of procedure you’re getting. Usually, you’ll need to go under general anesthesia, so that may mean you’ll have to refrain from eating or drinking for a set time prior to surgery.

The length of the procedure also depends on how much work you’re getting done, so talk to your surgeon about duration.

Always follow your surgeon’s instructions about caring for yourself prior to surgery. This is the best way to ensure your own safety and keep the risk of complications low.

What Is Recovery Like?

Again, this depends on the type of procedure you get. Most people experience pain and swelling in the face, which goes away in a few weeks to months. You may need to avoid overexertion or exercise for a period of time. Follow any instructions your surgeon gives you carefully.

It may take more than a year for the full results to show, so be patient. Most people end up happy with their results, even if it takes awhile to see the full effect.

Is Facial Feminization Covered By Insurance?

Historically speaking, these kinds of procedures have not been covered by insurance providers as they’re considered cosmetic.

However, times are changing. An increasing awareness of trans issues is making many insurance providers understand the importance of these procedures for one’s mental health and well-being. If you have insurance, they may cover some or all of the costs, so contact your provider for information.

The Bottom Line

Facial feminization procedures can be an incredibly rewarding experience for trans women. Although the recovery can be long, most trans women are pleased with the changes to their facial structure and feel more confident in themselves. If you’re considering facial feminization, you’ll have to do some serious research – with the help of a qualified medical professional – to determine the right treatment plan for you.

Ready to get started? Leif Rogers is an Ivy League-educated, board-certified plastic surgeon and a standing member of the American Society of Plastic Surgeons. If you’re considering facial feminization, get in touch with his team to schedule a consultation.

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