Facial Feminization Surgery – Before and After

This patient underwent the following procedures in one stage as part of Facial Feminization Surgery (FFS).

Hairline lowering – The patient presented with a moderately high hairline and desired further feminization of this area. The hairline lowering procedure effectively reduced the height, an improvement most noticeable in lateral views as well as in forward-facing images with the patient looking downward. This adjustment contributes to a softer and more traditionally feminine appearance.
Type 3 brow bone reduction – This patient exhibited a pronounced brow ridge, which was particularly evident in lateral views. The brow bone reduction helped transform the forehead by eliminating the central prominence and creating a smoother, more rounded contour that extends from the upper forehead down to the nose.
Orbital contouring – Orbital contouring was performed to address the shape and projection of the area around the eyes. The improved orbital contours are best appreciated in three-quarter views, where the reduction in the ledge above the eyes and the diminished heaviness of the outer brow area are clearly visible.
Brow lift – The brow lift procedure produced results that are most apparent in the front-facing view. Together with the brow bone reduction and hairline lowering, the brow lift allowed the brows to be positioned higher on the face, contributing to a more feminine and open look.
Chin and jaw reduction – Chin reduction results can be best observed in three-quarter views, where the previous squareness of the chin has been softened, resulting in a more feminine contour. Similarly, jaw angle reductions are evident in both three-quarter and lateral views. In these perspectives, the jaw angles appear higher, softer, and rounder, further enhancing the overall facial shape.
Fat grafting to the cheeks and lips – This patient had a limited amount of harvestable fat for use in cheek and lip augmentation, a consideration that is often discussed with patients prior to surgery. In thin patients, fat grafting typically yields subtle results and may require additional procedures to achieve the desired volume in the cheeks and lips. Nonetheless, there is a slight increase in volume of the lips and the soft tissue around the cheek prominences.

Dr. Mittermiller’s approach to facial feminization is to create a result that appears inherently feminine and natural. These before-and-after photos allow patients to observe the significant visual transformation possible through targeted FFS. Because facial structure and personal goals vary, discussing your specific anatomy and expectations during a private consultation is essential.