Facial feminization

Facial feminization surgeries have become popular over the last 15 years, although such interventions were made since the 1930’s. The procedure is as challenging as it is beautiful, because in this field the surgeon must have a very well developed aesthetic sense in order to transform a male into a female physiognomy, sculpting the patient's features, so as to produce a harmonious and delicate face.

Informations about the medical procedure

Facial feminization involves not only reshaping the bone structure of the face, neck and the thyroid cartilage. For a complete, faultless work, the esthetician works together with experts in endocrinology, dermatology etc., and the result is amazing; the touch of an artist is truly sensed.

The feminization process is a very extensive one, and interventions are complex, as it involves reshaping of the forehead, the male has a more prominent bone structure, to lower the hair line insertion (another male feature), raising the eyebrows, cheek augmentation where they are not sufficiently accentuated, reconstruction of the nose shape, definition of the lips and correction of the chin, the Adam’s apple and the ear lobe, improvement interventions, depending on each patients’ characteristics.

Consultation

Before proceeding the to facial feminization procedures the doctor will become familiar with the patient's wishes related to the expected changes, and the reason behind the decision to turn to this action. He will then analyze the patients’ features, based on images, and will explain in detail what are the procedures required to obtain the desired result.

Duration

Depending on the number of concurrent procedures performed by the specialist, intervention may last from one hour to five hours.

Anesthesia

Some of the interventions are performed by local anesthesia with sedation, while others require general anesthesia.

Hospitalization

It is indicated for major surgery, requiring general anesthesia.

Side effects and surgical risks

Immediately after the operation, the areas where tissue, soft or hard, was removed or added will inflame, the swelling will carry down to the jaw and neck, due to the action of gravity on the body. Ecchymosis (contusion) may not appear immediately after the procedure and will disappear gradually over a few weeks. In 80% of cases the swelling disappears after two to three weeks after surgery.

After surgery advice

Since the facial feminization process is quite difficult and involves a variety of interventions in order to achieve the desired appearance, this type of surgery is not recommended to patients with low motivation and unrealistic expectations.

Contraindications

Patients are advised not to spend much time in bed immediately after surgery and to move their limbs to prevent blood clotting. It is recommended to sleep with the face elevated, what will hasten edema resorbtion. If the patient has undergone a remodeling intervention of the chin, they must avoid overstraining the lower jaw over the first four weeks; eating solid foods is not allowed. Otherwise the risk exists to trigger trauma in the chin area.
The sutured area should be cleaned daily, and crusts removed carefully. After complete healing of incisions, the patient will switch to gentle massage of the area, with a cicatrizing ointment, for two months. An easy makeup may be applied on the face after seven to ten days, to hide scars and contusions.
Small postoperative scars must be protected from sunlight for six months, due to low melancocyte. Moreover, it is recommended that the patient shall not be exposed to the sun during the first seven days after surgery, to avoid hyper pigmentation, then they must choose a cream with high sun protection factor (SPF 50+).
If the patient has undergone a remodeling intervention to the forehead, it is recommended to wash the scalp daily, for the first two weeks. For wound healing, it is important that blood clots and scabs will be removed, even if a small bleeding of the incisions is possible. After a rhinoplasty, the patient should be careful not to wet the protecting cast bandage.
During recovery, the surgeon may prescribe the use of an ice bag on the operated area, disinfected with alcohol, in order to reduce edema.

Recovery

Depending on the complexity of interventions, recovery may take from a few days to three weeks, but the end result can be evaluated at least six months after the intervention.