Facial Feminization Surgery Techniques

Here are a lot of surgical techniques available to feminise a masculine face but not all surgeons use the same techniques to achieve the same results. Here is a rough overview of the main procedures.

Hairline

There are two options for reshaping and bringing forward masculine hairlines.

1: Scalp advance

In a scalp advance an incision is made along the hairline. A section of forehead skin is then removed from in front of the incision and the scalp is lifted and pulled forward to fill the gap. There is a limit to how far the scalp can be moved in one go and two or more separate advances several months apart may be required to achieve the desired result. There is always a visible scar from a scalp advance but how visible will be partly down to luck and partly down to your own tendency to scar. Many patients feel their scar is almost invisible except to people who know what they are looking for. If the surgeon is also doing work on the brow ridge, it can all be done via the same incision.

2: Hair transplants

In a hair transplant a strip of skin is removed from the back and sides of the scalp and all the hair follicles are dissected out (each follicle contains between 1 and 4 hairs). They are then be transplanted to the areas where they are needed and can be used to fill the corners of the male “M”, to bring the hairline forward and to thicken areas where the hair has become thin. There is a limit to how densely the hair can be packed in at one time so more than one procedure may be needed to achieve the desired density.

Forehead

To access the bones of the forehead an incision can be made across the top of the scalp from ear to ear. This means that any scar will be well hidden by your hair. If you are also having a scalp advance then the forehead will be accessed via the hairline incision instead. The skin of the forehead is then pulled down to reveal the bones. The orbital rims are solid bone and can simply be shaved down. The bone over the frontal sinuses is more difficult and there are 3 main options for dealing with it. These options depend on how far the bossing protrudes, how thick the bone is and the preferred techniques of your surgeon. The amount of bossing doesn’t actually tell you how thick the sinus bones are and some people with very little bossing can have thick bone with a small sinus cavity behind it while others with very prominent bossing might have very thin bone with a large sinus cavity behind it. Some surgeons access the bones endoscopically using smaller incisions but with this technique it is only possible to shave down the bones and not to reconstruct the forehead.

Option 1: Shave

If the bones over the frontal sinuses are thick enough then the bossing can simply be shaved down to give a flatter and more female contour.

Option 2: Shave and fill

Shaving alone may not be enough to achieve the desired result especially if the bones over the sinuses are too thin to be shaved down very much. A bone-filler can be used to fill in the indented areas around the bossing like the slightly hollow area that males often have in the centre of the forehead. Some surgeons feel that the shave and fill approach is sufficient to feminise most masculine foreheads; others disagree and prefer the reconstruction approach.

Option 3: Forehead reconstruction

Forehead reconstruction is the most complex technique. The orbital rims are shaved down as before but the bone over the frontal sinuses is first removed then re-shaped before being set back in place with wires or titanium screws. This technique is very powerful and can take a severely male forehead to well within normal female ranges.

An alternative forehead reconstruction technique has been developed by a top Thai surgeon that involves shaving the bones over the sinuses thin enough so that they become flexible and then literally compressing them into the right position.

Note: You may hear foreheads and forehead feminisation procedures classified as “Type I”, “Type II” or “Type III”. These classifications are best avoided as they are not used by all surgeons and the ones that do use them define them slightly differently from each other.

Eyebrows

Eyebrows can be lifted with a “brow lift” procedure. This is done by tightening the muscles attached to the outer third of the eyebrow or lifting the skin of the entire forehead. It can be performed via the incision made for a scalp advance or brow-bossing reduction; otherwise two small incisions are made in the scalp. If a brow lift is overdone it can leave the patient with a “surprised expression.

Nose

Noses can be feminised through standard rhinoplasty techniques. If you are having forehead work you will quite possibly also need a rhinoplasty and vice versa. This is because the nose and forehead need to flow nicely into each other – basically, if you can set back your brow bossing to the ideal position without it actually sitting behind the bridge of the nose and causing a step between the 2, you might be able to have your forehead done without needing a rhinoplasty. Likewise you might be able to have a rhinoplasty without forehead work as long as the changes to the bridge of your nose are not going to cause a step between your nose and forehead. See the links page for more information on rhinoplasty.

