The Story of a Trans Woman’s Face

March 29, 2018

The Story of Our Patient’s Facial Feminization Was Featured in The New Yorker Magazine

“Abby Stewart sometimes thought that she was born to be a teacher. At the small college in Colorado where she was an instructor in the biology department, she enjoyed preparing lectures for business or history majors who were simply fulfilling a requirement by taking her course in anatomy and physiology. She worked hard to prove to these students that they should still care about biology, and one way she captured their attention was by describing natural phenomena that, at first glance, might seem peculiar. She revealed that clown fish—like Nemo, in the Pixar movie—are hermaphrodites, starting out as male but sometimes becoming female as they mature…” Continue reading on The New Yorker’s website. 

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Asian Masseter Muscle Reduction

January 31, 2018

Reduction of the Masseter Muscle for Asian Patients (Surgical & Non-Surgical)

When undertaking any form of plastic or cosmetic surgery, it is critical to take into consideration each patient’s ethnicity. Different ethnic groups have different facial proportions and different cultural concepts of what constitutes ‘beauty’. A skilled plastic and craniofacial surgeon will take these into account and adapt surgical procedures accordingly. Often, patients of Asian ethnicity — such as Korean, Japanese, Chinese, and other Asian countries and regions — may seek out a jaw and chin narrowing procedure known as Asian V-Line surgery. Depending on their existing facial proportions, the patient may also need to reduce the size of their masseter muscle to reduce a prominent mandibular angle and jaw width to produce a narrower, slender and more feminine facial profile.

What is the Masseter Muscle? Why is it larger in those of Asian background?

The masseter muscle runs down the cheekbone to the lower jaw on each side of the face. It is known as one of the “muscles of mastication” because it helps us to chew food and move our jaw up and down while speaking. The masseter is typically larger in people of Asian ethnicity due to natural genetic differences creating a wider face proportion. Typically Asian women, or Asian transgender individuals seeking facial feminization, want a softer, smoother appearance to the jawline, and therefore seek to reduce the size of the masseter muscle at the same time.

Reduction of the masseter muscle for those of Asian ethnicity may be performed by either non-surgical or surgical method…

1. Non-Surgical Reduction of the Masseter Muscle using Botox® or Dysport®

The masseter muscle can be reduced significantly using non-surgical injectable treatments such as botulinum toxin — more commonly known as Botox® or Dysport®. The procedure is non-invasive because it involves a series injections placed directly into the masseter muscle. The treatment is performed over several sessions with small doses of botulinum toxin until the masseter muscle has reduced down by degrees to the desired appearance. The number of sessions will depend on the individual’s reaction to the treatment. Some people may only need 1-2 sessions, others may need 3-4 sessions to achieve the desired results. In most patients, the masseter muscle will stay reduced in size permanently – even without further injections.

2. Surgical Reduction of the Masseter Muscle:

For some Asian patients, non-surgical masseter muscle reduction will not have the desired effect, making a surgical reduction of the muscle their best option. The surgery is performed on the inside of the mouth between the gum and cheek via small incisions that leave no visible scarring. The jaw bone and masseter muscle are surgically reduced and reshaped to achieve a rounder, smoother, and more slender contour. When the correct amount of muscle and bone has been removed, the incision is closed with self-dissolving sutures.

Which form of masseter muscle reduction is right for you?

Ultimately, an in-person consultation with your plastic surgeon will help you decide if a surgical or non-surgical option is the best course of action for you.

Read more about masseter muscle reduction here.

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Considering Facial Feminization? Unsure about V-Line Surgery vs. Feminizing Jaw Surgery?

January 24, 2018

Understanding the Differences Between V-Line Surgery and Feminizing Jaw Surgery is Critical

The Gender-Specific Differences of Male and Female Jaws

Typically, the male jaw is wider and taller than the female jaw. Men tend to have wider, heavier-set jawlines with a flatter base and a sharper angle between the chin and jaw. This gives the male jawline a prominent “square” look. Women’s jawlines typically have rounded edges, are more tapered and pointed.

“Asian” V-Line Jaw Surgery vs. Feminizing Jaw Surgery

Many of our patients who are considering undertaking facial confirmation surgery to feminize the face, often mistakenly think that they need “Asian” V-Line surgery for the jaw when what is actually needed is feminizing jaw surgery — otherwise known as FFS-specific jaw contouring or jaw tapering.

What is the difference between “Asian” V-Line Jaw Surgery and Jaw Tapering?

V-Line jaw surgery typically works to narrow the jawline and bring it forward. This procedure is typically ideal for women who have an overly-square jawline and want a more feminine, streamlined appearance to the jaw and the chin. This tactic, however, doesn’t work to feminize a male’s face because typically a male face is taller or longer, so a V-Line procedure would only make the face appear more elongated. In the case of a male transitioning into a female, what is really needed is jaw contouring surgery to shape the jaw into a more feminine aspect as well as a vertical reduction genioplasty (shortening the height of the chin). In comparison, a V-Line procedure commonly should not reduce the vertical height of the chin as that would run counter to the intended appearance.

If the face to be feminized is overly long, a condition that is known as vertical maxillary excess or “long face syndrome”, we may also recommend surgical correction via a jaw surgery procedure known as the Le Fort Osteotomy I. Read more about Long Face Syndrome and Facial Feminization here.

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