Facial Feminization Surgery: What Is It and What Are the Risks? - Step To Health

Facial Feminization Surgery: What Is It and What Are the Risks?

Facial feminization is the process of minimizing the harshness or masculinity of certain facial features. This can be done on both transgender and cisgender women.
Facial Feminization Surgery: What Is It and What Are the Risks?

Last update: 25 November, 2021

Facial feminization surgery refers to a set of aesthetic surgeries aimed at changing certain features in a person’s face. Of course, the result is intended to be as natural and harmonious as possible.

It’s most commonly demanded by transgender women in the process of physical transition. However, it’s also frequent in cisgender women, who seek to soften certain rather masculine features, such as a square chin or marked Adam’s apple.

There are several surgical procedures within the category of facial feminization. They can be performed simultaneously, combining several interventions, or only one specific area of the face can be worked on.

What is facial feminization, and why is it done?

Our face is the part we show the most to the world. Hence, for many people, having a pleasing or harmonious face is paramount.

The female face tends to have finer features compared to the male face. In particular, this can be seen in details such as a narrow forehead, a small and profiled nose, full lips, an oval face, or protruding cheekbones.

However, a person may not feel comfortable or at ease with their appearance, considering that their features are “harder” or “more masculine.” For this, facial feminization can be done.

Essentially, it consists of a series of surgical interventions for aesthetic purposes. As far as possible, surgeons work to ensure that the results correspond to both the bone structure and the person’s wishes. Therefore, the goal is that their features have a feminine appearance and are harmonious.

The surgical process is considered important in people whose gender identity differs from the sex they had at birth (gender dysphoria). It’s even necessary to modify some features of the face, especially when the process of physical transition to their self-affirmed gender takes place.

What is the facial feminization procedure like?

To achieve the changes, a personalized and very detailed study of the face must be carried out since each person’s bone and facial structure is unique.

In some cases, several techniques are required, including x-rays and computerized tomography, as well as photographs. Overall, the changes sought may be related to the following:

  • Hairline and size of the forehead
  • Superciliary arches
  • Eyelids and eyes
  • Lips
  • Cheekbones
  • Jaw and chin
  • Nose
Cirugía estética de feminización facial.
The surgery first requires a thorough study of the features to establish a projection of the changes.

What surgeries can be performed?

The facial feminization work can be done jointly or simultaneously, as well as by zones. Among the different surgeries that can be performed are the following:

  • Smoothing of the frontal sinus and superciliary arches.
  • Frontoplasty: Lowering of the hairline.
  • Modification of the jaw angles to accentuate or give the oval shape.
  • Mentoplasty: Changes in the chin to refine or sharpen the face.
  • Thyroplasty to stylize the Adam’s apple.
  • Blepharoplasty: For those who are not recommended for facial feminization to eliminate eye bags.
  • Upper lip lift to give projection, as well as definition and volume to the lips.
  • Cheekbone augmentation.
  • Rhinoplasty: Although there are different types of noses, the female nose is usually thinner and pointed. If that doesn’t work, rhino modeling can be done, which is a simpler procedure.
  • Bichectomy: removal of fat pockets in the cheeks.
  • Facial feminization facelift provides smoothness and firmness and accentuates the appearance of a well-groomed complexion.
  • Removal of facial hair.

You’ll definitely like this article: 8 Useful Tips to be an Independent Person

Preparation for facial feminization

As in other surgeries, before performing a facial feminization, a series of examinations and medical check-ups must be performed to rule out any conditions. This includes the following:

  • A review of the medical history, both personal and family
  • A complete physical examination
  • Laboratory tests: lipid profile, blood glucose, blood count, liver enzymes, etc.
  • Serology for VDRL, HIV, and other sexually transmitted diseases.

The patient should inform the surgical team if they are undergoing treatment. They may be asked to stop taking certain medications, such as blood thinners.

In addition, an evaluation by a mental health professional is recommended. It should be determined if the individual is of sound mind before signing any consent form.

Post-procedure care

Considering that several procedures may be performed at once during facial feminization, a recovery period is required. Therefore, recommendations should be taken into account to help in the process.


