The process of feminizing a male face involves knowing the differences that exist between the two sexes. We perform open browlifts to raise and arch the eyebrows and drill down the underlying ridge of bone, which characterizes the male skull. We add cheek implants to create a dramatic, youthful feminine face and reduce and rotate up the nose, if it is too strong a feature. The lips are made fuller and more pouty, and the chin is reduced, if it is prominent. Lastly, we shave down the Adam’s apple (laryngeal shave), which helps produce a more graceful, feminine appearance.