Facial Feminization Surgery - 謝明吉、姜厚任 顎顏面 美學 重建 專科診所-風華整形聯合診所
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Facial Feminization Surgery



What a relief! An angel having the wrong gender/p>

GeenaRocero, a beautiful and well-shaped fashion model is standing on TED's stage. She says: "Today, this very moment is my real coming out." Over the past nine years, some of Geena's neighbors, colleagues or even her agent did not know her history.
 


This is GeenaRocero. Whoever meets her would think that she is a gorgeous model.
Source: retrieved from a TED video clip.

 

This is also GeenaRocero. She says: "I remember when I was five years old in the Philippines walking around our house, I would always wear this t-shirt on my head. And my mom asked me, 'how come you always wear that t-shirt on your head?' I said, 'Mom, this is my hair. I'm a girl.'"
Source: retrieved from TED's video clip

That's right. GeenaRocero is a transgender model. In March 2014, she stood on TED's stage and courageously admitted her true inner self: a transgender person.
 

Geena was born in the Philippines. Before she was fifteen, she wore like a boy. Later she met an agent who was a transgender beauty pageant manager. She invited Geena to attend the beauty pageant and she placed the second runner up. GeenaRocero was quite satisfied with her life of attending beauty pageants. When she was nineteen, her mother emigrated to America and successfully applied a green card for her. At first, she was not interested but her mother said to her that "did you know that if you move to the United States you could change your name and gender marker?"This was all she needed to hear. So before moving to America, she received a sex reassignment surgery. Geena started from changing her appearance so as to truly fulfill her real inner self. Four years later, she received the sex reassignment surgery. Geena's successful case can serve as a reference for the transgenderists who have the same goal as Geena.

 

GeenaRocero says: "When I look at this picture, at that time I felt like, Geena, you've done it, you've made it, you have arrived." Source: retrieved from TED's video  

 

As most people know, those who are the third gender or transgender bear great pressure. The situation not only occurs in the western society not to mention the eastern society. In fact, GeenaRocero's case makes us know that some people have been aware of their sex orientation since childhood. However, some people are hesitating about their sex or exploring which sex they belong to. Regardless of the types, facial feminization is a must choice. It's just a matter of time.
 

The patient has been thinking about being placed in the wrong body. Being introduced with facial feminization surgery (FFS), she made major changes in forehead, facial bone, nose and malar. Masculine skeleton was suddenly feminized. Facial parts of larger sizes were reduced and shapes were beautified. Both inner self and appearance are tuned to the same frequency.  

 

By looking at the silhouette, it is clearly found that her forehead has become rounder and her face is smooth and feminized. These are the keys for people to identify a person as a man or woman. The forehead (including brow bones) is the weak point to reveal a person's gender. This is also the marker for archeologists to most precisely identify gender.  

 

FFS(Facial Feminization Surgery) Should come before SRS(Sex Rezssignment Surgery)

My years of experience in contact with transgender people have taught me that from the perspective of a patient FFS should come before SRS though SRS is the same important as FFS. This principle allows them to have some flexibility to deal with social pressure. By receiving FFS, they are visually, mentally and spiritually satisfied by having a feminized face. By doing so, they won't feel too much pressure placed by the society. Instead, it's quite acceptable to see feminized men nowadays. They are quite popular. When they choose FFS as a start to make a change, they may not be negatively judged. They are even considered as Korean metrosexuals.
 

After completing FFS, they can visually and psychologically feel satisfied by looking at the mirror for a period of time. Such a period serves as a buffer for them to think more and explore more for the possibility of adopting SRS. After all, sex reassignment involves stages of physical, mental and spiritual transitions. FFS is able to fulfill mental and spiritual changes first. When they feel it's time to make a further change, sex reassignment surgery will play its role to complete the final stage of physical transition. And the impact and harm on oneself and friends and relatives can be minimized.
 

