Recovery after facial masculinization surgery might seem daunting, but by following Dr. Deschamps-Braly’s post-operative instructions, you can have a smooth recovery process. Here is what you need to know when preparing for facial masculinization recovery.

What is Facial Masculinization Surgery? 

Facial masculinization surgery is a gender-confirming procedure offered by Dr. Jordan Deschamps-Braly, a world leader in facial feminization and masculinization. Facial masculinization is customized for each patient’s facial anatomy and desired look, but the main goal is to masculinize the facial profile and help transgender men feel more confident in their appearance. Women typically have rounded facial features and a slimmer nose while men have angular facial structures with sharp contours. Procedures commonly used in facial masculinization include rhinoplasty, jaw augmentation, forehead reshaping, and Adam’s apple augmentation. Dr. Deschamps-Braly will restructure each of these areas to sharpen the contours of the face, creating a more masculine profile.

How Long is Recovery from Facial Masculinization Surgery? 

After facial masculinization surgery, swelling and bruising are common but will improve significantly during the first two weeks. Bandages and compression garments should be worn at all times to minimize swelling and aid in proper recovery. Drainage tubes placed during the surgical procedure will be removed at our office after one week. Patients will also be prescribed pain medications and antibiotics to aid in healing and prevent infections. After two weeks, patients can start to see changes in their appearance, but there will still be some swelling. It can take 6-12 months for swelling to completely reduce. During this time, patients will gradually begin to see more changes in the contours of their face.

How to Prepare for Recovery

Preparing for a surgical recovery will set you up for the easiest possible recovery, and our concierge team will be happy to provide recommendations for local accommodations and travel services. We recommend that traveling patients book a hotel near our San Francisco office so that they can be close by for their post-operative appointments. Stocking up on groceries and any supplies you might need will help create a comfortable environment for you to rest and recover.

What to Avoid During Recovery 

It is important to give yourself time to rest and recover after facial masculinization procedures. A soft diet may also be recommended, especially after jaw reconstruction. Strenuous exercise and heavy lifting should be avoided for about four weeks, or until you have been cleared by Dr. Deschamps-Braly. Regular post-operative appointments will be scheduled at our office and we are always available to answer questions and address any concerns you might have during recovery.

Schedule a Consultation

The Deschamps-Braly Clinic is committed to exceptional patient care and our team is here for you at each stage of your surgery and recovery. To learn more about facial masculinization and your surgical options, we encourage you to schedule a consultation today at our office in downtown San Francisco.

Congratulations on your recent weight loss! More and more people are losing weight through diet and exercise, not to mention through weight-loss drugs like Ozempic, Mounjaro, Wegovy, Rybelsus, Trulicity, and Saxenda.

Weight loss reduces fat throughout the body, including the face. Facial fat is a big part of youthful appearance, and reduction in facial fat can make sagging skin and wrinkles more noticeable.

Deschamps-Braly Clinic has a wide range of options for giving you back your youthful look after weight loss.

Non-Surgical Options

Our board-certified Aesthetic Nurse Specialist Jennifer Fick explained all the ways she can help:

• Neuromodulation: “Neuromodulators like Botox are a great option for softening facial expressions that result in wrinkles, like relaxing a furrowed brow. This can make patients look less “angry” and really help bring out their eyes. Neuromodulators can even help some patients with TMJ, migraines and hyperhidrosis (unwanted sweating).”

• IPL Photofacial: “Intense pulsed light treatment can reduce the appearance of fine lines and wrinkles that often show up after weight loss. It can also reduce the effects of sun damage, reduce redness, reduce visible blood vessels, reduce birthmarks, and reduce stretch mark discoloration. It’s one of our most popular options.”

• Non-surgical facelifts: “We offer a wide array of minimally invasive options, including injectables and fillers like Juvéderm, Restylane Kysse, or Belotero. We also offer microneedling, as well as a combination of procedures that can include IPL.

Surgical Options

Patients seeking a more dramatic change also have surgical options available. Dr. Deschamps-Braly sat down with us to go over your options.

