Gender-Affirming Facial Feminization Surgery

Blonde woman smiling - gender affirming facial feminization surgery blog post

Facial feminization surgery for transgender patients is growing in popularity, but it’s still not routinely offered at most surgical centers. At The Center for Plastic Surgery at Sentara Princess Anne & Fort Norfolk, experienced surgeons have been providing the procedures for several years.

“Facial feminization surgery can make a big difference in a patient’s life,” says Richard Tyrell, M.D., a plastic surgeon at The Center for Plastic Surgery at Sentara Princess Anne & Fort Norfolk. Dr. Tyrell received training in facial feminization during a craniofacial surgery fellowship at the University of Utah. He describes the services he offers and what patients can expect.

What Is Facial Feminization?

Facial feminization involves several procedures to change the shape of the face. “There are a few key areas I address to make a masculine face more feminine,” Dr. Tyrell says.

Those areas may include:

  • Forehead and brow: Surgeons can lower the hairline to create a smaller forehead, which is more common in cisgender women. They also smooth the area between the forehead and nose to create a more delicate, feminine brow.
  • Nose: Rhinoplasty can help create a smaller, narrower nose.
  • Cheeks: Cisgender women tend to have rounder cheeks. Surgeons can create more feminine cheeks by changing the position of the cheekbones, transplanting fat into the cheeks or placing cheek implants into the face.
  • Jaw: Surgery can narrow the chin and jaw, making the face more oval rather than square.
  • Lips: A lip lift procedure can make a face more feminine by shrinking the distance between the nose and upper lip.

Facial Feminization: Surgery and Recovery

Before facial feminization procedures, surgeons work with patients to determine the specific changes that will help them achieve their goals. Depending on the plan and the patient, those procedures may be done during a single surgery or take multiple surgeries.

At Sentara, surgeons use virtual surgical planning models to map a detailed plan for surgery. The models are based on CT scans of the patient’s skeletal structure. “This leading-edge technology provides a guide so that I can be very precise in making the changes,” Dr. Tyrell says. “Having that detailed plan reduces the length of the surgery, lowering the risk of complications.”

After surgery, patients usually spend a night in the hospital for observation and pain control. “Patients can expect significant swelling right after surgery. At about the two-week mark, most patients feel like themselves again and can start resuming normal activities,” he says.

Patients generally tolerate facial feminization procedures well, and most patients are very satisfied with the changes to their appearance, Dr. Tyrell says. “We don’t completely change your face,” he adds. “You’ll still look like yourself, but a more feminine version of you.”

A Commitment to Gender-Affirming Care

Sentara also offers other gender-affirming procedures, such as top surgery to remove breast tissue and tracheal shaves to reduce the appearance of the Adam’s apple. Multiple specialists play a role in offering gender-affirming care, including OB-GYNs, urologists, psychiatrists and endocrinologists, in addition to plastic surgeons such as Dr. Tyrell. “Sentara stands out for our multitude of specialties that come together to provide care for transgender and gender-nonconforming patients,” he says.

Beyond those specialties, Sentara offers gender-affirming care throughout its clinics and hospitals. “Patients’ preferred names and pronouns are listed in their medical charts, and our staff is dedicated to providing a safe and comfortable environment for all of our patients,” Dr. Tyrell says.

Call 757-507-0720 to learn more or to schedule a consultation.