Non-Surgical Facial Feminization
It is easier than ever to make your outer appearance a better reflection of your inner self. Facial feminization procedures have been gaining popularity among men hoping to look more approachable or transition to female, as well as among women hoping to have a more feminine appearance.
Fortunately, altering facial features to create a softer, feminine look does not have to require facial feminization surgery (also known as FFS). Below are the most common non-surgical procedures to achieve facial feminization without plastic surgery.
1. Re-Defining the Jaw
“Men have square and lower jaws, strong mid faces, and a more hallowed face,” West Hollywood-based board certified dermatological surgeon Jason Emer, MD, explains, “women need to be more full, lifted, with a heart-shaped look.” While many people jump to jaw reduction plastic surgery to re-contour and re-shape the mandible bone, there are less invasive and non-permanent options as well. Botox® of the masseter muscle is an injectable that can also narrow the jawline. The masseter muscle wraps around the jaw and can be temporarily contracted with Botox® injections, leaving patients with a more narrow jawline. While Botox® will take a few sessions to achieve your desired look, and requires continued injections, compared to jaw reduction surgery it is significantly less risky. When consulting with a board certified plastic surgeon, make sure to discuss the risks of jaw reduction surgery, like the potential of a damaged the mental nerve (the sensory nerve which provides sensation to the front of the chin, lower lip, and teeth).
Another minimally invasive technique is a PDO thread lift, which uses threads to lift any sagging tissues in the neck or face, such as the cheek, chin, and jaw bone. By lifting the loose tissues, you can re-define the appearance of the desired area. Like Botox®, a PDO thread lift is temporary, lasting about six months.
2. Volumizing the Cheeks
Usually, women have fuller, more forward projected cheeks compared to men. Cheek augmentation can be done surgically with permanent cheek implants, where patients can choose from varying sizes and shapes to achieve the right degree of fullness and forward projection they desire. Non-surgically, dermal fillers like Voluma® or Radiesse® are also a good option. Dermal fillers work with the cheek’s native tissue to give a natural appearance. While dermal filler requires more maintenance than cheek implants, there is a lower risk of infection, migration, and asymmetry.
3. Chin Augmentation
Because of men’s square jawlines, their chins are usually not as pointed as women’s and do not create a triangle with the two cheekbones. The options for chin augmentation are very similar to those for the jaw and cheeks. There is reconstructive plastic surgery available to resculpt the chin bone as well as Botox® and dermal filler to provide a non-surgical and non-permanent option. Botox® works with the mentalis muscle to turn the chin down and dermal filler adds fullness to make a more pointed chin. Since jaw redefinition, cheek volumization, and chin augmentation all require Botox® and/or dermal filler, often patients will choose to do all three together for a more symmetrical and feminized face.
4. Reshaping the Nose
Believe it or not, a rhinoplasty (a.k.a. nose job) is not the only way to restructure the nose. Small amounts of dermal filler, including long-lasting Bellafill®, can help feminize the nose too. While dermal filler isn't able to reconstruct the nose (e.g. make the nose smaller or narrower), it can enhance feminization by lifting the tip of the nose and reducing the appearance of dorsal humps.
5. Lip Augmentation
Lip fillers like Juvéderm® Volbella, or Restylane® Silk, are another non-invasive way to instantly feminize the face. It takes about 15 to 20 minutes for a dermatologist to inject the dermal filler, the results are immediate, and it can last around four to six months. Due to recent celebrity trends, lip augmentation has been overwhelmingly popular, especially for women. Different types of filler will give different results — from volume to smooth vertical lines around the mouth.
6. Facial Hair Removal
Removing facial hair is a good first step for those transitioning, particularly for transgender women who are not undergoing hormone therapy. When transitioning to female, hormone therapy includes lowering testosterone levels and increasing estrogen into a typical female range. Lowered testosterone is responsible for the thickening of facial hair and, if lowered, can result in lessened hair growth. However, trans women not undergoing hormone therapy can eliminate facial hair through laser hair removal. While it can take anywhere from six to 12 sessions to see a significant reduction in facial hair growth, the results are long-lasting and only require occasional maintenance. The procedure is non-invasive and produces stronger results than waxing or shaving. Be sure to speak with a dermatologist to determine which type of laser is best suited for your hair type.
7. Eyebrow Shaping
Another noticeable difference between the male and female face is the eyebrow shape. Women tend to have higher set eyebrows that sit above the brow ridge (also known as the supraorbital ridge), the brow bone located above the eye sockets, as well as a more arched shape. While there are surgical facial feminization surgeries, such as an endoscopic brow lift, Botox® is a good non-surgical option to create a more feminine arch. Additionally, patients can opt for an ultrasound to tighten the skin around the eye, thread lifts to give a cat-eye look, or filler under the eye to lift the brow.
While most features can be feminized through Botox® and filler, there are some features that would require surgery. A lip lift, for example, requires a plastic surgeon to remove a section of skin in between the tip of the nose and upper lip. Additionally, an Adam’s apple reduction would include a surgical tracheal shave (also known as a thyroid cartilage reduction or TCR).
As always, it is crucial that patients carefully vet providers and, in this case, choose a surgeon or doctor who specializes in FFS. Achieving the softer, feminine face you have always dreamed of is an empowering and life-changing moment. Experimenting with dermal fillers, Botox®, and PDO threads is a great non-permanent start.