Cheeks

Cheek bones can be enhanced either with solid implants, a bone-filler paste or by using fat from another part of the body. Solid implants are available in several shapes and can be placed over or under the cheekbone or lower down near the sides of the nose according to the needs of the patient. Bone-filler is moulded to the desired shape in situ and sets solid. Both these techniques are for enhancing the cheekbones and the Incisions for them are usually made in the gums. If the cheeks need to be fuller and more rounded you can have fat from another part of the body injected into the area. Some of this is reabsorbed and you may need a top-up a few months later. After one or two top-ups, the fat is usually permanent. See the links page for further information on cheek augmentation.

Top lip length

To shorten the distance between the nose and top lip an incision is made just under the nose. A section of skin is then removed and the gap is closed to raise the lip. Depending on the angle of the cut, this can also be used to roll the lip out a little giving it a fuller and more feminine shape. A similar technique involves making an incision along the top edge of the lip, removing a section of skin as above and then closing the gap though any scarring left along the edge of the lip can be very noticeable. There is a limit to how far a lip can be raised if it is to look natural and work properly. The whole section of skin from lip to nose can be angled back slightly if necessary.

Lip shape

There are many different types of implant that can be used to make the lips fuller. These can be natural or synthetic and may be solid or injectable. Not all of them are permanent and not all of them are removable.

Chin

The chin can be changed by shaving the bone to the desired shape or through a procedure called “sliding genioplasty”. In a sliding genioplasty the chin-bone is cut through from front to back to separate a “horseshoe” of bone. This horseshoe can be moved forwards or backwards to correct a receding or protruding chin and sometimes another section of bone is removed altogether so that when the horseshoe is reattached, the chin is shorter. The angle of the original cut also affects the final height of the chin. Implants or bone-filler paste can also be used to correct a receding chin. The incision for chin work is made in the lower gums. Liposuction can also be used under a masculine chin to help remove weight from the lower face.

Jaw

The jawbone can be reduced by bone shaving or cutting and quite a lot of bone can be cut away to round off and narrow the square corners at the back. To make the jaw even narrower the large masseter muscles that attach to the corners can be surgically reduced. Incisions for jaw work are usually made inside the mouth but are occasionally made externally under the jaw. Patients over the age of about 40 often experience some loose skin around the jaw after bone has been removed from the jaw or chin. This can be tightened up a few months after the original procedure with a lower face-lift.

Adam’s apple

The Adam’s apple can be reduced (a procedure often referred to as a tracheal or “trach” shave) but there is a limit to how much can be removed without risking permanent damage to the extremely delicate voice box. Also, the cartilage that forms the Adam’s apple tends to harden with age which may limit the amount that can be removed in an older patient. The incision for a trach shave is either made directly over the Adam’s apple or just under the chin. Trach shaves seem to carry a higher risk of complications than most other FFS procedures and should always be considered very carefully.

Gender Reassignment Surgery

Gender reassignment surgery is no longer the novelty it once was. Thousands of transsexuals, both male-to-female and female-to-male, worldwide have now undergone this procedure. But it is still true that only a small fraction of those people who consider themselves to be transgendered actually go this far. The cost is a major barrier for many people. Others find ways to accommodate their transgender feelings while continuing to live in their birth sex or in some in-between state.

Gender reassignment surgery is expensive, costing thousands or tens of thousands of dollars, depending on which procedures are undertaken. Some governments will cover the entire cost under their medicare programs. Others will cover it partially or not at all.

Surgery is irreversible. Once the original sex organs are removed and new organs constructed, there is no going back. Surgery also renders the patient sterile. Although several surgeons have speculated that it may some day be possible for post-operative transsexuals to be parents, this is not possible today.

Like any surgery, gender reassignment surgery has its dangers. But if one is in good health and follows the surgeon’s guidelines to prepare for the operation, one can expect good results. It is equally important to follow a proper routine after surgery, or much of the surgeon’s work can be undone.

Surgical techniques are constantly evolving. In the ’60s, it took a team of at least two surgeons as long as 12 hours to perform the operations. Results were superficially satisfactory, but patients were not always able to have normal sexual intercourse or experience orgasm.

Today, some surgeons perform male-to-female reassignment surgery in under three hours, with almost no blood loss. And most post-op patients report normal sexual functioning, including orgasms within three months to a year after surgery.

Life is more complicated for female-to male transsexuals. There are several techniques for constructing a new penis and each has its drawbacks. But post-op patients are generally happier now than prior to surgery and some are reporting near-normal sexual functioning.

