An In-Depth Guide to Facial Feminization Surgery - Jae Pak MD Medical

An In-Depth Guide to Facial Feminization Surgery

Your face is the ultimate first impression, telling a story with every expression and feature. But many people feel that they could benefit from aesthetic changes to their facial structure to match their identity and improve their quality of life.

Let’s begin our in-depth guide to Facial Feminization Surgery (FFS) and offer some tips for patients in the early stages as they decide which strategy to pursue for the best, long-lasting results.

Facial Feminization Basics

In the fast-growing field of facial feminization, there are plenty of procedures that accomplish just this, ranging in complexity, cost, and outcome. No two journeys are the same, and everyone has a unique set of goals that must be reached with a customized approach.

Any procedure that alters the craniofacial structure to create more feminine features can be categorized as a type of FFS. Feminine facial characteristics include a softer jawline, less defined cheekbones, and less angular (rounder) features in general. 

These procedures may be minor and non-invasive, or completely transformative using the latest plastic surgery techniques.

Because the scope of these procedures is so broad, patients are advised to work with specialists who can help coordinate multiple treatments if needed, ensuring the correct order of operations and minimal risk.

Reasons for Facial Feminization Surgery

FFS procedures can be effective for men, women, and trans people who wish to reduce their masculine appearance and signal a more feminine identity to the world around them.

These procedures are popular among trans women who are transitioning from biologically male physiology. In combination with hormone therapy and other treatments, the right FFS methods can change an individual’s entire facial structure within just a few years. 

Many cisgender women seek out similar procedures, but the term “FFS” is less commonly used. Instead, these methods are referred to as standard plastic or cosmetic surgeries in the context of cis women.

The reasons for pursuing FFS come down to the individual, and understanding all the available treatment options is crucial to ensuring satisfaction, safety, and long-term results in every case.

Consultation and Costs

The techniques employed in FFS are similar to established plastic and craniofacial surgeries that have developed over the past several decades.

Depending on the patient’s focus area, different methods will be used to attain the most significant, permanent results with minimal input. As part of the consultation process, doctors should work with clients to determine the best course of action for each area of the face and proceed accordingly while offering complete transparency throughout.

Consultation is crucial in FFS practices since techniques are frequently evolving with new technologies and discoveries. A standard FFS procedure five years ago may now be considered outdated or even obsolete.

Clients must also articulate their desired outcome to their fullest ability, using reference materials and researching in-depth beforehand. The more accurately they can describe these aesthetic objectives to the clinic and physician, the more effective a procedure will be, along with higher satisfaction rates long term.

In terms of costs, the most basic, non-invasive fillers and short-term treatments can be as low as $1000 or less, though repeat visits are often required to maintain results.

The more complex and comprehensive procedures become, the steeper costs will climb. Restructuring and recontouring facial features are $5000 minimum per region and when combined with other procedures, the total costs can be well into the $20,000 range.

With that said, clients and doctors must work together in the consultation to figure out a cost-effective, long-term solution for their shared objectives, which may mean a unique mix of non-surgical treatments and more substantial procedures.

Surgical Procedures

Understanding FFS as a broad term, it’s time to learn more about the individual procedures that can be part of a patient’s facial feminization strategy. These surgeries can be completed individually, in combination with others, or performed strategically with alternative therapies.

Let’s examine each procedure, its objectives, how they’re performed, and relevant info that can help patients get better results. 

Jaw and Chin Recontouring

Masculine facial features are usually defined by a strong, angular jawline, making this area a core focus in many FFS playbooks.

Through jaw and chin recontouring procedures, patients can achieve a softer, more rounded, and less angular jawline, reducing the masculine look of the lower third of the face. 

A non-invasive method could include injectable dermal fillers, which can simultaneously reduce fine lines and wrinkles while boosting volume along the jawline. 

Reducing the size and shape of the chin may be necessary to achieve a balanced, feminine facial structure. Surgeons must add or remove tissue in their efforts to keep a smooth and even appearance. 

