Facial Feminization Surgery (FFS) is frequently sought by transgender women. Psychologically, it may be considered more important than gender reassignment surgery, as it significantly assists in social integration for TG women by permitting a higher rate of "passing" as a genetic female.

The face, at a glance, gives the first impression of a person...in that split second, the brain assigns a gender.

While other parts of the body can be hidden, camouflaged or exaggerated to look more feminine, it is not always possible to mimic feminine facial features without surgical intervention. For this reason transgender women seek facial feminization surgery as a way to transform the face. However, FFS techniques allows to obtain significant skull and facial changes that are often also desired by genetic females with more prominent masculine features.

In recent years the facial skeleton has been treated almost exclusively by maxillofacial or craniofacial surgeons. Improvements in surgical procedures and approaches to the facial bone complex have allowed for remarkable results in facial surgery.

The ability to transfer these innovative techniques to the field of Facial Feminization Surgery allows to deal directly with the bone contours. The effects of sculpting facial bone are predictable, which guarantees facial surgery results over the long term. Newly developed sculpting techniques are employed directly on the bone surface to modify contours and volume, aimed at obtaining a more harmonious oval shape. Subtle or dramatic changes are made possible, according to the desired results, by the following facial surgery:

• sculpting the brow bone prominence

• softening the jawline

• reducing the square-shaped or prominente chin

• minimizing the tracheal prominente (adam’s apple)

Soft tissues (skin, fat, muscle and tendon) are exposed to numerous agents of change (contraction and muscle relaxation, liquid retention, gravitational effect, loss of elasticity and cohesive properties, etc.), which make it difficult to predict the results of a surgery on these tissues over the long term. On the contrary, the facial skeleton is not subject to the same change vectors as those mentioned above, meaning that surgical modifications will remain unchanged over time. Considering this advantage and analyzing the principal differences between male and female facial skeletons, it is possible to redefine a human skeleton with FFS to achieve a more harmonious and, finally, more feminine face.