Male to femaleAlthough each surgeon has his preferred technique, the overall procedure is similar across the board. The testes are removed, an opening is created in the correct spot for the new vagina, the inside of the penis is removed, the skin of the penis is inverted like a glove and used to line the vagina, sensitive parts of the penis are used to create a clitoris, the urethra is shortened and relocated to the appropriate place, the skin of the scrotum is used to create labia.

Some surgeons do this in a single operation. Others prefer to do it in two steps. And sometimes, if there isn’t enough penile skin, a graft is taken from elsewhere to create the vagina.

Some patients also opt for other operations to give themselves a more feminine appearance. These include: breast implants, Adam’s apple shaving, larynx adjustment to raise the voice, removal of the lower ribs to create a narrower waste, facial reconstruction, and hair implants.

Female to maleFemale-to-male patients often undergo more surgery. Typically, the first stage is removal of the breasts to create a normal male chest. This is sometimes done in several operations. The first removes the bulk of the mammary glands and most of the excess skin. The second fine-tunes the result, removing further excess skin and perhaps reducing scars left from the first stage.

The next major surgery is a hysterectomy. This removes the womb, uterus and ovaries.

The final surgery is the creation of a penis along with the relocation of the urethra to the centre of the penis. There are two distinct ways of creating a penis. One utilizes a skin graft, usually from an arm. The other involves building up the clitoris, which is usually enlarged after a patient has been taking male hormones for some time.

Preparation for surgerySurgeons always supply information sheets to patients outlining their specific requirements. In general, one must stop taking hormones about a month prior to surgery. The hormones can raise the risk of surgery. Many patients worry that going off hormones will result in their bodies reverting back to something more like their birth sex, but in fact this can’t happen in such a short time. Many patients do report mood changes, or hot and cold spells, but these are only temporary and disappear when hormones are resumed about a week after surgery.

One must also stop drinking alcohol and not use ASA or any illicit drug. These can all interfere with healing and blood flow.

All surgeons will require that you undergo a complete physical, including a blood test, a month or so prior to surgery. The surgeon will supply you with a list of tests he requires. The presence of any major health condition, such as high blood pressure, obesity, a heart condition or a communicable disease like AIDS could make a patient ineligible for surgery.

Post-surgeryIt is critical that patients follow their surgeon’s advice on post-care procedures. Healing takes a long time and unless one sticks to the routines, results can easily be less than satisfactory.

The first three to five days after surgery are usually spent in hospital. The patient is on pain killers and attached to a catheter. One can be up and walking in three days, but no strenuous activity is permitted.

After about five days, patients are more mobile and can reduce pain killers a little. For male-to-female patients, catheters come out at about a week and dilation begins. For female-to-male patients, the catheter may remain in place for several weeks, depending on which surgical technique was used.

Patients return home about ten days after surgery, but this can vary from surgeon to surgeon. Pain fades within a month and one can return to work after about two months, although some discomfort may remain for several more months.

Full healing can take six months to a year. Some patients find they have swelling or numbness that is more of an irritant than an impediment to functioning. Certainly, a year after surgery, one should feel normal and function normally.

SurgeonsThere are only a handful of surgeons worldwide offering gender reassignment surgery. I don’t recommend any one surgeon or surgical procedure. It is important to investigate any surgeon you are considering. Ideally, you should talk to former patients to get their take on the surgery. If a doctor isn’t willing to put you in touch with former patients, be wary.

Also be wary of trying to find the perfect vagina or perfect penis. Everyone is different and any given surgeon will achieve different results with each patient. Age, genes and your health will partly determine the results you get. But you should expect that you function normally after surgery and that at least superficially you look as if you were born with the new plumbing.

Check list of surgeons. The U.K., The United States and Austral-Asia and please feel free to contact them, either via their Web sites or by mail or phone. Surgeons will often send information kits if you request it. If you contact the Canadian surgeons by phone, don’t worry if one of the secretaries answers in French, they all speak English as well.

Winnipeg Transgender Group – 2006

First Transgender Islamic School in Pakistan

A madrasah “islamic school” for trans people was opened for the first time in Pakistan.

Rani Khan, who taught the Koran in the first madrasah for transgender people in a country where the ‘third gender’ was officially recognized and the Transgender People (Protection of Rights) Act passed parliament in 2018, said, “Most families do not accept transsexuals. They throw them out of their homes. “I was one of them, too,” said.