Take GeenaRocero as an example, only her face is shown in this picture. However, it is enough to make people think that she is a beautiful woman. This illustrates why FFS should be done first. After receiving FFS, you will have become a woman in your own eyes or in other people's eyes no matter if you receive SRS or not.
Source: retrieved from GeenaRocero's Facebook

 

In addition, compared with SRS, FFS is safer and has a shorter recovery period. However, the change can immediately be seen on the face by looking at the mirror every day. This is a solution which makes everybody happy. It's also the main reason I recommend to have FFS (Facial Feminization Surgery) first.
 

Haed to tell the gender? Forehead is the answer!

Many people must have doubted how archeologists can precisely tell the gender of the remains they have excavated. In fact, the gender can be judged by identifying the forehead. Generally speaking, males have a longer and broader chin. The lines of lower jaw are not as round as females'. The nose of males is usually larger than females'. The frontal bone (forehead) has a more obvious tilt. The lower edge of the frontal bone, that is, brow bone, is more protruding. Such a feature extends from the position between eyebrows to the upper rim of eye sockets.
 

If we carefully observe the male (left) and female (right) skulls in the picture, it's not hard to tell the gender by pointing out the differences in forehead, cheekbone and lower jaw. The male forehead has a more obvious tilt than the female one. It also has a more protruding brow bone. The male cheekbone has bigger angles and is more solid. Unlike the round and smooth female jaw, the male one has an angle of almost 90 degrees.
Source: 3.bp.blogspot.com

 

Simply speaking, the size of a male skull is bigger and the skull is shaped with solid lines and more obvious angles. Such feature is quite easy to spot at chin, lower jaw (mandible), cheekbone and forehead. One thing worth noticing is that the chin, lower jaw and cheekbone are not the best standards for identifying gender. The lines of a skull is affected by genetic factors while the acquired conditions such as occlusal problems caused by chewing and pressure may form a square face, rigid cheekbone and chin with protruding angles in females. Only the lines of forehead between men and women are different with a nearly 100% accuracy of gender identification.
 

Ai has received FFS. People who don't know him would call him Miss at first sight. However, the patient still feels something's wrong. Being introduced by a friend, Ai came to our clinic and realized that the problem lied in the forehead. (Left) The picture shows the patient's forehead before the surgery. The more obvious tilt in forehead reveals his gender. However, after receiving foreheadsculpture (right), the contrast between the five sense organs on Ai's face becomes more obvious. An additional touch of feminine charm and attraction suddenly flows from the eyes.  

 

I met a patient who had been living in Japan for 15 years and got married. While communicating with her, what impressed me most was something she said: "in my adolescence, I was wondering why my waist had no curve by looking at other girls. Why didn't I have the secondary sexual characteristics? I've been thinking that my soul is in the wrong body!" Obviously, the patient clearly knew her sex orientation when she was young. She said she had the sex reassignment surgery as soon as she turned into 20. Nonetheless, she still felt something's missing while looking at the mirror. Subconsciously, she particularly wore her hair in a fringe so as to cover her forehead. Actually, people who meet her for the first time would consider her a female unless they have a closer and careful look at her. Her facial appearance reveals masculinity because she had a more protruding cheekbone. In the past, she used to adopt micro-cosmetic adjustment via injections to improve her cheekbone problem. However, this method cannot last long. Hence, she decided to choose a cosmetic surgery. I did forehead sculpture and cheekbone reduction surgeries. This case explains the importance of forehead sculpture to become feminized.
 

GeenaRocero, a beautiful and well-shaped fashion model is standing on TED's stage. She says: "Today, this very moment is my real coming out." Over the past nine years, some of Geena's neighbors, colleagues or even her agent did not know her history. Please click here to watch movie This is GeenaRocero. Whoever meets her would think that she is a gorgeous model. Source: retrieved from a TED video clip.

