Facial Feminization Surgery – Before and After

This patient underwent the following procedures in one stage as part of Facial Feminization Surgery (FFS).
– Type 3 brow bone reduction, orbital contouring, brow lift
– Cheek implants
– Lip lift
– Genioplasty, and jaw contouring
– Tracheal shave

Type 3 brow bone reduction – This patient presented with a prominent brow ridge and pronounced frontal bossing, which was particularly evident in the profile and three-quarter views. The Type 3 brow bone reduction set back the anterior wall of the frontal sinus, eliminating the heavy central ridge and creating a continuous, gently curved forehead slope that transitions smoothly into the nasal bridge.

Orbital contouring – Orbital contouring was performed to reshape the superior and lateral margins of the eye sockets. By reducing the heavy bony ledge surrounding the eyes, this procedure opened up the periorbital area and softened deep shadow patterns, a change best appreciated in the front-facing and three-quarter views.

Brow lift – The brow lift elevated the brow complex into a softer, arched position above the newly contoured orbital rim. These subtle, rejuvenating adjustments in resting brow height and upper facial openness are most visible in the front view and smiling perspective.

Cheek implants – Malar cheek implants were placed to enhance midface volume and projection. The added fullness creates a more defined, feminine cheek contour and restores a balanced heart-shaped structure to the face, which is best evaluated in the three-quarter and lateral views.

Lip lift – A subnasal lip lift was performed to reduce an elongated philtral distance and subtly evert the upper lip. This procedure created a more youthful distance between the base of the nose and the vermilion border while increasing natural upper tooth display, results most noticeable in the front view, lateral profile, and gentle open repose.

Genioplasty – Genioplasty was utilized to reshape and narrow the chin point, eliminating previous squareness and heavy anterior projection. The resulting delicate, feminine taper is most apparent in the front view and the upward-angled basal view.

Jaw contouring – Contouring of the mandibular body and angles was performed to narrow the lower face and eliminate sharp, lateral bony flares. The streamlined, soft taper of the lower jawline is best observed in the front view, three-quarter views, and the upward-tilted profile view.

Tracheal shave – A tracheal shave (chondrolaryngoplasty) was performed to reduce the prominence of the thyroid cartilage. This smoothed the anterior throat, creating a clean, flat neck transition that is most evident in the lateral profile views and the upward-angled perspective.

Dr. Mittermiller’s approach to facial feminization surgery is to create a result that appears feminine and natural. These before after photos allow people to see what type of results can be obtained after undergoing various procedures. Every person’s face and goals are different, so it is important to discuss your specific situation and expectations with your surgeon.