Congratulations. You’re beautiful, but are you “feminine”?

Beauty is often mistaken for femininity with regards to facial features — especially within the context of gender-related plastic surgery. And, it is also critical to note that there is a world of difference between aesthetic beauty and a truly feminine face.

As a plastic and craniofacial surgeon with a specialization in transgender facial surgery, a very common type of operation we perform is surgery to correct a previous surgeon’s work for an unsatisfied or unhappy patient.

Often, attempts to make the face more beautiful may not have achieved the primary goal of making the face more feminine.

In nearly all cases, revision surgeries are necessary because what constitutes masculinity or femininity in the patient’s facial features has not been successfully captured or represented. The patient may appear more beautiful, but not “feminine” or “masculine” — as is their desired gender representation.

The characteristics that constitute the visual appearance of gender are elusive aesthetic qualities that are very different from what constitutes “beauty”.

For example, people of both sexes, regardless of gender, may seek to have an operation to alter their forehead shape. Understanding the subtleties and deeper implications of gender with regards to the shape and projection of the forehead is crucial to be able to perform an operation that not only beautifies, but also complements their preferred gender representation.

What are the characteristics of facial “femininity”?

The aesthetic quality of facial “femininity” is a subtle aspect that may mystify patients and surgeons alike. You may not know the difference between beauty and femininity, and your surgeon may not know it either!

Yet, if you’re transitioning from male to female, then the qualities of what constitutes “femininity” is certainly extremely important to you.

Just a few examples of facial femininity include clear differences in specific characteristics between the female face and the male face:

  • The male hairline is often higher on the forehead and may recede with aging. To make the hairline more feminine, it is lowered through forehead reduction surgery (also known as scalp advancement or hairline correction).
  • Male brows are usually lower on the face; a brow lift procedure raises the eyebrows into a higher, more feminine position on the face.
  • Male noses are usually wider and larger, to make them appear smaller and more feminine they need reshaping and refining via a feminizing rhinoplasty procedure that narrows and reshapes the nose cartilage.
  • The male jaw is usually wider and more angular than the female jaw. Men tend also to have a sharp back “corner” to the jaw, which can be made to appear rounder and smoother through jaw contouring resulting in a more feminine look.

Case Study: Facial feminization, race, and femininity

When feminizing the male face via facial feminization surgery, not only is gender a critical element, but race and ethnic background also play important roles in defining what is “feminine”.

For example, Patient A, who was transitioning from male to female, is of Korean ethnicity and has very characteristic Asian-Korean facial features.

She came into our office unhappy about her previous surgeon’s work and seeking a forehead shaping revision procedure.

The previous surgeon had made her forehead too large instead of smaller — as is befitting her ethnicity. This had the effect of actually masculinizing the forehead instead of feminizing it.

We performed revision surgery ensuring that her forehead was reduced in size to make it appear more feminine; and also to ensure aesthetic harmony with her other facial features.

Capturing the essence of true facial femininity

To capture the elusive aesthetic “truth” of true aesthetic gender expression your surgeon needs to fully understand the science behind male and female faces; and also a deep appreciation and awareness of the aesthetic qualities of what constitutes gender.

Only then can you achieve the perfect expression of beauty and femininity within the context of facial feminization.