• Eyelid and under-eye surgery: “Many people who lose weight are surprised to see changes around their eyes that were hidden when they were heavier. You have several great surgical options to reduce bags under the eyes and to improve drooping eyelids and skin below the brows.”

• Lip lifts: “When people age or lose weight, their upper lip can start to appear longer. To improve this, I remove a small section of skin below your nose. This subtly brings your lip up, exposing more lip tissue. This makes your lips appear fuller and gives a more typically feminine and youthful look. I can perform a similar lip lift for the corners of the mouth. This creates a more pleasant resting expression by reducing the downward turns at each corner that make it look as if you are frowning. This also gives the appearance of more lip volume.”

• Cheek implants: “While a few patients may benefit from cheek implants to make their faces more symmetrical, I generally recommend improving the cheeks in other ways. For patients who have lost weight, adding a cheek implant may make the hollows of your cheeks more pronounced. That is often the opposite of what we are trying to achieve.”

• Fat grafting: “This is a much more versatile option. The fat pad on your cheekbones is a very important indicator of health and youthfulness, and weight loss often reduces fat in that area. I harvest your own fat from a donor area and graft it to your cheeks, giving a younger and healthier look.Fat can also be grafted below lines and wrinkles to reduce their appearance. The result is a subtle but significant change in how old you look. I often do fat grafting during bony work, but it can be done at any time to refresh the face.”

• Facelifts: “This is a very popular option following weight loss. It can result in dramatic changes in appearance, especially by reducing the appearance of nasolabial folds [the lines from the corners of your nose to the corners of your mouth]. For patients with pronounced horizontal lines on their forehead, I can improve those by making small incisions behind the hairline and tighten the underlying structures. Some patients may benefit from a scalp advancement to lower the hairline. I also perform a SMAS plication facelift, which can improve your new jawline and reduce any remaining ‘double chin’ caused by loose skin under the mandible [lower jaw].”

Dr. Deschamps-Braly concluded the interview by saying, “Weight loss has a wide range of long-term health benefits, and I am very pleased that you have taken this important step in your self-care. Now let’s see how we can help you reach other goals so you can move through the world with even more confidence. We look forward to seeing you in our offices.”

Jennifer added, “I hope you’ll book a consultation today to learn more about all the ways Dr. Deschamps-Braly and our colleagues can enhance your happiness!”

Book your consultation today by filling out on online contact form.

Facial feminization surgery (FFS) can be a pivotal step in the gender confirmation journey of transgender and gender-nonconforming individuals. Jaw feminization surgery has gained prominence in recent years as an essential procedure for FFS. In this educational blog, we will discuss the intricate aspects of jaw feminization surgery, exploring its techniques, advancements, potential risks, and transformative impact on patients’ lives.

What is Jaw Feminization Surgery?

Jaw feminization surgery primarily focuses on altering the mandibular structure to achieve a softer and more feminine appearance. Unlike traditional jaw surgeries aimed at correcting functional issues, jaw feminization surgery emphasizes aesthetic refinement. The shape of the jawline plays a significant role in a feminine vs. masculine facial structure. The female jawline is typically softer with a shorter, narrower chin than the male jawline. Dr. Deschamps-Braly utilizes a variety of surgical techniques in jaw feminization surgery to enhance his patients’ appearances while creating harmony with other facial features.

How is Jaw Feminization Surgery Performed?

Jaw feminization surgery typically involves a combination of techniques tailored to the patient’s unique anatomy and aesthetic goals. Common procedures include mandibular angle reduction, bone shaving, masseter muscle reduction, and genioplasty (chin augmentation or reduction). Generally, incisions will be made inside the cheeks and mouth to limit visible scarring and create an aesthetically pleasing result.

Mandibular Resections

Mandibular angle resections are often performed in conjunction with other jaw feminization techniques to achieve harmonious facial proportions and enhance overall feminization results. This technique involves the surgical reduction of the mandibular angle, the lower-back part of the jawbone. The mandibular angle gives the jaw a squared look, which is often associated with the male aesthetic. By reshaping and removing this section of the jaw bone, a softer and more tapered facial contour is created.

