Facial masculinization surgery (FMS) is a set of

plastic surgery Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofa ...

procedures that can transform the patient’s

face The face is the front of an animal's head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may aff ...

to exhibit typical masculine

morphology Morphology, from the Greek and meaning "study of shape", may refer to: Disciplines * Morphology (archaeology), study of the shapes or forms of artifacts * Morphology (astronomy), study of the shape of astronomical objects such as nebulae, galaxies ...

Cisgender Cisgender (often shortened to cis; sometimes cissexual) is a term used to describe a person whose gender identity corresponds to their sex assigned at birth. The word ''cisgender'' is the antonym of ''transgender''. The prefix ''wiktionary:cis ...

men may elect to undergo these procedures, and in the context of

transgender A transgender (often abbreviated as trans) person is someone whose gender identity or gender expression does not correspond with their sex assigned at birth. Many transgender people experience dysphoria, which they seek to alleviate through tr ...

people, FMS is a type of facial gender confirmation surgery (FGCS), which also includes

facial feminization surgery Facial feminization surgery (FFS) is a set of reconstructive surgical procedures that alter typically male facial features to bring them closer in shape and size to typical female facial features. FFS can include various bony and soft tissue proced ...

(FFS) for

transgender women A trans woman or a transgender woman is a woman who was assigned male at birth. Trans women have a female gender identity, may experience gender dysphoria, and may transition; this process commonly includes hormone replacement therapy and som ...

. FMS can include various bony procedures such as

chin augmentation Chin augmentation using surgical implants can alter the underlying structure of the face, providing better balance to the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of m ...

cheek augmentation Cheek augmentation is a cosmetic surgical procedure that is intended to emphasize the cheeks on a person's face. To augment the cheeks, a plastic surgeon may place a solid implant over the cheekbone. Injections with the patients' own fat or a sof ...

, as well as augmentation of the forehead,

jaw The jaw is any opposable articulated structure at the entrance of the mouth, typically used for grasping and manipulating food. The term ''jaws'' is also broadly applied to the whole of the structures constituting the vault of the mouth and serv ...

, and Adam's apple. In FMS, most procedures involve "having structures added to give more angles to the face."Yarbrough E (2018). ''Transgender Mental Health.'' American Psychiatric Association Publishing.

History

Trans men have requested FMS procedures since the 20th century.Ng EM (1999). Sexuality in the New Millennium: Proceedings of the 14th World Congress of Sexology, Hong Kong SAR, China, August 23–27, 1999. Compositori FMS is currently less common than FFS.Colebunders B, D’Arpa S, Weijers S, Lumen N, Hoebeke P, Monstrey S (2016). Female-to-Male Gender Reassignment Surgery. In Ettner R, Monstrey S, Coleman E, Eds. ''Principles of Transgender Medicine and Surgery.''

Routledge Routledge () is a British multinational publisher. It was founded in 1836 by George Routledge, and specialises in providing academic books, journals and online resources in the fields of the humanities, behavioural science, education, law, and ...

Urologist Miriam Hadj-Moussa notes that "transgender men rarely undergo facial masculinization surgery since

testosterone Testosterone is the primary sex hormone and anabolic steroid in males. In humans, testosterone plays a key role in the development of Male reproductive system, male reproductive tissues such as testes and prostate, as well as promoting secondar ...

therapy leads to growth of

facial hair Facial hair is hair grown on the face, usually on the chin, cheeks, and upper lip region. It is typically a secondary sex characteristic of human males. Men typically start developing facial hair in the later stages of puberty or adolescence, ...

and makes it easier for them to present." In 2011,

Douglas Ousterhout __NOTOC__ Douglas K. Ousterhout is a retired craniofacial surgeon who practiced in San Francisco, CA, United States. His specialty was facial feminization surgery for trans women, and he was widely considered the foremost facial feminization surg ...

outlined the available FMS procedures, drawing on the work of

Paul Tessier Paul may refer to: *Paul (given name), a given name (includes a list of people with that name) *Paul (surname), a list of people People Christianity * Paul the Apostle (AD c.5–c.64/65), also known as Saul of Tarsus or Saint Paul, early Chri ...

. In 2015 Shane Morrison published an overview of all gender confirming surgeries for trans men, including FMS. In 2017, Ousterhout's successor

Jordan Deschamps-Braly Jordan Christopher Deschamps-Braly (born 1979) is an American maxillofacial and craniofacial surgeon specializing in facial gender-affirming surgery for transgender people.Mead, Rebecca (June 16, 2018)The story of a trans woman's face.''The New Y ...

published a

case report In medicine, a case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case reports may contain a demographic profile of the patient, but usually describe an unusual or novel occurrence ...

on the first female-to-male facial confirmation surgery that included masculinization of the Adam's apple. According to the

World Professional Association for Transgender Health The World Professional Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a professional organization devoted to the understanding and treatment of gender identity and ...

(WPATH), for many

men, FMS is considered medically necessary to treat

gender dysphoria Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identitytheir personal sense of their own genderand their sex assigned at birth. The diagnostic label gender identity disorder (GID) was used until ...

(2016)
Position Statement on Medical Necessity of Treatment, Sex Reassignment, and Insurance Coverage in the U.S.A.
Page accessed September 8, 2018World Professional Association for Transgender Health.
Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, Version 7.
'' pg. 58 (2012). Following the WPATH recommendations, several literature reviews and summaries of the state of the art were published.

Surgical procedures

The surgical procedures most frequently performed during FMS often include facial implants and include the following, as outlined in a special 2018 issue of ''Clinics in Plastic Surgery'' edited by Loren Schechter and Bauback Safa.Schechter LS, Safa B, Eds. (2018). Gender Confirmation Surgery. ''Clinics in Plastic Surgery.'' Volume 45, Issue 3, Pages 295-446 (July 2018). ;Forehead augmentation Forehead augmentation can be done with a customized implant, or with injected materials that are molded into shape before they harden. ;Jaw augmentation

Orthognathic surgery Orthognathic surgery (), also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion ...

was first performed for functional reasons in the late 19th century, with cosmetic procedures being improved and refined throughout the 20th century. It is performed with fillers or customized implants. ;Chin augmentation

Chin augmentation Chin augmentation using surgical implants can alter the underlying structure of the face, providing better balance to the facial features. The specific medical terms mentoplasty and genioplasty are used to refer to the reduction and addition of m ...

, also called a mentoplasty or genioplasty, is performed with fillers or customized implants. It can also be performed with an

osteotomy An osteotomy is a surgical operation whereby a bone is cut to shorten or lengthen it or to change its alignment. It is sometimes performed to correct a hallux valgus, or to straighten a bone that has healed crookedly following a fracture. It is ...

plus an implant made of alloplastic materials like Proplast I, Proplast II, and porous block hydroxyapatite. ;Adam's apple augmentation This newer procedure uses an implant made from

cartilage Cartilage is a resilient and smooth type of connective tissue. In tetrapods, it covers and protects the ends of long bones at the joints as articular cartilage, and is a structural component of many body parts including the rib cage, the neck an ...

taken from the patient’s

rib cage The rib cage, as an enclosure that comprises the ribs, vertebral column and sternum in the thorax of most vertebrates, protects vital organs such as the heart, lungs and great vessels. The sternum, together known as the thoracic cage, is a semi- ...

References

External links

Facial Masculinization Surgery
via American Society of Plastic Surgeons {{DEFAULTSORT:Facial Masculinization Surgery Surgical procedures and techniques Plastic surgical procedures Gender-affirming surgery (female-to-male)

History

Surgical procedures

See also

References

External links