Skip to main content
Book cover

Lesbian, Gay, Bisexual, and Transgender Healthcare pp 377–388Cite as

Facial Feminization Surgery: Review of Facial Analysis and Surgical Procedures

  • Chapter

  • 2361 Accesses

Abstract

The field of facial feminization surgery includes a range of procedures performed on the male to female transgender patient. These surgeries can increase the quality of life for this patient population and greatly help with feminine recognition by the public. Surgery is complemented by hormone therapy and coordinated with other medical and mental health professionals.

Facial analysis of the male to female transgender patient can be challenging, but the initial consultation is similar to other facial plastic surgery evaluations. This chapter reviews many “normal” values of facial analysis found in the literature with emphasis on the differences between stereotypic male and female faces.

Second, this chapter provides an overview of surgical procedures with particular importance given to upper face alteration. Facial feminization surgery can include procedures to address the upper face and hairline, nose, midface, lower face and mandible, and the larynx. Non-surgical therapy can also affect facial shape using injectables and implants. Finally, voice therapy or vocal procedures may help raise the pitch of the voice.

Challenges exist but should not deter a facial plastic surgeon from providing this important care to the male to female transgender community. A mutual understand of expectations will result in a more meaningful experience.

Keywords

  • Facial feminization surgery
  • Facial plastic surgery
  • Forehead cranioplasty
  • Reductive rhinoplasty

This is a preview of subscription content, access via your institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-19752-4_21
  • Chapter length: 12 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   44.99
Price excludes VAT (USA)
  • ISBN: 978-3-319-19752-4
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   59.99
Price excludes VAT (USA)
Hardcover Book
USD   79.99
Price excludes VAT (USA)
Learn about institutional subscriptions
Fig. 21.1
Fig. 21.2
Fig. 21.3
Fig. 21.4
Fig. 21.5
Fig. 21.6
Fig. 21.7

References

  1. Becking AG, Tuinzing DB, Hage JJ, Gooren LJG. Transgender feminization of the facial skeleton. Clin Plast Surg. 2007;34(3):557–64.

    CrossRef  PubMed  Google Scholar 

  2. Spack NP. Management of transgenderism. JAMA. 2013;309(5):478–84.

    CrossRef  CAS  PubMed  Google Scholar 

  3. Ainsworth T, Spiegel JH. Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Qual Life Res. 2010;19(7):1019–24.

    CrossRef  PubMed  Google Scholar 

  4. Spiegel JH. Challenges in care of the transgender patient seeking facial feminization surgery. Facial Plast Surg Clin North Am. 2008;16(2):233–8.

    CrossRef  PubMed  Google Scholar 

  5. Spiegel JH. Facial determinants of female gender and feminizing forehead cranioplasty. Laryngoscope. 2011;121(2):250–61.

    CrossRef  PubMed  Google Scholar 

  6. Ousterhout DK. Facial feminization surgery: a guide for the transgendered woman. Omaha, Nebraska: Addicus Books; 2009.

    Google Scholar 

  7. Powell N, Humphreys B. Proportions of the aesthetic face. New York, NY: Thieme Medical Publishers; 1984.

    Google Scholar 

  8. Morgan JPI, Haug RH. Evaluation of the craniomaxillofacial deformity patient. In: Greenberg AM, Prein J, editors. Craniomaxillofacial reconstructive and corrective bone surgery. New York: Springer; 2002. p. 5–21.

    CrossRef  Google Scholar 

  9. Gonzalex-Ulloa M. Quantitative principles in cosmetic surgery of the face (profileplasty). Plast Reconstr Surg Transplant Bull. 1962;29:186–98.

    CrossRef  Google Scholar 

  10. Zimbler MS. Aesthetic facial analysis. In: Flint PW, Haughey BH, Lund VJ, Niparko JK, Richardson MA, Robbins KT, et al., editors. Cummings otolaryngology – head and neck surgery: head and neck surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010. p. 272–3.

    Google Scholar 

  11. Noureai SAR, Randhawa P, Andrews PJ, Saleh HA. The role of nasal feminization rhinoplasty in male-to-female gender reassignment. Arch Facial Plast Surg. 2007;9(5):318–20.

    PubMed  Google Scholar 

  12. Ousterhout DK. Feminization of the forehead: contour changing to improve female aesthetics. Plast Reconstr Surg. 1987;79(5):701–13.

