Facelifts and Facial Feminization

Facelifts and Facial Feminization
Facelift. Image credit: Chris Gralapp
Facelift. Image credit: Chris Gralapp

Facelifts, Aging, Gender Confirmation, and Rejuvenation

Aging is a natural part of life, but a man’s face ages differently in comparison to a woman’s face. Men tend to develop more fullness in the submental or under-chin area, which creates excess skin and fat, whereas women generally develop an excess of facial skin. It’s only natural that over time your skin’s elasticity, firmness, and underlying bone, fat, and muscle support are each affected by the aging process. Depending on your age and skin condition, you may want to consider a facelift in addition to your facial gender confirmation surgery.

How does aging affect the feminized face?

The answer to this question depends on the facial area affected. For example, when forehead size is decreased, the upper face may not experience any aging issues because the skin is usually tightened by the procedure itself, and/or an accompanying brow lift or hairline lowering. However, the lower features of your face will respond differently. As the lower jaw is made smaller with feminization, it loses some tissue support. Tightening this area cannot be accomplished with, or during, feminization because it takes at least 3-6 months after jaw tapering for the swelling and muscle mass changes to settle. If you are at an age when your skin still has sufficient elasticity, the excess skin left after a feminizing process will contract nicely. If, on the other hand, you are older (in your 40’s or 50’s) loss of elasticity will become an issue that needs to be anticipated. This loss can show up in sagging jowls, a fold of skin on your upper throat, or deeper nasolabial grooves.

When is the right time to have a facelift?

In terms of timing, if you are deciding on having both FFS and a facelift, you should not plan for a facelift until about six months after your facial confirmation procedure. Also, if you are trying to lose weight, the facelift shouldn’t be completed until after your weight loss has stabilized. When you lose weight after a facelift, some of the weight will come off your face — potentially leading to an excess of sagging skin. This might then require another lift sooner than you would like.

Is there a specific type of facelift for feminization?

Typically your facelift procedure will be the most commonly used; known as the or deep plane facelift or SMAS (Superficial Muscular Aponeurotic System) – the deep, underlying layer of facial muscle and fibrous tissue under your skin. Modern facelifts work on a much deeper, structural level that literally lifts the underlying facial structures for a more natural-looking, longer-lasting result. In terms of timing, if you are deciding on having both facial feminization and a facelift, you should plan on having a facelift approximately 6 months after your FFS procedure.

Will I also need a neck lift along with my facelift?

In most people, the neck will show signs of aging even before the face, so a neck lift may be recommended in tandem with a facelift. Undertaking both of these procedures at the same time amplifies the positive results and ensures facial aesthetic harmony. However, depending on your age, a full surgical neck lift may not actually be necessary, and you may also want to explore non-surgical options such as Botox® or Dysport® injections for a rejuvenated and youthful appearance.

Read more about face and neck lifts here.

What about non-surgical alternatives to facelifts?

Invasive plastic surgery is not always necessary. Sometimes, depending on your desired results, a non-surgical approach is best to achieve a more youthful appearance. Facial volume restoration via injectable dermal fillers or stem cell fat transfer may also work to lift the cheeks and restore lost facial volume. 

Read more about our non-surgical facial procedures here.