 

This is also GeenaRocero. She says: "I remember when I was five years old in the Philippines walking around our house, I would always wear this t-shirt on my head. And my mom asked me, 'how come you always wear that t-shirt on your head?' I said, 'Mom, this is my hair. I'm a girl.'" Source: retrieved from TED's video clip That's right. GeenaRocero is a transgender model. In March 2014, she stood on TED's stage and courageously admitted her true inner self: a transgender person. Geena was born in the Philippines. Before she was fifteen, she wore like a boy. Later she met an agent who was a transgender beauty pageant manager. She invited Geena to attend the beauty pageant and she placed the second runner up. GeenaRocero was quite satisfied with her life of attending beauty pageants. When she was nineteen, her mother emigrated to America and successfully applied a green card for her. At first, she was not interested but her mother said to her that "did you know that if you move to the United States you could change your name and gender marker?"This was all she needed to hear. So before moving to America, she received a sex reassignment surgery. Geena started from changing her appearance so as to truly fulfill her real inner self. Four years later, she received the sex reassignment surgery. Geena's successful case can serve as a reference for the transgenderists who have the same goal as Geena. GeenaRocero says: "When I look at this picture, at that time I felt like, Geena, you've done it, you've made it, you have arrived." Source: retrieved from TED's video As most people know, those who are the third gender or transgender bear great pressure. The situation not only occurs in the western society not to mention the eastern society. In fact, GeenaRocero's case makes us know that some people have been aware of their sex orientation since childhood.

 

However, some people are hesitating about their sex or exploring which sex they belong to. Regardless of the types, facial feminization is a must choice. It's just a matter of time. The patient has been thinking about being placed in the wrong body. Being introduced with facial feminization surgery (FFS), she made major changes in forehead, facial bone, nose and malar. Masculine skeleton was suddenly feminized. Facial parts of larger sizes were reduced and shapes were beautified. Both inner self and appearance are tuned to the same frequency.

 

By looking at the silhouette, it is clearly found that her forehead has become rounder and her face is smooth and feminized. These are the keys for people to identify a person as a man or woman. The forehead (including brow bones) is the weak point to reveal a person's gender. This is also the marker for archeologists to most precisely identify gender. My years of experience in contact with transgender people have taught me that from the perspective of a patient FFS should come before SRS though SRS is the same important as FFS. This principle allows them to have some flexibility to deal with social pressure. By receiving FFS, they are visually, mentally and spiritually satisfied by having a feminized face. By doing so, they won't feel too much pressure placed by the society. Instead, it's quite acceptable to see feminized men nowadays. They are quite popular. When they choose FFS as a start to make a change, they may not be negatively judged. They are even considered as Korean metrosexuals. After completing FFS, they can visually and psychologically feel satisfied by looking at the mirror for a period of time. Such a period serves as a buffer for them to think more and explore more for the possibility of adopting SRS. After all, sex reassignment involves stages of physical, mental and spiritual transitions. FFS is able to fulfill mental and spiritual changes first. When they feel it's time to make a further change, sex reassignment surgery will play its role to complete the final stage of physical transition. And the impact and harm on oneself and friends and relatives can be minimized. Take GeenaRocero as an example, only her face is shown in this picture.

 

