Reveal your true reflection.
At Evolve Your Life, we believe everyone deserves to feel seen — not just by the world, but by the person in the mirror. For transgender women, nonbinary individuals, and anyone seeking softer, more traditionally feminine features, Facial Feminization Surgery (FFS) is a powerful, life-affirming step toward alignment between self and appearance.
Led by internationally recognized facial gender surgeon Dr. Amir Dorafshar, our practice offers a comprehensive, three-phase approach to FFS that tailors each plan to your unique anatomy, goals, and identity — for natural, harmonious, and lasting results.
What is Facial Feminization Surgery?
Facial feminization surgery is a set of surgical procedures designed to soften traditionally masculine features and create a more feminine facial appearance. These procedures modify the underlying bone structure, facial soft tissue, and neck anatomy to bring your outer appearance into alignment with your gender identity and sense of self.
FFS may involve subtle refinements or more dramatic transformations depending on each patient’s needs. By addressing the upper, middle, and lower thirds of the face, as well as the neck, we help patients achieve results that feel natural, affirming, and uniquely their own.
Who seeks out Facial Feminization Surgery (FFS) — and why?
Many of our patients are transgender women or nonbinary individuals who experience gender dysphoria related to facial characteristics. Others may be cisgender women who feel their facial features are more angular or prominent than they’d prefer. Regardless of background, the common thread is the desire to feel comfortable that your face belongs to you.
Good candidates for facial feminization surgery FFS typically:
- Are in good physical and mental health
- Do not smoke or are willing to stop before and after surgery
- Have realistic expectations for results and recovery
- Seek facial harmony that aligns with their identity, not a “cookie-cutter” ideal
The Four Key Areas of Facial Feminization
1
Upper Third of the Face
Forehead • Hairline • Brow Bone
The upper third has a powerful influence on gender perception. This region includes the hairline, forehead contour, and eyebrows — all of which are typically more prominent and angular in masculine anatomy. Feminization involves reshaping and repositioning these features to soften the overall appearance.
Evolve Your Life may recommend:
- Forehead contouring and brow bone reduction. This involves contouring or reconstructing the frontal sinus (the area above the eyes) to eliminate prominent ridges and achieve a smoother, more curved forehead.
- Hairline advancement (scalp advancement). This procedure lowers the hairline, shortening the forehead and correcting “M-shaped” recession patterns that are common in cis-male hairlines.
- Brow lift. These techniques elevate and reshape the brows, creating a more natural feminine arch and opening the upper eye area.
- Supraorbital rim contouring. Contouring softens the upper edge of the eye socket, helping to reduce a deep-set appearance and brighten the eyes.
We use CT-based 3D surgical planning and custom guides to create a precise surgical plan that matches your anatomy.
Incision techniques include:
- Coronal incision – Placed behind the hairline, ideal for patients with good hairline shape.
- Pretrichial incision – Made along the hairline to allow lowering and reshaping; well-camouflaged over time.
2
Middle Third of the Face
Cheeks • Nose • Upper Lip
The middle third of the face includes the cheeks, nose, and upper lip — all of which play a key role in defining feminine softness, curvature, and proportion.
In masculine facial anatomy, this area often features flatter cheekbones, a longer upper lip, and a broader nose. Feminization techniques restore volume and refine these structures to enhance harmony with the rest of the face.
Evolve Your Life may recommend:
- Cheek augmentation. This is achieved using fat grafting or custom implants to restore or enhance volume and forward projection, creating rounder, more youthful cheek contours.
- Feminizing rhinoplasty. This procedure refines the nose by smoothing the bridge, narrowing the nostrils, and reshaping the tip to be softer, slightly upturned, and in balance with other features. We always take care to preserve function and ethnic identity.
- Lip lift or upper lip reshaping shortens the distance between the nose and upper lip, increases dental show, and creates a fuller, more delicate mouth shape and a youthful, feminine smile.
3
Lower Third of the Face
Jawline • Chin
The lower third of the face strongly influences facial width, angularity, and perceived gender. A square jaw and broad chin are hallmarks of masculine anatomy. Feminization in this area involves reducing bone volume and reshaping the jawline into a more tapered, “V-line” form.
Evolve Your Life may recommend:
- Mandibular angle reduction. This procedure removes or reshapes the lower jaw angles to slim a square or wide jaw. This is done through incisions inside the mouth, leaving no visible scars.
- V-line contouring. This shaping procedure may involve removing bone along the lower border of the jaw to create a smoother, more delicate shape.
- Genioplasty (chin surgery). This can allow for precise adjustments in chin height, width, and projection. This helps bring the lower face into better proportion with the cheeks, nose, and forehead.
All lower face incisions are placed inside the mouth to avoid visible scars. We use 3D modeling and computer-assisted planning for accuracy and safety, minimizing nerve injury risk and helping ensure symmetric results.
4
Neck
Adam’s Apple • Thyroid Cartilage
The Adam’s apple is a prominent gender marker. Tracheal shave, also known as chondrolaryngoplasty, reduces the visibility of the thyroid cartilage for a smoother, more feminine neck contour.