Masseter Muscle Reduction

The masseter muscle is located between the back of the lower jaw and the cheekbone. Excess chewing, teeth grinding, or natural size of the muscle can give the jaw an overly square look, which might not be desired by feminine-presenting individuals. The bulky appearance of this muscle can be reduced during feminizing jaw surgery or non-surgically with Botox or Dysport.

Risks and Complications

While jaw feminization surgery is generally safe, like any surgical procedure, it carries inherent risks and potential complications. These may include infection, bleeding, nerve damage, asymmetry, and suboptimal aesthetic outcomes. However, these risks are significantly reduced when you choose a highly experienced surgeon who specializes in facial feminization surgery like Dr. Deschamps-Braly, a world leader in facial feminization and pioneer of several advanced surgical techniques. At your consultation, he will discuss potential risks and complications so that you can make an informed decision about your treatment.

Recovery and Postoperative Care

Recovery following jaw feminization surgery varies depending on the extent of the procedures performed. Patients typically experience swelling, bruising, and temporary discomfort, which gradually subside over several weeks. Most patients can return to work and other daily activities after 2-3 weeks. At your consultation, Dr. Deschamps-Braly will provide comprehensive postoperative care instructions, including dietary restrictions, oral hygiene practices, and follow-up appointments to monitor healing progress and address any concerns.

Schedule a Consultation

At The Deschamps-Braly Clinic, patients can rely on our expert team to provide personalized care with advanced surgical techniques. Schedule a consultation today at our San Francisco office to learn more about jaw contouring and other facial feminization procedures. We look forward to meeting you and helping you take the next step in your gender confirmation journey.

At Deschamps-Braly Clinic, we support all eligible citizens being able to exercise their right to vote. In this important election year, we’ve prepared this overview to help trans and gender-diverse American citizens exercise their constitutional right to vote.

If You Have Already Changed Your Name And Gender

Adult US citizens who have already changed their identity documents can visit the website maintained by the National Association of Secretaries of State (NASS).

NASS has a section called Can I Vote that has information on how and when to register and vote in your state or territory of residence, as well as information on how to change name and gender on an existing registration.

If You Are An American Citizen Living Outside The United States

Service members, their families, and overseas citizens should consult the Federal Voting Assistance Program.

Registering To Vote

Before you can vote, you must be registered to vote in most US states and territories. Many places have a registration deadline before the next election.

You register in the state or territory where you legally reside. Many young adults in continuing education are still legally residing with their parents, even if their school is in another state. Your legal residence is usually the address you list on your tax return.

The legal name you use to register must match the legal name on your government identification documents. If you have not changed your name and gender legally, Advocates for Transgender Equality has a section on how to change your identity documents.

In many states you can register with a political party affiliation, which allows you to vote in primary elections. You can also usually choose independent or no affiliation.

After you have registered, you will get a confirmation from the state. Be sure to keep this for when you are ready to vote.

The Voting Process

Most states and territories offer several ways to vote. You may find that some ways are more convenient and less stressful than others.

• By mailed ballot: Many trans and gender diverse voters prefer this option. Your state or territory will mail you a ballot that you can fill out and return. This allows you to take your time filling out your ballot, and you can research ballot initiatives and candidates you don’t know. You can complete it when you are ready, as long as it is returned or postmarked before polls close on Election Day. You may have the option to drop off your ballot in person, so check with your county or parish for options.
• Early voting in person: Most states and territories offer early in-person voting, usually a week or more before Election Day. Movement Advancement Project has a map that shows each state’s current rules. Early voting usually takes less time and is less stressful than voting on Election Day. Election workers will be under less pressure, so this is often better for trans and gender diverse voters.
• Voting in person on Election Day: All states and territories allow this. Your voter information packet mailed to you before Election Day should show where you need to go to vote. If you are not sure, Vote.org has a Polling Place Locator. Note: you may have to wait in line, so make sure you leave plenty of time. If you are in line before the polls close, they have to let you vote.