Islamabad Deputy Commissioner Hamza Shafqaat said that the madrasa can help trans people to participate actively in society and said, “I hope things will be better if this model is implemented in other cities.”

In Pakistan, where trans rights are legally protected, LGBTI+ individuals are still discriminated against. In the census conducted in 2017, it was recorded that approximately 10 thousand trans people lived in Pakistan. Trans rights groups stated that in the country with a population of 220 million, this number may now be over 300 thousand.

Previously, a madrasah for trans people was opened in Dhaka, the capital city of Bangladesh.

Turkish Police Detained Trans Women in Istanbul

Turkey Women’s Movement, met the day before the March 8 International Women of Kadikoy. As they dispersed after the action, trans activists were stopped by the police and asked to be taken into custody. Trans women got into taxis after other protesters prevented their detention. However, trans women were detained in taxis that were stopped by the police.

Police took strict security measures during the demonstration. Some banners were not allowed.

The 8 March Women’s Platform announced that, Havin Özcan and Yıldız İdil Şen were detained.

It was learned that a total of 6 people, 1 of whom was a journalist, were detained.

On Friday, before March 8, International Women’s Day, women gathered in Istanbul to prevent femicides, end violence and effectively implement the Istanbul Convention.

After the Bosphorus protests, there is a harsh attitude towards LGBTI people. LGBTI banners were not allowed in the action held yesterday in Beşiktaş on Friday.

First Night Out Transgender

So, you want to go out, feel liberated… but don’t know where to go or how to go about it? Some quick tips and suggestions follow.

Get your makeup done professionally and obtain a wig that feminizes you and looks natural. Or, if you’re going to do your own makeup, do the homework first — read magazines and practice. Thre are many articles out there on makeup regarding skin tones, highlighting and contouring. And even articles about hair –different styles that enhance different types of face shapes. Style and color are very important. Do the very best you can and listen to advise from others you meet.

Be sure your clothing will blend in with the venue you’re headed to. Don’t wear faded jeans to a formal event, nor dress like Alexis Carrington for a rock concert. Going shopping? NO fishnets and/or mini skirts!

Wear shoes you can walk in! A wobbly gal attracts attention (and not the good kind)

Take a ride in the car. Get gas, go shopping! You will find that IF your attitude is carefree, others most likely will be as well. Good posture, and a confident outlook will get you far. Believe in you remind that you are simply a gal like all the rest going about her business. People are generally too busy to notice you. If they do notice, why do you care?

Some gals find that wearing sunglasses gives them a sense of security. If you need to speak, do so softly and slower then you normally do? Try to avoid that falsetto that everyone cansee past.

An LGBTI bar or party is always a great “bet” for an outing, espicially a first outing. Or the village in NYC – just about anywhere there is safe, check the events calendar in the community section with listings of friendly places to go.

For an outstanding first experience try known establishments like a FemmeFever event. We are having our Gala Ball on April 18th and go out of our way to make it comfortable and fun for all! From walking you into the ballroom from your car or room – and more.

Do a little exploring… Ask around… check out the New York or Arts & Enertainment section for past events that maybe coming around again.

There is more out there for you then imaginable! Sharing the experience is priceless!

What Shape Of Breast Form Should I Purchase?

Lets review the many options for shape, size, and quality.

Nothing can enhance a women’s fashion better than a nice shape; and breast, lets face it, are synonomous with feminine. These days there are a lot of choices when trying to choose a pair of breast forms to provide you with the best effect.

So let’s first review the styles:

Push-Ups These are smaller and more oblong to allow for an even “push-up” effect. This style is often used for the lifting of your bust in your bras and swimsuits. These are often adhesive (Nubra and generic versions). Unless you have significant breast tissue of your own, these are not useful for most tgs.

Teardrops These forms add extra fleshy “full-ness” to your underarm area as the “tear” portion of the breast form is meant to be tucked into the band of your bra. This is especially important to Mastectomy patients and many Crossdressers when trying to achieve a very natural look. The tear portion is not really intended to stick out of the top of your bra although many tgs do so.

Triangles This shape is the most desirable when thickness and protrusion are important to your look. This is especially important to smaller framed females and many Crossdressers who demand firmness and protrusion. It’s the most popular for TGs

Raindrops: These are simple half domes without any extra material around the form. They look most like a natural female breast but may not have the projection many tgs want. They are also made by only a few companies.

Style unto itself is not the end-all. Size is just as important; a great style that’s too large or too small will take away from the feminine lines you’re trying to project.