- Tracheal shave (chondrolaryngoplasty) reduces the projection of the thyroid cartilage. This can be done through a small incision in the neck crease (transcervical) or internally through the mouth (transoral), depending on your goals and anatomy.
The goal is a smoother neck contour that complements other facial changes — without affecting the vocal cords or voice.
Our Approach: The Three Phases of Facial Feminization Surgery
Guided by extensive experience in reconstructive and feminization surgeries, Dr. Dorafshar has developed a three-phased approach to facial feminization that promotes safe healing, natural-looking integration and optimal results. He customizes each phase based on your goals and anatomy. Not all patients will require all three phases, and each treatment plan is unique. But many patients will see the benefit of this careful staging.
Facial Feminization Surgery (FFS) Phase 1:
Foundation – Bone Contouring & Structural Changes
This first phase lays the groundwork for facial transformation. It’s where we create the skeletal foundation of your new facial profile by reshaping the bone structures that define facial gender. This is often the most dramatic transformation in your FFS journey.
- Forehead contouring and brow bone reduction smooth and soften prominent features in the upper third of the face, helping create a more traditionally feminine brow and forehead shape.
- Scalp advancement lowers the hairline to reduce forehead height and improve facial proportions.
- Jaw angle reduction reshapes the lower face, slimming wide or angular jawlines and enhancing facial symmetry.
- Genioplasty (chin reshaping) adjusts the size and projection of the chin to achieve softer, more balanced lower facial contours.
- Tracheal shave reduces the prominence of the Adam’s apple to refine the neck profile.
What to expect:
- Most patients stay overnight for observation.
- Swelling and bruising typically peak around 2 weeks and improve steadily.
- You can usually return to light activities within 3–4 weeks, with continued healing over the next several months.
- Results from this phase are permanent and create the structural foundation for everything that follows.
Facial Feminization Surgery (FFS) Phase 2:
Nasal Refinement
Feminizing Rhinoplasty
The nose is a central feature — and even small changes can dramatically shift facial harmony. Once the underlying bone work from Phase 1 has healed, we refine the nose to align with your new proportions and overall facial aesthetic.
- Feminizing rhinoplasty involves smoothing a prominent nasal bridge, refining the nasal tip, narrowing the nostrils, and adjusting projection or rotation as needed.
- This procedure is fully customized to your facial anatomy, goals, and ethnic identity, so the result feels natural and authentic — never overdone.
- Functional improvements (like correcting a deviated septum or improving airflow) are often performed at the same time.
What to expect:
- Most patients experience visible swelling and bruising for 2–3 weeks.
- Subtle swelling may persist for several months, with final results becoming clearer at 6–12 months.
- Most return to work or social activities within 1–2 weeks.
- This is often one of the most noticeable and rewarding phases of FFS.
Facial Feminization Surgery (FFS) Phase 3:
Final Refinements & Volume Restoration
The final phase focuses on the details — the subtle touches that bring your results together. Here, we enhance volume, refine contours, and create softness in areas where bone work alone isn’t enough. This phase is about balance, symmetry, and completing the picture.
- Fat grafting or implants may be used to add fullness to the cheeks, lips, or temples — areas that naturally hold more volume in feminine faces.
- Lip lift or reshaping shortens the upper lip and increases dental show, enhancing your smile and adding youthful lift.
- Contour adjustments fine-tune facial harmony, smoothing transitions and enhancing symmetry where needed.
What to expect:
- Recovery is typically shorter and less intense than earlier phases.
- Swelling usually resolves within 1–2 weeks.
- Many patients return to routines within 7–14 days.
- This phase often marks the moment when everything comes together — and when your reflection truly begins to feel like you.
About Dr. Dorafshar
Dr. Amir Dorafshar is a board-certified plastic, aesthetic, and reconstructive surgeon, renowned worldwide for his pioneering work in aesthetic surgery, craniofacial and microsurgical reconstruction, facial gender-affirming surgeries, and computer-assisted surgical techniques.
With over three decades of professional experience, Dr. Dorafshar’s commitment to medical innovation and his passion for advancing surgical practices have established him as a leading expert, respected author, and authoritative figure in the field.
From Our Patients
At Evolve Your Life, we’re committed to delivering a world-class experience through attentive, responsive, and compassionate care. How are we doing?
See what some of our patients have to say:
Savannah Greene
I am grateful for the care and expertise he and his team provided, and I highly recommend Dr. Dorafshar to anyone seeking facial feminization surgery. I cannot recommend Dr. Dorafshar enough; he has changed my life for the better, and I feel blessed getting to know and work with him during my journey.
Mai Mai
Absolutely incredible staff. Let me start by saying that Dr. Dorafshar is an incredibly respected and well known name for gender affirming procedures. It’s almost beyond words how caring he and his team are.
“I recently had the privilege of being under the care of Dr. Dorafshar, and I cannot express enough gratitude for the exceptional experience I had. It was evident that he is not only an excellent surgeon but also an incredibly caring and empathetic individual.”
—Fergie
See yourself. Be yourself.
At Evolve Your Life, we know how important it is to look in the mirror every day and see a reflection that feels like your own.
