The facial anatomy of a male and female differs in many aspects like the jawline, eyebrows, nose, chin, facial hair and Adam’s apple. For a female-to-male transition, your face will have to undergo some surgeries to get masculine facial features.
Usually, an FTM aims for a straight nose, thick eyebrows, and a square, chiseled jawline, because that is what makes for the sex appeal of a good looking man. Face masculinization surgery requires procedures like facial implants, chin augmentation, and other operations to achieve a masculine appearance.
Preparing for the Surgery
Before you start your surgery your doctor will give you some pre-operative measures.
- Go for a medical evaluation or a lab test
- Prescribe some medications
- If you are a smoker, you will be required to take a break from nicotine
- You will be asked to avoid certain medications like aspirin or anti-inflammatory drugs, to prevent an increase in bleeding
- Before deciding on the outcome, your preference, the doctor’s evaluation, and requirements from your procedure will be considered
- Prepare to spend at least two weeks for the surgery
Surgical Procedures in Facial Masculinization
Some of the frequent surgeries required for a female-to-male reassignment transition are as follows.
Since your forehead covers 30-40% of our face, change in this area will be significant. There are three primary areas assigned for the surgery; the brow ridge, flat expanse of forehead, and slope of the forehead.
The goal is basically to get a more angular and taller forehead, which requires two procedures – lengthening and augmenting. Forehead lengthening increases the height from the eyebrows to the hairline. An incision is made close to the hairline, and the scalp is placed in a more masculine position. Forehead augmenting involves enlarging the forehead from the glabella to the brow ridge by making an incision on the right or at the back of the hairline – this will depend on whether there should be any change made in the hairline or not.
These two procedures will be undertaken under the same surgical session. Forehead augmentation is typically done with a biological synthetic material which will not affect your sinuses.
The typical male jaw is square and looks strong as opposed to the narrow jaws in a female face. Orthognathic surgery is performed on the jaw with customized implants or fillers.
This surgery involves repositioning the jaws. An incision is made inside the mouth and implants to create a strong jawline are inserted. After inserting and positioning, the implants are fastened with titanium screws.
Genioplasty or mentoplasty is a surgery to augment the chin using fillers and implants. The male chin appears to be fuller and chiseled while female chins are tapered.
Surgery on your chin will involve internal incision accessing your chin for a sliding osteotomy (surgical cutting and realignment of bone). The positioning will be done both vertically and horizontally, reshaping the width and structure of your chin.
After placing the bone to its new position, titanium screws will be fixed inside the lower lip to hold the chin profile. Precautions will be taken to avoid harming the root of your teeth.
Adam’s apple Augmentation
The protruding larynx or Adam’s apple is responsible for the deep voice in males. Sex reassignment of a female-to-male will require changing your feminine voice to a masculine vocal sound, which means an augmentation to deepen the voice.
This procedure does not require any donor because the implants will be harvested from your ribcage. Cartilage taken from your ribs will be placed on top of your thyroid cartilage to form Adam’s apple.
An incision is made under the chin to avoid the visibility of scars after surgery. After separating the vertical muscles of your throat, the cartilage from your ribs will be placed on your existing larynx, resulting in a protruding larynx or your new Adam’s apple.
There is a common misconception that on taking testosterone therapy, your Adam’s apple will naturally grow, which is not the case.
Complications and Risk
The possible risks may include bleeding, swelling, infection, hematoma, implant migration, failure of the bone to heal, and poor reaction to anesthesia. In about seven days you may notice that mostly the bruising, swelling and other discomforts will subside before you fully recover in three to four weeks.
Results of Facial Masculinization Surgery
Following instructions from your surgeon will be the best way to take care of yourself after the surgery. Scars from incisions along the chin, jaws, and hairline will minimize overtime, though it won’t disappear completely. When you have achieved the masculine features overcoming gender dysphoria, these subtle scars will diminish from your concerns.
Less Invasive Facial Surgery
Face masculinizing surgery gives satisfying results but it can be time-consuming and costly. There are some non-invasive approaches for gender confirmation surgery.
- Chin liposuction: This procedure involves removing fats from the chin to reshape your jawline or neck. You will need only mild sedation, and the whole surgery will not take more than an hour. It gives a positive result that lasts long. Recovery time will take around five to seven days. Before you go for chin liposuction make sure you are in good health.
- Chin implants: This is another non-invasive but an effective approach to add masculine features to your face. Sedation combined with local anesthesia is used for chin implant surgery lasting for about an hour. After surgery, it will take at least a week to resume your normal life while avoiding physical activities and exercises.
- Dermal Fillers: There is another non-invasive approach using injection called dermal fillers. Just as you depend on hormone therapy to add strength to your face shape, fillers such as Restylane are commonly injected to either side of the chin. You will start noticing your chin getting wider and more prominent.
Q: Will I still look like me after the facial masculinization surgery?
A: This question is common among patients considering facial masculinization surgery. A good surgeon will retain your unique facial features by making subtle changes. The result will be a more masculine face that will still look like you.
Q: Is masculinization surgery possible in any face?
A: There is no qualification for facial masculinization based on face type. But any surgery should be done only after making sure that your body is safe for any medical surgeries.
Q: How do I choose a good plastic surgeon?
A: Pick a surgeon who is certified by the board, check their credentials and history of experience on the field as well. They should have completed training on both craniofacial surgery and general plastic surgery. A successful track record and satisfying before-after pictures from previous patients is a good way to start your search.
Q: Is facial surgery painful?
A: Usually, a certified surgeon will take pre-op and intra-op medical measures to reduce post-operative pain. Surgery is done under general anesthesia, and only a mild pain is experienced post surgery.
Q: Will there be prominent scars after surgery?
A: Any surgery will involve cuts and incisions, so scarring will be there to some degree. The good news is, in a facial masculinization surgery, most of the incisions are made in areas where scars will not be noticeable.