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A Guide to Facial Feminization Surgery

A cover image for a Guide to Facial Feminization Surgery

What is Facial Feminization Surgery?

Facial feminization surgery is an umbrella term that includes multiple surgeries and treatments to make the face look more feminine, such as creating a smaller forehead, adding volume to the lips, and augmenting the cheekbones. People opt for facial feminization surgery to soften their features or to honour their gender identity by presenting on the outside how they feel on the inside.

Structural Differences in the Face

There are many features determined as “more masculine” and “more feminine.” Many MTF transgender people (Male to Female) struggle with face feminization, as it is the first part of the body people notice. By animating the eyes, softening the jaw and brows, and adding volume to areas that traditionally represent feminine beauty, many are able to finally feel like themselves.

Facial feminization is not just for folks in their transition journey but also helps many women with more traditionally masculine features feel more feminine. Male and female faces hold many aesthetic differences, which are detailed below.

Traditionally masculine facial features: A sharp jawline, large/broad nose, lower brows, large forehead, chiselled cheeks, thinner lips, a prominent chin, Adam’s apple, and larger ears.

Traditionally feminine facial features: A softer jawline, small chin and ears, animated eyes, shapely eyebrows, plump cheeks with gentle cheekbones, small forehead, larger lips, and a smaller nose.

Types of Facial Feminization Procedures

SpaMedica offers various procedures as part of the facial feminization process so you can be your true self and put your best face forward.

Forehead Reduction

A forehead reduction procedure is performed similarly to a brow lift by removing excess skin from the forehead and advancing the hairline. Often combined with a brow lift, a forehead reduction is a great way to make your face appear smaller and more feminine. Your incisions will be hidden within your hairline and eventually fade away.

Brow Lift

A brow lift is performed by Dr. Bell with a unique technique that is catered to the patient’s facial structure and eyebrow positioning. Incisions will be made with care and hidden as much as possible. Through these incisions, Dr. Bell modifies parts of the eyebrow muscle that can cause furrows and removes excess skin from the brow so the eyebrows and eyes are lifted to a more youthful, animated level. Learn more about the various brow lift procedures offered by SpaMedica.


SpaMedica offers many rhinoplasty options to achieve complete facial surgery and feminization. The most common rhinoplasty treatments Dr. Bell offers are external and internal rhinoplasty.

External rhinoplasty involves a small incision at the base of the nose so the skin can be lifted over the bone structure, and Dr. Bell can change the structure of the nasal tip for fantastic long-term results. Internal rhinoplasty involves incisions placed within the nose and nostrils for effective dorsal bridge reductions and improving breathing by addressing obstructed airways and minor nasal tip problems.

SpaMedica also offers revision rhinoplasty procedures if you are unhappy with the results from a previous rhinoplasty procedure that did not meet your facial feminization expectations.

Cheek Augmentation

A cheek augmentation often involves cheek implants inserted to restore volume in the face. First, your individual needs and aesthetic goals will be discussed, and you will be given the opportunity to “try on” the type of cheek implants you’d like by applying temporary dermal fillers to the treatment area and seeing if you like your new look.

Once you’ve opted for a cheek augmentation, you will receive anesthesia, and Dr. Bell will make an incision in your mouth, meaning you will have no visible scarring. Your augmentation results will reveal a youthful, feminine glow, and volume will be restored to improve facial symmetry and feminization.

Lip Augmentation

A lip augmentation starts with a consultation to discuss your ideal lip shape and contour. Once you have also decided upon the filler that best suits your sensitivity levels and medical history, the solution is injected under the skin to increase the volume of your lips. To help discomfort, laughing gas can be administered.

By altering the volume and shape of your lips, you can increase the feminine appearance of your face and add a natural-looking soft, plump appearance to your smile. This non-surgical treatment is available from various filler brands, including Revanesse, Restylane, Perlane, or Juvenderm.

Chin & Jaw Contouring

Chin and jaw contouring involve non-surgical injections strategically placed into the chin and jawline. The injection solution is catered to your unique aesthetic goals and can add volume to your chin where you may want more prominence or to fill in spots that cause asymmetry in the face. You can also reduce the volume in the chin and jaw by adding volume in other areas.

Adam’s Apple Reduction

Adam’s apple reduction also referred to as a tracheal shave, is one of the first treatments MTF trans people seek out to further “feminize” their face and neck region. This procedure is usually performed under general anesthesia, reducing the size of your Adam’s apple by shaving the bone down until it is unnoticeable. This treatment is available for everyone and anyone who would like to reduce the structure of their neck to make it appear softer and more feminine.

Earlobe Reduction

Earlobe reduction, also known as otoplasty, is a procedure offered by the SpaMedica team of medical professionals to pin your ears and reduce their size. Anesthesia is administered, and incisions will be made on the back of each ear. If incisions need to be made in front of the ear, Dr. Bell will place them strategically in your skin folds so you can avoid having any visible scarring.

Dr. Bell will then reshape or remove the cartilage in the ear, and internal stitches may be made to keep the remaining cartilage in place. Once your ears are shaped to your desired look, Dr. Bell will place external stitches on the incision sites to ensure your ears look naturally smaller. This facial feminization procedure helps improve the proportion and shape of the ear to achieve full facial symmetry.

