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Facial Feminization

Facial Feminization Surgery refers to multiple procedures done that minimize masculine features of the face, and enhance the feminine features.
There is no particular defined marker that makes a single face look more masculine or feminine. We all are different, and in this world, it’s safe to say that no person is exactly the same. It is a number of different masculine or feminine characteristics that determine societal conceptions of gender. For the prospective patient considering facial feminization, below are several photos to illustrate the results of different minor procedures that can yield significant change.

Male and female faces, have basic differences. Many are just components of different ethnicities and cultures. Generally females, have a more pointed chin, a soft curve from the chin to the cheeks, and a lesser degree of nasal prominence. The forehead from the eyebrows to hairline typically has a soft curve, with a small ridge around the eyebrow. The shape of the skull also expresses gender. Ideally, a female face will tend to have more of a heart shape, versus the generally more squared look of the male face, which is often referred to as “chiseled.”

As mentioned above, a female face that is considered attractive is often heart shaped. The hairline is generally lower and has soft, rounded corners from a hairline that is full even around the temples, down to a single point at the chin. The jaw and cheeks are higher and the jaw itself has a gentle soft curve down to the smaller, rounded chin. Male faces tend to have a more square appearance and an “M” shaped hairline with recession in the temples coming down to a wide, square cornered jaw at the bottom. The lower third of the male face is usually longer because of a long top lip and tall chin. In profile, the female face tends to be flat while the male forehead slopes backwards, with the lower half of the face protruding forward. In summary, a female face has soft curves, no extremes, while having a smaller, slimmer appearance, while the larger male face has sharp angles.


The forehead is one of the more prominent gender markers. It is characterized by degree of curvature, and the bony ridge running across the forehead above the eyes, known as brow bossing. In males, the degree of forehead curvature is generally much more extreme, and males will have a bony ridge above the eyes. Combined with the generally M-shaped hairline and receding temples, this area of the face can be drastically different than it’s female counterpart. Females on the other hand have almost no discernible brow bossing, and a soft curvature from the brows to hairline, with minimal sloping. Like with males, the fuller, lower hairline along with the features, offer a very different appearance. Unfortunately this is a bony mass, and hormonal treatment is ineffective in changing this feature.


The general shape of eyebrows vary heavily between ethnicities, but there are still commonalities. Male eyebrows are fairly straight and thick and sit on or just under the orbital rims. Female eyebrows generally sit higher and have a natural arch. Over time, hormone-replacement therapy changes the eyebrow shape. Complimented with waxing, plucking, or other shaping methods, the patient can achieve satisfaction.


The eyes in a woman appear larger. This is in part because of the shape of the bony rim above and the forehead, and partly because of the cheek bones. The combination of bone shapes create a relatively larger eyes which is considered feminine and attractive.


The nose will vary based on ethnicity, but generally differences occur between males and females. The female nose is smaller and shorter. It has a narrower bridge and nostril, often has a more concave profile and tends to be blunter at the tip. Also, it has a greater angulation between the lip and the tip of the nose (points upwards more). The male nose is varied, but quite the opposite. It is larger in side, the bridge and nostrils are larger, and it can have a generally flat or slightly convex profile. The tip will be larger as well. Males for some reason can often have a little more tissue in this area, and from hormonal changes, transitioners over time may notice a slight reduction in the apparent size of their nose.


Female cheeks tend to be fuller and more rounded, and cheekbones are placed slightly higher on the face, and protrude further in a round shape. Male cheeks are flat, with lower cheekbone placement. Flatter cheeks tend to emphasize a sharper jaw, which we will be getting to shortly. It is notable that males tend to carry less fat in this area, and transgender individuals can find major changes in this region of their faces.


The distance between the nose’s base and lip’s top is usually longer in males. The palate also tends to be a bit more pronounced. When a female mouth is relaxed and slightly open, it usually shows just a hint of the top row of teeth, which lends a youthful appearance to the face. The area between the top lip and nose often has a more backward slope in females. The male face is more often than not the opposite of this.


The male jawbone is usually built heavier and tends to be wider, because the muscles attached to the corners of the jawbone are larger. Female jaw lines run in a gentle curve from the earlobe to the chin. In males they drop down straight from the ear and then turn at a sharp angle towards the chin giving a square appearance. Hormone treatments will affect this area slightly due to fat distribution and muscle mass decline.


Female chins are shorter in overall length and softly rounded. Male chins are wider, have a flat base and have two corners that form a square shape. Male chins are taller and heavier and more likely to have a vertical cleft in the middle.

Adam’s Apple

The Adam’s apple is often visible and very prominent in males, but rarely visible in females.

Bone fragments from Facial Feminization

Because hormone-replacement therapy brings about major changes, it is best to postpone surgical treatments until the body has had ample time to adjust to a new hormone profile. Skin changes drastically during hormone therapy. Elasticity, density, and clarity changes in part due to fat redistribution. Therefore, facial surgeries are most successful after the hormone changes can be accounted for.