However, it is enough to make people think that she is a beautiful woman. This illustrates why FFS should be done first. After receiving FFS, you will have become a woman in your own eyes or in other people's eyes no matter if you receive SRS or not. Source: retrieved from GeenaRocero's Facebook In addition, compared with SRS, FFS is safer and has a shorter recovery period. However, the change can immediately be seen on the face by looking at the mirror every day. This is a solution which makes everybody happy. It's also the main reason I recommend to have FFS (Facial Feminization Surgery) first. Many people must have doubted how archeologists can precisely tell the gender of the remains they have excavated. In fact, the gender can be judged by identifying the forehead. Generally speaking, males have a longer and broader chin. The lines of lower jaw are not as round as females'. The nose of males is usually larger than females'. The frontal bone (forehead) has a more obvious tilt. The lower edge of the frontal bone, that is, brow bone, is more protruding. Such a feature extends from the position between eyebrows to the upper rim of eye sockets. If we carefully observe the male (left) and female (right) skulls in the picture, it's not hard to tell the gender by pointing out the differences in forehead, cheekbone and lower jaw. The male forehead has a more obvious tilt than the female one. It also has a more protruding brow bone. The male cheekbone has bigger angles and is more solid. Unlike the round and smooth female jaw, the male one has an angle of almost 90 degrees. Source: 3.bp.blogspot.com Simply speaking, the size of a male skull is bigger and the skull is shaped with solid lines and more obvious angles. Such feature is quite easy to spot at chin, lower jaw (mandible), cheekbone and forehead. One thing worth noticing is that the chin, lower jaw and cheekbone are not the best standards for identifying gender. The lines of a skull is affected by genetic factors while the acquired conditions such as occlusal problems caused by chewing and pressure may form a square face, rigid cheekbone and chin with protruding angles in females. Only the lines of forehead between men and women are different with a nearly 100% accuracy of gender identification. Ai has received FFS. People who don't know him would call him Miss at first sight. However, the patient still feels something's wrong. Being introduced by a friend, Ai came to our clinic and realized that the problem lied in the forehead. (Left) The picture shows the patient's forehead before the surgery. The more obvious tilt in forehead reveals his gender.

 

However, after receiving foreheadsculpture (right), the contrast between the five sense organs on Ai's face becomes more obvious. An additional touch of feminine charm and attraction suddenly flows from the eyes. I met a patient who had been living in Japan for 15 years and got married. While communicating with her, what impressed me most was something she said: "in my adolescence, I was wondering why my waist had no curve by looking at other girls. Why didn't I have the secondary sexual characteristics? I've been thinking that my soul is in the wrong body!" Obviously, the patient clearly knew her sex orientation when she was young. She said she had the sex reassignment surgery as soon as she turned into 20. Nonetheless, she still felt something's missing while looking at the mirror. Subconsciously, she particularly wore her hair in a fringe so as to cover her forehead. Actually, people who meet her for the first time would consider her a female unless they have a closer and careful look at her. Her facial appearance reveals masculinity because she had a more protruding cheekbone. In the past, she used to adopt micro-cosmetic adjustment via injections to improve her cheekbone problem.

 

However, this method cannot last long. Hence, she decided to choose a cosmetic surgery. I did forehead sculpture and cheekbone reduction surgeries. This case explains the importance of forehead sculpture to become feminized. In other words, when a male intends to feminize his face, more obvious corners and angles should be smoothened. A smaller streamlined facial profile combined with delicate lines of the five sense organs can turn a male into a stylish metrosexual. While targeting at becoming a female, the size and lines of the face will be sculptured based on female standards. For example, the angles of lower jaw bone will be streamlined and designed to have a more obvious tilt. Such adjustments can help create a V-line face. Forehead sculpture then focuses on removing protruding brow bone and making it more round and smooth. In addition, hairline problem will be treated at the same time. Males usually have a higher hairline and the problems like hair loss and a receding hairline easily occur. Having such cases, I usually move the hairline forward while dealing with forehead sculpture. Face lift can be done together. Therefore, the three major purposes of forehead sculpture, lower hairline and rejuvenation can be completed in one treatment.
 

The left picture shows the conditions before the Facial Feminization Surgery (FFS). The patient has a broader forehead and looks like a masculine female. The face doesn't reveal elegancy and female charm. After receiving FFS, the facial bone and forehead were reduced and sculptured and the hairline moved forward (right). Even if the patient is neutrally dressed, the face naturally sends a touch of female charm. People will no longer doubt if it's a she or he.

 

By looking at the silhouette, the forehead becomes round and full and the hairline moves forward. The forehead can fully send female charm. Even if the patient frowns, a lovely expression is there. Having received whole face bone sculpture, the facial shape turns to be softer and sweeter. Now, many people may simply think that he is a female with a straightforward personality instead of considering him a male.

 

Orthognathic surgery creates your golden ratio

The need for having a female look is not the final step. It would be even better if you can become a beautiful woman while considering turning into one. What type of women can be called "beautiful women"? In fact, it's really hard to define. People have different standards for beauty. But it can be sure that the appearance is not attractive when facial proportions are not right.
 

