Facial Feminization Surgery – Before and After

This case study outlines a comprehensive, two-stage facial feminization surgery (FFS) designed to soften facial features while gently correcting facial asymmetries.

Quick Case Overview

Clinical Focus	Targeted Concerns	Core Surgical Interventions
Upper Face	High hairline, heavy brow ridge, low brows	Scalp advancement Type 3 brow bone reduction Orbital contouring Brow lift
Mid-Face	Nasal hump, wide bridge, long upper lip	Complete primary rhinoplasty Subnasal lip lift
Lower Face	Wide, asymmetrical jaw & chin	Osseous genioplasty (chin reshaping) Mandible reduction
Volume	Thin lips	Autologous fat grafting (6cc total)

Surgical Breakdown by Facial Zone

1. Upper Face: Forehead & Brow Remodeling

• Type 3 Forehead Reduction: Shaved and set back the anterior wall of the frontal sinus to eliminate the prominent brow ridge.
• Orbital Contouring: Reshaped the orbital rims to open and soften the eye area.
• Hairline Lowering & Coronal Brow Lift: Advanced the scalp forward to reduce forehead height while simultaneously lifting the eyebrows into a higher, feminine arch.

2. Mid-Face: Structural Rhinoplasty

• Dorsal & Width Reduction: Removed the nasal hump and narrowed the nasal bones using bilateral osteotomies (in-fractures).
• Tip Refinement & Support: Utilized bilateral spreader grafts, a cephalic trim, and precision tip sutures to create a stable, delicate, and slightly upturned nasal tip.

3. Lower Face: Jaw Narrowing and Chin Contouring

• Mandibular Reduction: Bilaterally narrowed the jaw angles and body. Corrected structural asymmetry by elevating the low right mandibular angle.
• Osseous Genioplasty: Reshaped the chin bone by narrowing its overall width and reducing the vertical height on the right side to establish improved facial symmetry.

4. Perioral Rejuvenation & Lip Augmentation

• Subnasal Lip Lift: Shortened the distance between the nose and upper lip, increasing youthful tooth show at rest.
• Autologous Fat Grafting: Injected 3cc of purified fat into each lip (6cc total) for long-lasting, natural volume.

Key Takeaway for Patients

Combining bone contouring (forehead and jaw) with soft tissue refinement (rhinoplasty and lip enhancement) provides a dramatic yet natural-looking transformation. Correcting underlying bone asymmetry ensures the face looks balanced and harmonious from every angle.