The size of the breast form should generally follow the rest of your measurements. Tgs should resist the impulse to have especially large forms. It’s helpful to remember that the average bra size is a 34B. Now, most tgs do not have a 34 band, but stay with a B or C cup, especially if passing is important to you.

We will talk about bra sizing next. In picking a breast form it’s helpful to follow standard clothing chart sizing (which each store has on their web site), so your clothes will fit better.

It’s helpful to start with the waist and then adjust bust and hip sizes to match the size which coordinates best with your waist. That is, if your waist is 34″, you will fit into size 14 clothes. You should pick breast forms that will yield about a 41-42″ bust (measured around the fullest part of your breast and which is not your bra size). . Hip padding, which we will talk about shortly, should yield about a 42″ around the fullest part.

In terms of quality, there is a wide range available. You can spend anywhere from $15 to $300 per breast form ($30 to $600 — or more — for two). The price is often artificially high for Mastectomy patients since insurance will often be paying for it. However, there is often little difference in quality between a $50 and $150 breast form, especially if it’s for casual use.

What does matter though is the softness and pliability of the form. Some forms are very soft and pliable, while others may be very rigid and unnatural. Sometimes, but not always, less expensive forms may be firmer. PALS is a very inexpensive breast form, under $50.00 a pair, and you can purchase more then one size! And, they will not rip or tear!

What about self-adhesive forms, for that braless look?

Most breast form vendors offer at least one model that can be worn without a bra. Some involve an adhesive support that attaches to the chest wall and then hooks to the form via Velcro. This works well but the patches are expensive and can only be used once. Make sure the chest hairs are gone before attaching the patch or they will come off afterwards – with a lot more pain!!).

Increasingly, forms are appearing that do not require a patch but have the adhesive on the form itself. It may be reused some number of times. Originally only the breast enhancers (Nubra) used this technique but now most manufacturers offer it for their regular forms. It requires a clean skin surface and diligence about cleaning the form afterwards. It also works only for moderate sized forms. One must be careful about wearing them for too long or with too much activity or they can come loose!!

TIP – its often helpful to apply some baby power between the form and the your skin (if not using adhesive forms) to counter the moisture that develops. Unlike natural breast, the form does not breath and so there will be a tendency for moisture to occur. This can be uncomfortable and the baby power helps eliminate it. It also has a nice feminine scent!

I recommend the Breast Form Stores, for any new girl. They provide personal care by telephone, if you’re not sure what size or shape to purchase!

06 February 2013 – Written by Denae Doyle @tglife.com

2013-02-06 04:08:00

Trans Women May Be At Greater Risk For Depression

The LGBT community has always been thought to be at greater risk for clinical depression than the general population because of the alienation that LGBT people often feel after “coming out” to family and friends, and it seems that the stigma and pain is a greater onus for women and transgender women because of the male-dominated social hierarchy that these individuals are forced to struggle against in the process. Surprisingly studies have shown that LGBT women that are open about their sexuality usually experience less depression. However, there is still an unsettling amount of research that has shown that Transgender women have a lifetime risk for developing depression of about 62% versus the 16% risk for the general population.

A review done this year on the factors that are thought to be behind the lifetime prevalence of depression in transgender women looked at interpersonal and intrapersonal support systems in several studies. The author of this review concluded that although social support from family and self-esteem both influence the risk of developing depression, the woman’s employment status and whether or not she has experienced violence related to her transgender identity are the two most critical factors influencing the rate of depression. Transgender women are thought to suffer violence at the hands of co-workers more often than most LGBT individuals. There is concern that unemployment rates among Transgender women is higher because of harassment and violent assaults at the hands of coworkers, and workplace discrimination against people with transgender identity ends with the victim being blamed. There is a vicious cycle of violence, unemployment, lower economic status, and thus an increased chance of depression in transgender women.

An article in Huffington Post published this year discussed the new workplace training program “Understanding the T in LGBT: Gender Identity and Gender Expression” and how it hopes to help reduce the prevalence of workplace violence and harassment directed against transgender individuals. The online program is part of a Diversity and Inclusion web course series that is designed to increase acceptance of diversity and help prevent identity and cultural “gaps” from leading to workplace harassment. The current rate of workplace harassment experienced by Transgender individuals is reported as 90%.

Dr. M. Mirza, LGBT Health Wellness, 2014