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Facial Feminization Surgery or FFS is a vital component of the overall gender transition process. There are a number of classically male features involving the face that once addressed, allow the face to take on a much more female appearance. Technically, FFS is a combination of craniofacial surgery and rhinoplasty. As a craniofacial surgeon and an expert at rhinoplasty, New Jersey based plastic surgeon Robert Morin MD FACS has a unique ability and an enormous amount of experience reconstructing and redesigning both the bones and the soft tissue of the face. Dr. Morin uses the complex craniofacial techniques he learned during his fellowship in order reshape the structure of the face during his gender-confirming surgeries. Dr. Morin is sensitive to his transitioning patient’s needs and concerns. Combining his surgical expertise with his compassionate personality, Dr. Morin is able to provide his patients with beautiful, feminine results.

Facial Feminization Surgery or FFS - Robert Morin MD
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What is Facial Feminization Surgery?

Facial feminization surgery, also known as “FFS,” is the term used to describe a number of complex surgical procedures designed to alter the gender appearance of the face. These procedures are used in order to soften the masculine appearance of a genetically male face in order to create a more feminine look. FFS procedures are a vital part of the overall male to female transition process. Sensitive to his patient’s needs, Dr. Morin completely understands the goals of facial feminization. By carefully listening to his patients, he is able to help them create a more accurate version of themselves.

Facial Feminization Surgery Methods

To modify the existing masculine face, Dr. Morin combines a complex array of plastic surgery and craniofacial surgery techniques in order to make male facial features softer, gentler and more feminine. Every patient’s unique surgical plan is highly individualized based on your specific aesthetic goals and concerns. Dr. Morin works closely with his patients in order to ensure high quality and safe results. Facial feminization surgery is usually performed under general anesthesia in order to ensure maximum patient comfort. During your initial consultation, Dr. Morin will explore in detail all of the latest surgical options available and design a unique surgical plan to fit your aesthetic goals.

Procedures and targeted areas typically involved in facial feminization surgery include:

Facial Feminization Surgery Methods

*Results may vary

There are many subtle differences that differentiate a male from a female nose. The length, width, projection and overall shape of the nose can be redesigned in FFS surgery, in order to more closely match the proportions of a beautiful female. During male to female transgender rhinoplasty, a masculine nose is generally made smaller, narrower and more defined.

The female hairline is usually lower and straighter than the male hairline. In addition, the length of the forehead is usually shorter in a woman. Forehead reduction surgery (also referred to as a “Hairline Lowering, Scalp Advancement and Hairline Correction”) effectively moves the hairline into a more feminine position by advancing the scalp and removing a small segment of the non-hair bearing forehead. This is especially helpful in patients who have a small degree of male pattern hair loss.

Jaw contouring:

The side projection of a patient’s jawbone or lower mandible is narrowed and reshaped during facial feminization surgery. This procedure, preformed entirely through small incisions made on the inside of the mouth, helps make the entire face look narrower, more angular and more feminine.

Brow lift:

This procedure lifts the eyebrows into both a more feminine and a more youthful position. The shape and contour of the eyebrows are also redesigned in order to create a more defined female appearing arch. This procedure can also improve the appearance of aging eyes by partially elevating the position of the upper eyelid.

Cheek Augmentation/Reduction:

The patient’s midface can be made more feminine and fuller by injecting either hyaluronic acid filler (temporary) or a patient’s own fat (permanent). Cheek augmentation surgery increases the projection of the cheeks and immediately creates a more youthful and more feminine overall look. Increasing the upper midface volume can also give the appearance of a subtle midface lift.

Commonly referred to as a “Genioplasty” and/or “Mentoplasty”, this procedure changes the width, height and/or projection of the chin. The female chin tends to be softer and less prominent than the male chin. A reduction genioplasty can therefore be performed through a small incision inside of a patient’s mouth in order to create a more feminine chin and lower third of the face.

Lip augmentation and reshaping:

The size, contour and volume of both the upper and lower lip can be altered based on a specific patient’s desires. Generally, hyaluronic acid filler or micro fat grafting is performed in order to increase lip fullness and adjust lip shape, contour and proportion. More beautiful and feminine lips can be created by carefully adjusting the complex anatomy of the lip.