What To Bring

If you decide to vote in person, it is a good idea for trans and gender diverse voters to bring more documentation than most voters bring. Some volunteer poll workers may not know all the rules for trans and gender diverse citizens. You should bring:

• The kind of ID that is required
• Your voter registration confirmation document
• A utility bill showing the same name and the address on your registration
• Other IDs if you have them, like a passport, social security card, birth certificate
• The Voting While Trans PDF, printed or on your phone, to show to poll workers

If You Need Help

The US Election Assistance Commission offers a National Mail Voter Registration Form in 21 languages.

You can also contact the nearest LGBTQ community center. They can often help with identity documents and voter registration. In 2024, the Connie Norman Transgender Empowerment Center in Los Angeles opened America’s first transgender voting center.

If you don’t have a way to get to the polls on Election Day, Rideshare2Vote can help, and apps like Lyft and Uber often offer free or discounted rides to the polls.

Deschamps-Braly Clinic is proud to support you in making your voice heard, exercising your rights, and hope that this is helpful in providing guidance.

A chiseled jawline is a desirable feature for many individuals, especially cisgender or transgender men who want to achieve a more masculine appearance. If you are considering jaw augmentation, it is helpful to know what to expect during recovery so that you can effectively prepare for surgery.

What is Jaw Augmentation?

Jaw augmentation is a cosmetic surgery that enhances jawline definition and symmetry in the lower face. Board-certified plastic and craniofacial surgeon Dr. Deschamps-Braly performs jaw augmentation with a number of different types of implants based on the specifics of the patient’s case. These implants are customizable and are carefully tailored to each patient’s facial anatomy and desired goals. During the procedure, incisions are made inside the mouth so that there are no visible scars. The jaw implants will be permanently attached to the jaw bone using titanium screws. These implants enhance the projection of the jaw to achieve a more angular contour and stronger facial profile.

Who is a Candidate for Jaw Augmentation?

Healthy individuals who desire a more sculpted or masculine jawline are the ideal candidates for jaw augmentation with implants. Jaw augmentation can be performed alone or included in facial masculinization surgery procedures to create a sharper, more angular jawline. During your consultation with Dr. Deschamps-Braly, qualifications for surgical candidacy and options for jaw augmentation will be discussed in detail.

How to Prepare for Jaw Augmentation

Before receiving jaw augmentation, patients will schedule a consultation with Dr. Deschamps-Braly to discuss their treatment goals in detail. A physical examination or blood tests may be needed to ensure that patients are healthy and can safely receive surgery. Before jaw implant surgery, patients will need to stop taking certain medications and supplements. Smoking should also be avoided for at least six weeks before your surgery date to limit the risk of complications. Antibiotics may be prescribed before surgery to prevent infection.

What to Expect After Jaw Augmentation

After jaw augmentation, patients should expect moderate swelling that will start to improve after 24-48 hours. Mild to moderate discomfort is also common but prescription or over-the-counter pain medications often keep patients comfortable. We also recommend that patients sleep with their heads elevated for a few days and use cold compresses as needed to limit swelling. Strenuous activities and exercise should be avoided for at least two weeks or until patients have been cleared by Dr. Deschamps-Braly.

While the incisions are healing, patients should eat a soft diet or liquid diet while avoiding spicy foods and food or drinks that are too hot or too cold. Antibacterial mouthwash and antibiotics will limit the risk of infection and help your incisions heal quickly.

Jaw Augmentation Results

The results of a jaw augmentation procedure will gradually become visible as swelling reduces. Improvements in jaw definition can be seen after 1-2 weeks but it can take up to three months to see the final results. These results are permanent.

Schedule a Consultation

Dr. Deschamps-Braly is a world-renowned plastic, craniofacial, and facial gender-affirming surgeon. Anyone who is considering jaw augmentation in San Francisco is encouraged to call The Deschamps-Braly Clinic or fill out an online contact form to schedule a consultation and take the next step toward their ideal appearance.

We’ve been noticing a concerning trend among some of our patients: they first receive surgery from an in-network surgeon and then come to Dr. Deschamps-Braly for revision surgery after getting poor results. This should not be your plan when considering gender-affirming surgery because it can leave you at risk for complications and later problems. Here’s what you need to know when choosing your plastic surgeon.

