Though not a facial feminization procedure, this operation will make a person look younger and healthier, which contributes to the overall improvement seen with the facial feminization surgery. Additionally, since many men age more in the area under the jawline versus the usual facial laxity and wrinkling that women experience with aging, this procedure will go a long way to avoid the disparity seen between the genders.
Facelift (before & after)
Cheek augmentation
It has always been my impression that a good looking, balanced face is more square than oval. This necessitates having well developed cheeks and angles to the jaw. For a face to look more feminine, the cheeks are stronger than the angles. And vice versa for a face to be more masculine. To this end, we usually augment the cheeks with either the person's own fat, injectable fillers or synthetic cheek implants. The implants I use are made of silicone and are screwed to the cheekbone with a tiny titanium steel screw. This ensures that stability and symmetry will be maintained and not change over time. The approach is under the upper lip, and either a malar implant is used to augment the cheekbone area or a combined implant is used to augment both the cheekbone and sub-cheekbone areas.
Cheek augmentation (before & after)
Hairline
One of the most distressing male features in someone transitioning from male to female is the male pattern of baldness. This usually starts out as temporal recessions but may proceed to a significant loss along the entire frontal hairline. A female hairline is rather straight across and appears to be positioned approximately one third the height of the frontal face when measured up from the eyebrows. Correction to achieve this goal may involve a scalp advancement, hair transplants or a combination of the two.