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.
Dr. Deschamps-Braly is a board-certified plastic and craniofacial surgeon specializing in facial plastic surgery, orthognathic (jaw) surgery, and craniofacial surgery for adults and children. He is also one of the world’s foremost leaders and innovators in facial gender confirmation surgery.