The Importance of Choosing the Right Surgeon

The “right” surgeon is someone with the knowledge, training, and experience necessary to perform a specific surgical procedure safely and effectively. Gaining an immediate sense of trust in your surgeon’s abilities is also a great sign. Dr. Deschamps-Braly is a double board-certified plastic and craniofacial surgeon and a world-renowned leader in facial gender confirmation surgery who has helped invent many of the commonly used techniques of facial feminization and masculinization procedures. He has genuine care for his patients and is fully invested in each person’s individualized treatment plan.

Why Do People Choose In-Network Surgeons First?

While there are some fantastic surgeons in-network, patients should never rush to get their surgery done. The main concern is that patients will first choose an in-network surgeon and then schedule revision procedures with Dr. Deschamps-Braly to save money. Unfortunately, this results in more costs than choosing Dr. Deschamps-Braly first and it can lead to unsatisfactory results. Patients should always plan for one surgery.

It can be helpful to understand the benefits or possible setbacks of choosing an in-network surgeon. These are some of our patients’ main considerations when choosing their facial gender surgeon:

Out-of-Pocket Expenses

Money is an understandable concern among patients. Dr. Deschamps-Braly is not in-network, meaning he does not take insurance and patients pay out-of-pocket. To reduce these expenses, people might choose an in-network doctor even if that surgeon has less experience. Unfortunately, this can lead to “bad” surgeries and unsatisfactory results that will have to be corrected with revision surgery. Instead of paying for two surgeries, it’s a much safer and cheaper option to spend the money upfront and know that you will be cared for by a reliable and highly skilled surgeon like Dr. Deschamps-Braly.

Long Wait Time

Dr. Deschamps-Braly has a longer waitlist than other practices because he is the only surgeon at our clinic. However, we and many patients believe that the wait is worth it, which is an additional reason for the long wait time and a testament to our work. Dr. Deschamps-Braly and our team take a personalized approach and get to know each patient when planning their individualized surgery. Patients who do not want to wait can still enjoy quality care from non-surgical treatments with board-certified aesthetic nurse Jennifer Fick. Non-surgical dermal fillers can be used to subtly alter your appearance and give you some idea of what surgical results will look like.

Emotional Well-Being

Patients wait their whole lives for FFS or FMS surgery and they put a lot of planning into it. Emotions surrounding gender-affirming procedures are high; patients are understandably excited but anxious. When their results don’t match their expectations after weathering the entire recovery process, it can be devastating. Choosing a highly experienced surgeon like Dr. Deschamps-Braly will set patients up for success so that they can focus on the excitement and joy that facial feminization and masculinization brings.

Risks of Revision Surgery

Planning for one procedure with an experienced surgeon will set you up for the best possible results and a much higher chance of achieving your ideal look. After the initial surgical procedure, the facial structure will have already been altered and resculpted, which can make it difficult or even dangerous to reset the bones and underlying anatomy a second time. Another possible complication is that the first surgeon took too much tissue away, making revision and correction even more challenging. Because of these complications, Dr. Deschamps-Braly or other doctors may not be able to accept patients for a revision. To learn whether you are a candidate for revision facial surgery, please schedule a consultation at our office.

Schedule a Consultation

Dr. Deschamps-Braly and our team are committed to safety and exceptional care at our San Francisco clinic. When it comes to your face and a life-changing procedure like gender confirmation surgery, you don’t want to settle for anything but the best. To learn more about your options for facial feminization and facial masculinization surgeries, schedule a consultation today with Dr. Deschamps-Braly.

If you’re considering getting fillers, you’ve likely come across many different brands during your research. If it feels overwhelming to pick one, you’re not alone! It’s normal to feel like there’s a “best” choice when it comes to choosing your filler brand, but it might be helpful to know that the answer is a little more nuanced. Here are some things to keep in mind as you explore your options and meet with Jennifer Fick, M.S.N., F.N.P-C, C.A.N.S during a consultation.

How Do Dermal Fillers Work?

