The ideal male face is chiseled, masculine, and well-defined. While many trans men are able to achieve traditionally-male facial features with the use of hormone therapy (testosterone), facial masculinization surgery (FMS) is an ideal option for the patient who would like to achieve a greater degree of masculinization. Because the face offers important clues to the outside world about one’s personality and gender identity, obtaining a more masculine facial appearance is an important treatment goal for many trans men. While the decision to undergo FMS is a very personal and individualized one, trans men who do opt for this procedure typically experience an improved self-esteem and self-image, along with an enhanced ability to “pass” in society as a male.
Due to genetic variation and the effects of sex hormones like estrogen and testosterone, men and women tend to have different facial characteristics. In contrast to the average woman’s facial structure, men usually have longer, larger, and more angular faces. Men typically also display a more prominent and protruding brow bone, which is known as “bossing”, along with a larger and higher chin. Other facial features that are generally perceived as masculine include a prominent nose, thick eyebrows, a square jaw, and a visible Adam’s apple. In contrast, facial features that are considered more feminine include an absence of bossing, a smaller chin and nose, fuller cheeks, and an arched brow. No one facial feature defines a traditionally masculine or feminine face; rather, these traits are achieved through the combination of various features and the ratio of male to female characteristics. With FMS, the goal is to achieve a masculine appearance while taking the patient’s overall facial proportions and anatomy into consideration.
Facial masculinization surgery typically involves a combination of procedures tailored to the individual patient’s unique needs and goals. Procedures that may be performed during FMS include forehead lengthening/augmentation, cheek augmentation, rhinoplasty, chin recontouring, jaw contouring, and thyroid cartilage enhancement (Adam’s Apple surgery). Your surgeon at the Trans Center will work with you to choose the ideal combination of procedures in order to achieve the very best possible results.
Because female foreheads are typically shorter, lengthening the forehead by increasing the distance between the eyebrows and hairline can create a more masculine appearance. Additionally, forehead augmentation can create a larger, more angular forehead. With both of these procedures, the surgical incision can be made within the hairline to avoid visible scarring. The scalp is then lifted and pulled backwards; or a prosthetic material is used to mold the forehead, in the case of augmentation.
During cheek augmentation, implants are placed in between the bone and the skin to create a more angular and masculine shape. Because the surgical incision is made inside the mouth, cheek augmentation leaves no visible scars.
With rhinoplasty (“nose job”) performed during FMS, the goal is to create a larger and/or wider nose, or increase the nasal projection. Because every nose is different, this tends to be a very individualized procedure, and several surgical techniques can be utilized to obtain the best possible aesthetic result. Surgical incisions from rhinoplasty usually heal very well with minimal scarring. After rhinoplasty, a cast will be placed on the nose for about one week, along with absorbable sutures to close the surgical incisions.
Because male chins tend to be longer and squarer, the goal of chin recontouring is to increase the size of the chin for a h2er, more angular appearance. This is a very effective procedure for masculinization of the face. During this procedure, an incision is made inside the mouth and the bone is moved to reshape and recontour the chin; implants can also be used.
Jaw contouring is a useful procedure to create masculine facial proportions, increase the overall width of the face, and provide definition between the lower face and neck. During a jaw contouring procedure, the surgeon places an implant into the jaw through an incision in the mouth. This technique avoids visible facial scarring.
Thyroid Cartilage Enhancement
The “Adam’s Apple”, a prominent notch in the thyroid cartilage, is one of the most visible differences between the male and female visage. With thyroid cartilage enhancement, a small incision is made below the chin and an implant is placed in the throat area. The neck muscles are then closed over the implant in order to protect the vocal cords; however, some vocal weakness is expected during the first few weeks post-surgery.
Because every patient is unique, the surgeons at the International Center for Transgender Care don’t believe in a “one-size-fits-all” approach. Instead, we opt to work with each patient to design a unique treatment plan tailored to your individual needs. Our surgeons are not only highly skilled technically, but have the aesthetic and artistic awareness to know what constitutes a masculine face. During a consultation appointment, your surgeon will meet with you to assess your facial structure, discuss your needs, and answer any questions you have about FMS and the recovery process. Most trans men choose to have all facial masculinization procedures performed at once. Depending upon which specific procedures are performed, FMS can take between 6-12 hours. In general, patients who undergo FMS will stay overnight after their procedure and return home the following day. Some swelling, bruising, and discomfort is expected with each of these procedures, but this generally resides after about 7 days, with full recovery expected within 3-4 weeks. Any pain can typically be well-controlled with prescribed medications.
While most trans men are very happy with the results of their FMS, no surgery is without risk. While rare, complications such as poor reaction to the anesthesia can occur. It is important that trans men understand the risks and benefits of FMS and have realistic expectations going into surgery. While FMS can provide you with a more masculine appearance, results may not be “perfect”. Additionally, final results may not be visible for several months due to post-surgical swelling.
Facial masculinization surgery is an important component of the female-to-male transition, offering many physical and psychological benefits for the trans man. Because FMS is such a significant procedure, it is paramount to work with only the most expert surgeons. At the International Center for Transgender Care, our board-certified surgeons have more than 20 years of experience treating transgender patients. We are proud to offer all of our services in a respectful, welcoming environment at our world-class surgical center in Dallas, Texas. We look forward to assisting you in achieving the very best possible results for your FMS. Contact us today to schedule a consultation or call us at (972) 543-2477.