Facial Feminization Surgery (FFS)

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Facial Feminization Surgery (FFS) is an important part of the male to female transformation. At UCSF Facial Plastic Surgery, we are proud to be a destination for patients seeking FFS. We understand the importance of this surgery and its role in helping our patients transform their faces to reflect their inner self. FFS is one part of an overall feminization strategy that includes hormone therapy and potentially a variety of other surgical procedures in other areas of the body.

FFS broadly describes a group of surgeries that create a feminine appearance of the face. After a thorough discussion and examination of each patient by our surgeons, a surgical plan is jointly created with the patient’s direct input and desires. This carefully customized surgical plan aims to help our patients confidently look and feel feminine.

Facial Feminization Surgery (FFS)

A variety of surgical procedures are used in FFS and are performed in combination to produce a powerful and elegant effect:

Hairline Advancement

The male hairline can have peaks at the temples and may be recessed. Using scalp advancement, the hairline is moved forward and the peaks are removed. Incisions are created in the scalp to accomplish this. This creates a rounded hairline that is more typical of a female hair line.

Brow Lift

As the male appearing eyebrow sits lower on the forehead, elevating the eyebrows produces a more feminine appearance. A variety of methods can be used to raise the eyebrows and our surgeons will discuss these techniques.

Forehead and Orbital Rim Contouring

The male-type forehead has characteristic excess bone above the eyebrows, primarily in the lower forehead and above the eyes. Removing the “extra” bone and moving the forehead bone into a more female appearing position creates a drastic change that is essential for facial feminization of the upper part of the face.

Eyelid Surgery

The eyes and eyelids are the central point of gaze when looking at a face, and they can convey much of a person’s emotion and personality. However, the eyelids can change with age. By rejuvenating them and making the eyelids appear younger, a beautiful and feminine appearance is created around the eyes.

Chin and Jaw Modification

The female appearing jaw is typically more pointed and tapered than the male appearing jaw. The male jaw bone has extra bone that creates these differences. This extra bone can be removed to taper, thin, and feminize the lower face. The chin itself is also typically square in shape in the male face. Tapering the bone and adjusting the tissues that make up the chin create a feminized, refined, and elegant appearing chin. A chin implant may be required to produce these changes. Our surgeons discuss these surgical techniques with you.

Cheek Augmentation

The female face is known to have defined and high cheeks, with the widest part of the female face occurring at the cheeks. By performing cheek augmentation with fat grafting or implants to the cheek bones, the face can be significantly feminized. A beautiful, curved contour of the face is created that is natural and carries a beautiful feminine appearance.


The nose is the center of the face and is a major focus point in FFS. The male appearing nose is wider, longer, and extends further out from the face. The tip of the male nose is also turned slightly more upward and is smaller. Therefore, to feminize the nose, a rhinoplasty is performed to create a more petite nose that matches the surrounding feminized face. A rhinoplasty changes the shape of the nose by altering the bone and cartilage that make up the nose. Our surgeons are skilled in rhinoplasty to perform these essential changes to the nose.

Upper Lip Shortening

The upper lip is typically longer in males. Shortening a long upper lip complements the feminized nose to create a harmonious female appearance in the mid portion of the face.

Facelift and Neck Lift

While a facelift and neck lift are typically used to help reverse the signs of facial aging, they can be an important part of FFS. As the face ages, masculine features can become more visible. Therefore, reducing signs of aging and excess skin of the face and neck can help to create a more feminine appearance of the face. Facelift and neck lift can be an important overall part of FFS. Our surgeons carefully assess the face to determine if facelift and neck lift procedures may provide additional feminization.

Tracheal Shave

The Adam’s Apple (or thyroid cartilage) is larger and more visible in the male neck. Reduction of this prominence may be needed. Additionally, speech therapy can be helpful to retrain the voice and speech pattern. Our surgeons work with speech therapists and voice surgeons.

Facial Feminization Surgery: Before and After