Eyelid Surgery

Blepharoplasty, commonly known as eyelid surgery, removes sagging skin, reduces pockets of excess fat, and tights the skin around the eyes for a smoother, more youthful appearance that helps to lift and animate the eyes.

If you receive blepharoplasty on your upper eyelids, Dr. Bell will cut along the fold of the eyelid to remove excess skin. For lower eyelid surgery, Dr. Bell will remove and redistribute excess skin and fat in the area. All eyelid surgeries are performed under anesthesia with IV sedation, and on-site overnight rooms are provided to aid recovery.

Facial Feminization Surgery Cost

The price range for facial feminization surgery depends on the number of procedures you choose to receive and the severity of your concerns. This treatment can begin at $9,000 and go up to $62,000. Costs at SpaMedica vary based on the procedures’ complexity, Dr. Thomas Bell’s renowned expertise, and the Toronto MedSpa market prices. Additional expenses like anesthesia, post-op care, and pain medication can impact the final cost of your facial feminization surgery.

Does Insurance Cover Facial Feminization Surgery?

No, OHIP does not cover facial feminization surgery.

OHIP funds some transition-related procedures that do not concern cosmetic adjustments. For example, OHIP covers assessments for hormone therapy, counselling, mastectomy procedures, and treatments associated with bottom surgery, such as labiaplasty or metoidioplasty.

OHIP does not cover procedures more concerned with improving your aesthetic appearance, such as liposuction, chest contouring, hair removal treatments, and facial feminization.

Preparing for Facial Feminization Surgery

To prepare for facial feminization surgery, you may be asked by the SpaMedica team to:

  • Get lab tests or a medical evaluation.
  • Adjust your current medications.
  • Stop smoking and drinking for weeks prior.
  • Avoid taking anti-inflammatory drugs and herbal supplements that can thin the blood.

Facial feminization is performed in a medical setting, commonly under general anesthesia, but some treatments can be performed on an outpatient basis. Everything will be discussed during your facial feminization consultation at the SpaMedica clinic, which you can book today.

Facial Feminization Surgery Before & After

The final results of your facial feminization surgery can help further confirm your gender identity, ease feelings of gender dysphoria, and/or further feminize your face so you can live life with full confidence. Over time, your scars will fade, and the final results from all procedures you receive will be visible. If you experience any shortness of breath, chest pains, or heart palpitations during your recovery, seek medical help immediately.

Post-Operative Instructions & Recovery

Your post-operative timeline fully depends on the treatments you receive, but we have provided a general guideline for those ready to receive any surgical facial procedures.

One Week Post-Op: Any drains that have been placed for excess fluids will be removed by your first day post-op. Dr. Bell will clean the incision line and instruct you in regard to wound care.
One Month Post-Op: Your sutures will be removed by the two-week mark, and you will need to continue to apply antibiotic ointment to the incision areas until they heal. Swelling and bruising will subside after two weeks, and any numbness in the scalp after a brow lift or forehead reduction will go away after a month.
Three Months Post-Op: Swelling, bruising, and a stuffy nose after rhinoplasty will resolve after 1-2 months. At this point, all compression garments can stop being worn, and you can resume a normal diet (specifically regarding chin augmentation).
Six Months Post-Op: Specifically after jaw surgery, all tingling and numbness of the treatment area will subside. Any temporary voice changes due to Adam’s apple surgery will completely subside by this point, and your voice will return to normal.
12 Months Post-Op: Some swelling after certain procedures can persist for up to 9 months, so expect to see full results after your treatment at this 12-month mark.
18 Months Post-Op: By this point, you can continue all strenuous activity and go out in direct sunlight. You should experience no more discomfort, scarring, or swelling. You will begin to see the final results at this point.
Final Results: After 18 months, all results will be visible, and you can face the world in a way that represents who you truly are!

Frequently Asked Questions

Can females get facial feminization surgery?

Yes, cisgender people can also get facial feminization surgery if they have ever felt self-conscious about the prominence of their jawline, forehead, or more “masculine” features. Our surgical procedures are available to anyone who wants to feel and look their best.

Is facial feminization surgery safe?

Yes, facial feminization surgery is safe – especially when you’re in the hands of an experienced cosmetic surgeon like Dr. Bell. While risks are associated with each treatment, they will be minimized with the SpaMedica team’s talent and care, so you will not experience noticeable scarring, longer-than-expected recovery times, or severe complications.

Book a consultation with the SpaMedica team today to begin your facial feminization process and look forward to being your true self.

Dr. Thomas Bell | SpaMedica

by Dr. Thomas Bell

Dr. Tom Bell, with over 25 years of practice experience dedicated to cosmetic plastic surgery, pioneered Avenue Road and Yorkville as Toronto’s Beverly Hills of plastic surgery with his first surgical center in Yorkville’s Avenue road corridor back in 1986. Named as Canada’s best plastic surgeon by W magazine and one of the world’s best, Dr. Bell returns home to join the SpaMedica Plastic Surgery team as the reigning King of Plastic Surgery.
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