Understanding how your injector will select a dermal filler can be helpful in knowing what to look for. Dermal fillers, like Restylane, are made with hyaluronic acid, a molecule naturally found in your skin. This ingredient is responsible for keeping your skin moisturized. When it’s injected into the skin as a dermal filler, it attracts water and creates volume to plump the skin or fill in deep wrinkles and facial folds.

Different formulations of fillers attract different amounts of water and have different consistencies. Some options are smoother, thinner in consistency, and have very small molecules that allow for great flexibility. Other types of fillers are thick and robust, allowing them to provide substantial volume. In this regard, the thickness and consistency of a given filler is often more important than the brand. Therefore, it’s always best to select a qualified and board-certified provider who you can trust, like master cosmetic injector Jennifer Fick. She can help you select the ideal formula, regardless of brand. These are a few other considerations that she will have in mind when selecting the best filler for your treatment:

What’s Your Treatment Area?

The treatment area is one of the most important considerations in selecting the right filler. For example, if you’re looking to enhance your lips, you’ll need a different filler than if you’re looking to contour your jawline. More delicate areas like the lips or under eyes will require a thinner, more flexible formulation. The thin skin around these areas could be easily over-plumped with a thick filler. For jawline or chin contouring, you will need a very stable and supportive gel that holds its shape when injected. When looking at your filler options, start by having a good idea of your treatment area and what you want to achieve.

What Are You Looking to Treat?

In some cases, you may even need different fillers for different goals in the same treatment area. The lips are a great example – for some patients, fine lines and wrinkles are their top concern, meaning a thinner, softer formulation will smooth the skin without creating too much projection. For other patients, a more stable formulation is needed to change the shape of the lips or create a more notable enhancement.

The cheeks are another example – you may need more supportive volume for deeper facial folds, which requires a dense, stable formula. If smoother, glowing skin is your goal, a thin formula with hydrating properties is a better option. Keep in mind what effect you want to achieve with fillers in your treatment area as different formulations will create different results.

Is This Your First Time Receiving Fillers?

Whether you are a first-time patient or are looking for a touch-up will also impact the choice of filler. If this is your first time receiving fillers, Jennifer Fick will focus on creating a foundation, which could mean thicker, more stable products. At your first appointment, deep facial folds will be filled in and more definition can be created in the jawline, cheeks, and chin, depending on your individual goals. As the hyaluronic acid filler is gradually absorbed into the skin, you might start to notice the return of fine lines and wrinkles. Additional appointments can be scheduled to touch up your results; at these touch-up appointments, different fillers than were originally used might be necessary since the quality and texture of the skin have changed.

How Long Do You Want Results to Last?

Some patients seek long-term rejuvenation with dermal fillers while others use fillers to visualize the results they can expect from a surgical procedure. First-time patients might also prefer fillers that dissolve quickly in case they are dislike the way their fillers look. While some fillers can last up to 12 months, others only last an average of six months.

For permanent results, patients might also consider fat injections. A fat transfer is a minimally invasive procedure that harvests body fat from the abdomen and transfers it to the lips or cheeks. This procedure is performed by Dr. Deschamps-Braly. Sometimes patients start with a fat transfer, but it might be a good idea to first start with temporary dermal fillers.

Schedule a Consultation

At Deschamps-Braly Clinic, patients can choose from a full range of injectables and dermal fillers under the expert guidance of our Aesthetic Nurse Specialist, Jennifer Fick. As a master cosmetic injector with over two decades of experience in aesthetics, she can help you select the ideal option for your needs during a consultation. To learn more, contact our San Francisco office by calling or filling out our online form.

Adam’s apple surgery is a popular procedure for transgender men because it creates a seamlessly masculine appearance between the face and neck. However, it’s important to recognize that no procedures are required for gender confirmation surgery. If you are considering facial masculinization surgery, this is what you should know about Adam’s apple surgery so that you can determine whether it is right for you.

What is Adam’s Apple Surgery?

It is a common misconception that the Adam’s apple will grow naturally with testosterone therapy. Transgender men who want to achieve a more masculine look with a visible Adam’s apple will require Adam’s apple surgery, a groundbreaking procedure developed by Dr. Deschamps-Braly. During the procedure, a small piece of cartilage is taken from the ribs to create a natural implant. Next, small incisions are made under the chin to fit the custom-made implant around the existing Adam’s apple. The implant will be carefully positioned to augment the size of the existing Adam’s apple and increase its projection.

