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Gender Confirming Facial Surgery – Show Your Real Face To The World!

The Male and Female Face: Understanding the Differences and Reasons for FFS

Facial feminization surgery has the objective to “sculpt out” feminine features out of preexisting masculine ones. This is achieved by contouring the forehead, reshaping and lowering the hairline, lifting the eyebrows, reducing the orbital bone, cheek augmentation, lip lift and augmentation, feminizing the nose and refining the chin, reducing the Adam’s apple and feminizing the voice.  These procedures when correctly combined can transform a face and a presence from masculine to feminine, in a procedure that is life-changing.

Below are some of our FFS procedures:

In men, the hairline is often higher than in females and usually becomes even higher at the temples that give it an “M” shape. The hairline can be moved forward and given a more rounded shape either with a scalp advancement or with hair transplants, or the combination of both. In the scalp advancement procedure, the scalp is repositioned to the ideal feminine hairline. The incisions are made in an irregular fashion just behind the natural hairline in a fashion that results in hair growing through the incision line to further camouflage it. When hair transplantation is performed, a strip of hair-bearing skin is removed from the scalp and then transplanted to cover any areas of temporal balding and excess forehead (follicular unit strip or FUS technique). In alternative, the hair follicles can be harvested one by one in order to avoid a linear scar on the scalp (follicular unit extraction or FUE technique).The new grafts take about 6 months to populate the new hairline.

The forehead is the most gender-defining feature of the face. This is because the eyes are the most important feature of the female face and a prominent forehead casts a shadow over the eyes, thus obscuring their appearance and beauty. Men typically have a prominent ridge of bone at the eyebrow level called the brow ridge, while female foreheads tend to be smoother, flatter, with no bossing. The bony rims that the eyebrows sit on are called the “supraorbital ridges”. The supraorbital ridges are shaved down during a forehead contouring procedure. Under the prominent bone of the lower forehead basically serves as the front wall of a sinus cavity called the frontal sinus. Exception made for the cases in which the frontal sinus is missing (3-5% of the population), in order to achieve a perfect oval contour of the forehead, Dr Mardirossian would enter the sinus and set back its front wall. The thickness of the wall is not reduced but it is simply repositioned to give the forehead the desired contour, while maintaining its strength. This technique is routinely called Type 3 Forehead feminization or Group 3 reduction-recontouring after Osterhout. This is the technique that Dr Mardirossian was trained into during his 7-year-long training with Dr Jeffrey Spiegel and he currently performs in 90-95% of his patients.

Eyebrows are usually horizontal in men while in women they are arched with the highest point corresponding to a line passing through the lateral edge of the iris of the eye. Along with advancing the hairline and contouring the forehead Dr Mardirossian performs a browlift to elevate the brows above the orbital rims; this improves the appearance of the eyes and underlines their beauty.

Generally, men tend to have bigger and wider noses than women, and the nasal tip is bulbous and pointing down.   The female nose is smaller, refined, and delicate compared to male noses. The attractive female nose has a slight scoop at the dorsum and the tip is slightly turned up (or rotated) and less prominent (or less projected) than a male nose.

Women`s cheeks are fuller and with a more defined contour and projection than men. This is especially true for the area of the cheeks under the eyes. This portion is very important because, when fuller, it reflects light into the eyes to make them more attractive. Fillers, fat grafting and cheek implants are all viable options for cheek augmentation.

Men tend to have longer and heavier chins than women. In men the chin is often square whereas in women the chin is more refined and pointy, almost the height of the upper and lower lip together. The chin height can be reduced in several ways including 3D bone contouring, with a procedure called a “sliding genioplasty” or a T-genioplasty where a section of bone is removed. In addition males have a more prominent body of the mandible (the area under the cheeks) and more prominent mandible (or jaw) angles. All these areas can be reduced very effectively by means of bone contouring which is a 3D gradual process that enhances feminine appearance, narrows and reduces the length of the face while good supper for the soft tissue is preserved. This is a very safe procedure which Dr Mardirossian as been performing for years.

The length of the philtrum (or area above the upper lip) is greater in men than in women and becomes longer with age. This process is contrasted and reversed thanks to the lip lift procedure that lifts the upper lip to show several millimeters of the upper teeth. Upper teeth show is perceived as very feminizing. It creates attractiveness to the lips and the lower face as a whole, but also contributes to a shorter and more feminine face image. The incision is hidden underneath the nose and with meticulous closure becomes invisible in the vast majority of patients. To improve lips fullness for more attractive and “kissable” lips we routinely use fillers, fat, dermal-fat grafts or soft silicone implants. These, as well as many other procedures can be performed under local anesthesia as well as in conjunction with FFS.

Men tend to have a much more prominent laryngeal cartilages (aka Adam’s apple) than women. The Adam’s apple can be reduced with a procedure called a “tracheal shave” or “Chondrolaryngoplasty”.  It is very important that your surgeon visualizes the attachment of the vocal cords to the laryngeal cartilage prior to removing the unwanted cartilage in order to avoid injury to the attachment of the vocal folds and changes in voice. This is not an in-office procedure and requires a one night hospital stay. The incision is hidden under the chin to prevent it from being seen. Meticulous closure, proper placement and short incision produce a very inconspicuous healed incision almost in all patients.

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