Facial feminization surgery: current state of the art

Facial feminization surgery (FFS) is a group of surgical procedures; the objectives of which are to change the features of a male face to that of a female face. This surgery does not aim to rejuvenate the face. FFS is carried out almost exclusively on transsexual women (males who are transitioning into females) and who have gender dysphoria. Some non-transsexual women may undergo some feminizing surgical procedures if they feel that they have male facial characteristics. Most transsexual women will have lived in role for sometime and they often undergo FFS before any other form of gender reassignment surgery as it assists them in passing as a female and integrating into everyday society. Various specific facial surgical procedures are utilized to feminize the face, often involving sculpture and contouring of the facial skeleton. These include correction of the hairline by scalp advance, contouring the forehead, brow lift, rhinoplasty, cheek implants, resection of the buccal fat pads of Bichat, lip lift and lip augmentation with dermis graft, mandible angle reduction and taper, genioplasty and thyroid shave. This article discusses the current state of the art in facial feminization surgery.