Why Choose Dr. Deschamps-Braly?

Adam’s apple surgery or Adam’s apple augmentation is an innovative procedure designed by Dr. Deschamps-Braly and Dr. Douglas Ousterhout: two world leaders in facial masculinization surgery. Dr. Deschamps-Braly trained for many years with Dr. Ousterhout and other pioneers of facial gender confirmation surgery and craniofacial surgery. His extensive experience has equipped him with a deep understanding of facial anatomy and the intricate differences between a feminine and masculine facial structure. Dr. Deschamps-Braly’s goal is to create natural-looking and aesthetically pleasing results so that his patients can feel confident in their appearances.

Is Adam’s Apple Surgery Required?

Your appearance does not define your gender. Adam’s apple surgery is not required with facial masculinization surgery; it is simply an option for those who want to augment the appearance of the Adam’s apple to achieve a more masculine appearance. If you are unsure whether this procedure is right for you, there are non-surgical alternatives that will help you achieve the look of a pronounced Adam’s apple until you are ready for surgery. Our office is here to answer any questions you might have to help you on your gender confirmation journey. We also encourage you to check out patient testimonials and our video series for more information about facial masculinization.

Am I a Candidate?

The ideal candidates for Adam’s apple surgery are people undergoing female-to-male gender confirmation or cisgender men who desire a more masculine appearance. Patients should be in overall good health with realistic expectations for their surgery outcomes. Depending on your individual goals, Adam’s apple augmentation can be performed in combination with chin augmentation or jaw contouring to masculinize the entire lower face and neck area. These procedures, and other facial masculinization surgeries, can be discussed in greater detail at your consultation.

Schedule a Consultation

To learn more about Adam’s apple surgery and how you can benefit, schedule a consultation today at The Deschamps-Braly Clinic in San Francisco, CA. Our office is easily accessible to local and traveling patients who desire exceptional care for their facial masculinization surgery.

When we first meet our patients, many are already taking hormones or have considered hormone replacement therapy (HRT) as part of their transition. Whether patients can receive surgery while on hormones is a common question and an understandable concern. Luckily, most patients can safely receive surgery without delaying their hormone treatment, and the addition of surgery can even offer added benefits to one’s treatment process.

Understanding Hormone Therapy 

HRT is often one of the first steps in gender-affirming treatments and it can help transgender individuals express their gender identity in a way that matches how they feel on the inside. Feminizing hormone therapy increases estrogen in the body, leading to the development of female sex characteristics and a decrease in male sex characteristics. Results will vary but may include some degree of breast growth, fat redistribution, loss of muscle mass, thinning facial and body hair, and more.

Masculinizing hormone therapy increases testosterone in the body to develop male sex characteristics and minimize female sex characteristics. Potential changes may include increased growth of facial hair and loss of hair on the top of the head. Fat redistribution and increased muscle mass are also potential changes, in varying degrees.

Does Hormone Therapy Impact Surgical Candidacy? 

Although there is ongoing research on the correlation between HRT and surgical outcomes, Dr. Deschamps-Braly has not found that hormones pose a surgical risk for his patients. He helped pioneer the latest techniques used in facial feminization and masculinization procedures and has successfully treated many patients taking hormones at the time of their surgery. For this reason, and the differing role that hormones and surgery have in a patient’s transition, HRT typically does not affect his surgical decisions. 

Understanding how HRT and surgery affect facial appearance (and aid in gender transition) is an important consideration. Hormones can redistribute facial fat, leading to minor alterations in a person’s appearance, but they do not change the bone structure of the face. About 80% of the surgical procedure focuses on the skeletal structure, allowing for more fundamental and dramatic changes to the facial features.

How Long Should I Be on Hormones Before Surgery? 

Patients just starting HRT or those who have been using hormones for many years can all benefit from gender-affirming procedures. In fact, HRT in combination with surgery can be especially helpful for feminizing procedures. Most of the changes seen with feminizing hormone therapy only offer subtle changes to the face. Surgery is often needed to adequately feminize the face and give patients the best possible results.