Recovery times may vary from patient to patient or according to the type of intervention. However, it’s recommended that the first 24 hours are of absolute rest. Then, you should wait between 1 and 2 weeks to return to work.

Take prescribed medications

Some medications may be prescribed, such as antibiotics, painkillers and anti-inflammatory drugs, and even corticosteroids. To avoid complications, it’s suggested that you follow your medical team’s medication recommendations to the letter.

Apply cold if necessary

You may experience a feeling of tightness, warmth, or tightness in the treated areas. In addition to medication for pain and swelling, a local cold compress may be applied after the first 24 hours following surgery.

Avoid touching any wounds

As should be the case after any surgery, avoid touching wounds, pulling stitches, or picking at scar scabs.

Wounds should be kept clean and dry. It’s recommended to clean with saline or antiseptic soap. If the wound bleeds a little during washing, there’s no need to worry.

Don’t sunbathe

It’s recommended not to expose yourself to the sun during the first week after surgery. Then, in the following months, you should use sunscreen with SPF 50 to prevent the appearance of spots on the skin.

Rinoplastia para feminización facial.
All these procedures are surgeries. Therefore, the same risks and contraindications apply as in similar processes. 

This surgery should only be performed when the person has finished growing and the face and skull bones have finished forming. On the other hand, it’s not recommended in case of uncontrolled mental conditions, which are thought to affect the possible reactions to the results or limit decision-making capacity.

Other health conditions that discourage the performance of facial feminization are bleeding disorders, history of deep vein thrombosis, heart disease, and kidney disease.

Feminization and self-acceptance

In the end, we all want to feel good about ourselves. We all want to be accepted and to feel accepted. And in part, this involves being comfortable with the body we have and the face we see in the mirror.

However, in the particular case of facial feminization, some issues need to be clarified. First of all, patients do not necessarily have to undergo all the interventions. Likewise, they should not always be done at the same time.

For the results to look natural, the operations should be done progressively. In this sense, the evolution should be observed by professionals after each of the interventions. The definitive results will not be appreciated until months later.

The greatest risk is that the person does not feel satisfied with what they see after the process. Therefore, to avoid problems and minimize impacts and the importance of the patient’s expectations, the surgeon must also be assertive when communicating the possible expected results.

It might interest you...
6 Keys to Close Cycles and Move Forward in Life
Step To Health
Read it in Step To Health
6 Keys to Close Cycles and Move Forward in Life

Can't find a way to close cycles and move forward in life? We've prepared 6 tips you can follow to help you get back on your feet.

  • Adauy A, Sandoval J, Ríos R, Cartes A, Salinas H. Terapia hormonal en persona transgénero según World Professional Association for Transgender Health (WPATH) y Guías clínicas de la Endocrine Society. Rev. chil. obstet. ginecol.  2018;  83(4): 426-441.
  • Di Maggio M. Feminización facial completa. Remodelación ósea y de partes blandas faciales. Rev. Argent. Cir. Plást. 2009; 15(2): 90-94.
  • Escolano F, Sánchez Navas S. Anafilaxia en anestesia. Revista Española de Anestesiología y Reanimación. 2013; 60(1): 55-64.
  • Lorenci M. Repensando los orígenes de la disforia de género. Revista de Estudios de Juventud. 2013; 103: 33-50.
  • Moseson H,  Zazanis N, Goldberg E, et al. El imperativo de incluir los géneros no binario y  Transgénero. Más allá de la salud de la mujer. Obstetrics & Gynecology. 2020; 135(5): 5-14.
  • Sánchez-González J. Feminización facial en pacientes transgénero: Revisión de la literatura y propuesta de un algoritmo de manejo. Bogotá: Universidad Nacional de Colombia, 2021.
  • Smerilli A, Sacot N. Anestésicos locales: historia, acción farmacológica, mecanismo de acción, estructura química y reacciones adversas. Revista de la Facultad de Odontología UBA. 2004; 46: 19-24.
  • Toibaro J, Ebensrtejin J, Parlante A, et al. Infecciones de transmisión sexual en personas transgénero y otras identidades sexuales. Medicina Buenos Aires. 2009; 69: 327-330.
  • Weinmann E, Salzman E. Trombosis venosa profunda. Rev cubana med. 1996;  35(2): 118-135.