Facial Feminization

Facial Feminization Surgery (FFS) describes a range of procedures that transform masculine facial features into feminine ones. Dr. Costa considers FFS as helping individuals appear on the outside as they feel on the inside. FFS is gender affirmation surgery for the face. FFS procedures are performed for male to female (MTF) transgender individuals, for some nonbinary individuals, and for cisgender women who desire more feminine features.

For transgender or non-binary individuals that experience gender incongruence with their face, gender affirming facial surgery is transformative in helping others to identify your gender as your true gender in a reliable and consistent way.  FFS also helps you to appear on the outside as you feel on the inside, providing harmony between the external appearance and internal identity.  

Dr. Melinda Costa is unique as one of the few surgeons in the United States with extensive training in Facial Feminization Surgery and Aesthetic Craniofacial Surgery. Dr. Costa is double fellowship trained in surgery of the face and facial skeleton. Significantly, Dr. Costa received extensive training with Dr. Kyle Keojampa in Facial Feminization and Aesthetic Craniofacial Surgery and Gender Affirming Facial Surgery and is a member of WPATH.

Every patient is unique, and every surgical plan is customized for each individual. The following are facial feminine procedures for which you may benefit:

Forehead Contouring (Type 3 Cranioplasty): This impactful procedure significantly changes the appearnace of the browridge. The area of the forehead over the eyes and in the center, above the nose, is more prominent in males. In this transformative procedure, the bone is set back and contoured to create a soft, feminine shape. Usually, the bone must be removed, contoured, and set back into place for the best result.

Orbital Rim Contouring Reduction: The orbital rims are an important feature that differs between masculine and feminine faces. Orbital rim reduction removes overhanging bone and contours it to create a softer, more open and feminine appearnace

Hairline Lowering Scalp Advancement: This procedure feminizes the forehead by lowering and reshaping the hairline. Masculine hairlines tend to be higher and lack hair on the sides with a M shaped pattern. In this procedure, an incision is made just at the start of your hairline. Your hairline is brought forward, the gaps lacking hair on the sides are closed, and the excess forehead skin is removed.

Brow Lift: A brow lift raises the brow to a more feminine position.

Rhinoplasty (Nose Reshaping): The nose can be made smaller and more lifted.

Cheek Augmentation (Implants and Fat Grafting): The cheeks are made rounder, more voluminous, and softer.

Lip Lift: The upper lip is elevated, revealing the upper teeth and feminizing the mouth.

Lip Augmentation: The lips are made more voluminous and softer.

Genioplasty (Chin Reduction): The chin is made shorter, narrower, and more petite.

Mandibuloplasty (Mandible Reduction and Reshaping): The lower jaw is narrowed.

Mandibular Angle Reduction: The jaw angle is softened and reduced.

Tracheal Shave (Chondrolaryngoplasty): The Adam’s Apple is reduced and smoothed.

You also might benefit from skin-tightening surgery, such as a Facelift or other treatments. Upper Blepharoplasty, or eyelid lifting, may be performed as well.

Where does Dr. Costa perform FFS?

Surgeries are performed in the San Francisco Bay area at Austin SF Surgery Center, St Francis Memorial Hospital in San Francisco, Alma at Addison Surgery Center in Palo Alto next to Stanford University, and Good Samaritan Hospital in San Jose.   All anesthesiologists are board certified. All surgery centers are certified by the Joint Commission. It is imperative that the highest level of safety is maintained for our patients.

Insurance Coverage

Many insurance plans provide coverage for facial feminization surgery. For patients using insurance, we request authorization from your insurance company prior to the operation. Health insurance may or may not cover surgical procedures considered aesthetic for the general population.