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Facial Feminization:
My approach to facial feminization is to listen to what each patient wants and needs, as well as offer my opinion based on years of professional experience. What suits each individual is different, and therefore every patient gets a custom surgical plan. The personally tailored surgical plan is based on each woman’s anatomy, as well as what will be most helpful in alleviating dysphoria.
- Dr. Regina Rodman
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Facial feminization surgery or FFS softens masculine features making them more feminine. There are certain facial characteristics that cue others to think of someone as male or female. Facial feminization surgery can change those features to make them appear more traditionally female. Many transgender women easier time presenting as female and a decrease in dysphoria after FFS. Facial Feminization is a combination of surgeries to soften both the soft tissue and bony structures of the face. Because every patient is different, the surgeries needed may vary from patient to patient. Also, each patient has different areas that cause strong dysphoria. Still, most transgender women desire surgery on the hairline, forehead (brow bossing), nose, Adam’s apple, jaw, and chin, as the bony changes in this area do not feminize with hormones alone. Additionally, women may wish to change their lips, cheeks, eyes, and neck. To find out what procedures would be most beneficial for each patient, Dr. Rodman conducts a thorough consultation with each patient. The patient and Dr. Rodman decide on a plan together.
Traveling to Houston for SurgeryThese can be done in combination with Brow bone reduction.
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Makes the nose smaller and more refined. Usually by deprojecting and rotating the nose, often also removing a dorsal hump
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Because your chin is a central point on your face, chin reduction surgery can dramatically revolutionize how you appear and how you feel about yourself. To enhance the look of a large or over-projecting chin, chin reduction surgery involves the removal of extra bone to provide balance and harmony to your face.
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Dr. Rodman recommends this be done with any jaw and chin reduction. The goal is to tighten the skin over the lower face to see the changes in the jaw.
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Reduces the thyroid cartilage prominence, otherwise known as the Adam’s apple.
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This gives more vertical show to the upper lip and decreases the distance from the nose to upper lip.
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Reduces extra skin over the eyes, making them appear brighter.
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Implants can be placed to increase volume of cheeks.
Facial Fat GraftingFat is harvested from the abdomen and injected into cheeks, temples, and lips. Gives a softer more feminine appearance.
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Fat from the area under the cheekbones is removed through the mouth. This gives concavity to the lower face and helps the cheekbones look more defined.
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For patients with an aging face, this procedure can be done at the same time to give a rejuvenated appearance.
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Some patients may wish to undergo , Renuvion laser skin tightening or microdermabrasion to resurface and renew the skin of the face.
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Your eyebrows play a vital role in defining your facial features and conveying your expressions. If brows are in a low position over the orbital rims, patients may look tired or convey a stern look. It may also make patients look angry.
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YIt has been shown in several studies that the brow and the upper ⅓ of the face are the most important facial characteristic in identifying gender. One of the most important differences between male and female faces is the projection of the brow bone and orbital rims. For patients who want to appear masculine, adding volume to the brow is very important.
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A few factors make some a good candidate for FFS.
While Dr. Rodman does not require letters from a therapist to proceed with FFS, she does recommend that patients have a relationship with a licensed professional who has experience counseling patients with gender dysphoria.
The combinations of surgeries mean a long time under general anesthesia. Patients should be cleared by their primary care doctor and/or cardiologist, depending on age and past medical history. A healthy diet and good hydration will help patients to heal quickly.
Patients must quit smoking and using all nicotine products 30 days before surgery. All products with nicotine are (including gum, mints, and vape) constrict blood vessels and slow healing.
FFS is a positive change for patients, but there are still stressors with ups and downs along the path before and after. Having a support system of family and/or friends will help to get through the recovery period. Dr. Rodman recommends traveling with a close companion or staying in a recovery house in Houston so patients are not alone after surgery.
Dr. Rodman does not require patients to be on hormone therapy in order to get FFS. She understands that some patients may not want to take hormones for various reasons. For patients who do take hormones, she recommends being on them for at least 18 months before proceeding with surgery. Hormones will not change the bony structures of the face such as forehead and chin/jaw, but it will thin and soften the skin as well as add some subdermal fat. These changes may improve the results of rhinoplasty as well and cheek augmentation during FFS. Dr. Rodman also understands that some patients have such severe dysphoria they feel they cannot wait for 18 months. This can be discussed on a case by case basis in consultation.
Being able to “pass” depends on many factors in addition to facial features. The way a patient’s voice sounds, the way she walks and moves, her mannerisms, and other factors matter in how the public assigns gender. To transition to living full time as a woman, patients will need to be mindful of how they present themselves to the public. Some patients will need speech therapy to help with their voice. The more time spent living as a woman, the more natural these behaviors become.
When it comes to Facial Feminization Surgery Houston plastic surgeon Dr. Rodman can help you create a plan for your FFS process and help set expectations. Knowing what to expect is very important to mentally prepare for this transformation.
Risks vary depending on the procedure performed. General possible risks of surgery on the facial skin and skeleton include bleeding, infection, poor healing or scarring, asymmetry, malposition, poor bone healing, unintended fracture of facial bones, contour abnormalities, dental injury, nerve injury (with facial numbness or weakness), injury to the brain or facial sinuses, and need for revision. Every precaution is taken to minimize these risks. Dr. Rodman gets a CT scan on every patient for pre-surgical planning. The CT helps map out where each patient’s important nerves are to ensure they are protected during surgery. The CT also helps Houston Facial Feminization Surgery provider Dr. Rodman plan where to make cuts in the bone to get the best outcome possible.
Recovery time varies based on what surgeries are done and how physical the patient’s job is. Most patients take 3-4 weeks off of work to recover. Out of town patients should plan to stay 2 weeks in Houston. The first week patients will be very sore and swollen. Patients need a lot of help the first week as the eyes swell and may even limit vision. Some patients have difficulty swallowing after surgery and need help to ensure they eat and drink enough. The second week, swelling starts to go down and bruising starts to fade. Patients are able to walk around but will still feel very weak and low energy. After two weeks Dr. Rodman will take out the last few sutures. Patients from out of town may travel back home after being in Houston for 2 weeks. Most patients start to feel better at week three and are able to start going out in public. Small amounts of bruising may be covered with makeup. Week four energy begins to return and many patients go back to work. Swelling in the face is still present but decreased to the point of being presentable. Swelling continues to fade over the first year. Patients will still notice subtle changes in the face for many months after surgery. The amazing shift FFS can make in a woman’s life needs some planning, a lot of self-love and 2 – 4 weeks of time to recover. Be prepared to take this time.
Schedule Your Houston Plastic Surgery Consultation Today
The Face Forward process starts with a consultation. You will meet with Dr. Rodman (either in the office or via video call) to discuss the result or look you want to achieve. Dr. Rodman will review and educate you about your options and schedule you for the procedure of your choice. Follow-up appointments will be scheduled as necessary. Achieve your look and enjoy the new you! Schedule your consultation for plastic surgery in Houston at Face Forward today.
1900 North Loop West, Suite 370, Houston TX 77018
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Tuesday - 9am - 5pm
Wednesday - 9am - 5pm
Thursday - 9am - 5pm
Friday - 7:30am - 3:30pm