Removal of the Buccal (Bichat’s) Fat Pad:

Lower midface fullness can be reduced and overall facial shape can be redesigned by removing a small amount of fat from the middle/lower cheek area. Through a small incision in the mouth, the buccal or Bichat’s fat pads can be carefully removed giving a patient a narrower, more angular and more feminine appearance.

Adam’s Apple Reduction:

Commonly referred to as a “Tracheal Shave,” prominent thyroid cartilage is carefully removed from the neck through a small incision in order to reduce the prominence of the Adam’s apple.

Recovery Period

FFS surgery is performed on an outpatient basis and patients who undergo facial feminization surgery generally go home the same day. Dr. Morin and his attentive staff will review all pre and post-op recovery care instructions in detail in order to help achieve as quick and pain free a recovery as possible. The amount of swelling and the time required before returning to work and other activities depend on the number and types of procedures performed. Follow-up appointments will be made periodically so Dr. Morin can assess your progress and ensure your healing is progressing as expected. As with any surgical procedure, incisions will be required. However, many of the incisions used in FFS are placed on the inside of the mouth. These incisions will therefore not be noticeable. Any skin incisions are skillfully and strategically placed in order to be as inconspicuous as possible.

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Facial Feminization Questions and Answers

How much does facial feminization cost?

The term “facial feminization” is used to describe a set of procedures that help soften a patient’s features in order to create a more feminine appearance. The procedures used vary from one individual’s case to another depending on the patient’s specific anatomy, goals, and desires. As a result, the price of the entire treatment will vary. The best way to get an accurate estimate is to contact a board-certified plastic surgeon and craniofacial surgeon in order to arrange either an in-person or virtual consultation.

How does facial feminization surgery work?

Men and women have distinct anatomic features that we perceive as belonging to either the masculine or feminine gender. Facial feminization surgery (FFS) aims to alter the shape and contour of the face in order to create a more feminine appearance. Common areas addressed include the nose, forehead, eyebrows, cheeks, chin, jawline, lips and neck. Dr. Morin often says that FFS is a combination of craniofacial surgery and rhinoplasty. As a fellowship-trained craniofacial surgeon and an expert at rhinoplasty, Dr. Robert Morin is in the unique position to provide the highest quality of facial feminization surgery available today.

What are the most common facial feminization surgery procedures?

A feminizing rhinoplasty is one of the most important aspects of facial feminization surgery. Other procedures that make a significant difference in appearance include: forehead bone reduction, browlift, hairline advancement, narrowing of the mandible, cheek augmentation, genioplasty and tracheal shave.

How painful is facial feminization surgery?

The discomfort experienced during facial feminization surgery recovery depends on the exact procedures performed. Dr. Morin creates a personalized action plan and goes over the details with all of his patients before the procedure to help them make an informed decision. Most patients experience a relatively mild amount of pain that can generally be managed with a short course of pain medication taken by mouth.

How long does facial feminization surgery take?

Because facial feminization surgery usually includes two or more procedures, the total surgical time can be up to 6 hours. If additional procedures are required beyond what can be accomplished in 6 hours, additional surgery could be required in the future. In general, we do not plan elective surgical procedures that we know will take longer than 6 hours.

Can you get your Adam’s apple shaved down?

It is absolutely possible to include a tracheal shave as part of facial feminization surgery. In order to set realistic expectations, discuss your goals with Dr. Morin during your in-person or virtual consultation.

What Risks are Associated with Facial Feminization Surgery?

During a patient’s transition from male to female, facial feminization surgery is one of the critical steps. Dr. Morin transforms traditional male characteristics of the face into softer, more feminine features through the use of multiple surgeries. Facial feminization surgery in NJ can be incredibly beneficial to the recipient, but FFS may come with the following risks:

  • Excessive swelling
  • Loss of hair along the line of incision
  • Bleeding
  • Infections
  • Scars
  • Nerve damage in the face
  • Fluid accumulation

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