Similarly, transmasculine individuals who desire dramatic changes in their appearance may want to consider surgery early on in their hormone treatment. While some patients are satisfied with the results of hormones alone, surgery is necessary to develop a more chiseled jawline, broader forehead, and larger chin.

Schedule a Consultation

If you are considering gender-affirming surgery, the best way to plan your treatment is to meet with an expert, like Dr. Deschamps-Braly. He can discuss your individual concerns in more detail to help you determine the best course of treatment with HRT and/or surgery. Schedule your consultation today by calling our office or filling out an online contact form.

Reference:

https://www.sciencedirect.com/science/article/abs/pii/S0193953X16300727?via%3Dihub

Facial feminization surgery describes a variety of procedures that can help transwomen achieve a more feminine look. Rhinoplasty is a key component of feminization surgery, and there are several techniques that Dr. Deschamps-Braly considers to achieve the best possible results.

Male vs. Female Anatomy

Differentiating male and female features is essential when considering rhinoplasty for facial feminization or masculinization surgery. The male nose typically has more bone and cartilage, giving it a larger appearance. Women typically have a narrower nose with a sharper tip and smaller nostrils. Since the nose is central to the face, it has a significant impact on overall facial harmony and whether patients’ features look feminine or masculine.

Feminization of the Nose

Facial feminization typically involves a reduction of the nose, forehead, and jaw to soften the facial features. The following rhinoplasty techniques will be taken into consideration during your surgery:

Feminized Profile

An important aspect of rhinoplasty for feminization is the removal of excess cartilage and bone from the dorsum (nasal bridge). This will reduce its projection and create a slope where the nose meets the forehead (the radix) for a softened look. In many men, the radix noticeably protrudes and must be reduced to avoid a “shelf” at the base of the nose, which can reduce the impact of a more feminine curve on the bridge. If patients have a dorsal hump, this can also be removed during surgery. Dr. Deschamps-Braly will carefully remove enough tissue to effectively reduce the nose while ensuring that enough cartilage is left to support the nose and prevent collapse.

Narrowing of the Bridge

Similar to lowering the nose, excess bone and cartilage is removed from the sides of the nose to narrow its frame. This often requires the nasal bone to be fractured on both sides. To create support, spreader flaps or grafts can be placed between the septum (the wall that separates the nostrils) and the upper lateral cartilage.

Tip Refinement

A lifted or upturned nasal tip can help create a more feminine look that blends seamlessly with your narrowed nose. To lift the tip, a strip of cartilage will be removed, and a graft will be placed to support the remaining tissues and create an attractive projection.

Shortening of the Nose

To reduce the length of the nose, a portion of the septum close to the nostrils is removed. This not only shortens the nose but also helps rotate the tip. This can also enhance the look of a newly lifted tip.

Additional Facial Feminization Procedures

Several procedures can be combined with rhinoplasty to simultaneously enhance patients’ overall facial structures with only one surgery and one recovery.

Forehead Reduction with Rhinoplasty

Rhinoplasty combined with forehead reduction can significantly change the appearance of the face. Like the male nose, men have a larger forehead that projects further outward. This creates an angular look where the nose meets the forehead. During forehead reconstruction, the frontal bone between the eyebrows is reduced and reshaped to soften the brow and balance the look of a more delicate nose. This is most often recommended to be combined with rhinoplasty to achieve the best possible result.

Lip Lift with Rhinoplasty

A lip lift is also easily combined with rhinoplasty since incisions can be positioned to simultaneously access the interior nasal structures and lift the upper lift. A lip lift requires an incision to be made directly beneath the nose and a strip of skin and tissue will be removed to subtly pull the lip up. This increases the visibility of the pink vermillion on the lips and gives the lips a fuller look for a beautifully feminine aesthetic.

Schedule a Consultation

Dr. Deschamps-Braly is a leading expert in plastic and craniofacial surgery. To discuss your rhinoplasty options in more detail, schedule a consultation today at our office in San Francisco and get started on a personalized facial feminization procedure.