Many people don't believe it's the same woman in the above pictures. Truly speaking, Alice only received the orthognathic surgery which highlighted her facial profile and the lines of her eyes, nose and mouth to a significant degree. When a person's silhouette is no longer flat, the well-shaped face with beautiful curves immediately presents youth, brilliance and 100% attraction.

 

For helping a patient to become an attractive woman, the adjustments of facial proportions and symmetry are definitely the keys regardless if the patient is a transgender. According to my medical experiences over the past ten plus years, only osteotomy and orthognathic surgery can help patients achieve their ideal faces. Osteotomy is able to sculpture perfect symmetry of a face while the orthognathic surgery can turn facial bones clockwise for a relatively better position. The result is shown most clearly on a patient's silhouette.
 

FFS, an easier safer start, fulfills mental and visual needs of transgender people

Is it difficult to become a woman? Narrowing the mandible, shortening and sharpening the chin, streamlining forehead and moving the hairline forward are excellent choices for sculpturing a female look.
 

SRS (sex reassignment surgery) involves at least two psychiatrists for examination, longer recovery period and difficulties in gaining a sense of identity and support from friends and family members. Contrarily, FFS (facial feminization surgery) paves an easier entry and meanwhile it features betterfeasibility, safety and stronger sense of identity. The facial feminization surgery is a series of facial bone sculpture procedures. When a patient seriously injured by accident needs to rebuild his or her face, bone sculpture surgeries will also be applied. The application of FFS is based on the facial proportions of a female while sculpturing. The sculpture of forehead, brow bone, hairline, nose, lower jaw, chin, lips and the Adam's apple at the same time can help remove all of the male characteristics. FFS can fulfill mental and visual needs of transgender people in a fast and safe manner.

With the advances of medical technologies, FFS (facial feminization surgery) is carried out inside a patient's mouth if the sculpture for lower jaw or chin is desired. No scars will be found on face. The wound for sculpturing cheekbone is located right below the temple and next to the middle part of the ear. It's around 0.8 cm in length. No scars can be seen after six months. As to forehead sculpture, it depends on a patient's hairline. If a patient has a higher hairline, the incision will not be made across the hairline buthide in the hair. The scar can barely be seen two weeks after the surgery. However, most men have the problem of a higher hairline so the incision will be made along the hairline so as to move the hairline forward for solving the problem in one treatment.
 

Like other facial bone surgeries, the facial feminization surgery causes bruises and swelling to a certain degree. Based on my long-term clinic experiences, general painkillers can control almost all types of pains and aches. Only very few people may need advanced painkillers while thirty percent of the patients do not need any painkillers. Patients can wear a slight makeup or wear sunglasses to go out just one week after the surgery. They can go back to work 7~10 days after the surgery. Mild exercise is not suggested until two weeks after the surgery while strenuous exercise is not allowed until at least one month after the surgery.
 

"Michelangelo once said: 'I saw the angel in the marble and carved until I set him free'. To me, FFS (Facial Feminization Surgery) is the surgery setting angels free". I've read many articles like this describing the changes brought to the patients by the Facial Feminization Surgery. Some people think that FFS integrates their spirit, soul and body into one so that they gain inner peace. One patient revealed that FFS was the solution for no longer relying on makeup or hairstyle to hide the real self. Some people even think that FFS is the magic making the limped to walk, the blind to see and the deaf to hear. FFS enables the patients having received SRS (sex reassignment surgery) to enjoy a better life. So far I've been quite impressed by the saying that "FFS is the surgery setting angels free". I can now understand more about the pains and struggles of transgender people being long-term placed and trapped in a body of wrong sex inconsistent with their real self.


 

 

Results of surgery vary among patients. Please consult your doctor.
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Copyright © 2007-2017 

All Written Contents and Pictures Created by Dr. Adrian M. Hsieh and Dr. Scott H. Jiang

 

 

 

 

Results of surgery vary among patients. Please consult your doctor.