    CrossRef  CAS  PubMed  Google Scholar 

  13. Habal MB. Aesthetics of feminizing the male face by craniofacial contouring of the facial bones. Aesthetic Plast Surg. 1990;14(2):143–50.

    CrossRef  CAS  PubMed  Google Scholar 

  14. The American Society for Aesthetic Plastic Surgery. Cosmetic Surgery National Data Bank [Internet]. 2013. Available from: http://www.surgery.org/media/statistics

  15. Ramirez AL, Ende KH, Kabaker SS. Correction of the high female hairline. Arch Facial Plast Surg. 2011;11(2):84–90.

    Google Scholar 

  16. Altman K. Facial feminization surgery: current state of the art. Int J Oral Maxillofac Surg. 2012;41(8): 885–94.

    CrossRef  CAS  PubMed  Google Scholar 

  17. Roth JM, Metzinger SE. Quantifying the arch position of the female eyebrow. Arch Facial Plast Surg. 2003;5(3):235–9.

    CrossRef  PubMed  Google Scholar 

  18. Cho S-W, Jin HR. Feminization of the forehead in a transgender: frontal sinus reshaping combined with brow lift and hairline lowering. Aesthetic Plast Surg. 2012;36(5):1207–10.

    CrossRef  PubMed  Google Scholar 

  19. Hoenig JF. Frontal bone remodeling for gender reassignment of the male forehead: a gender-reassignment surgery. Aesthetic Plast Surg. 2011;35(6):1043–9.

    PubMed Central  CrossRef  PubMed  Google Scholar 

  20. Glasgold MJ, Glasgold RA, Lam SM. Volume restoration and facial aesthetics. Facial Plast Surg Clin North Am. 2008;16(4):435–42.

    CrossRef  PubMed  Google Scholar 

  21. Downs BW, Wang TD. Midcheek and lower face/neck rejuvenation in the male patient. Facial Plast Surg Clin North Am. 2008;16(3):317–27.

    CrossRef  PubMed  Google Scholar 

  22. Bentsianov B, Francis A, Blitzer A. Botulinum toxin treatment of temporomandibular disorders, masseteric hypertrophy, and cosmetic masseter reduction. Oper Tech Otolaryngol Neck Surg. 2004;15(2):110–3.

    CrossRef  Google Scholar 

  23. Conrad K, Yoskovitch A. Endoscopically facilitated reduction laryngochondroplasty. Arch Facial Plast Surg. 2003;5(4):345–8.

    CrossRef  PubMed  Google Scholar 

  24. Van Borsel J, De Cuypere G, Van den Berghe H. Physical appearance and voice in male-to-female transsexuals. J Voice. 2001;15(4):570–5.

    CrossRef  PubMed  Google Scholar 

  25. Spiegel JH. Phonosurgery for pitch alteration: feminization and masculinization of the voice. Otolaryngol Clin North Am. 2006;39(1):77–86.

    CrossRef  PubMed  Google Scholar 

  26. Fakhry C, Flint PW, Cummings CW. Medialization thyroplasty. In: Flint PW, Haughey BH, Lund VJ, Niparko JK, Richardson MA, Robbins KT, Thomas JR, editors. Cummings otolaryngology – head and neck surgery: head and neck surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010. p. 904.

    CrossRef  Google Scholar 

Download references

Conflicts of Interest and Sources of Funding

None.

Author information

Authors and Affiliations

  1. Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792-7375, USA

    Scott R. Chaiet M.D., M.B.A.

Authors
  1. Scott R. Chaiet M.D., M.B.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Scott R. Chaiet M.D., M.B.A. .

Editor information

Editors and Affiliations

  1. Program for LGBTI Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Kristen Eckstrand

  2. Program for LGBTI Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Jesse M. Ehrenfeld

Rights and permissions

Reprints and Permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Chaiet, S.R. (2016). Facial Feminization Surgery: Review of Facial Analysis and Surgical Procedures. In: Eckstrand, K., Ehrenfeld, J. (eds) Lesbian, Gay, Bisexual, and Transgender Healthcare. Springer, Cham. https://doi.org/10.1007/978-3-319-19752-4_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-19752-4_21

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19751-7

  • Online ISBN: 978-3-319-19752-4

  • eBook Packages: MedicineMedicine (R0)