V-Line Jaw Reduction

Popular in many Asian countries but suitable for anyone, V-line surgery creates a more narrow, V-shaped lower third of the face. This type of surgery is only advised for a specific type of facial feminization results, but the technique is ideal for anyone seeking that outcome.

The procedure involves making incisions along the jawline and shaving down the bone of the mandible to remove some of the material while shaping the chin and jaw.

V-Line jaw surgery may be used in combination with contouring, fillers, and other methods to create a unique aesthetic result.

Forehead Reduction

Some patients find that a lower forehead can create a more feminized facial appearance, especially if a trans woman has a mature hairline or early pattern balding.

With forehead reduction, surgeons make an incision along the hairline and pull the skin forward several centimeters before using sutures to keep the skin in its new place.

The procedure can be a suitable alternative for hair transplant among clients who don’t want to use donor hair but has limitations such as limited skin mobility.

A Forehead Reduction can also be accomplished in a less invasive way by hairline lowering through a hair transplant. This will be discussed later in this article.

Brow Lift

Raised brows are a feminine feature that can create a more youthful look while increasing the roundness and openness of the eyes. The brow lift is a favorite in the plastic surgery field and can offer the extra boost that many FFS patients are looking for.

In this procedure, surgeons separate deep tissue that connects brow skin from the face, then lift up the skin to the desired position before connecting and sealing the gap. 

Each brow lift must work with the shape of the patient’s face to highlight the best natural features.


Altering the shape of the nose is often included in the long list of FFS procedures, as this is the focal point of the face. A smaller, more feminine nose can bring together a more feminine appearance and is typically one of the final procedures to be administered.

Rhinoplasty surgeons should be aware of the patient’s goals and work with them to reconstruct a nose that blends well with the rest of the face in the feminization process.

Adam’s Apple Reduction

For men transitioning to women, the Adam’s apple may be one of the last remaining signals of masculinity. Therefore, minimizing this feature might be the final step toward achieving a fully feminized face. 

Surgeons can remove a significant amount of bone material from the Adam’s apple, smoothing the neck and creating a more feminine look.

Hair Transplantation

While hair transplants typically fall outside the usual FFS procedure lineup, they may be a useful addition to clients seeking an extra layer of assurance for their hairline as they age. 

With advanced procedures like FUT and FUE, today’s hair transplants are highly effective, with lasting results and the ability to perform smaller follow-ups. In many cases, transplantation is preferred to forehead reduction and may be referred to as hairline lowering

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Work With Trusted Doctors

Trust in your physician helps ensure successful FFS procedures. Here are some key criteria to look for when seeking out your doctor and clinic.

1. Experience (With People Like You)

Since facial feminization is relatively recent, not all doctors have a proven track record for the procedures we’ve outlined here. Check the clinic’s before and after galleries to see visible proof they’ve successfully worked with people of your gender, background, and ethnicity, plus have the skills for the procedures you wish to have done.

2. Variety of Procedures (Within One Discipline)

Not even the world’s greatest doctor can be an expert in all fields. However, you should work with physicians who have mastered their particular discipline to get the best results in a certain focus area.

For example, craniofacial surgeons work best with jawlines and cheek contouring, while hair restoration experts like Dr. Jae Pak can perform hairline lowering and eyebrow transplants among the best.

3. Continued Treatment and Follow-Up

It’s rare for patients to have a single FFS procedure. Therefore, continued consultation, communication, and follow-up surgeries are often expected in this field.

Clients should be ready to move forward with other procedures should they so choose and be open to new techniques according to the doctor’s recommendations.

Your Unique Facial Feminization Path

While many procedures are covered under the FFS label, this guide covers all the basics you need to know. 

If your focus is on maintaining or restoring your hairline and eyebrows throughout the process, be sure to connect with Dr. Jae Pak today for the experience you need and get the plan in motion. 


Facial Feminization for Cisgender Women | ASPS

Evaluation and Treatment of Facial Feminization Surgery | NIH

Facial Feminization Surgery (FFS) | University of Utah

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