Over the past year, I have been given the opportunity to co-edit a surgical atlas on Transsexual Surgery. The book is primarily aimed at teaching surgeons, who are interested in this field, the various techniques currently being used. It will cover, in detail, many topics including: feminization of the male face, voice feminization, body contouring and genital procedures including reassignment. I will post additional updates of this exciting project as they unfold.

I recently performed a procedure to feminize the upper face of a male to female transsexual. To obtain the correct exposure, a coronal incision is first made. Then the bony ridge over the eyes is burred down using an electric hand drill. Following this, an arch to the eyebrows is created, as with a standard open browlift. Finally, there was filling in and rounding out of a depression over the ridge with methyl methacrylate. Though most patients do not need the synthetic augmentation, occasionally it is necessary to obtain the optimal, more feminine result.

The process of feminizing a male face involves knowing the differences that exist between the two sexes. We perform open browlifts to raise and arch the eyebrows and drill down the underlying ridge of bone, which characterizes the male skull. We add cheek implants to create a dramatic, youthful feminine face and reduce and rotate up the nose, if it is too strong a feature. The lips are made fuller and more pouty, and the chin is reduced, if it is prominent. Lastly, we shave down the Adam’s apple (laryngeal shave), which helps produce a more graceful, feminine appearance.