Transgender women frequently seek facial feminization surgery (FFS). Psychologically, it can be considered more important than gender reassignment surgery, as it significantly helps the social integration of TG women by allowing a higher “pass” rate as a genetic woman.

The face, at a glance, gives us the first impression of a person … in that fraction of a second, the brain assigns a gender.

While other parts of the body can be hidden, camouflaged, or exaggerated to appear more feminine, it is not always possible to mimic female facial features without surgical intervention. For this reason, transgender women seek facial feminization surgery as a way to transform the face. However, FFS techniques allow us to obtain major changes to the skull and face that are often also desired by genetic women with more prominent male features.

The actual requirements of the surgery vary from person to person and can be minimal or extensive. Each patient should receive personalized advice and the opinion of a facial surgeon to determine the desired and required procedure.

In recent years the facial skeleton has been treated almost exclusively by maxillofacial or craniofacial surgeons. Improvements in surgical procedures and facial bone complex approaches have enabled remarkable results in facial surgery.

The ability to transfer these innovative techniques to the field of Facial feminization surgery allows us to directly treat the bone contours. The effects of sculpting the facial bone are predictable, ensuring long-term facial surgery results. Newly developed sculpting techniques are used directly on the surface of the bone to modify the contours and volume, with the aim of obtaining a more harmonious oval shape. Subtle or dramatic changes are possible, according to the desired results, by the following facial surgery:

– sculpt the prominence of the brow bone

– softening of the jaw

– reduce the chin in a square or prominent shape

– minimizing the prominent tracheal (Adam’s apple)

Soft tissues (skin, fat, muscles and tendons) are exposed to numerous agents of change (muscle contraction and relaxation, fluid retention, gravitational effect, loss of elasticity and cohesive properties, etc.), which make it difficult to predict results. long-term surgery on these tissues. In contrast, the facial skeleton is not subject to the same vectors of change as those mentioned above, which means that surgical modifications will remain unchanged over time. Taking this advantage into account and analyzing the main differences between male and female facial skeletons, we were able to redefine a human skeleton with FFS to achieve a more harmonious and, finally, more feminine face.